HU217941B - Revivificating device for ensuring active compression and decompression - Google Patents

Abstract

The resuscitation device according to the invention has a central device body (1), a guided push button (13) and a flexible bell (14). Its characteristic feature is that its push button (13) is fixed in a piston (11) guided in the cylinder (10) in the device body (1) and the space of said cylinder (10) above the piston (11) on a single drain valve (2) and an additional suction valve (10). connected via a pressure valve (9) to the airspace, the space below the bell (14) is connected to the air space via a discharge valve (3) and via a vacuum connection line (15) via a vacuum pump (16). ŕ

Description

SUMMARY OF THE INVENTION The present invention relates to a device for resuscitating humans, which, in the event of loss of blood circulation and breathing due to a cause (sudden cardiac death), is intended to compensate for the loss of heart and lung function by compressing and expanding the chest.

In health today, the principles introduced by Kouvenhoven, Jude and Knickerlocker in 1960 still form the basis of resuscitation:

A - Make airways interoperable

B - ventilated ventilation

C - compression heart massage

In the latter, the two superimposed palms are placed on the sternum, perpendicular to the heart, and then replaced with an extended arm, across the palate, with the application of body weight, with the chest compressed at a rate of 80 to 100 beats / min. heart pumping.

Loss of breath - after opening the respiratory tract, it is also artificially maintained, with mouth-to-mouth or nasal ventilation, if necessary with special equipment. The rate of this ventilation is 15-20 / min, resulting in a heart rate to 5: 1 respiratory rate.

In this classic, commonly used method, the chest compression phase is "active", the decompression phase (chest deflection = expansion) is "passive", therefore the effectiveness of resuscitation, the restoring power of the rib arches at all times (elasticity, injury, immobility, etc.). .) depends.

A revolutionary new breakthrough in resuscitation in 1991-92 was the introduction of the principle of "active" compression- "active" decompression (ACD resuscitation). By using it, the efficiency of resuscitation can be two to three times higher than the conventional method. The device for implementing the method is called an ACD pump. Information on its use and the experience gained can be found in the medical-health magazines. For example, Cohen TJ-Tucker KJ et al: The New Method of Cardiopulmonary Resuscitation (Circulation, 11, 11-9 April 1991), Schulz J Cohen P et al: Evaluation of Standard and Activation Compression - Decompression CPR in Acute Human Model of Venticular Fibrillation (Circulation 1994. 89. 684-692.) by Lurie KG-Schultz JHJ et al. Evaluation of Active Compression-Decompression CPR in Victim of Out of Hospital Cardiac Margin (USA, JAMA 1994. 271. 1405-1411.)

These known ACDs, developed in the Americas and Denmark, consist of a central metal or plastic housing, an elastic bell for adhesion and a central push button.

The housing (plate) is designed to allow both hands to be gripped and to transfer suction and compression force to the chest and sternum. The elastic bell (optionally a diaphragm plate) transmits the tensile force (decompression) by means of a vacuum formed during compression, while the push button transmits the compression force (compression) to the sternum. As an accessory, a compression element is placed on the housing to inform you of the pressure exerted and the force that can be applied to people of different physics.

Also known is an ACD device (marketed by AMBU in Hungary) whose push button is guided in a cylinder formed in the central housing and is provided with a compression spring. In this solution, the force during resuscitation is indicated by a pressure gauge with a mechanical display attached to the compression spring.

The central push button integrated into the ACD device provides an effective cardiac massage when placed on the sternum of the heart. The suction cup attached to the chest wall allows the chest to be lifted, the decompression phase becomes "active" and has a very beneficial effect on the blood circulation that is thus maintained.

Experimental and human clinical studies have shown that compression decompression at 80 / min increments significantly increases cardiac blood flow in both phases of the same cycle, increases arterial systolic diastolic blood pressure, time: the "velocity time integral" (parameter for cardiac output), the concentration of CO _{2 in} the exhaled air. All these prove the effectiveness of the resuscitation.

The benefits of this method cannot be fully exploited with existing devices in about 30% of cases. Chest of various deformities (hen breast, funnel breast) is not secured with the push button or bell, or in women with large breasts, in men's haired chest, in the skin due to atrophy of skin, when rescued from water on the skin, due to electro-shock etc the bell does not stick properly.

For heavy weight, heavy-bodied people, the bell's grip force (the vacuum suction power generated by the bell returning to its original shape after squeezing the bell) is not sufficient to lift the chest, tear off the device and depend on the shape of the bell. All of this may also affect the pressure indicator display, which results in uncertainty in determining the optimum effort.

Installation and operation of the device binds both hands, such as making the airways permeable, and stethoscopic monitoring cannot be performed during yeast.

A further disadvantage is that the push fungus rises from the sternum in the suction (decompression) phase, causing damage to the skin and the underlying connective tissue and bone (causing injury).

In the process of the present invention, it is an object of the present invention to overcome the shortcomings of known ACDs (ACD pumps) by providing a device that fits well into the chest of people of different physics, can be quickly and reliably mounted, requires less effort, controlled and safe operation.

HU 217 941 Β

We have realized that the above objectives can be fully achieved by adjusting the height of the push button at the time of insertion, independently of the housing (body) and elastic bell, while at the same time lying in a non-impact air chamber during operation and providing adequate vacuum This means that the bell will stick and push the fungus to the sternum during operation.

In addition, by properly shaping the body of the device, conveniently positioning controls and indicators, and using a centrally located handle, the resuscitation operation can be performed more conveniently, even with one hand, after a quick placement of the device.

Thus, our solution is to further develop known resuscitation devices having a central device body, an elastic bell attached thereto, and a push button guided in the central device body. Particularly new features of our solution are that the pushbutton is fixed in a piston, which piston is guided in a cylinder in the central body, the space above the piston of which is connected to the air through a drain valve and an additional suction and discharge valve, and is also connected to the airspace via a drain valve, and a so-called vacuum connection line is connected to the space below the bell to which a vacuum pump is connected.

Preferably, a pressure gauge is mounted on the body of the device, which is connected to the cylinder above the piston.

In a preferred embodiment of the device according to the invention, the vacuum pump is automatically operated and is housed within the body of the device. Preferably, the vacuum pump is also provided with an actuator (which can be actuated, for example, by a foot).

It is also desirable that the vacuum connection conduit is provided with a conduit connector located on the body of the device (to provide an external vacuum such as a mobile vacuum pump or conduit system connection).

In a preferred embodiment of the resuscitation device of the present invention, the central device body has a plate-shaped, rounded contour, with a palm rest on its upper part and a circular recess on the lower part corresponding to the finger tips.

Preferably, the body of the device is provided with a centrally located handle, and a handle with a blinker and a switch is integrated into the handle.

Preferably, the resilient bell consists of a cylindrical ribbed diaphragm and a diaphragm plate with an outer and inner abutment flange attached thereto.

Hereinafter, a preferred embodiment of the invention will be described, with reference to the drawings, in the design and operation of a resuscitation device according to the present invention, wherein:

Figure 1 is a sectional view of the device, a

2a. Fig. 6a shows a top view of the most important controls and the body, while

2b. Figure 3A is a sectional view showing the construction of a drain valve.

As shown in Figure 1, the resuscitation device of the present invention has a plate-shaped body 1. The other elements are mounted thereon: a resilient bell 14 consisting of a ribbed diaphragm 14a and a diaphragm plate 14b, the base of which is a silicone-based plastic having rubber-like elasticity. The same resilient material also comprises a push button 13 of the device which is contained in a piston 11 sealed in the cylinder 10 formed in the body 1 of the device. (The push button 13 is preferably fixed in shape in the piston 11.)

The bell 14 and the piston 11 guided in the cylinder 10 firmly fixed in the body 1 are connected to the body 1 by a closure 12.

A handle 4 is fastened to the plate-shaped device body 1 by a gripping screw 6 in a line of its axis of symmetry, and a handle of a known construction is mounted inside the handle 4, the actuator of which is a switch 5b and a display 5a on the handle 4.

The body 1 is made of a hard plastic material, the handle 4 is preferably made of light aluminum alloy, the surface of which is covered by a hard anodized hardwearing layer. On the upper part of the plate-shaped device body 1 there are two palm pads 7a made of silicone rubber, while on the lower part a circumferential recess 7b is formed for the finger tips of the two hands gripping the device body 1. The contours of the device body 1 and the handle 4 are rounded so that they have a good grip.

On the side of the device body 1, located near one of the palm pads 7a, is the operating button 3a of the drain valve 3 which connects the space below the bell 14 to the outside air space. (The drain valve 3 itself and the connecting line are provided in the body 1).

According to the actuation button 3a, but on the other side of the handle 4, the actuation button 2a of the drain valve 2 which connects the space of the cylinder 10 to the air space is also formed in the housing 1.

A pressure gauge 8 is connected to the space of the cylinder 10, the sensitive capillary display of which is shown at the front of the handle 4 with the blinker 5a. (Good visibility is provided by the placement of the palm restraints 7a and the design of the handle 4).

Underneath the handle 4 is located on the body 1 the push button 9a of the suction pressure valve 9 for filling the space of the cylinder 10 at a suitable pressure.

Fig. 1 shows another automatically operating vacuum pump 16 with a drainage valve of known construction, the vacuum connection line 15 of which is connected to the space below the bell 14. (All of these elements are also provided in the housing 1).

HU 217 941 Β

Figure 1 also shows the connection line for the drainage valve under the bell 14 and the drainage connection 3 for the cylinder 10.

2a. Fig. 4a shows a top view of the plate body 1 with its fixed handle 4 and symmetrically shaped plate pylons 7a on both sides and actuating valves 2a and 3a of the bell drain valve 3 and cylinder 10 located close to the plate pillar 7a. The figure also shows the switch 5b of the timer built into the handle 4 and the pressure gauge 8 placed under the handle 4.

2b. 2a. Figure A-A is a sectional view corresponding to the sectional plane A-A, showing the structure of the drain valve 2 formed in the device body 1, the drain valve 2 being connected to the space of the cylinder 10 by a connecting channel 2b. The figure further illustrates the design of the palm cushion 7a and the circumferential recess 7b.

With the resuscitation device of the present invention, resuscitation is performed as follows:

The resuscitation device is handled by the operator such that the blinker 5a of the timer and the actuation buttons 2a and 3a of the drain valves 2 and 3 are on the opposite side of the operator.

The resuscitator rotates the device body 1 with one (left) hand, turning the bell toward it, while pressing the actuation button 2a of the cylinder space drain valve 2 and pulling the push button 13 as far as it will go. The body 1 is then gripped with both hands by the palm resting on the palm pads 7a and pressed on the patient's chest by pushing both the valve 2 and the drain valve until the bell 14 is fully compressed and the push button 13 rests on the sternum. After insertion, it is necessary to rotate the device 10-20 mm to the left and right to ensure that the rim 14b of the bell 14 and the skin fold are smoothed out and the bed is perfectly seated.

By releasing the actuation buttons 2a and 3a of the drain valves 2 and 3, the space below the bell 14 and the cylinder 10 are closed and the bell 14 is slightly raised.

Under the handle 4, the push button 9a of the valve 9 which fills the cylinder 10 in the center of the body 1 must be repeatedly pressed with the thumb of both hands to set the internal so-called base pressure of the cylinder 10 as indicated by the pressure gauge.

Thereafter, a rhythmic resuscitation can be initiated, the rate of which is indicated by the flashing of the on-clocked transmitter 5a, i.e. the rate of the pulling and pressing movements.

When the device is pressed down, the vacuum of the space below the bell 14 is increased by the vacuum pump 16, which automatically activates when pressed, until it switches off when a vacuum adapted to the patient's body is reached.

The 8 pressure gauges continuously indicate the respective compression or suction power. Preferably, the pressure applied to patients with different conditions is indicated by well-defined colored bands. (Compressive forces used: 0-240 N for elderly, weak physically, 0-360 N for normal men, and 0-480 N for men with strong physique.)

When the pressure gauge on the 8 gauge has swung to the end of the corresponding bar, the device must be pulled up. (Usable suction power: 0-150 N. depending on physique)

The device can be operated with one hand using the 4 handles, and can be used by both right and left handed users.

Although the proper (flange) configuration of the bell 14 provides good adhesion, which is maintained by the auxiliary vacuum, for example, the patient's chest surface conditions may cause the vacuum to cease and the device to fall off. Then, as described above, the device can be quickly replaced and resuscitation resumed.

The device is removed by pressing the actuation button 3a of the bell drain valve 3.

Advantageously, the device body 1 of the resuscitation device may also be provided with a tubing connection, connected to the bell space 14, to which an external mobile vacuum pump or vacuum line may be connected.

In summary, the improved device of the present invention is more efficient yet gentle in the resuscitation operation. The height-adjustable push-button 13 ensures quick and good fit to the sternum, regardless of the shape of the sternum (which in practice requires approximately ± 5 cm of adjustment). The appropriate amount of vacuum automatically generated during operation of the bell 14 and the design of the bell 14 ensure sufficient adhesion during the suction strokes. The push-button 13 made of elastic material delivers a controlled amount of pressure through an "intervening" spring cushion, thus ensuring optimum and gentle compression, while minimizing injury during operation. The centrally located handle also allows for one-handed operation, and the built-in pacemaker indicates the applicable resuscitation rhythm.

Claims (8)

PATENT CLAIMS An active compression and decompression resuscitation device having a central device body, an elastic bell attached thereto and a push button guided in the device body, characterized in that the push button (13) is fixed in a piston (11) in the device body (11). 1) is guided in an existing cylinder (10) and the space of this cylinder (10) above the piston (11) is connected to the air space through a drain valve (2) and an additional suction and discharge valve (9); The space below 14 is also connected to the air space via a drain valve (3) and the space below the bell (14) is also connected to a vacuum pump (16) via a vacuum connection line (15). The resuscitation device according to claim 1, characterized in that the device body (1) has a A watch (8) is connected to the interior of the cylinder (10). The resuscitation device according to claim 1 or 2, characterized in that its vacuum pump (16) is automatic and is located in the device body 5 (1). The resuscitation device according to claim 1 or 2, characterized in that its vacuum pump (16) is provided with an actuator. 5. The yeast device according to any one of claims 1 to 10, characterized in that the vacuum connection lead (15) is provided with a tube connector located on the device body (1). 6. A resuscitation device according to any one of claims 1 to 3, characterized in that the device body (1) is a plate having two palm pads (7a) and a circumferential recess (7b). 7. A resuscitation device according to any one of claims 1 to 4, characterized in that the device body (1) has a handle (4) in which is arranged a stroke transmitter with a switch (5b) and a blinker (5a). 8. A resuscitation device according to any one of claims 1 to 4, characterized in that its resilient bell (14) consists of a cylindrical ribbed membrane (14a) and a diaphragm plate (14b) with flanges.