JP4971461B2 - 除細動と胸部圧迫の同期 - Google Patents
除細動と胸部圧迫の同期 Download PDFInfo
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- JP4971461B2 JP4971461B2 JP2009539544A JP2009539544A JP4971461B2 JP 4971461 B2 JP4971461 B2 JP 4971461B2 JP 2009539544 A JP2009539544 A JP 2009539544A JP 2009539544 A JP2009539544 A JP 2009539544A JP 4971461 B2 JP4971461 B2 JP 4971461B2
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- defibrillation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3987—Heart defibrillators characterised by the timing or triggering of the shock
-
- 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
- A61H31/005—Heart stimulation with feedback for the user
-
- 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
- A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
- A61H31/004—Heart stimulation
- A61H31/007—Manual 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
- A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
- A61H2031/002—Artificial respiration or heart stimulation, e.g. heart massage fixed on the chest by adhesives
-
- 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
- A61H2201/50—Control means thereof
- A61H2201/5007—Control means thereof computer controlled
-
- 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
- A61H2201/50—Control means thereof
- A61H2201/5023—Interfaces to the user
- A61H2201/5043—Displays
-
- 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
- A61H2201/50—Control means thereof
- A61H2201/5023—Interfaces to the user
- A61H2201/5048—Audio interfaces, e.g. voice or music controlled
-
- 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
- A61H2201/50—Control means thereof
- A61H2201/5058—Sensors or detectors
- A61H2201/5071—Pressure sensors
-
- 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
- A61H2201/50—Control means thereof
- A61H2201/5058—Sensors or detectors
- A61H2201/5084—Acceleration sensors
-
- 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
- A61H2201/50—Control means thereof
- A61H2201/5097—Control means thereof wireless
-
- 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
- A61H2230/00—Measuring physical parameters of the user
- A61H2230/08—Other bio-electrical signals
- A61H2230/10—Electroencephalographic signals
Description
多くの異なる種類の異常心臓鼓動が存在し、これらの異常心臓鼓動のうちの幾つかは除細動治療により処置することができる(「除細動適応鼓動」)が、幾つかの異常心臓鼓動は除細動治療では処置することができない(「除細動非適応鼓動」)。例えば大きな心拍出量を生み出すECG鼓動のほとんどは、除細動に非適応であると考えられる(例えば、典型的な洞律動、所定の徐脈、及び洞頻脈を挙げることができる)。また、結果的に大きな心拍出量を生み出すことはないが、除細動に非適応であると考えられる幾つかの異常なECG鼓動もあり、これは、除細動処置が通常、これらの症状には効果的ではないからである。除細動非適応鼓動の例として、心停止、電気機械解離(EMD)、及び他の興奮収縮解離(PEA)を挙げることができる。患者はこれらの致死的でかつ除細動非適応鼓動では生命を維持することができないが、ショックを与えても鼓動を変えるためには役立たないことになる。ケアギバーが除細動を施す必要がある除細動適応鼓動の主要な例としては、心室細動、心室性頻拍、及び心室粗動を挙げることができる。
1)5秒間のAutoPulseによる荷重セル信号を記録し(除細動ショックを加えることなく)、記録した信号を再生し、ショック段階(77ms,365ms,526ms,564ms,688ms)を調整する必要があるかどうかをチェックする;
2)第1テストエネルギー=1.7×体重(kg)を選択し、5に丸める;
3)Stat.padzの成人用除細動パッドのペアを横方向に並べて載置する;
4)ショックを加える順番をランダムにして(77ms,365ms,526ms,564ms,688ms)、テスト段階を選択する;VFを誘発させる;
6)5秒間待機し、VFが維持される場合、AutoPulseの電源をオンにする;
7)AutoPulseの電源をオンにした後、5秒経過した時点で、除細動器を充電し、更に手作業で2回だけ換気(ventilations)を行なう;
8)除細動器を充電した後、10秒経過した時点で、テストエネルギーをテスト段階で与える;
9)VFが治まった場合、AutoPulseの使用を中止し、供給されたジュール熱、インピーダンス、及び電流をデータスプレッドシートに記録し;除細動に失敗した場合、AutoPulseの使用を継続し、2倍のエネルギーを与えて救命ショックを加え;除細動に再び失敗した場合、200ジュールの熱を与えて救命ショックを加える。5回の救命ショックが失敗した後、1分間のAutoPulseによるCPRを、別の救命ショックを最大5回まで加える前に行なう;
10)ステップ4及びステップ9を、5つのテスト段階の全てが行なわれるまで繰り返す;
11)ステップ4〜10をもう1回繰り返す;
12)成功率を、上の2回のショックシーケンスの総合テスト結果に基づいて計算する;
13)成功率<50%の場合、次のテストエネルギーを10ジュールだけ増やし;成功率≧50%の場合、次のテストエネルギーを10ジュールだけ減らした;
14)除細動パッドを交換する;
15)ステップ4〜12を繰り返す;
16)成功率<50%の場合、次のテストエネルギーを5ジュールだけ増やし;成功率≧50%の場合、次のテストエネルギーを5ジュールだけ減らした;
17)ステップ4〜11を繰り返す;
18)50%に最も近い成功率をもたらした上の3つの使用テストエネルギーのうちの一つを次のテストエネルギーとして選択する;
19)ステップ4〜10を6回だけ、または動物が圧迫装置から出されるまで繰り返す。
Claims (21)
- 救助者が心室性不整脈を発症している患者を蘇生させるために使用する蘇生システムであって、
圧迫解除段階の開始を示す胸部圧迫段階のタイミング情報を検出するように構成された回路及び処理手段と、
電磁治療を行なって心室性不整脈を終了させるように構成された回路及び処理手段と、を備え、
前記電磁治療を行なう回路及び処理手段は、前記胸部圧迫段階のタイミング情報を利用して、前記圧迫解除段階の開始から300ミリ秒以内に前記電磁治療の施術を開始する、蘇生システム。 - 前記電磁治療の施術が前記圧迫解除段階の開始から25〜250ミリ秒以内に開始される、請求項1記載の蘇生システム。
- 前記電磁治療が電気除細動である、請求項1記載の蘇生システム。
- 前記電磁治療が磁気除細動である、請求項1記載の蘇生システム。
- 前記胸部圧迫が機械的胸部圧迫装置によって行なわれる、請求項1記載の蘇生システム。
- 前記機械的胸部圧迫装置と除細動器とが別々の筺体内にて構成される、請求項5記載の蘇生システム。
- 前記機械的胸部圧迫装置と除細動器とが共通の筺体内に一体的に組み込まれる、請求項5記載の蘇生システム。
- 前記圧迫が手動圧迫によって行なわれる、請求項1記載の蘇生システム。
- 前記胸部圧迫段階のタイミング情報を検出する回路及び処理手段は更に圧力センサを含む、請求項8記載の蘇生システム。
- 前記胸部圧迫段階のタイミング情報を検出する回路及び処理手段は更に加速度計を含む、請求項8記載の蘇生システム。
- 加速度のゼロクロス点を利用して圧迫段階を検出する請求項10記載の蘇生システム。
- 前記手動圧迫のサイクルにおける圧迫解除のアップストローク速度を最適化すべくフィードバックを行なう請求項8記載の蘇生システム。
- 除細動中に手動圧迫を施術可能とすべく患者の表面を覆って延びる電気的絶縁層を更に備える請求項1記載の蘇生システム。
- 前記電気的絶縁層が除細動電極の構造に組み込まれる、請求項13記載の蘇生システム。
- 心電図動作に圧迫を同期させる請求項1記載の蘇生システム。
- 前記心電図動作が、0.75mVrmsを超える絶対振幅の粗いVFである、請求項15記載の蘇生システム。
- 前記心電図動作のスペクトル分析を更に行なう請求項15記載の蘇生システム。
- 胸部圧迫に起因する影響を除去すべく前記心電図動作を更にフィルタリングする請求項15記載の蘇生システム。
- 前記電磁治療がペーシングを含む、請求項1記載の蘇生システム。
- 前記電磁治療が、換気サイクルに同期した除細動ショックを含む、請求項1記載の蘇生システム。
- 換気の呼気段階が、前記除細動ショックを加えてから2秒以内に完了する、請求項20記載の蘇生システム。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US134707P | 2007-11-01 | 2007-11-01 | |
US61/001,347 | 2007-11-01 | ||
PCT/US2008/082237 WO2009059288A1 (en) | 2007-11-01 | 2008-11-03 | Synchronization of defibrillation and chest compressions |
Publications (2)
Publication Number | Publication Date |
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JP2010502414A JP2010502414A (ja) | 2010-01-28 |
JP4971461B2 true JP4971461B2 (ja) | 2012-07-11 |
Family
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2009539544A Active JP4971461B2 (ja) | 2007-11-01 | 2008-11-03 | 除細動と胸部圧迫の同期 |
Country Status (6)
Country | Link |
---|---|
US (2) | US8478401B2 (ja) |
EP (2) | EP3058929A3 (ja) |
JP (1) | JP4971461B2 (ja) |
CN (1) | CN101568320B (ja) |
AU (1) | AU2008264145B2 (ja) |
WO (1) | WO2009059288A1 (ja) |
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2008
- 2008-11-03 JP JP2009539544A patent/JP4971461B2/ja active Active
- 2008-11-03 EP EP16162078.6A patent/EP3058929A3/en not_active Ceased
- 2008-11-03 CN CN2008800006142A patent/CN101568320B/zh active Active
- 2008-11-03 EP EP08826325.6A patent/EP2224892B1/en active Active
- 2008-11-03 WO PCT/US2008/082237 patent/WO2009059288A1/en active Application Filing
- 2008-11-03 US US12/263,813 patent/US8478401B2/en active Active
- 2008-11-03 AU AU2008264145A patent/AU2008264145B2/en not_active Ceased
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2013
- 2013-07-01 US US13/932,192 patent/US8700147B2/en active Active
Also Published As
Publication number | Publication date |
---|---|
US8478401B2 (en) | 2013-07-02 |
CN101568320B (zh) | 2013-09-11 |
EP3058929A3 (en) | 2016-10-19 |
US8700147B2 (en) | 2014-04-15 |
EP2224892B1 (en) | 2016-05-04 |
AU2008264145A1 (en) | 2009-05-21 |
US20090149903A1 (en) | 2009-06-11 |
JP2010502414A (ja) | 2010-01-28 |
EP3058929A2 (en) | 2016-08-24 |
AU2008264145B2 (en) | 2010-06-17 |
CN101568320A (zh) | 2009-10-28 |
EP2224892A1 (en) | 2010-09-08 |
US20130289639A1 (en) | 2013-10-31 |
EP2224892A4 (en) | 2011-09-28 |
WO2009059288A1 (en) | 2009-05-07 |
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