JP6002536B2 - Resuscitation device - Google Patents

Description

  The present invention relates to a resuscitation treatment support apparatus that evaluates the state of a patient such as a newborn immediately after birth and supports appropriate resuscitation treatment when resuscitation treatment is necessary.

Conventionally, neonatal resuscitation therapy is known in which a newborn is quickly evaluated at the time of birth, and when it is determined that it is necessary based on this evaluation, resuscitation is performed on the newborn.
For example, after a resuscitation treatment is performed on a newborn baby, heart rate measurement is performed for 6 seconds, the heart rate is evaluated, and when it is determined that it is necessary based on this evaluation, a resuscitation treatment is further performed. Then, when necessary thereafter, the resuscitation treatment is repeated for 5 to 10 minutes while appropriately evaluating by measuring the heart rate for 6 seconds.
At this time, newborns that need resuscitation are generally immediately housed in an incubator such as an open incubator (infant warmer) at the time of birth. It is determined according to the timer provided in.

  For example, Patent Document 1 discloses an incubator with a built-in timer used for resuscitation treatment so that resuscitation treatment applied to a newborn (patient) and evaluation of a newborn can be performed alternately. The resuscitation treatment timer provided in this incubator has an elapsed time display section that can display the total elapsed time from the start of resuscitation treatment (at the time of birth) and the progress of the evaluation period for evaluating newborns. An evaluation period display unit for displaying the end stage is provided, and a doctor or the like can accurately and quickly recognize the elapsed time and the end point of the evaluation period. Therefore, the doctor can quickly evaluate the newborn through measurement of the newborn's respiratory rate, skin color, heart sound, and the like.

Japanese Patent No. 4976232

By the way, in the neonatal resuscitation treatment, respiration and pulse rate (heart rate) are simultaneously evaluated as clinical evaluation items. As a result of checking respiration and pulse rate, if it is determined that resuscitation or respiratory assistance is required, artificial respiration or continuous airway while monitoring SpO ₂ value (arterial oxygen saturation) with a pulse oximeter (SpO ₂ monitor) A positive pressure (CPAP: continuous positive air pressure) is performed. Thus, when the doctor determines that resuscitation treatment is necessary for the newborn, in order to effectively perform the resuscitation treatment, the doctor accurately recognizes the time course from the start of the resuscitation treatment, and at that time breathing and It is required to quickly and appropriately evaluate the state of the newborn based on the evaluation target value of the pulse rate, and to perform appropriate treatment for the newborn.

  The present invention has been made in view of such circumstances, and assists doctors and the like to perform appropriate resuscitation for patients such as newborns while accurately recognizing the passage of time from the start of resuscitation therapy. It is intended to do.

The present invention relates to a resuscitation treatment support device that supports performing resuscitation treatment and evaluation of a patient based on an elapsed time from the start of resuscitation treatment for a patient such as a newborn baby, the progress from the start of resuscitation treatment for the patient. An elapsed time display unit for displaying time , and an evaluation for displaying from the start point to the end point of the evaluation period for evaluating the condition of the patient after a predetermined elapsed time from the start of the resuscitation treatment at intervals of 1 second and duration display unit, and the SpO ₂ value display unit for displaying the measured SpO ₂ value in real time of the patient, the pulse rate of the patient have a pulse rate display unit for displaying in real time, the SpO ₂ value display unit , The measured SpO ₂ value can be displayed in real time by using arithmetic numbers and display screen switching operation, along with the elapsed time from the start of the resuscitation treatment, A graph display unit that graphs the progress of the measured SpO ₂ value corresponding to the elapsed time, and the pulse rate display unit displays the pulse rate in real time using arithmetic numbers; A graph display unit that displays a plethysmograph waveform of the patient's pulse wave that can be displayed by a switching operation of the display screen, and together with the digital display unit of the measured SpO _binary value and the digital display unit of the pulse rate, any graphical representation of the graph display area or plethysmographic waveform of the pulse wave SpO ₂ values selected by the switching operation of the display screen is provided so as to be displayed.

In addition to each display unit that displays the elapsed time and evaluation period, an SpO ₂ value display unit that displays both the SpO ₂ value (actually measured SpO ₂ value) and the pulse rate, which are evaluation items necessary for patient evaluation, and the pulse rate By providing the number display section, doctors and the like can quickly recognize the two evaluation items of SpO ₂ value and pulse rate within a limited time during resuscitation treatment. Therefore, the doctor can quickly evaluate the patient and can perform appropriate resuscitation for the patient.

The actual measured SpO ₂ value, in addition to the digital display, and a displayable by the graph display unit which can be freely displayed by the switching operation of the display screen, the doctor or the like, in the recognition of actual SpO ₂ values, digital display The patient can be evaluated by preferentially selecting an easily understandable display method from the two display methods of the display unit and the graph display unit.

Furthermore, the graph display unit of the measured SpO ₂ values, together with the actual SpO ₂ value, may the course of recommended evaluation target value is SpO ₂ value at the elapsed time from the resuscitation start is displayed superimposed.
In this case, doctors and the like can quickly recognize the measured SpO ₂ value and the evaluation target value, and can easily compare these values, so that the patient can be evaluated quickly. Become.

According to the present invention, in addition to each display unit that displays the elapsed time and evaluation period, a doctor or the like can provide resuscitation treatment by providing a display unit that displays the SpO ₂ value and pulse rate necessary for patient evaluation. While accurately recognizing the passage of time from the start point, it is possible to quickly recognize the two evaluation items of SpO ₂ value and pulse rate within a limited time during resuscitation treatment. Therefore, the doctor can quickly evaluate the patient and can appropriately assist so that an appropriate resuscitation treatment can be effectively performed.

It is a front view of the resuscitation treatment support device of one embodiment of the present invention, and shows the state where the 1st evaluation screen was displayed on the control and display part. The 2nd evaluation screen of the control and the display part of the resuscitation treatment support apparatus shown in FIG. 1 is shown. It is a flowchart for demonstrating neonatal resuscitation treatment.

Hereinafter, an embodiment of the present invention will be described with reference to the drawings.
FIG. 1 shows a resuscitation treatment support apparatus 100 according to an embodiment of the present invention. This resuscitation treatment support device 100 is connected to an incubator such as an infant warmer, for example, and supports resuscitation treatment and evaluation of a patient based on the elapsed time from the start of resuscitation treatment for a patient such as a newborn baby. is there. The resuscitation treatment support apparatus 100 has a built-in pulse oximeter, and the patient's SpO ₂ value and pulse rate (heart rate) can be measured by attaching the detection unit 101 of the pulse oximeter to the patient. It can be done. The SpO ₂ value indicates the saturation of oxygen contained in the artery, and the pulse oximeter obtains the SpO ₂ value based on the degree of redness of arterial blood.

  As shown in FIGS. 1 and 2, the control / display unit 10 of the resuscitation treatment support apparatus 100 has various display units for transmitting information to doctors and the like, and for operating the display of these display units. And an operation unit. Further, the control / display unit 10 operates at least a first evaluation screen 10A shown in FIG. 1 and a second evaluation screen 10B shown in FIG. 2 by operating a changeover switch 11 provided at the bottom of the screen. The screen can be switched freely

  The elapsed time display part 40 shown in FIG.1 and FIG.2 displays the elapsed time from a patient's resuscitation treatment start using an arithmetic number. The elapsed time display unit 40 is configured to display a four-digit number, and the two-digit number on the right side sequentially displays seconds from “00” to “59” as time elapses. To do. The two digits on the left side sequentially display the minutes from “00” to “99” as time passes.

The elapsed time display unit 40 displays a count of a timer provided in the resuscitation treatment support apparatus 100, and is operated by operating the timer switch 41 by pressing or the like (generally, Is operated when a newborn is born.) A timer is started and the elapsed time is started to be counted. Therefore, the elapsed time display unit 40 generally displays the elapsed time since the birth of the newborn in minutes and seconds.
The elapsed time display unit 40 can also include a time display. Furthermore, when the timer switch 41 is in the on state, the timer switch 41 can be returned to the off state by operating it again by pressing or the like.

  The evaluation period display unit 50 displays an evaluation period for evaluating a patient after a predetermined elapsed time. Seconds for sequentially lighting and displaying the evaluation period from 0 to 6 every second. A point display unit 51 is provided. This second point display section 51 has a sixth point light emission display disposed at a position corresponding to 6 o'clock from a 0th point light emission display section 52a disposed at a position corresponding to 12:00 on a dial of a normal analog clock. The seven point light emission display parts 52a to 52g up to the part 52g are provided, are provided in a substantially semicircular shape, and are sequentially lit at intervals of 1 second from the start point to the end point of the evaluation period of 6 seconds. It is configured.

  The 0th point light emission display part 52a is for displaying the start time of the evaluation period of 6 seconds, and the sixth point light emission display part 52g is for displaying the end time of the evaluation period. Therefore, it is preferable that the emission color is different from that of the other point light emission display portions 52b to 52f. For example, the light emission color of the point light emission display portions 52a and 52g can be blue, and the other point light emission display portions 52b to 52f can be orange.

The SpO ₂ value display unit 21 displays the actual measured SpO ₂ value (actual measured value of the SpO ₂ value) of the patient measured by the pulse oximeter in real time. Both the first evaluation screen 10A and the second evaluation screen 10B are displayed. The screen is provided with a digital display unit 21 that displays the measured SpO ₂ value using arithmetic numbers. Then, on the right side of the digital display unit 21, the alarm SpO ₂ value display unit 22 for displaying the alarm set value of the SpO ₂ value is provided. In this case, the alarm SpO ₂ value display unit 22 is configured to display an upper limit value 23 and a lower limit value 24 of the alarm set value of the SpO ₂ value stored in advance, and the actual measured SpO ₂ value of the patient is set to SpO _{2. When} the range of the upper limit value 23 and the lower limit value 24 of the binary alarm set value is out of range, an alarm sound is emitted.
For example, in the first evaluation screen 10A shown in FIG. 1, the upper limit value 23 of the SpO ₂ value alarm setting value is set to “99”, the lower limit value 24 is set to “74”, and the measured SpO ₂ value of the patient is 74. An alarm sound is emitted when the value is outside the range of 99% to 99%. In the second evaluation screen 10B shown in FIG. 2, the upper limit value 23 is displayed as “-”, the upper limit value 23 is not set, but the lower limit value 24 is set to “73”, and the patient's measured SpO _An alarm sound is emitted only when the binary value is less than 73%.

Then, on the second evaluation screen 10B shown in FIG. 2, in addition to the digital display unit 21 that displays the measured SpO ₂ value in real time using arithmetic numbers, the measured SpO ₂ corresponding to the elapsed time from the start of resuscitation treatment. A graph display unit 25 that graphs the progress of values is provided. The doctor can freely switch between the first evaluation screen 10A and the second evaluation screen 10B by operating the changeover switch 11, and by displaying the second evaluation screen 10B, a digital display of the measured SpO ₂ value. Along with the unit 21, the graph display unit 25 can be displayed. In the graph display unit 25, the measured SpO ₂ value (solid line 26) and the evaluation target value of the SpO ₂ value (one-dot chain line 27) are displayed in an overlapping manner, and the measured SpO ₂ value and its evaluation target value can be easily displayed. Can be compared. The evaluation target value of the SpO ₂ value is, for example, 60% or more after 1 minute from the start of resuscitation treatment, 70% or more in 3 minutes, 80% or more in 5 minutes, 90% or more in 10 minutes . Although not shown, the graph display unit 25 can display not only the measured SpO ₂ value but also the progress of the pulse rate in an overlapping manner.

The pulse rate display unit 30 displays the patient's pulse rate measured by the pulse oximeter in real time. Both the first evaluation screen 10A and the second evaluation screen 10B are provided with a digital display unit 31 that displays the pulse rate with arithmetic numbers. On the right side of the digital display unit 31, an alarm pulse rate display unit 32 for displaying an alarm set value of the pulse rate is provided. In this case, the alarm pulse rate display unit 32 is configured to display the upper limit value 33 and the lower limit value 34 of the alarm set value of the pulse rate stored in advance, and the pulse rate of the patient is set to the alarm setting of the pulse rate. An alarm sound is emitted when the value exceeds the range of the upper limit value 33 and the lower limit value 34.
For example, in the first evaluation screen 10A shown in FIG. 1, the upper limit value 33 of the pulse rate alarm setting value is set to “190”, the lower limit value 34 is set to “50”, and the patient's pulse rate is 50 times / minute. An alarm sound is emitted when the value exceeds the range of 190 times / minute or less. In the second evaluation screen 10B shown in FIG. 2, the upper limit value 33 is set to “170”, the lower limit value 34 is displayed as “---” and is not set, and the heart rate of the patient is 170 times / minute. The alarm sound is emitted only when exceeding.
Further, by displaying the first evaluation screen 10A shown in FIG. 1, the graph display unit 35 that displays the plethysmograph waveform of the pulse wave and the like together with the digital display unit 31 that displays the pulse rate in real time using the arithmetic numbers. Can be switched.

  The control / display unit 10 may be configured to display an evaluation screen different from the first evaluation screen 10A and the second evaluation screen 10B. The control / display unit 10 can also display a menu screen (not shown) for changing the environment setting of the resuscitation treatment support apparatus 100 and the setting of each measurement function. For example, the menu / screen switch 12 is operated. Thus, the evaluation screens 10A and 10B can be switched to the menu screen.

In addition, the resuscitation treatment support device 100 includes a speaker that can generate a notification sound such as a bell sound or a buzzer sound. When the notification sound is set to the ON state, a notification sound for notifying from the end of the resuscitation treatment period to the end time, a notification sound for notifying the evaluation timing of the SpO ₂ value, and the like are emitted from the speaker. Yes.
For example, the notification sound is emitted at intervals of 1 second for about 3 seconds from the end of the resuscitation treatment period 3 seconds before (when the resuscitation treatment period has passed 27 seconds) to the end of the resuscitation treatment period. Can inform the physician that the patient should be prepared for evaluation. In addition, at the timing of 1 minute, 3 minutes, 5 minutes, and 10 minutes from the start of resuscitation treatment, a notification sound different from the notification sound for notifying the end point of the resuscitation treatment period is configured to be emitted. The doctor can be notified that it is time to evaluate the patient's SpO ₂ value.
The resuscitation treatment support apparatus 100 is provided with a main power switch (not shown), and the main power switch is put into an operable state.

  FIG. 3 is a flowchart of neonatal resuscitation treatment performed by a doctor using the resuscitation treatment support apparatus 100 shown in FIGS. 1 and 2. First, as shown in FIG. 3, by turning on the main power switch, the resuscitation treatment support device 100 is set in an operable state (s1: step 1). When a doctor or the like operates the timer switch 41 to start the timer almost simultaneously with the birth of the newborn (s2: step 2), the elapsed time starts counting and the elapsed time display unit 40 is displayed at the time of birth (resuscitation). The elapsed time from the start of treatment starts to be displayed in units of 1 second. The doctor can recognize the resuscitation treatment period (for example, 30 seconds) for performing the resuscitation treatment and the evaluation period (for example, 6 seconds) for evaluation according to the timer provided in the resuscitation treatment support apparatus 100.

  First, the doctor promptly evaluates the newborn through measurement of the newborn's respiratory rate, skin color, heart sound, etc. almost simultaneously with the operation of the timer switch 41. If the doctor determines that this is necessary based on this assessment, the neonate will be given initial treatments for resuscitation, such as warming, body position, airway opening, skin dryness and irritation, and breathing and pulse rate to determine its effect. Check. If it is determined that resuscitation or respiratory assistance is required, the pulse oximeter detector 101 is attached.

  When the necessary resuscitation treatment (s3: step 3) is being performed and the elapsed time from birth has elapsed for 27 seconds, a notification sound is emitted from the speaker at 1 second intervals until the end of the resuscitation treatment period (30 seconds). Sounded. Thereby, the doctor can prepare to switch from the resuscitation treatment (s3) to the newborn to the evaluation of the newborn (s4: step 4). Then, when the resuscitation treatment period has elapsed, during the period from the start of counting to 36 seconds, the 0th to 6th point light emission display parts 52a to 52g of the second point display part 51 are sequentially lit at intervals of 1 second, and 6 seconds. When the time has elapsed, all the point light emission display portions 52a to 52g are turned off simultaneously. Therefore, the doctor can recognize the progress of the evaluation period for the evaluation of the newborn. In addition, evaluation of a newborn is performed at a timing of every 30 seconds from the start of resuscitation treatment.

  Then, the doctor evaluates the newborn during the evaluation period of 6 seconds (s4), and when it is determined that it is necessary based on this evaluation, the resuscitation treatment necessary for the newborn is performed again (s5: Step 5). ) In the next 6 second evaluation period, the newborn is evaluated again (s6: Step 6), and the same procedure is repeated as necessary.

In addition, a notification sound different from the notification sound for notifying the end point of each resuscitation treatment period is emitted at the timing when the elapsed time from birth is one minute, three minutes, five minutes, or ten minutes. Thus, the physician is able to recognize that it is time to evaluate the SpO ₂ value newborns. At this time, the doctor can recognize the actually measured SpO ₂ value of the newborn from the SpO ₂ value display unit 20 of the control / display unit 10.
Further, by switching the screen of the control and display unit 10 between the first evaluation screen 10A and the second evaluation screen 10B, with the digital display 21 and digital display 31 of the pulse rate measured SpO ₂ values, measured SpO _The binary graph display unit 25 or the pulse rate graph display unit 35 can be displayed.
In the above embodiment, the resuscitation treatment period is set to 30 seconds and the evaluation period is set to 6 seconds. However, these settings can be changed manually.

  For example, in the first evaluation screen 10A shown in FIG. 1, the elapsed time display unit 40 can recognize that 1 minute and 2 seconds have elapsed since the start of resuscitation treatment, and the second resuscitation treatment period shown in FIG. It can be seen that this is a process of evaluating a newborn (s6). In addition, since the 0th to 2nd point light emission display parts 52a to 52c of the second point display part 51 are in the lit state, the doctor can recognize the time point at which 2 seconds have passed in the evaluation period.

The physician can recognize that measured SpO ₂ value neonatal at present by the digital display 21 of the SpO ₂ value display unit 20 is "97".
The doctor can also recognize that the pulse rate of the newborn at the present time is “68” by the digital display unit 31 of the pulse rate display unit 30 simultaneously with the evaluation of the measured SpO ₂ value. As described above, the doctor can quickly recognize the two evaluation items of the SpO ₂ value and the pulse rate within the limited evaluation period on the first evaluation screen 10A.

  Further, the first evaluation screen 10A is provided with a graph display unit 35 for displaying the patient's pulse wave as a plethysmograph waveform, so that the doctor can recognize the neonatal pulse rate graphically. Yes. Therefore, on the first evaluation screen 10A, the doctor preferentially selects an easy-to-understand display method among the two display methods of the digital display unit 31 and the graph display unit 35 for the recognition of the pulse rate. Evaluation can be made.

Further, in the second evaluation screen 10B shown in FIG. 2, the elapsed time display unit 40 can recognize that 7 minutes and 14 seconds have elapsed since the start of resuscitation treatment, and each point light emission display unit 52a to 52a of the second point display unit 51. Since 52g is in the off state, the doctor can recognize that it is within the resuscitation period.
The physician can recognize that measured SpO ₂ value neonatal at present by the digital display 21 of the SpO ₂ value display unit 20 is "75".
Further, the doctor can recognize that the pulse rate of the newborn at the present time is “60” by the digital display unit 31 of the pulse rate display unit 30 simultaneously with the evaluation of the actually measured SpO ₂ value. Thus, the doctor can quickly recognize the two evaluation items of the SpO ₂ value and the pulse rate in the second evaluation screen 10B within the limited evaluation period, similarly to the first evaluation screen 10A. .

Further, the second evaluation screen 10B, the graph display unit 25 for displaying overlapping the evaluation target value of the measured SpO ₂ values and the SpO ₂ value of the patient is provided, the physician, found SpO ₂ values newborns and Evaluation target values can be easily compared. Therefore, on the second evaluation screen 10B, the doctor preferentially selects an easily understandable display method from the two display methods of the digital display unit 21 and the graph display unit 25 for the recognition of the measured SpO ₂ value, Newborns can be evaluated. In the graph display unit 25 shown in FIG. 2, the one-dot chain line 27 indicating the progress of the SpO ₂ value evaluation target value indicates the progress of the measured SpO ₂ value from the start of resuscitation treatment to the present time (7 minutes and 14 seconds). A solid line 26 is superimposed.
Further, since the screen of the control / display unit 10 can be freely switched between the first evaluation screen 10A and the second evaluation screen 10B by operating the changeover switch 11, the doctor together with the digital display 21 and digital display 31 of the pulse rate measured SpO ₂ values, by selecting one of the graphical display unit 25 or the pulse rate of the graph display unit 35 of the measured SpO ₂ values can be displayed.

As described above, in the resuscitation treatment support device 100, in addition to the display units 40 and 50 that display the elapsed time and the evaluation period, the SpO ₂ value (actually measured SpO ₂ value) that is an evaluation item necessary for the evaluation of the patient and the pulse by providing the SpO ₂ value display unit 20 and the pulse rate display unit 30 both displays of a few, doctor or the like, while accurately recognize the time elapsed from the resuscitation beginning, only at the time of resuscitation Within _two hours, the two evaluation items of SpO ₂ value and pulse rate can be quickly recognized.

Further, the SpO ₂ value display section 20, in addition to providing a graphical display unit 25 of the digital display unit 21, by displaying overlapping the evaluation target value of the measured SpO ₂ value and the SpO ₂ values, the measured SpO ₂ value The evaluation target value can be easily compared. Evaluation target value of SpO ₂ value will vary in response to the elapsed time from the resuscitation start, the doctor or the like, the evaluation target value also displayed SpO ₂ value graph display section 25, SpO ₂ at that time The evaluation target value of the value can be quickly recognized, and the patient can be evaluated quickly.
Therefore, the resuscitation treatment support device 100 allows a doctor to quickly evaluate a patient and appropriately assist so that an appropriate resuscitation treatment can be effectively performed.

  Further, although one embodiment of the present invention has been described in detail above, the present invention is not limited to this embodiment, and various modifications and changes are made based on the spirit of the invention described in the claims. Correction is possible.

10 control and display unit 10A first evaluation screen 10B second evaluation screen 11 changeover switch 12 menu screen changeover switch 20 SpO ₂ value display section 21 digital display 22 alarm SpO ₂ value display section 23 the upper limit value 24 lower limit 25 graph display unit 26 Measured SpO ₂ value (solid line)
Evaluation target value of 27 SpO ₂ value (dashed line)
30 Pulse rate display unit 31 Digital display unit 32 Alarm pulse rate display unit 33 Upper limit value 34 Lower limit value 35 Graph display unit 40 Elapsed time display unit 41 Timer switch 50 Evaluation period display unit 51 Second point display unit 52a to 52g Point emission display unit 100 Resuscitation Support Device 101 Detection Unit

Claims (2)

A resuscitation treatment support device for supporting resuscitation treatment and evaluation of a patient based on the elapsed time from the start of resuscitation treatment for a patient such as a newborn, and displaying the elapsed time from the start of resuscitation treatment for the patient An elapsed time display unit and an evaluation period display for displaying from the start point to the end point of an evaluation period for evaluating the condition of the patient set after a predetermined elapsed time from the start of the resuscitation treatment at intervals of 1 second and parts, and SpO ₂ value display unit that displays in real time the measured SpO ₂ values of said patient, and a pulse rate display unit for displaying the pulse rate of the patient in real time possess,
The SpO ₂ value display part can be displayed by a digital display part that displays the measured SpO ₂ value using arithmetic numbers in real time and a switching operation of the display screen, and with the elapsed time from the start of the resuscitation treatment, A graph display unit that graphs the progress of the measured SpO ₂ value corresponding to the elapsed time ;
The pulse rate display unit is a digital display unit that displays the pulse rate in real time using mathematical numbers, and a graph display that displays a plethysmograph waveform of the patient's pulse wave that can be displayed by a switching operation of the display screen. With
Along with the digital display unit for the measured SpO ₂ value and the digital display unit for the pulse rate , either the graph display unit for the measured SpO ₂ value or the graph display unit for the plethysmograph waveform of the pulse wave is operated by switching the display screen. A resuscitation treatment support device, which is provided so as to be selectable and displayable . Wherein the graph display area of the actual SpO ₂ values, together with the actual SpO ₂ values, that course of recommended SpO ₂ value at which evaluation target value in the elapsed time from the resuscitation start is displayed superimposed The resuscitation treatment support apparatus according to claim 1 .

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