MX2008005908A - Advanced cardiac life support apparatus and method - Google Patents
Advanced cardiac life support apparatus and methodInfo
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- MX2008005908A MX2008005908A MXMX/A/2008/005908A MX2008005908A MX2008005908A MX 2008005908 A MX2008005908 A MX 2008005908A MX 2008005908 A MX2008005908 A MX 2008005908A MX 2008005908 A MX2008005908 A MX 2008005908A
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Abstract
An apparatus (300, 400) and method operable to guide responders, via audible prompts and visual cues, through the proper procedures to be applied to a patient during a cardiac arrest. An embodiment of the present invention advantageously makes the ACLS procedures, such as types and dosages of medications to administer, and sequence of performing actions (such as cardiac pulmonary resuscitation (CPR)) on the patient easier to acknowledge and follow. An exemplary embodiment of the present invention (300) can be located on a conventional hospital crash cart which stores the emergency equipment and medications, or can be hardware and application software, the application software being loadable and loaded into computer hardware (200).
Description
APPARATUS AND ADVANCED CARDIAC LIFE SUPPORT METHOD
CROSS REFERENCE TO RELATED REQUESTS
This Request claims the benefit of the Request
Provisional of E.U.A. No. 60 / 35,371 filed on November 12, 2005, entitled "The Code Blue Clock".
TECHNICAL FIELD The preferred embodiment of the present invention relates to a computer hardware and software-based system used during the performance of cardiac pathway support.
BACKGROUND Every year thousands of patients suffer from sudden cardiac death. Since 1919 cardiovascular disease (CVD) has been the leading cause of death in this country. Almost 40% of deaths in this country refer to CVD in some way. In addition, the population ages, resulting in more people being admitted to hospitals. When it is discovered that a patient in a hospital has had a sudden cardiac event, a series of actions take place in an attempt to resuscitate that person. Optimally, a response team (called
conventionally as a blue code response team) consisting of nurses, supervisors, respiratory staff, technicians and a physician, who, preferably will specialize in advanced cardiac life support procedures (ACLS), are convened to perform resuscitation process. However, many times, a doctor is not immediately available to coordinate the ACLS or is not an expert on specific protocols. It is not required that the majority of staff working in a normal hospital floor learn or be certified in ACLS. In addition, most doctors outside of an intensive care unit (ICU) or emergency room (ER) do not use ACLS protocols often enough to retain accurate knowledge. of many medications and specific time control sequences involved in a blue code situation. An unfortunate but very common situation is the following: a nurse reviews a patient in his rounds at 3:00 a.m. The nurse realizes that the patient breathes with extreme difficulty and the frequency of the patient's heart is only ten beats per minute. The patient does not wake up when the nurse calls or moves him. ' The nurse activates a switch (conventionally known as a blue code button) located in the patient's room.
patient, for example, on the wall, who sends an urgent notice to all those who are necessary inside the hospital, except to a doctor. Often, there is only one doctor in the entire building at that time, and if the doctor is treating critical patients in ER, he can not leave that area. The floor secretary could notify the patient's private doctor via a response service. The answering service usually assures the floor secretary that if the doctor does not return the call within 20 minutes he will notify the doctor again. Meanwhile, the patient can stop breathing. One of the respondents recalls the ACLS process will be critically needed in the patient's room. However, it is often the case that nobody in the room works in ER or has kept them with the latest changes in the ACLS protocols. As a result, the patient may die, regardless of the heroic efforts of the respondents who unfortunately have inadequate knowledge and experience in ACLS. What is desired is a method and apparatus that can operate to guide those who respond, via auditory and visible ideas, through the appropriate medications, doses and time sequences required during a cardiac arrest event, in accordance with the protocols of ACLS.
SUMMARY A preferred embodiment of the present invention comprises an ACLS method and apparatus that can be operated to guide the people who responded, via auditory notices and visual cues, through appropriate procedures that can be applied to a patient during a cardiac arrest. A preferred embodiment of the present invention can be located in a conventional hospital shock truck that stores emergency equipment and medications, or can be application hardware and software, aviation software can be rechargeable and loaded into the computer hardware that has a central processing unit (CPU), memory, input / output means such as keyboard, mouse, touch pad, trackball, speaker, buzzer, illuminated indicators, video screen and the like, the data collectors and operation software and controllers. The hardware of the computer can be a main frame, personal computer (PC), terminal, PC "Tabler", portable PC, personal digital assistant (P.).; by its acronym in English), and the like. The input to the hardware / software of the computer can be facilitated via keys, touching the screen, button or activation switch, voice recognition, pressing the mouse button, biometric recognition and the like. A preferred modality of
present invention advantageously performs ACLS procedures, such as types and doses of drugs that will be administered, and sequence to perform actions (such as cardiac pulmonary resuscitation (CPR)) for the easier recognition and monitoring of the patient . For those skilled in the art to which the present invention relates, many changes in construction were suggested and modalities and applications which differ widely from the invention will be suggested by themselves without departing from the scope of the invention as defined in the claims. annexes. The present disclosures and descriptions are illustrative only and are not intended to be in a limiting sense.
BRIEF DESCRIPTION OF THE DRAWINGS For a better understanding of the preferred embodiments of the present invention including the aspects, advantages and specific modalities, reference is made to the following detailed description with accompanying drawings in which: Figs. 1A-1RRR give a flow chart of an illustrative method of the present invention as it will be administered to an adult patient;
Fig. 2 is a block diagram of an illustrative computer-based apparatus adapted to carry out methods of the present invention; Figs. 3A-3C are three views of an illustrative apparatus adapted to perform the methods of the present invention adapted to be installed in a hospital shock car; and Fig. 4 is an illustrative apparatus adapted to perform the methods of the present invention in the form of a PDA. The references in the detailed description correspond to similar references in the Figures unless otherwise noted. Similar numbers refer to similar parts through the different figures.
DETAILED DESCRIPTION OF A PREFERRED MODE While the preferred embodiments of the present invention discussed in detail below are made and used, it should be appreciated that the preferred embodiments of the present invention provide many applicable inventive concepts that can be modalized in a wide variety of specific contexts. . Some aspects of the preferred embodiment shown and treated can be simplified or exaggerated by illustrating the principles of the invention.
The preferred embodiment of the present invention comprises an ACLS method and apparatus that can operate to guide the respondents, via auditory notices and visual notes, through that appropriate procedures that will be applied to a patient during a cardiac arrest. As seen in Fig. 2, a preferred embodiment of the present invention preferably comprises application software operated on the computer hardware, the application software being able to be loaded or loaded into the computer hardware having a central processing unit ( CPU), memory, input / output means, such as a keyboard, mouse, touch pad, touch screen, trackball, speaker, buzzer, illuminated indicators, printer, video screen, ports (such as serial, parallel, USB) , infrared (IR), and wireless) and the like, data collectors, a power supply and regulation circuit and operating software and controllers. The hardware of the computer can be in a main frame, personal computer (PC), mobile terminal, thin-ribbon terminal, "Tablet" PC, portable PC, personal digital assistant (PDA) (as seen in Figure 4) and similar. Input to the hardware / software of the computer can be facilitated via the keys, pulses on the screen, activation by button or switch, voice recognition, mouse, biometric recognition and the like.
One embodiment of the present invention has the form of at least one means that can be read on the computer and processor instructions contained in at least one computer readable medium. Processor instructions contain the algorithms that will be used during the ACLS process, such algorithms generally take the form of decision trees. A decision tree is a set of defects and their possible consequences used to create a panel to achieve a goal, in this case the resuscitation of a patient. A decision tree is a predictive model that is a mapping of observations about a patient to draw conclusions about the possible outcomes of the patient. Processor instructions are configured to read at least one medium that can be read on the computer by at least one processor and thus cause at least one processor to determine when to provide notes, accept inputs, start time controllers, and indicate the status of events. One embodiment of the present invention could be located in a conventional hospital shock car that stores emergency equipment and medications as seen in Figures 3A-3C. Figure 3A is a front view of the apparatus 300 having audio output 301, touching the sensitive digital screen 302 and digital clock screens 303. Figure 3B
is a top view showing digital clock screens 303 of the upper part and the input buttons 304 for responding to the notes and commands of the apparatus 300. Figure 3C is a side view of the apparatus 300. In general, a preferred embodiment of the present invention comprises an apparatus for use in order to carry out ACLS processes having at least one notification means for obtaining uniuser observation; at least one means of entry to obtain answers from users for information notes; at least one means of time control to obtain time information based on elapsed time or temporary presentation of events; a logical means that can be operated to determine a decision path selection based on the user responses for the information notes and time control information; and at least one means of egress to provide communication notices to guide respondents through appropriate procedures that will be applied to a patient during a cardiac arrest based on the departure of the logical means. The operation of the computer hardware, being directed via the software, can be changed by improving or modifying the software. Such changes can be made to the software via a hardware port, when, for example, the ACLS process is improved or changed or as new ones are introduced
medications and doses. It is understood that the scope of the present invention encompasses the ability to make such changes. The preferred embodiment of the present invention advantageously performs the ACLS procedures, such as types and doses of drugs that will be administered and sequence of performing the actions (such as cardiac pulmonary resuscitation (CPR)) on the patient easier for recognition and tracing. The following will generally describe the operation of a preferred embodiment of the present invention. The details of the method and the apparatus that implements the method will be after the general discussion. Assume that a hospital patient suffers from cardiac arrest and a physician with knowledge of ACLS procedures is not readily available. A nurse carries a crash cart including a preferred embodiment of the present invention in the patient's room. The device is activated by means of an on / off switch. In one embodiment of the present invention, a touch screen notifies the nurse to initiate a specific algorithm by choosing whether the patient is an adult or infant, and within seconds the first auditory command is issued from the apparatus to a volume that is suitable for let those who respond respond. Once the first command is followed, the nurse touches the screen to report that fact to the
apparatus, and a first time control of a plurality of time controls is activated. The first time control is taken into account at a certain level (such as zero), after which an addition command is given. The additional time controllers, v.gr, a second time control, third time control, a fourth time control of the plurality of time controllers operate concurrently and / or consecutively, each providing an accurate determination of when a time delay occurs. Additional event in the ACLS procedure or an action is ordered. Such actions and events may include, among other things, dosage and administration of medications, performance of CPR, and monitoring of vital signs of the patient. If the conditions of the patient change during the resuscitation process, the method and apparatus are adapted to indicate to the nurse of the change of condition and the method causes the screen selections to change accordingly. Alternatively, the scenario could involve a physician who is not well acquainted with the ACLS processes using a PDA that has been loaded with application software that is adapted to perform the methods of a preferred embodiment of the present invention. In any case, the auditory and visual notes can be in English or any other language appropriate to the place and language of the people who answer the call.
As can be seen, a preferred embodiment of the present invention is adapted to guide those who respond through a difficult situation by instructing them to follow the sequential order and controlling the timing of events accurately. In this way, the appropriate medications are administered in the correct doses and actions are taken at the appropriate time, thus improving the patient's likelihood of survival. Throughout the resuscitation process, a preferred embodiment of the present invention provides audible notifications to those who respond about the nature over time to administer medicine and at what intervals. An additional aspect of a preferred embodiment of the present invention is the use of medicaments in color-coded drug packages in combination with the apparatus and method of the present invention. In this way, auditory commands can be simplified by directing a nurse to administer a medication in a particular package, regardless of the medical name of the medication. In this way, any respondent who can initiate an intravenous (IV) fluid can administer the appropriate medications guaranteeing the situation. An additional aspect of a preferred embodiment of the present invention is in combination with an automated external defibrillator (AED).
English) . Such a combination, for example, could be implemented using the software and hardware components of a preferred embodiment of the present invention and the EED power source. The use of a preferred embodiment of the present invention with an AED could result in a modification to the method of a preferred embodiment of the present invention as the AED, not the responding person, will recognize the individual rhythm before proceeding with the protocol. In other words, the protocols will remain intact except for the steps that request rhythm recognition. It is observed that the protocols of drugs, IV and auxiliary airways and CPR cycles are not part of the AED. Another aspect of a preferred embodiment of the present invention relates to a security aspect. Preferably, when the respondent is made to select one of a choice of drugs, the choices, while appearing on the same screen, are located at a distance close to part so as to avoid inadvertent selection of the wrong choice. In an additional security aspect, for particularly critical decisions, confirmation notices can be provided in order to confirm the choice of the respondent. Said confirmation can also be done using a bar code or similar reader to read medicine packaging bar codes to configure the steps that have been carried out. In one aspect
In addition to a preferred embodiment of the present invention, a list of actions taken within the memory portions of the hardware are reviewed, and furthermore they are displayed on the video screen for quick reference during the ACLS process. In addition, an option can be provided to the user, via the video screen or via a separate switch or key stroke to return to a previous screen to review the actions taken or the available choices. Actions stored in memory can be printed on a printer concurrently as events occur, such time as universal world time (UTC) or local time. For example, access IV obtained at 2:34; first epinephrine at 4:10; second the shock at 7:42, etc. If mistakes are made during the ACLS process, the device will allow the respondent to notice these errors and any actions taken in response to them, via a keyboard. If it is necessary to pronounce the death of a patient, the apparatus of a preferred embodiment of the present invention will accept an input from the respondent of the pronouncement, whereby the apparatus will provide an indication to ensure that it is the desired action. A preferred embodiment of the present invention, as implemented, will be adapted to receive input from the
person who responds with reference to the age, weight and / or height of the patient. In response to the input, the device will be adapted to make the correct doses for the medications and to level the voltage shocks that will be applied. For example, the video screen and the auditory indication can provide: "If it is a newborn, go to step x, if it is infant, go to step and, if it is a child, go to step z". In this way, a revision to the table loaded in the hardware of the computer's memory could have values that represent dose data for newborns, infants, toddlers and children. The same concept extends to, for example, tube sizes for IV and endo-tracheal tubes. This could advantageously overcome the need to perform such calculations during the ACLS procedure. Figures 1A-1TTT provide a detailed flow chart of the method that can be implemented in a first embodiment of the apparatus of the present invention, which is used to facilitate adult resuscitation. The method can be modified as described herein in a manner that facilitates the resuscitation of children. As shown below, all text in the citations are commands or indications communicated by the apparatus of the first embodiment of the present invention to the respondent, either audibly, visually or both via a sound transducer, touch screen, video screen, and the like.
In addition, as noted herein, a plurality of time controllers are used in the first embodiment of the present invention, which are used to determine when certain actions should be taken. The first embodiment of the present invention preferably uses six (6) time controllers (hereinafter referred to as clocks) as follows: External clock A. This clock counts the time since the beginning of the ACLS procedure and the end of the ACLS procedure (said elapsed time hereinafter sometimes referred to as the "code" due to its nature as a blue code event) until the user stops the entire event. This clock is displayed on the video screen and is visible to those who respond and is therefore referred to as external. Clock B of CPR. This clock is not visible to responders (and therefore is called with or "internal") and is in a two-minute cycle denoting the length of an individual CPR session. The ACLS guidelines are very specific about the importance of chest compressions on medications. The vasopressor clock C. This is also an internal clock that tracks the time of this class of medications (Epinephrine or Vasopr sine). Their cycles are every three minutes. Their cycles are every three minutes.
Anti-arrhythmic Clock D. This internal clock cycles every three minutes and tracks the time of Epinephrine and Amiodarone. Atropine clock E. This internal clock takes two out of three minutes and tracks atropine time. Indication of IV / Airways. This [Internal] OR [external] clock has cycles every five minutes until it is asserted by the touch screen or other input-recognition. Note that the different reluges can be implemented on a computer using a signal clock source. In addition, the first embodiment of the apparatus of the present invention includes an audible metronomic cadence. Current ACLS protocols emphasize the need for better, faster and uninterrupted CPR. The new regime for chest compressions is 100 / min. The audible metronic cadence auditorily establishes the frequency for this regime. Referring now to Fig. 1A, an initial choice between children and adults is indicated. If a child is chosen, the device carries out the steps for the resuscitation of a child, which are modified steps, as described below, of the adult version. The steps are taken automatically by the device (based on the algorithm following the responses and / or inputs of a user (or
sensor) in response to the syndications, and communications from, the device. In step 1, as shown in Figure IB, the external clock A starts. The device communicates: "Connect the monitor and defibrillator" and "Check the pulse". If you have a pulse, go to step 55. If there is no pulse, choose: Ventricular Tachycardia / Ventricular Fibrillation Algorithm (referred to as "Tac V or Fib V" or (VT / VF) (go to step 2), Asistole Algorithm ( go to step 18) or Pulseless Electrical Activity Algorithm (PEA) (go to step 36) In step 2 (VT / VF), as shown in Figure 1C, the device communicates: "Defibrillate at 200 joules" and "Clear" (three times) and "Start CPR at 100 compressions per minute." Then start the metronic cadence at 100 / min.The Clock B adjusts for 2 minutes and then starts. then it communicates: "Was IV access established?", if the user answers yes, initiates step 3. If not, then the same question is asked every 3 minutes until the answer is "Yes." The device then communicates "Is it in place the airway device and confirmed? "If not, the question can be asked every 5 minutes until an affirmative answer is obtained. n can remain on the screen until contact is established the IV and / or air.
In step 3 (VI / VF) as shown in Figure ID, clock B reaches 2 minutes and the device communicates: "Stop CPR / Check rhythm". Then four options are presented: VT / VF (continue later), Asistole (go to step 18 (b)), PEA (go to step 36 (b)) and Return Pulse (go to step 55). If the first option is chosen, the device communicates ("Defibrillate to 300 joules" and "Clear All" (three times) and "Continue CPR to 100 compressions per minute." The metronomic cadence starts at 100 beats per minute. At this point, if IV is set, the device proceeds to step 4. If IV is not set, the device continues to indicate until it is established, while the respondent indicates that it is not set. UV was established, but there is an oral airway in place, the device begins in step 5 (a) .If the airway is not in place, the device continues to indicate it until there is an airway in place. device can indicate that if no IV or oral airway is established, no medication can be given In step $ (with IV access) (VT / VF) as shown in Figure 1E, the device communicates medicine, dose and method of administration: Epinephrine 1 mg IV or Vasopressin 40 units IV. ta for 3 minutes. The device can be made to indicate that Vasopressin is only taken once. Therefore, if they are given together it is not an option in 1
next step. However, if not given in this step, it can be offered as an option once again. The above also applies to step 4 (a). Alternatively, in step 4 (a), without IV access, but with the airway device confirmed, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS or Vasopressin 40 ET units in 5 ml of water or NS . The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. In step 5 (VT / VF) as seen in the Figure
A1F, the device communicates: "Continue CPR at 100 compressions per minute" and the device will provide a metronomic rate at 100 beats per minute. Once the B clock reaches 2 minutes, the device communicates: "Stop CPR / Check rhythm". Based on the rhythm, four opinions are offered for user acceptance: VT / VF) continue later), Asistole (go to step 19 (b)), PEA (go to step 38 (v)) and return Pulse ( go to step 55). If the first option is chosen, the device communicates: "Defibrillate to 360 joules" and "Clear all" (three minutes) and "Continue CPR to 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 6 (with IV access) (VT / VF) as seen in Figure 1G, the device reports medicine, dosage and method of administration: Amiodarone 300 mg IV or Lidocaine
1-1.5 mg / kg IV. The D clock is adjusted for 3 minutes. Alternatively, in step 6 (a), without IV access, but with confirmed airway device, the device will communicate: Lidocaine 2-3 g / kg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". Clock D is then adjusted for 3 minutes. The device may indicate that Amiodarone can not be given through an airway device, therefore it is not provided as an option. Once it is indicated that the IV was established, the apparatus no longer communicates a need to carry out step 10 (a) during the rest of the protocols. In step 7, (VT / VF) as shown in Figure 1H, clock B reaches 2 minutes and the device communicates: "Stop CPR / Review Rhythm". Then four options are presented: VT / VF (continue forward), Asistole (go to step 18 (b)), PEA (go to step 36 (b)) and Return Pulse (go to step 55). If the first option is chosen, the device communicates: "Defibrillate to 360 joules" and "Clear all" (three times) and "Continue CPR to 100 compressions per minute". Start the metronomic cadence at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 8 (with IV access) (VT / VF) as seen in Figure 11, the apparatus communicates the medicine, dosage and method of administration. Epinephrine 1 mg IV or Vasopressin 40 units IV. Clock C adjusts for 3
minutes The device can be made to indicate that Vasopressin only occurs once. However, if it is not given in this step, it can not be offered as a next option. The foregoing also applies in step 8 (a). Alternatively, in step 8 (a), without IV access, but with confirmed airway device, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS or Vasopressin 40 ET units in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. In step 9 (VT / VF) as seen in 1J, clock B reaches 2 minutes and the device communicates: "Stop CPR / Review rhythm". Then four options are presented: VT / VF (continue later), Asistole (go to step 19 (b)), PEA (go to step 38 (b)) and Return Pulse (go to step 55). If the first option is chosen, the device communicates: "Desfribrilar a 360 joules" and "Despejar Todo" (three times) and "Continue CPR at 100 compressions per minute." The metronomic cadence starts at 100 beats per minute. adjusts to 2 minutes and restarts In step 10 (with IV access) (VT / VF) as shown in Figure 1K, the device communicates medicine, dosage and method of administration: Amiodarone 150 g IV or Lidocaine 1- 1.5 mg / kg IV The clock D is adjusted for 3 minutes, alternatively, in step 10 (a), without IV access, but with
Airway device confirmed, the device will communicate: Lidocaine 2-3 mg / kg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". Clock D is then adjusted for 3 minutes. The device can observe that Amiodarone can not be given through an airway device, therefore it is not provided as an option. Once it is indicated that an IV was established, the device will no longer communicate the need to carry out step 10 (a) during the rest of the protocols. In step 11 (VT / VVF) as shown in Figure 1L, clock B reaches 2 minutes and the device communicates: "Stop CPR / Review Rate". Then four options are presented: VT / VF (continue later), Asistole (go to step 18 (b)), PEA (go to step 36 (b)) and Return Pulse (go to step 55). If the first option is chosen, the device communicates: "Defibrillate 360 joules" and "Clear all" (three times) and "Continue ERCP at 100 compressions per minute". Start the metronomic cadence at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 12 (with IV access) (VT / VF) as seen in Figure 1M, the apparatus communicates medicine, dosage and method of administration: Epinephrine 1 mg IV. Clock C is adjusted for 3 minutes. Alternatively, in step 12 (a), without IV access, worse with airway device
confirmed, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. In step 13 (VT / VT) as seen in the Figure
1N, the B clock reaches 2 minutes and the device communicates: "Stop CPR / Review rhythm". Then four options are presented: VT / VF (continue later), Asistole (go to step 19 (b)), PEA (go to step 38 (b)) and Return Pulse (go to step 559. If you choose the first option, the device communicates: "Defibrillate at 360 joules" and "Clear all" (three times) and "Continue CPR at 100 compressions per minute." The metronomic cadence starts at 10 beats per minute, Clock B is set at 2 minutes. and restarts In step 14 (VT / VF) as seen in the Figure
, the device communicates: "Has the patient received the maximum dose of 3 mg / kg of Lidocaine?", If the answer is no, then the device communicates Lidocaine 1-1.5 mg / kg IV and the watch is not adjusted for this drug. Alternatively, the apparatus continues to step 14 (a). If the answer is yes, then the device continues to step 15. In step 14 (a), without IV access, but with confirmed airway device, the device communicates: Lidocaine 2-3 mg / kg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations".
In step 15 (reversible causes) as seen in Figure 1P, the device communicates: "Have you considered the following reversible causes?" Then the following indications are communicated: In step 64 (Tachycardia / stable / narrow / regular) as seen in Figure 1MMM, the device communicates: "Consider treatment for SVT" and the following reminders are provided: Consultation with Expert; Consider frequency control with Diltiazem IV; Monitor; oxygen. The apparatus then proceeds to step 70. In step 16 (VT / VF) as seen in Figure 1Q, the B clock reaches 2 minutes and the apparatus communicates: "Stop CPR / Review Rhythm". Four options are presented: VT / VF (continue later), Asistole (go to step 18 (b)), PEA (go to step 36 (b)) and Return Pulse (go to step 55). If the first option is chosen, the device communicates: "Defibrillate to 360 joules" and "Clear all" (three times) and "continue CPR to 100 compressions per minute". Start the metronomic cadence at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 17 (with IV access) (VT / VF) as shown in Figure IR, the device reports medicine, dosage and method of administration: Epinephrine 1 mg IV. Clock C is adjusted for 3 minutes. Alternatively, in step 17 (a), without IV access, but with airway device
confirmed, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. At this point in the method, the device performs a nested cycle of steps 16 and 17. There are NO new medications until the team is ready to "declare the code" and pronounce the death of the patient. At this point, the termination sequence is on screen until step 54. In step 18 (Asistole), as noted in
Figure 1S, the device communicates: "Confirm asistole in two probes" and "Start CPR in 100 compressions per minute". Clock B is then adjusted for 2 minutes and starts. The device then indicates: "Was IV access established?" according to step 3. If so, the device continues in step 19. If not, the indication continues and is asked again every five minutes until an affirmative response is given. Meanwhile, the device communicates: "Is the airway device in place and confirmed?" The indication continues and is requested again every five minutes until an affirmative answer is given. In addition, the indication can remain on the touch screen until an IV or an airway is established. Alternatively, in step 18 (a) (Asistole), the device communicates: "Confirm asistole in two probes" and "Start CPR in 100 compressions per minute". The
Metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. The information about IV and airways of this step are stored in the computer's memory. In step 19 (with VI access) (Asistole) as seen in Figure IT, the device communicates: "Consider transcutaneous frequency". The device communicates medicine, dosage and method of administration: Epinephrine 1 mg IV or Vasopressin 40 units IV. Clock C is adjusted for 3 minutes. The device can be made to indicate that Vasopressin can only be given once. Therefore, if they are given in this union it is not an option for the next step. However, if they are not given in this step, it can be offered as an option once again. Alternatively, in step 19 (a), without IV access, but with confirmed airway device, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS or 40 units of Vasopressin ET in 5 ml of water or NS . The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. And the device continues to step 20. In step 19 (b) (Asistole), as shown in Figure IU, the device communicates: "Confirm asistole in two probes" and "Start CPR at 100 compressions per minute". Clock B then adjusts for 32 minutes and starts.
In step 20 (Asistole) as shown in Figure 1U the device communicates: "Consider transcutaneous frequency". Clock B reaches 2 minutes and the device communicates: "Stop CPR / Review Rhythm". Four options are presented: VT / VF (Continue step 20 (b)), assist (continue later), PEA (go to step 38 (b)) and Return Pulse (go to step 55). The device communicates: "Continue CPR and 100 compressions per minute". Start the metronomic cadence at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 290 (b) (VT / VF) the device communicates: "Defibrillate at 200 joules" and "Clear all" (three times) and "Continue CPR at 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. The apparatus then proceeds to step 4. In step 21 (with IV access) (Asistole) as seen in Figure IV the apparatus reports medicine, dosage, and method of administration: Atropine 1 mg IV. Alternatively, in step 21 (a), without IV access, but with confirmed airway device, the device will communicate: Atropine 2 mg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". The E Clock is then adjusted for 3 minutes. At this point in the method, the apparatus can remember who
responds that Atropina can occur only a maximum of four times in total, and this fact is encoded in the application software. In step 22 (reversible causes) as shown in Figure 1W the device communicates: "Have you considered the following reversible causes?". The following indications are reported: Hypovolemia, Drug overdose, Hypoxia, Heart plug, Acidosis, Pneumothorax tension, Hyperkalemia, pulmonary embolism, Hypokalemia, Coronary thrombosis, Hypothermia. Then the user is given the option to save the list for additional reference or hide the list. The device may include an announcement button or to display this list on the screen at the time it is necessary for a user who refers back to it to have easy access to it. In step 23 (Asistole), as shown in Figure IX, Clock B reaches 2 minutes and the device communicates: "Stop CPR / Review Rhythm". Then four options are presented: VT / VF (continue to step 20 (b)), Asistole (Continue later); PEA (go to step 36 (b)) and Return Pulse (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts.
In step 24 (with IV access) (Asistole) as seen in Figure 1Y, the device communicates medicine, dosage and method of administration: Epinephrine 1 mg IV or Vasopressin 40 units IV. Clock C is adjusted for 3 minutes. The device can be made to indicate that Vasopressin can only be given once. Therefore, if they are given together, it is not an option for the next step. However, if it is not given in this step, it can be offered as an option or one or more times. Alternatively, in step 24 (a), without IV access, but with confirmed airway device, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS or Vasopressin 40 ET units in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. In Step 25 (Asistole) as seen in the
Figure 1Z, the device communicates: "Stop CPR / Review Rhythm". Four options are presented: VT / VF (continue to step 20 (b)), Asistole (continue later), PEA (go to step 38 (b)), and Return Pulse (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". Start the metronomic cadence at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 26 (with IV access), (Asistole) as seen in Figure 1AA, the apparatus communicates medicine, dosage and method of administration: Atropine 1 mg IV.
Alternatively in step 26 (a), without IV access, but with confirmed airway device, the device will communicate: Atropine 2 mg ET in 5 ml of water or NS. The device will communicate: "Stop CPR and give five assisted ventilations". The Clock E is then adjusted for 3 minutes. It is internally marked by the device that is the second of four total doses of Atropine that can be given. This fact can also be communicated to the respondent as a reminder. In step 27 (reversible causes) as shown in Figure 1BB, the device communicates: "Have you considered the following reversible causes?". The following indications are reported: Hypovolemia, Drug overdose, Hypoxia, Heart plug, Acidosis, Pneumothorax tension, Hyperkalemia, pulmonary embolism, Hypokalemia, Coronary thrombosis, Hypothermia. Then the user is given the option to save the list for additional reference or hide the list. The device may include an announcement button or to display this list on the screen at the time it is necessary for a user who refers back to it to have easy access to it. In step 28 (Asistole) as shown in Figure ICC, Clock B reaches 2 minutes and the device communicates: "Stop CPR / Review Rate". Then four options are presented: VT / VF (continue to step 20 (b)), Asistole (Continue later); PEA (go to step 36 (b)) and returned
Pulse (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 29 (with IV access) (Asistole) as seen in Figure 1DD, the apparatus communicates medicine, dosage and method of administration: Epinephrine 1 mg IV. Clock C is adjusted for 3 minutes. Alternatively, in step 29 (a), without IV access, but with confirmed airway device, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS or Vasopressin 40 ET units in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. At this point, a termination sequence remains on the video screen until step 54. In Step 30 (Asistole) as seen in Figure 1EE, the device communicates: "Stop CPR / Review Rhythm". Four options are presented: VT / VF (continue to step 20 (b)), Asistole (continue later), PEA (go to step 38 (b)), and Return Pulse (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". Start the metronomic cadence at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 31 (with IV access), (Asistole) as seen in Figure 1FF, the apparatus communicates medicine, dose
and method of administration: Atropine 1 mg IV. Alternatively in step 31 (a), without IV access, but with confirmed airway device, the device will communicate: Atropine 2 mg ET in 5 ml of water or NS. The device will communicate: "Stop CPR and give five assisted ventilations". The Clock E is then adjusted for 3 minutes. It is internally marked by the device that is the second of four total doses of Atropine that can be given. This fact can also be communicated to the respondent as a reminder. In step 32 (Asistole) as shown in Figure 1GG, Clock B reaches 2 minutes and the device communicates: "Stop CPR / Review Rhythm". Then four options are presented: VT / VF (continue to step 20 (b)), Asistole (Continue later); PEA (go to step 36 (b)) and Return Pulse (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 33 (with IV access) (Asistole) as seen in Figure 1HH, the apparatus reports medicine, dosage and method of administration: Epinephrine 1 mg IV or Vasopressin 40 IV units. Clock C is adjusted for 3 minutes. Alternatively, in step 33 (a), without IV access, but with confirmed airway device, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS or Vasopressin 40
ET units in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. In Step 34 (Asistole) as shown in Figure III, Clock B reaches 2 minutes and the device communicates: "Stop CPR / Review Rate". Then four options are presented: VT / VF (continue to step 20 (b)), Asistole (Continue later); PEA (go to step 38 (b)) and Return Pulse (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 35 (with IV access), (Asistole) as seen in Figure 1JJ, the apparatus communicates medicine, dosage and method of administration: Atropine 1 mg IV. Alternatively in step 35 (a), without IV access, but with confirmed airway device, the device will communicate: Atropine 2 mg ET in 5 ml of water or NS. The device will communicate: "Stop CPR and give five assisted ventilations". The Clock E is then adjusted for 3 minutes. It is internally marked by the device that is the second of four total doses of Atropine that can be given. This fact can also be communicated to the respondent as a reminder. At this point, a termination sequence remains on the video screen of step 54. Steps 32 and 33 are linked
until the respondent declares the code or invokes the termination portion of the method. At this point, no more drugs are administered or more actions taken. In step 36 (PEA) as shown in Figure IKK, the device communicates: "Start CPR at 100 compressions per minute". Then the metronomic cadence starts at 100 beats per minute. Clock B adjusts for 2 minutes and then starts. The device then communicates: "Was IV access established?", If the user answers yes, initiates step 3. If not, then the same question is asked every 3 minutes until the answer is yes. The device then communicates "Is the airway device in place and confirmed?" If not, the question can be asked every 5 minutes until an affirmative answer is obtained. In addition, the indication can remain on the contact screen until the IV is established and / or an airway. If yes, the method continues in step 37. In step 36 (b) (PEA) as shown in Figure 1NN, the device communicates: "Start CPR at 100 compressions per minute". Then start the metronomic cadence at 100 beats per minute. Clock B adjusts for 2 minutes and then starts. In step 37 (with IV access) (PEA) as seen in Figure 1LL, the apparatus reports medicine, dosage and method of administration: Epinephrine 1 mg IV or Vasopressin 40 units IV. Clock C is adjusted for 3 minutes. It can
make the device indicate that the sun's Vasopressin is given once. Therefore, if n is given together, it is not an option in the next step. However, if they are not given in this step, it can be offered as an option once again. Alternatively, in step 37 (a), without IV access, but with confirmed airway device, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS or 40 units of Vasopressin ET in 5 ml of water or NS . The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then set for 3 minutes. In step 38 (PEA) as shown in Figure 1 M, once the B clock reaches 2 minutes, the device communicates: "Stop CPR / Check rhythm". Based on the rhythm, four options are offered for user acceptance; VT / VF (go to step 20 (b)), assist (go to step 19 (b)), PEA (continue later) and Return Pulse (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic rate begins at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. The device communicates: "Is the heart rate less than 60?" If the user selects yes, the method continues to step 39. If the user selects no, the method continues to step 40. In step 39 (with IV access) (PEA) as shown in Figure 1LL, the apparatus communicates medicine, dose and
method of administration: Epinephrine 1 mg IV. Alternatively, in step 39 (a), without IV access, but with confirmed airway device, the device will communicate: Atropine 1 mg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". The E Clock is then set for 3 minutes. It is internally marked by the device that this is the first of four total doses of Atropine that can occur. This fact can also be communicated to the respondent as a reminder. In step 40 (reversible causes) as shown in Figure 100, the device communicates: "Have you considered the following reversible causes?". The following indications are reported: Hypovolemia, Drug overdose, Hypoxia, Heart plug, Acidosis, Pneumothorax tension, Hyperkalemia, pulmonary embolism, Hypokalemia, Coronary thrombosis, Hypothermia. Then the user is given the option to save the list for additional reference or hide the list. The device may include an announcement button or to display this list on the screen at the time it is necessary for a user who refers back to it to have easy access to it. In step 41 (PEA) as shown in Figure 1PP, clock B reaches 2 minutes and the device communicates: "Stop CPR / Check rhythm". Then four are presented
options: VT / VF (continue in step 20 (b)), assist (go to step 18 (b)), PEA (continue later) and Return Pulse 8 to step 55). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 42 (with IV access) (PEA) as seen in Figure 1QQ, the apparatus reports medicine, dosage and method of administration: Epinephrine 1 mg IV or Vasopressin 40 IV units. Clock C is adjusted for 3 minutes. The apparatus can be made to indicate that the sun's Vasopressin is given once. Therefore, if n is given together, it is not an option in the next step. However, if they are not given in this step, it can be offered as an option once again. Alternatively, in step 42 (a), without IV access, but with confirmed airway device, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS or 40 units of Vasopressin ET in 5 ml of water or NS . The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then set for 3 minutes. In step 43 (PEA) as shown in Figure 1RR, once the B clock reaches 2 minutes, the device communicates: "Stop CPR / Check rhythm". Based on the rhythm, four options are offered for user acceptance; VT / VF (go to step 20 (b)), Asistole (go to step
19 (b)), PEA (continue later) and Return Pulse (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic rate begins at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. The device communicates: "Is the heart rate less than 60?" If the user selects yes, the method continues to step 44. If the user selects no, the method continues to step 45. In step 44 (with IV access) (PEA) as shown in Figure 1SS, the apparatus communicates medicine, dosage and method of administration: Epinephrine 1 mg IV. Alternatively, in step 44 (a), without IV access, but with confirmed airway device, the device will communicate: Atropine 1 mg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". The E Clock is then set for 3 minutes. It is internally marked by the device that this is the first of four total doses of Atropine that can occur. This fact can also be communicated to the respondent as a reminder. In step 45 (reversible causes) as shown in Figure ITT, the device communicates: "Have you considered the following reversible causes?". The following indications are reported: Hypovolemia, Drug Overdose, Hypoxia, Heart Plug, Acidosis, Pneumothorax Tension,
Hyperkalemia, pulmonary embolism, Hypokalemia, Coronary Thrombosis, Hypothermia. Then the user is given the option to save the list for additional reference or hide the list. The device may include an announcement button or to display this list on the screen at the time it is necessary for a user who refers back to it to have easy access to it. In step 46 (PEA) as shown in Figure 1UU, clock B reaches 2 minutes and the device communicates: "Stop CPR / Review rhythm". Four options are then presented: VT / CF (continue to step 20 (b)), Asistole (go to step 18 (b)), PEA (continue later) and Return Pulse (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". Start the metronomic cadence at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 47 (with IV access) (PEA) as seen in Figure 1VV, the device communicates medicine, dosage and method of administration: Epinephrine 1 mg IV. Clock C is adjusted for 3 minutes. Alternatively, in step 47 (a), without IV access, but with a confirmed airway device, the device will communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. At this point, a termination sequence remains on the video screen until step 54.
In step 48 (PEA) as shown in Figure 1WW, the device communicates: "Stop CPR / Check rhythm". Then four options are presented: VT / VF (continue in step 20 (b)), Asistole (go to step 19 (b)), PEA (continue later) and Return pulse (go to step 55). Start the metronomic cadence at 100 beats per minute. Clock B adjusts 2 minutes and restarts. The device communicates: "Is the heart rate less than 60?" If the user selects yes, the method continues to step 44. If the user selects no, the method continues to step 45. In step 49 (with IV access) (PEA) as shown in Figure 1XX, the apparatus communicates medicine, dosage and method of administration: Atropine 1 mg IV. Alternatively, in step 49 (a), without IV access, but with confirmed airway device, the device will communicate: Atropine 1 mg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". The E Clock is then set for 3 minutes. It is internally marked by the device that this is the first of four total doses of Atropine that can occur. This fact can also be communicated to the respondent as a reminder. In step 50 (PEA) as shown in Figure 1YY, clock B reaches 2 minutes and the device communicates: "Stop CPR / Check rhythm". Then four options are presented: VT / VF (continue in step 20 (b)), Asistole (go to
step 18 (b)), PEA (continue later) and Return Pulse (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In step 51 (with IV access) (PEA) as seen in Figure 1ZZ, the apparatus communicates medicine, dosage and method of administration: Epinephrine 1 mg IV. Clock C is adjusted for 3 minutes. Alternatively, in step 51 (a), without IV access, but with a confirmed airway device, the device will communicate: Epinephrine 2.5 mg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is adjusted for 3 minutes. In step 52 (PEA) as seen in the Figure
1AAA, clock B reaches 2 minutes and the device communicates: "Stop CPF / Check rhythm". Then four options are presented: VT / VF (continue to step 20 (b)), Asistole (go to step 19 (b)), PEA (continue later) and Pulse Return (go to step 55). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic rate begins at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. The device communicates: "Is the heart rate less than 60?" If the user selects yes, the method
continue to step 53. If the user selects no, the method continues to step 54. In step 53 (with access IV), (PEA) as shown in Figure 1BBB, the apparatus communicates medicine, dosage and method of administration: Atropine 1 mg IV. Alternatively in step 53 (a), without IV access, but with confirmed airway device, the device will communicate: Atropine 2 mg ET in 5 ml of water or NS. The device will communicate: "Stop CPR and give five assisted ventilations". The Clock E is then adjusted for 3 minutes. It is internally marked by the device that is the second of four total doses of Atropine that can be given. This fact can also be communicated to the respondent as a reminder. At this point, a termination sequence remains on the video screen of step 54. Steps 50 and 51 are linked until the respondent declares the code or invokes the termination portion of the method. At this point, no more drugs are administered or more actions taken. In step 54 as seen in Figure 1CCC, the termination sequence is invoked. The device communicates: "Are you sure you want to terminate the ACLS activities?" If so, - then the device communicates: "Are you sure you want to terminate ACLS activities?" If not, continue the cycle. , an option is given to the user to print a summary of events over time of drugs that are given in
relation to external clocks and the internal clock of elapsed time. In one aspect of the invention, a sheet of paper having an adhesive backing can be inserted into the apparatus, printed and then removed from the apparatus. In step 55 (Present Pulse) as shown in Figure 1DDD, the device communicates: "Check blood pressure and heart rate". Then three options are presented: Is the heart rate less than 60? (go to step 56); Is the heart rate 60 to 120? (go to step 68) Is the heart rate greater than 120? Go to step 61). In step 56 (Bradycardia) as seen in Figure IEEE, the device communicates: "Is the patient symptomatic or unstable?" Two options for selection are presented. If it is not, then continue later. If yes, go (to step 58). The device communicates: "Obtain 12 EKG probes". Then two options for selection are presented. AV Block Type II or III? If it is not, then continue later. If yes, go to step 57. The device communicates: "Place transcutaneous pads on patient, monitor and observe", and "Give Oxygen". Then an option is presented: If patients become unstable or symptomatic press here. If the action is selected, the method goes to step 58. In step 57 (Bradycardia) as seen in Figure 1FFF, the device communicates "Place pads of
transcutaneous gait, monitor and observe ", and" Give oxygen "and" prepare transvenous gait. "The person responding can be reminded and indicated: If symptoms develop, use transcutaneous gait until a transvenous gait is placed and the Immediate consultation with an Expert In step 58, (Bradycardia) as shown in Figure 1GGG, the device communicates medicine, dosage and method of administration: Atropine 0.5 mg V. The clock E is adjusted for 3 minutes. : "Place transcutaneous gait pads on patient" and "Give oxygen" and "If heart rate remains low consider:" and the following are displayed on the video screen: Atropine 0.5 mg every 3-5 minutes up to six doses; infusion of Epinephrine from 2 to 10 mcg / min, Infusion of Dopamine 2 to 10 mg / kg / min, and Find underlying causes In step 59 (Bradycardia) as shown in Figure 1HHH, the device communicates: "The frequency is less than 60? "or is the patient s symptomatic or unstable? " Two options for selection are presented. If not, continue later. If yes, select (go to step 60). The device then indicates: If the patient is very stable with no sign or serious symptom, monitor and observe. In step 60 (Bradycardia) as seen in Figure lili, the device communicates "Use transcutaneous gait". The device communicates medicine, dosage and method of
administration: Atropine 0.5 mg IV. The E clock is adjusted for 3 minutes. The device communicates: "If the heart rate remains low consider": and the following is displayed on the video screen: Immediate Consultation to the Expert; Atropine 0.5 mg every 3-5 minutes up to six doses; Infusion of epinephrine from 2 to 10 mcg / min; Infusion of dopamine from 2 to 10 mcg / kg / min; and Find underlying causes. In step 61 (Bradycardia / unstable) as shown in Figure 1JJJ, the device communicates: "Is the patient stable?" Two options for selection are presented. (Unstable (continue later) and stable (go to step 63) The device communicates: "immediate synchronized cardioversion 100 joules." The device communicates: "Is the patient stable?" If it is unstable, continue later. select stable, go to step 63. The device communicates: "Immediate synchronized cardioversion 200 joules2." In step 62 (Bradycardia / unstable) as shown in Figure 1KKK, the device communicates: "Is the patient stable?" two options for selection Unstable (continue further9 and stable (go to step 63) The device communicates: "immediate synchronized cardioversion 300 joules." The device communicates: Is the patient stable? "If it is unstable, continue later. If unstable is selected, go to step 63. The device communicates:
"Immediate synchronized cardioversion 360 joules". The method then goes to step 55. In step 63 (Tachycardia / stable) as seen in Figure 1LLL, the device communicates: "Give oxygen" and "Establish IV access" and "Immediate Expert Consultation" and "Obtain 12 EKG probes ". Four selection options are presented: narrow QRS (< 0.12 sec) (continue immediately); Wide QRS (> 0.12 sec) (go to step 66); Regular Rhythm (go to step 64) and irregular rhythm (go to step 65). In step 64 (Tachycardia / stable / narrow / regular) as shown in Figure 1MMM, the device communicates: "Consider treatment for SVT" and the following reminders are provided: Consultation with Expert; Bagas maneuvers; Rapid drive of adenosine IV; Monitor; oxygen. The apparatus then proceeds to step 70. In step 65 (Tachycardia / stable / narrow / regular) as seen in Figure 1NNN, the apparatus communicates: "Consider treatment for A-fib / agitation" and the following reminders are provided: Consult the Expert; Consider frequency control with Diltiazem IV; Monitor; oxygen. The apparatus then proceeds to step 70. In step 66 (Tachycardia / stable / narrow / regular) as seen in Figure 1000, the apparatus provides two portions: Regular Rhythm (continue below) and rhythm
Irregular (go to step 67). The device then communicates: "Consider Stable Ventricular Tachycardia" and the following reminders are provided: Amiodarone 150 mg IV for 10 minutes; Prepare for synchronized cardioversion if the patient becomes unstable; Expert consultation; Monitor; Oxygen. The apparatus then proceeds to step 70. In step 67 (Tachycardia / stable / wide / irregular) as seen in Figure 1PPP, the apparatus provides the following reminders: Expert Consultation; You can consider Amiodarone 150 mg IV for 10 minutes. You can consider magnesium 2 gm for 10 minutes for Torsades; Prepare for synchronized cardioversion if the patient becomes unstable; Monitor, Oxygen. The apparatus then proceeds to step 70. In step 68 (normal heart rate) as seen in Figure 1QQQ, the apparatus communicates: "Give Oxygen" and "Establish IV access". The device provides the following reminders: Immediate Consultation to Experts; Obtain 12 EKG probes; and Monitor vital signs and symptoms. The apparatus then proceeds to step 70. In step 70 (after resuscitation), the apparatus provides the following reminders: Expert Consultation; Oxygen; monitor vital signs and symptoms; Review posts D; Obtain 12 EKG probes; Send appropriate labels; Consider infusions of vasoactive medications.
The steps taken by the device if the patient selection is a child, are similar to those taken if the selected patient is an adult, such modifications are necessary due to the philological differences between adults and children. These modifications are the following. In pediatric step 1, the external clock A starts. The device communicates: "Check pulse" and "Connect monitor and defibrillator". If there is a pulse, go to pediatric step 31. If there is no pulse present, "Start CPR at 100 compressions per minute." Then start the metrometric rate at 100 / min. The device communicates: "Check rhythm". Two choices are offered: VT / VF (go to pediatric step 2), Asistole / PEA Algorithm (go to pediatric step 18). In the pediatric step (VT / VF), the device communicates:
"Defibrillate at 2 joules per kilogram" and "Clear all" (three times) and "Continue CPR at 100 compressions per minute". Then the metronomic cadence starts at 100 / min. Clock B is set for 2 minutes and then indicated. The device then communicates: "Was IV or 10 access established?" If the user answers yes, then starts step 3. If not, then the question is asked every 3 minutes until the answer is yes. The device then communicates: "Is the airway device placed and confirmed?" If not, the question can be asked every 5 minutes until an answer is obtained
affirmative. In addition, an indication may remain on the touch screen until IV and / or an airway is established. In pediatric step 3 (VT / VF) the B clock reaches 2 minutes and the device communicates: "Stop CPR / Check rhythm". Three options are present: VT / VF (continue later), Asistole (go to pediatric step 18), Organized Rhythm (go to pediatric step 28 (b)). If the first option is chosen, the device communicates: "Defibrillate in 4 joules per kilogram" and "Clear all" (three times) and "Continue CPR at 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. At this point, if IV / IO is established, the device continues at pediatric step 4. If IV / IO is not established, the device continues the indication until it is established. While, if the respondent indicates that IV / IO are not established, but the oral airways are in place, the device begins pediatric step 5 (a). If an oral airway is not in place, the device continues the indication until an airway is in place. The device may indicate that if no device is established, no medication is given. In pediatric step 4 (with IV or 10 access) (VT / VF) the device communicates medicine, dosage and method of administration: Epinephrine 0.01 mg (VI / 10 (1: 10,000, 0.1 ml / kg). it adjusts for 3 minutes.
Alternatively, in pediatric step 4 (a), without IV / 10 access, but with confirmed airway device, the device will communicate: Epinephrine 0.1 mg / kg ET in 5 ml NS (1: 10,000, 0.1 ml / kg). The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then set for 3 minutes. In pediatric step 5 (VT / VF) the device communicates: "Continue CPR at 100 compressions per minute" and the device will provide a metronomic cadence at 100 beats per minute. Once the B clock reaches 2 minutes, the device communicates: "Stop CPR / Check rhythm". Three options are then presented: VT / VF (continue later), Asistole (go to pediatric step 18), Organized Rhythm (go to pediatric step 28 (b)). If the first option is chosen, the device communicates: "Defibrillate at 4 joules per kilogram" and "Clear all" (three times) and "Continue CPR at 100 compressions per minute". The metronomic rate begins at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In pediatric step 6 (with IV / 10 access)
(VT / VF) the apparatus communicates medicine, dosage and method of administration: Amiodarone 5 mg / kg IV / 10 or Lidocaine 1 mg / kg IV / IO. The D clock is adjusted for 3 minutes. Alternatively, in pediatric passage 6 (a), without IV / 10 access, but with confirmed airway device, the
device will communicate: Lidocaine 2-3 mg / kg ET in 5 ml of water or NS. The device then communicates: "Stop CPR and give five assisted ventilations". Clock D is then set for 3 minutes. The device can observe that Amiodarone can not be given through an airway device, therefore it is not provided as an option. Once it is indicated that IV is established, the device will no longer communicate a need to perform pediatric step 4 (a) or 6 (a) during the rest of the protocols. In Pediatric Step 7, (VT / VF) Clock B leads to
2 minutes and the device communicates: "Stop CPR / Review Rhythm". Then there are three options: VT / VFR (continue later), Asistole (go to pediatric step 18), Organized Rhythm (go to pediatric step 28 (b)). If the first option is chosen, the device communicates: "Desfribrilar a 4 joules per kilogram" and "Despejar Todo" (three times) and "Continue CPR at 100 compressions per minute". The metronomic cadence begins at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In pediatric step 8 (with IV / 10 access)
(VT / VF) the device communicates medicine, dosage and method of administration: Epinephrine 0.01 mg UV / 10 (1: 10,000, 0.1 ml / kg). Clock C is adjusted for 3 minutes. Alternatively, in pediatric passage 8 (a), without IV / 10 access, but with the airway device confirmed, the
Apparatus will communicate: Epinephrine 0.1 mg / kg ET in 5 ml NS (1:10, 000, 0.1 ml / kg). The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. In the pediatric step 9 (VT / VF) the Clock B reaches
2 minutes and the device communicates: "Stop CPR / Check rhythm". Three options are then presented: VT / V (continue later), Asistole (go to pediatric step 18), Organized Rhythm (go to pediatric step 28 (b)). If the first option is chosen, the device communicates: "Defibrillate at 4 joules per kilogram" and "Clear all" (three times) and "Continue CPR at 100 compressions per minute". The metronomic rate begins at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In pediatric step 10 (with IV / 10 access)
(VT / VF) the device communicates medicine, dosage and method of administration: Lidocaine 1 mg / kg IV. The D clock is adjusted for 3 minutes. Alternatively, in pediatric passage 10 (a), without IV / 10 access, but with the airway device confirmed, the device will communicate: Lidocaine 2-3 mg / kg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five assisted ventilations". Clock D is then adjusted for 3 minutes. The device will then communicate "Check Bar D".
In pediatric step 11 (VT / VF) the B clock takes 2 minutes and the device communicates: "Stop CPR / Check rhythm". Three options are presented: VT / VT (continue later), Asistole (go to pediatric step 18), Organized Rhythm (go to pediatric step 28 (b)). If the first option is chosen, the device communicates: "Defibrillate to 4 joules per kilogram" and "Clear all" (three times) and "Continue CPR to 100 compressions per minute". Start the metronomic cadence at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In pediatric step 12 (with access IV / 10) (VT / VF) the device communicates medicine, dosage and method of administration: Epinephrine 0.01 mg IV / IO (1: 10,000, 0.1 ml / kg). Clock C adjusts to 3 minutes. Alternatively, in pediatric step 12 (a), without IV / 10 access, but with confirmed airway device, the device will communicate: Epinephrine 0.1 mg / kg ET in 5 ml of NS (1: 1, 000; 0.1 ml / kg). The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. In the pediatric step 13 (VT / VF) the Clock B arrives at 2 minutes and the device communicates: "Stop CPR / Review Rhythm". Three options are presented: VT / VF (continue later), Asistole (go to pediatric step 18), Organized Rhythm (go to pediatric step 28 (c)). If you choose thefirst option, the device communicates: "Defibrillate to 4 joules per kilogram" and "Clear all" (three times) and "Continue CPR to 100 compressions per minute". The metronomic rate begins at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In pediatric step 14 (VT / VF) the device communicates: "Has the patient received the maximum dose of 100 mg of Lidocaine?" If the answer is no, then the device communicates, in pediatric step 14 (a): Lidocaine mg / kg IV / IO and the clock no longer adjusts. Alternatively, the apparatus continues to pediatric passage 14 (b). If the answer is yes, then the device continues to pediatric passage 15. in pediatric passage 14 (b), without access to IV, but with the airway device confirmed, the device communicates: Lidocaine 2-3 mg / kg ET in 5 ml of water or NS. The device will then communicate: "Stop CPR and give five ventilations". The clock no longer fits. In pediatric step 15 the device communicates: "Have you considered the following reversible causes?". The following indications are reported: Hypovolemia, Drug overdose, Hypoxia, Heart plug, Acidosis, Pneumothorax tension, Hyperkalemia, pulmonary embolism, Hypokalemia, Coronary thrombosis, Hypothermia. Then the user is given the option to save the list for additional reference or hide the list. The device may include a button
announcements or to show this list on the screen at the moment that is necessary so that a user that refers back to it has an easy access to it. In pediatric step 16 (VT / VF) Clock B reaches 2 minutes and the device communicates: "Stop CPR / Check rhythm". Three options are presented: VT / VF continue later), Asistole (go to pediatric step 18), Organized Rhythm (go to pediatric step 28 (c)). If the first option is chosen, the device communicates. "Defibrillate to 4 joules per kilogram". The metronomic cadence begins at 100 beats per minute. Clock B adjusts to 2minutes and restarts. In pediatric step 17 (with access to IV / IO) (VT / VF) the device communicates medicine, dosage and method of administration: Epinephrine 0.01 mg IV / 10 (1: 10,999, 0.1 ml / kg). Clock C is adjusted for 3 minutes. Alternatively, in pediatric passage 17 (a), without IV / 10 access, but with a confirmed airway device, the paratop will communicate: Epinephrine 0.1 mg / kg ET in 5 ml NS (1: 1,000, 0.1 ml / kg) ). The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. At this point in the method, the device performs a nested cycle of pediatric steps 16 and 17. There are no new medications until the equipment is ready to "declare the code" and pronounce the death of the patient.
At this point, the termination sequence remains on screen until pediatric step 54. At pediatric step 18 (Asistole / PEA) the device communicates: "Start CPR at 100 compressions per minute". Clock B is then adjusted for 2 minutes and starts. The device then indicates: "Was access established IV / 10?" According to pediatric step 3. If not, the indication continues and is asked again every five minutes until an affirmative response is provided. Meanwhile, the device communicates: "Is the airway device in place and confirmed?" Continue the indication and ask again every five minutes until an affirmative answer is provided. The indication could remain on the touch screen until an IV / IO and / or airway is established. In pediatric step 19 (with access IV / 10)
(Asistole / POEA) the device communicates medicine, dosage and method of administration: Epinephrine 0.01 mg IV / 10 (1: 10,000, 0.1 ml / kg). Clock C is adjusted for 3 minutes. Alternatively, in pediatric step 19 (a), if the access is IV / 10, but with a confirmed airway device, the device will communicate: Epinephrine 0.1 mg / kg ET of 5 ml NS (1: 1,000; 0.1 1 / kg ). The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes.
In the pediatric step 20 (Asistole / PEA) the Clock B reaches 2 minutes and the device communicates: "Stop CPR / Review Rhythm". Three options are then presented: VT / VF (go to pediatric step 2), Asistole (continue later), Organized Rhythm (go to pediatric step 28 (b)). The device communicates: "Continue CPR at 1000 compressions per minute". The metronomic cadence begins at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In pediatric step 21 (with IV / 10 access) (Asistole / PEA) the device communicates medicine, dosage and method of administration: Epinephrine 0.01 mg (IV / 10 (1: 10,000, 0.1 ml / kg), Clock C is adjusts for 3 minutes.Alternatively, in pediatric step 21 (a), without access to IV / IO, but with confirmed airway devices, the device will communicate: Epinephrine 0.1 mg / kg ET in 5 mi NS (1: 1,000 0.1 mL / kg) The device will then communicate: "Stop CPR and give five assisted ventilations." EIReloj C then adjusts for 3 minutes At pediatric step 22 (Asistole / PEA) the device communicates: "Have you considered the following reversible causes? "The following indications are reported below: Hypovolemia, Drug overdose, Hypoxia, Heart plug, Acidosis, Pneumothorax tension, Hyperkalemia, Pulmonary embolism, Hypokalemia, Coronary thrombosis, Hypothermia Then the user is given the option to save the list for
Additional reference or hide the list. The device may include an announcement button or to display this list on the screen at the time it is necessary for a user who refers back to it to have easy access to it. In pediatric step 23 (Asistole / PEA) Clock B reaches 2 minutes' and the device communicates: "Stop CPR / Check rhythm". Three options are then presented: VT / VF (go to pediatric step 29, Asistole (continue later), Organized Rhythm (go to pediatric step 28 (b)) The device communicates: "Continue CPr to 100 compressions per minute". The metronomic cadence starts at 100 beats per minute, Clock B is adjusted to 2 minutes and restarted In pediatric step 24 (with IV / 10 access) (Asistole / PEA) the device communicates medicine, dosage and method of administration: Epinephrine 0.01 mg IV / IO (1: 10,000, 0.1 ml / kg) Clock C is adjusted for 3 minutes, alternatively, in pediatric step 2 (a), without access to IV / 10, but with the path device confirmed, the device will communicate: Epinephrine 0.1 mg / kg ET in 5 ml NS (1: 1, 000, 0.1 ml / kg) The device will then communicate: "Stop CPR and give five assisted ventilations." Clock C will then adjusts for 3 minutes At pediatric step 25 (Asistole / PEA) the device communicates: "Stop CPR / Review Rate." These op tions
they are presented later: VT / VF (go to pediatric step 2), Asistole (continue later), Organized Rite (go to pediatric step 28 (c)). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic rate begins at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In pediatric step 26 (Asistole / PEA) the device communicates: "Stop CPR / Check rhythm". Three options are presented: VT / VF (go to pediatric step 2), Asistole (continue later), Organized Rhythm (go to pediatric step 28 (c)). The device communicates: "Continue CPR at 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In the pediatric step 26 (Asistole / PEA) the device communicates: "Have you considered the following reversible causes?". The following indications are reported: Hypovolemia, Drug Overdose, Hypoxia, Cardiac Heel, Acidosis, Neomothorax Tension, Hyperkalemia, Pulmonary Embolism, Hypokalemia, Coronary Thrombosis, Hypothermia. Then the option is given to the user to save the list for later reference or hide the list. In the pediatric step 27 (Asistole / PEA) the device communicates medicine, dosage and method of administration: Epinephrine 0.01 mg IV / 10 (1: 10,000, 0.1 ml / kg). The Clock C
it adjusts for 3 minutes. Alternatively, in pediatric passage 26 (a), without IV / 10 access, but with the airway device confirmed, the device will communicate: Epinephrine 0.1 mg / kg ET in 5 ml NS (1: 1,000, 0.1 ml / kg). The device will then communicate: "Stop CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. At this point in the method, the apparatus performs a nested cycle of pediatric steps 25 to 27. Pediatric step 28 (c) creates the cycle. Then there are no new medications until the team is ready to "declare the code" and pronounce the death of the patient. At this point, the termination sequence is established on the screen until pediatric passage 54. Pediatric passage 28 (a) - (c) comprises pediatric passage 28 (Organized Rhythm). In the pediatric step 28 (a), the "Check Pulse" common device. If the pulse is present, then the device goes to pediatric step 29. If there is no pulse, the device goes to pediatric step 21. In pediatric step 28 (b), the device communicates "Check pulse". If a pulse is present, then the device goes to pediatric passage 29. If there is no pulse, the device goes to pediatric passage 24. In pediatric step 28 (c), the device communicates "Check Pulse". If the pulse is present, then the device goes to the pediatric step 29. If there is no pulse, the device goes to the pediatric step 27.
In pediatric step 29 (care after resuscitation / decompensation), the device communicates: "Check vital signs" and Consider a fluid bolus "(10-. {20 ml / kg of NS or Rl.) The device then indicates Hypotensive or decompensated (continue below) or normotensive or compensated (go to pediatric step 30.) The device then indicates: consider boluses of additional fluid; Consider: oxygen, Laboratory tests, CXR, pain control, NG tube, safe IV lines, pulse oximetry and monitoring, Epinephrine drip from 0.1 to 1 mcg / kg / min, and / or Dopamine drip from 2 to 20 mcg / kg / min, and / or Norepinephrine drip from 0.1 to 2 mcg / kg // min At pediatric step 30 (care after resuscitation / compensated), the device indicates: Consider additional fluid boluses, Consider: Oxygen, Laboratory tests, CXR, pain control, NG tube, safe IV lines, pulse oximetry and monitoring, Dobutamine drip from 2 to 20 mcg / kg / ml n; and / or drip of Dopamine 2 at 20 mcg / kg / min and / or drip of Epinephrine 0.05 to 0.3 mcg / kg / min and / or drip of Milrinone: Load with 50 to 75 mcg / kg. Infusion at 0.5 to 0.75 meg / kg / min. In pediatric step 31 (Pulse Present), the device communicates: "Check vital signs" and "Give Oxygen" and "Is IV or 10 access established?" (see pediatric step 3). If the answer is no, the question is asked again each
three inu7tos, or left on the display screen until it is affirmative. In pediatric step 32 (Pulse Present), three options are presented: Bradycardia (going to pediatric step 33), Normal Frequency (continued later) and Tachycardia
(go to the pediatric step). The device communicates: "Does the heart rate cause cardiopulmonary compromise?" If yes, continue to the pediatric step 33. If not, the device communicates: "Monitor and observe". In pediatric step 33 (Pulse Present / bradycardia), the device communicates: "Is the heart rate less than 60 or is the patient unstable?" If yes, the device goes to pediatric step 34. If it is not, the device communicates: "Monitor, ventilate and observe". In pediatric step 34, the apparatus communicates:
"Is there poor perfusion despite proper ventilation?" if yes, go to the pediatric step34 (a), otherwise, the device communicates: "Monitor, ventilate or observe". In pediatric step 34 (a) (unstable bradycardia) the device communicates: "Continue CPR at 100 compressions per minute". The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and restarts. In pediatric step 35 (with IV / 10 access) (unstable Bradycardia) the apparatus communicates medicine, dosage and method of administration: Epinephrine 0.01 mg (V / 10)
(1: 10,000, 0.1 ml / kg). Clock C is adjusted for 3 minutes. Alternatively, in pediatric passage 35 (a), without access to IV / 10; but with a confirmed airway device, the device communicates: Epinephrine 0.1 mg / kg ET in 5 ml NS (1: 1,000, 0.1 ml / kg). The device then communicates: "De4tner CPR and give five assisted ventilations". Clock C is then adjusted for 3 minutes. The device communicates: "Check Bar D". In pediatric step 36 (Unstable Bradycardia) the device communicates: "Have you considered the following causes reversible?" The following indications are reported: Hypovolemia, Drug overdose, Hypoxia, Heart plug, Acidosis, Pneumothorax tension, Hyperkalemia, pulmonary embolism, Hypokalemia, Coronary thrombosis, Hypothermia. Then the user is given the option to save the list for additional reference or hide the list. The device may include an announcement button or to display this list on the screen at the time it is necessary for a user who refers back to it to have easy access to it. In pediatric step 37 (Unstable Bradycardia) Clock B reaches 2 minutes and the device communicates: "Stop CPR / Check rhythm". Three options are present: VT / VF (go to pediatric step 2), Asistole (go to pediatric step 18), Organized Rhythm (go to pediatric step 28 (b)). The device
communicates: "Continue CPR at 100 compressions per minute." The metronomic cadence starts at 100 beats per minute. Clock B adjusts to 2 minutes and reindicates. In pediatric step 38 (Unstable Bradycardia) the device communicates medicine, dosage and method of administration: Epinephrine 0.01 mg (IV / 10 (1: 10,000, 0.1 ml / kg), Clock C is adjusted for 3 minutes. pediatric passage 38 (a), without access to IV / 10, but with the airway device confirmed, the device communicates: Epinephrine 0.1 mg / kg ET in 5 ml NS (1: 1,000, 0.1 ml / kg). The device will then communicate: "Stop CPR and give five assisted ventilations." Clock C is then adjusted for 3 minutes In pediatric step 39 (Tachycardia), the device communicates: "The heart rate that causes cardiopulmonary compromise or poor profusion? "If yes, go to pediatric step 43. If not, the device indicates: The QRS duration greater than 0.08 seconds? If yes, go to pediatric step 40. If it is not, then the device communicates:" Do you have history compatible with sinus tachycardia or P waves present? Yes, yes, go to pediatric step 42. If not, go to pediatric step 41. In pediatric step 40, (complex wide / stable tachycardia), the device communicates: "Possible ventricular tachycardia" and provides the following indications:
Consult the pediatric cardiologist. Consider: Support ABS with oxygen, IV line, pulse oximeter, monitor and connect defibrillator pads; Amiodarone 5 mg / kg IV over 20 to 60 minutes or Procainamide 15 mg / kg IV over 3 to 60 minutes or Lidocaine 1 mg / kg IV bolus. If the patient gives unstable shock from 0.5 to 1 joule / kg. It can increase to 2 joules / kg if the initial shock is ineffective. In pediatric step 41 (narrow / stable complex tachycardia), the device communicates: "Possible SVT". The device indicates: consult the pediatric cardiologist, Consider Vago maneuvers; Adenosine 0.1 mg / kg rapid bolus IV (the maximum dose of 6 mg); You can double and repeat the dose once (2nd dose maximum 12 mg); Supports ABC with oxygen, line IV, pulse oximeter, monitor and use defibrillator pads. In pediatric step 42 (narrow / stable complex tachycardia), the device communicates: "Probable sinusoidal tachycardia". The device indicates: Consult a pediatric cardiologist. Consider: ABC support with oxygen, line IV, pulse oximeter, monitor and defibrillate pads, You can try fluid bolus; investigate etiologies. In pediatric step 43 (narrow / unstable complex tachycardia) the device indicates: Is the QRS duration greater than 0.08 seconds? If it is not, then the device communicates: "Is the history compatible with
sinus tachycardia or P waves? "If not, go to pediatric step 44. If yes, the device communicates:" Probable sinusoidal tachycardia. "The device indicates: consult the pediatric cardiologist Consider: Supports ABC with oxygen, line IV , pulse oximeter, monitor and connect the defibrillator pads, you can try the fluid bolus, Investigate ethologies In pediatric step 44 (Complex narrow / unstable tachycardia), the device communicates: "Possible SVT." The device indicates: Consult to the Pediatric Cardiologist Consider sedating and the device then communicates: "Cardiovert of 0.5 to 1 Joule / kg." The device indicates: it can increase to 2 joules / kg if the incivil crash is ineffective Consider the maneuvers of the Vago; Adenosine 0.1 mg / kg of rapid bolus IV (the maximum dose of 6 mg); Can double and repeat a dose (2nd dose maximum 12 mg); Support ABC with oxygen, line IV, pulse oximeter, monitor and defibrillator pads. pediatric step co 45 (Complex wide / unstable tachycardia), the device communicates: "Possible ventricular tachycardia" The device indicates: Consider sedating then in communicating device: "Cardiovert of 0.5 to 1 Joule / kg". The device communicates: it can increase to 2 joules / kg if the initial shock is ineffective. Consider Amiodorone 5 mg / kg IV for 20 to 60 minutes, or Procainamide 15 mg / kg
IV for 30 to 60 minutes or Lidocaine 1 mg / kg IV bolus. Consult the pediatric cardiologist. Consider: Support ABC with oxygen, line IV, pulse oximeter, monitor. In pediatric step 54, the determination sequence is invoked. The device communicates: "Are you sure you want to terminate the ACLS activities?" If so, then the device communicates: "Are you sure you want to terminate ACLS activities?" If not, continue the cycle. an option is given to the user to print a summary of events over time of drugs that are given in relation to the external clocks and the internal clock of the elapsed time In one aspect of the invention, a sheet of paper having a reinforcement of adhesive can be inserted into the apparatus, printed and then removed from the apparatus.The apparatus should be adapted to provide audible and visual commands, indications, and reminders, in a variety of languages.An embodiment of the present invention includes a touch-sensitive screen that provides navigation and selection on the screen, graphics input elements, input buttons that provide program path / option selection, internal stopwatch that provides directions to the user and selection of e program path. In addition, one embodiment of the apparatus of the present invention is adapted to give audio commands using speakers or other sound transducers. The watches that are presented to whom
Responses may include illuminated segmented screens that provide numerical time representation (digital clock) adapted to count down, count up, and control the time for user actions within the program. The process of several commands within the CPU of the computer hardware includes common computer operations. Subsequent actions within the program perform time control, indications and / or subsequent input functions. Subsequent indications are displayed on the graphic display and announced via the audio output. The time control operations (countdown, count up, time elapsed and absolute time) are performed by the program and exit via the segmented screen. The user's subsequent entry for route selection, user recognition indicated within the program is achieved via the input buttons and I or touch screen. The application software in which a method of the present invention is modalized is adapted to be stored within a computer hardware memory device, including a hard disk, RAM memory, or standard medium, such as memory cards, devices of instant memory, magnetic disks, optical discs, or other commonly used storage media. Program updates, including updates to
ACLS algorithms, can be performed on writing obsolete code with new program files and / or program data in the memory medium. The shape factor accommodating a modality of the present invention may include a rectangular cube housing, having front perforations with a speaker mounted inside the housing behind the perforations and opening to receive a touch-sensitive graphic display, the buttons that They protrude from the top near the front and the segmented screen protrudes from the top, which looks at the front, near the back. The modalities shown and described above are only illustrative. Although numerous features and advantages of the preferred embodiment of the present invention have been exhibited in the foregoing description along with details of the invention, the description is illustrative only by the general broad meaning of the terms used in the appended claims.
Claims (20)
1. - An apparatus to be used for the purpose of preparing the Advanced Cardiac Life Support (SVCA) procedures, comprising: at least one point means to obtain user information; at least one input means for obtaining user responses for indication of information; at least a half of time to obtain the time information based on the elapsed time of the SVCA or events that occur during the SVCA process; operable logical means for accepting user information and time information and determining and taking a decision path selection based thereon; and at least one output means for communication instructions to guide users through the proper procedures to be applied to a patient during cardiac arrest based on the output of the logical means.
2. - The apparatus of claim 1, wherein at least one time means and logical means are implemented using a computer hardware having an operating system and application software, the computer hardware further comprising a supply of power, a input means, data conveyor, a central processing unit, a memory unit, output means.
3. The apparatus of claim 2, wherein the computer hardware is located in a remote unit to be installed in the collision car.
4. - The apparatus of claim 2, wherein the hardware has been one of those selected from a group consisting of the main unit, personal computer (PC), terminal, "Tablet" PC, portable PC and a personal digital assistant (PDA).
5. - The apparatus of claim 2, wherein the input means consist of one of those selected from a group consisting of keyboard, mouse, touch pad, tracking ball and touch screen device; and the output means consist of a selected one of a group consisting of a speaker, buzzer, illuminator indicator, video device and printer.
6. - The apparatus of claim 1, further comprising: the logical means including a computerized decision tree program adapted to be executed in the computer hardware; a search table within a computerized memory medium adapted to the storage information to be transported to an output means based on the input of the input means and time information; memory means adapted to store digital video representations and audio commands and indication data; a digital-to-analog converter and speech synthesizer adapted to convert digital audio data to analog signals; and output means comprising a sound transducer for outputting analog voice signals that guide the responder through the proper procedures to be applied to a patient during a cardiac arrest.
7. - The apparatus of claim 6, wherein the analog voice signals are in one of the selected group of the following languages consisting of English, Spanish, German, Chinese, Japanese, Russian, Portuguese, Korean, Vietnamese, Swedish, Norwegian and Finnish.
8. - The apparatus of claim 6, wherein the software is adapted to receive software updates.
9. - The apparatus of claim 6, adapted to instruct responders such as the types and doses of drugs to administer and sequence of preparing actions (such as cardiac pulmonary resuscitation (CPR)) in a patient.
10. - The apparatus of claim 9, further comprising an external clock adapted to retain the time elapsed since the start of the ACSC procedure to terminate the ACSC process; a B CPR clock, adapted to route an individual CPR session; a C vasopressor watch, adapted to route time or Epinephrine or Amiodarone; an E-clock of Atropine, adapted to route the time of Atrophin and; an air route clock IV.
11. - The apparatus of claim 1, in combination with an Automatic External Defibrillator (AED).
12. - The apparatus of claim 1, adapted to be configured to communicate a first set of instructions if the patient is an adult and a second set of instructions if the patient is a child.
13. - The apparatus of claim 1, adapted to give type of medicine and dosage instructions that reference the medicines as they are contained in the coding package maintained with the apparatus.
14. - The apparatus of claim 1, adapted to take, via a video device or printer, a list of actions taken during the process, correlated to the current time as the events occurred.
15. - A system to provide real-time instructions on the use of equipment and procedures to be followed in patient resuscitation, the system comprises: a means of entry and means of departure to provide a provision of related entries to program the route and choice of option; at least one time meter that provides user directions and program path selection; an output arrangement, including: voice prompts for user actions and tuning; graphic display of user information; digital time screen; a logical unit adapted to operate on chronometer information and inputs to manage and indicate users during the resuscitation of a patient's experimental cardiac pain.
16. - The apparatus of claim 14, wherein the input / output means comprises a touch-sensitive screen.
17. - The apparatus of claim 14, wherein the system comprises computer hardware selected from a group consisting of the main unit, computer personal (PC), terminal, PC "Tablet", laptop PC and a personal digital assistant (PDA).
18. - The system of claim 14, in combination with an Automatic External Defibrillator (AED).
19. - The system of claim 14, adapted to be configured to communicate a first set of instructions if the patient is an adult and a second set of instructions if the patient is a child.
20. - A method to provide real-time instructions on the use of equipment and procedures to be followed in patient resuscitation, the system comprising: a means of entry and means of exit to provide a collection of related entries to program the route and option selection; at least one time meter that provides user directions and program path selection; a collection of outputs, including: voice prompts for user actions and tuning; graphic display of user information; digital time screen; a logical unit adapted to operate in chronometer information and inputs to handle and indicate users during the resuscitation of a patient's experimental cardiac pain.
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US60/735,371 | 2005-11-12 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| MX2008005908A true MX2008005908A (en) | 2008-10-03 |
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