RU193963U1 - AUTOMATIC DEVICE FOR CARDIAC-PULMONARY REANIMATION IN EXTREME CONDITIONS - Google Patents

Abstract

The utility model relates to medical equipment. An automatic device for cardiopulmonary resuscitation in extreme conditions contains a box-shaped platform for placing a patient on it, a tissue bandage in the form of two chest pads with ribbons and fasteners, a mechanism for cyclic tensioning of ribbons placed in the holes located in the holes with guide rollers on the sides of the platform, control unit and autonomous source of electricity. The mechanism of cyclic tension of the tapes includes a partly rotary pneumatic engine, a torque sensor with an integrated system for measuring the angle of rotation and speed of rotation, and a shaft with a pulley, sequentially mounted coaxially inside the platform and interconnected by bellows couplings. The pulley has two blind holes made on its outward facing surface diametrically and symmetrically relative to its axis with one-sided radial cuts towards the outer cylindrical pulley generatrix, in which cylindrical fingers are installed for the loop-shaped ends of the tapes. At the ends of the chest pads in the places of their connection with each other, the stops facing the sternum are fixed in the form of protrusions of elastic material. The electrical outputs of the torque sensor and an autonomous power supply are connected to the corresponding inputs of the control unit, the outputs of which are connected to the electrical inputs of a five-line three-position pneumatic distributor, the pneumatic input of which is connected by means of a pressure regulator to a compressed gas cylinder, and the pneumatic working outputs are connected to the inputs of a part-turn pneumatic motor. The technical result consists in increasing the reliability and durability of the device. 3 ill.

Description

A useful model of an automatic device for cardiopulmonary resuscitation in extreme conditions relates to the field of medical equipment, namely, devices for cardiopulmonary resuscitation, and can be used to stop a person’s cardiac activity in extreme conditions (natural and environmental disasters, military field actions), and in other conditions (home, production, in ambulances, etc.).

A device for compression and decompression resuscitation (Patent of the Russian Federation No. 2180827, IPC A61H 31/00, published March 27, 2002), designed for closed (indirect) cardiac massage in various conditions, containing a supporting platform (platform) located under the patient’s chest, a rod with a scale in units of length that allows you to determine the size of the chest, a movable block for adjusting the parameters of the manually created point force of action on the chest, a lever with a movable contact element in the form of a suction cup, a nomogram for determining determination of the optimal compression and decompression parameters obtained experimentally.

The disadvantages of this device include: firstly, the inability to use in the patient transfer process due to the bulkiness (dimensions) of the structure, for example, in narrow passages, when descending from the upper floor of the building to the lower floor or when moving from the premises to the ambulance ; secondly, a significant physical load on the resuscitator when performing indirect heart massage (creating compression); thirdly, the use of scales and nomograms to determine the physiological parameters of the patient creates inconvenience for the resuscitator and can lead to errors in choosing the required parameters of the resuscitation process.

A device for cardiopulmonary resuscitation LUCAS (Lucas) manufactured by Michigan Instruments (USA) for conducting indirect cardiac massage (http://adhara.ru/articles/autopulse and_cpr.htm), containing a platform for placing the patient, a vertical stand for fixing pneumatic the mechanism of cyclic force point impact on the central part of the chest (sternum) by means of a pusher with an elastic element at the end, as well as a cylinder with compressed oxygen or air.

A known device for cardiopulmonary resuscitation LUCAS-2 (Lucas-2) (http://www.dealmed.ru/ustrojstvo_dlja_serdechno_legochnoj_reanimacii_lucas_2.html), used to restore and maintain the natural blood circulation in patients with a heart that does not work, provides depth and the frequency of the punching of the chest according to the established parameters and with the necessary constancy. The device comprises a platform placed under the patient’s back with one end pivotally attached to it by arched rigid semi-arches connected to the other ends with the body of a cyclic mechanism with an electric drive for power point impact on the center of the chest (sternum) by means of a pusher with an elastic element at the end in the form of a bellows, and also an autonomous source of electricity in the form of batteries.

A common disadvantage of LUCAS and LUCAS-2 devices is, firstly, the lack of the ability to ensure uniform compression of the entire chest, which reduces the effectiveness of the impact on the lungs for ventilation; secondly, the presence of a vertical strut or arched semi-arches significantly increases the dimensions of the devices in height, thereby complicating the evacuation of patients from emergency rooms and buildings through narrow and low passages; thirdly, the high location in relation to the platform of the center of gravity of the mechanism for creating a deformation force of the chest makes it difficult to move the working device with the patient along the staircases, for example, from the upper floor of the building to the lower, from the premises to the ambulance, and during transportation Angular displacements of the device (rack tilts) occur, which negatively affect the parameters of the resuscitation process.

The use of the mechanism of action on the chest with an electric drive as a part of the LUCAS-2 device significantly complicates its design due to the need to convert the rotational movement of the rotor of the drive electric motor to the translational movement of the pusher, as well as the need to increase the output torque to obtain the necessary force for chest deformation . All this leads to a decrease in the reliability of the device, an increase in metal consumption and energy consumption.

An automatic device for cardiopulmonary resuscitation selected as a prototype (https://www.zoll.com/ru/medical-products/resuscitation-system/autopulse/ems; http://adhara.ru/articles/autopulse_and_c.pr. htm.) contains a box-shaped platform located under the patient’s back, inside of which there is a cyclic mechanism equipped with an electric drive for tensioning the ribbons covering the patient’s chest, connected with a fabric bandage fastened on the chest.

After placing the patient on the platform, fastening the bandage, tightening the tapes to contact with the body and measuring the circumference of the chest, the device enters an operating mode that compresses the chest with a given frequency and with the necessary effort, resulting in a reduction in heart muscle from all sides, an increase cardiac output of blood, as well as contraction of the lungs with their subsequent straightening during a pause between loading cycles, i.e. passive ventilation of the lungs is carried out without the use of an artificial lung ventilation apparatus.

The disadvantages inherent in the prototype include the following.

Firstly, the complexity and metal consumption of the design of the mechanism of the cyclic tension of the band tapes, which uses an electric drive that requires mechanical converters for the rotational movement of the rotor of the drive electric motor into the translational motion of the tapes and mechanical amplifiers of the torque generated by the electric motor, in order to provide the required compression force of the chest .

Secondly, the cyclic mode of operation of the electric motor with a high frequency of reversal having a high inertia of the rotor (up to 100 ... 110 cycles of heart beat per minute) creates large alternating loads on the structural elements of the belt tension mechanism, causing them increased wear and breakage, and also reduces accuracy measuring the required movements of the tapes during their tension.

These disadvantages complicate the design of the device, increase its metal and energy consumption, reduce reliability and durability.

The purpose of the proposed utility model of an automatic device for extreme conditions is to simplify the design, reduce metal consumption, and as a result, increase reliability, durability.

Achieving this goal is ensured by the fact that in an automatic device for cardiopulmonary resuscitation in extreme conditions, containing a box-shaped platform for placing the patient on it, a tissue bandage in the form of chest pads with ribbons and fasteners, a mechanism for cyclic tension of the ribbons located inside the holes installed inside the platform with guide rollers on the sides of the platform, the control unit and an autonomous source of electricity, the mechanism of cyclic tension of the tapes includes the following flax mounted coaxially within the platform and interconnected bellows couplings Part-air motor, a torque sensor with an integrated system of measuring the rotation angle and rotation speed of the shaft and a pulley. The pulley has two blind holes made on its outward facing surface diametrically and symmetrically relative to its axis with one-sided radial cuts towards the outer cylindrical pulley generatrix, in which cylindrical fingers are installed for the loop-shaped ends of the tapes.

At the ends of the chest pads in the places of their connection with each other, the stops facing the sternum are fixed in the form of protrusions of elastic material.

The electrical outputs of the torque sensor and an autonomous power supply are connected to the corresponding inputs of the control unit, the outputs of which are connected to the electrical inputs of a five-line three-position pneumatic distributor, the pneumatic input of which is connected by means of a pressure regulator to a compressed gas cylinder, and the pneumatic working outputs are connected to the inputs of a part-turn pneumatic motor.

Between the totality of the claimed features of the utility model and the expected technical result obtained using the proposed automatic device for cardiopulmonary resuscitation, there is the following causal relationship.

Firstly, the pneumatic drive used as part of the pulse tension mechanism of the band tapes based on a part-turn air motor with a pulley on the output shaft provides the translational movement of the band tapes when they are wound on the pulley, does not require the use of special (additional) converters of rotational motion to translational.

Secondly, there is no need to use special power amplifiers (for example, gears) in the pneumatic drive to provide the required compressive forces of the chest, since the required power is achieved by using a half-turn pneumatic motor of a larger size without changing the design of the mechanism of cyclic tension of the belts or by increasing the working gas pressure using pressure regulator.

Thirdly, since the specific power of the pneumatic drive (the power expended per unit weight) is greater than the specific power of the electric drive, a reduction in metal consumption and a reduction in energy consumption is provided.

Fourthly, the absence of special motion converters and power amplifiers (torque) in the device simplifies the design, thereby reducing the likelihood of failure to operate and increasing the reliability and durability of the work.

Fifth, the five-line three-position pneumatic directional valve with electromagnetic control used in the device simplifies setup and maintenance, since in the neutral (middle) position of its locking element (spool), when all working outputs are in communication with the exhaust, the piston is in the form of an air motor blade, and, therefore, the associated pulley with tapes can rotate manually without the resistance created by the pressure of the compressible gas located in the working cavities.

In FIG. 1 is a diagram of an automatic device for cardiopulmonary resuscitation; in FIG. 2 - design of the mechanism of cyclic tension of the tapes; in FIG. 3 is a view along arrow A in FIG. 2.

The automatic device (Fig. 1) contains a flat box-shaped platform 1 of rectangular shape, length L and width B, placed under the back of the patient 2, a fabric bandage consisting of chest pads 4 and 5 connected to each other by a fastener, at the ends of which are adjacent to the fastener fixed stops facing the hollow of the sternum 6 are stops 7 and 8 in the form of protrusions of an elastic material, for example, silicone rubber.

To the outward facing sides of the linings are attached one of their ends with the possibility of changing the working length of the tape 9 and 10, which are connected through their cylindrical loops 15 and 16 through the holes 11 and 12 with guide rollers 13 and 14 on the sides of the platform of length L fingers 17 and 18 with a pulley 19 of diameter D and width C of the mechanism of their cyclic tension placed inside the platform (Fig. 2 and 3).

Cylindrical fingers are installed in the center of the blind holes 20 and 21, made on the side of the outward facing surface of the pulley, located symmetrically to its axis in the same diametrical plane, and having one-sided radial cuts 22 and 23 in the direction of the outer cylindrical forming pulley with a diameter D.

The pulley is fixed using a pin 24 on one of the ends of the shaft 25 (Fig. 2), mounted in the sliding bearings 26 of the bracket 27, attached from the inside to the box platform. The other end of the shaft is connected via a bellows coupling 28 to one of the ends of the rotor of a coaxially mounted torque sensor 29, for example, type T-22 (http://www.hbm.ru/catalog/datchiki/datchik-krutyashchego-momenta-t22/ ) with an integrated system for measuring the angle of rotation and speed of rotation, the other end of the rotor of which is connected by means of a bellows coupling 30 to the output shaft 31 of a coaxially mounted part-turn air motor (rotary drive) 32 (Fig. 1), for example, of the DRVS - 40 - 180 - type p (www.festo.com/cat/ru_ru/products_DRVS) with an angle of rotation of the output shaft from 0 to 180 °, which ensures that the pulley rotates the same angle.

The sensor and air motor, as well as the pulley shaft bracket, are attached internally to the platform.

The pneumatic pneumatic motor inlets are connected by pipelines 33 and 34 to the working pneumatic outlets of a five-line three-position pneumatic distributor 35, the pneumatic inlet of which is connected via a duct 36, a pressure regulator 37 with a pressure gauge 38 and a valve 39 with a compressed gas cylinder 40, and its electrical inputs are connected to the corresponding the outputs of the control unit 41, one of the inputs of which is connected to the output of an autonomous source of electricity 42, and the other to the electrical output of the sensor Torque Ika 43.

To eliminate the spontaneous slipping of the loop of the tapes from the cylindrical fingers in the blind holes of the pulley, a rotary elastic latch 44 is mounted on the pulley shaft with the washer 45.

Preparation of the device for operation and operation in resuscitation mode is carried out in stages in the following sequence.

At the first stage of preparation, the power supply from the autonomous power source 42 to the control unit 41 is turned on, and through it to the torque sensor 30.

On command from the control panel, which is part of the control unit, the air distributor 35 switches to the average (neutral) shown in FIG. 1 position in which its working outputs are in communication with the exhaust, and the pulley 19 can rotate manually without the resistance created by the pressure of the gas motor (air, oxygen) compressed by the blade located in its working cavities, which will freely flow through the air distributor channels from one working cavity to another, which greatly simplifies the maintenance of the device (adjustment, adjustment) in the process of preparing it for work in automatic mode.

Then, valve 39 opens and, using a pressure regulator 37 with a pressure gauge 38, the required working gas pressure is set (within 3.0 ... 6.0 MPa), which comes under high pressure from cylinder 40.

Patient 2 (Fig. 1) is placed on platform 1 so that the center of his sternum is in a plane passing through holes 11 and 12 at the same distance from them, and is fixed on it with safety belts (not shown in Fig.).

Then the device is returned to its initial state, for which the air distributor 35 switches to the extreme left position, in which the compressed gas enters from the pipeline 36 through the pipeline 34 to the corresponding working cavity of the air motor, causing its piston (blades) to rotate to the extreme position, ensuring the rotation of the pulley 19 and the location of its diametrical plane with the blind holes 20 and 21 made in it parallel to the platform (Figs. 1 and 3), which allows you to maximally stretch the tapes 6 and 10 attached to the pulley from the platform and set the torque sensor 29 to zero.

Using the fastener 3, for example, in the form of hooks with loops, the chest pads 4 and 5 of the bandage are connected to each other, and using the buckles on the pads and digital marks on the tapes (not shown in Fig.), Preliminary manual lifting of the tapes to the patient’s body is performed with the purpose of eliminating their excessive sagging and ensuring the working length necessary for the implementation of the resuscitation regime corresponding to the closest working size within the accepted size range used in the development of the control program embedded in the memory of Roller control unit. The selected digital mark is also stored using the control panel in the memory of the control unit.

At the second stage, the automatic tightening of the band tapes is carried out until full contact with the patient’s chest and the circumference of the band is determined, which is necessary for the automatic selection of the required parameters of the resuscitation mode. For this, the pneumatic distributor switches, for example, to the extreme right position, the compressed gas flows through a pipe 33 to another working cavity of the air motor, providing rotation of its output shaft 31 and the shaft 25 connected to it with a pulley 19, for example, clockwise, and, therefore, and tensioning the tapes 6 and 10 wound around the pulley.

Upon reaching full contact of the chest pads, stops and belts with the patient’s body, an increase in the torque controlled by the sensor 29 occurs, which is a signal to stop pulling up and switching the air distributor to the neutral position, and by the value of the sensor rotor angle when the belts are fully tightened, using the program installed in the control unit, the amount of movement of the tapes, the circumference of the chest of the patient and the recommended value of its deflection in the sternum area without damage are determined eber.

At the third stage, an automatic resuscitation mode is implemented, consisting of two phases - compression (compression) and decompression (decompression) of the chest, which is equivalent to respiration and inhalation, respectively.

To realize the compression phase, the air distributor switches to the right position again, i.e. to the position in which the belts were tightened and the compressed gas entering the corresponding working cavity of the air motor causes its output shaft 31 and the pulley 19 connected to it to rotate, for example, clockwise, which leads to the tension of the belts 9 and 10 wound around the pulley and to create in the contact zones of the stops 7 and 8 with the depression of the sternum 6 the forces F, and in the zones of contact of the tapes with the ribs of the distributed compressive forces q, causing a decrease in the circumference of the chest and the deflection of the sternum 6 by δ.

To implement the decompression phase, the air distributor switches to the leftmost position. Compressed gas entering the other working cavity of the air motor causes its output shaft to rotate counterclockwise with a pulley. The tension of the tapes is eliminated, which allows the ribs to return the rib cage to its original state due to the energy of elastic deformations accumulated in them during compression increase to the primary length its circumference of the cyclic loading of the chest, i.e. frequency of inspiration and expiration.

The diameter D of the pulley 19, ensuring the tension of the tapes when they are wound on it, is determined taking into account the following recommendations.

The average chest circumference of an adult (male) is 870.0 mm (http://opnevmonii.ru/wp-content/uploads/2017/01/Drawing_1.jpg) (Measurement table), and the recommended depth of deflection of the sternum with closed massage the heart should be 50.0 ... 60.0 mm in adults (http://okardio.com/ostalnoe/serdechno-legochnaya-reanimaciya-590.html).

Calculations show that to ensure sternum deflection δ = 50 mm, it is necessary to reduce the circumference of the chest by compression by 154 mm, i.e. after pulling, each belt should move when winding onto a pulley by 77 mm.

Given the above, the length of the semicircle of the pulley πD / 2 with a diameter of D should be equal to the sum of the displacements of each of the belts when tightening, (for example, 30.0 mm), when compressing the chest (77.0 mm) and some reserve movement (for example, 20.0 mm) ,

those. πD / 2 = 30.0 + 77.0 + 20.0 = 127 mm,

whence D≈81 mm.

The magnitude of the movement of the tapes during tightening and during compression of the chest is determined through the angle of rotation of the rotor of the torque sensor 29.

Claims (1)

An automatic device for cardiopulmonary resuscitation in extreme conditions, containing a box-shaped platform for placing a patient on it, a tissue bandage in the form of two chest pads with ribbons and fasteners, a mechanism for cyclic tensioning of tapes placed in the holes in the holes with guide rollers on the sides of the platform , a control unit and an autonomous source of electricity, characterized in that the mechanism of cyclic tension of the tapes includes sequentially mounted coaxially in In the morning the platform and the interconnected pneumatic engine, bellows couplings, a torque sensor with an integrated system for measuring the angle of rotation and speed of rotation, and a shaft with a pulley, the pulley having two blind holes made diametrically and symmetrically located relative to its axis on its end face facing outwards with one-side radial cuts towards the outer cylindrical pulley generatrix, in which cylindrical fingers for shaped the ends of the tapes, and at the ends of the chest pads in the places of their connection, fixed in the direction of the sternum are fixed stops in the form of protrusions of elastic material, while the electrical outputs of the torque sensor and an independent power source are connected to the corresponding inputs of the control unit, the outputs of which are connected to electrical inputs of a five-line three-position pneumatic distributor, the pneumatic input of which is connected by means of a pressure regulator to a cylinder of compressed gas, and pneumatic slaves The outputs are connected to the inputs of the part-turn air motor.

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