WO1999025306A1 - Dispositif de reanimation cardio-pulmonaire assistee - Google Patents

Dispositif de reanimation cardio-pulmonaire assistee Download PDF

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Publication number
WO1999025306A1
WO1999025306A1 PCT/IL1998/000561 IL9800561W WO9925306A1 WO 1999025306 A1 WO1999025306 A1 WO 1999025306A1 IL 9800561 W IL9800561 W IL 9800561W WO 9925306 A1 WO9925306 A1 WO 9925306A1
Authority
WO
WIPO (PCT)
Prior art keywords
victim
piston
controller
chest
rescuer
Prior art date
Application number
PCT/IL1998/000561
Other languages
English (en)
Inventor
Yoram Lass
Aharon Lamish
Original Assignee
Cpr Devices, Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cpr Devices, Ltd. filed Critical Cpr Devices, Ltd.
Priority to JP2000520741A priority Critical patent/JP2001522707A/ja
Priority to IL13601898A priority patent/IL136018A0/xx
Priority to CA002310618A priority patent/CA2310618A1/fr
Priority to AU12565/99A priority patent/AU748550B2/en
Priority to BR9814971-7A priority patent/BR9814971A/pt
Priority to EP98955878A priority patent/EP1033960A1/fr
Priority to KR1020007005379A priority patent/KR20010032189A/ko
Publication of WO1999025306A1 publication Critical patent/WO1999025306A1/fr
Priority to NO20002458A priority patent/NO20002458L/no

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
    • A61H31/005—Heart stimulation with feedback for the user
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
    • A61H31/006—Power driven
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
    • A61H31/007—Manual driven
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A61M16/024—Control means therefor including calculation means, e.g. using a processor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3904—External heart defibrillators [EHD]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/12—Driving means
    • A61H2201/1238—Driving means with hydraulic or pneumatic drive
    • A61H2201/1246—Driving means with hydraulic or pneumatic drive by piston-cylinder systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5056—Control means thereof pneumatically controlled
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/04—Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057—Pumps therefor
    • A61M16/0063—Compressors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3904—External heart defibrillators [EHD]
    • A61N1/39044—External heart defibrillators [EHD] in combination with cardiopulmonary resuscitation [CPR] therapy

Definitions

  • the invention relates to methods and devices for assisted cardiopulmonary resuscitation.
  • cardiopulmonary resuscitation CPR to maintain the flow of blood and oxygen to the heart and brain so as to prevent damage until the victim's own heartbeat can be reestablished.
  • CPR The simplest form of CPR, manual CPR, involves administrating cycles of two ventilations followed by 15 manual chest compressions of 3.75-5 cm in depth, at a rate of about 100 compressions per minute.
  • Manual CPR typically utilizes almost all of the rescuer's musculature simultaneously so that a substantial physical effort is required on the part of the rescuer. Since CPR may be required for 20 minutes or more, the rescuer often becomes exhausted and forced to discontinue CPR and/or apply CPR incorrectly before the victim is revived or professional help arrives (Baubin et al.). Rescuer fatigue is therefore a significant limiting factor in the effectiveness of manual CPR.
  • manual CPR provides active compression, it relies on passive expansion of the chest following each compression.
  • Active compression-decompression (ACD) CPR provides for both active compression and decompression by pushing the chest inward and forcibly pulling it out.
  • U.S. Patents 5,636,789, 5,295,481, and 5,645,522 disclose a vacuum cup which is placed directly on the victim's chest. The chest is compressed by pressing down on the vacuum cup and lifted by pulling it up so as to provide the active decompression. ACD-CPR devices, however, do not solve the problem of rescuer fatigue. In fact, 25% more work is required for performing ACD-CPR in comparison to manual CPR (Shultz et al., Resuscitation, 29:23-31 (1995)).
  • U.S. Patent 4,928,674 discloses a pneumatic vest designed to fit around the victim's chest.
  • the device is inflated and deflated automatically by a computer controlled compressor applying pressure to the torso from all directions. While such automatic CPR devices solve the problem of rescuer fatigue, their efficacy has not been established (Halperin et al.). In addition to requiring greater expertise for their operation, the fully automatic devices such as the one disclosed in the '674 patent are extremely heavy and bulky and so are difficult to bring to the victim. Also, the set-up time of such devices may be unacceptable.
  • One object of some preferred embodiments of the invention is to reduce rescuer fatigue during application of CPR.
  • the applied CPR meets American Heart Association guidelines for the application of CPR.
  • meeting these guidelines is assisted by a device in accordance with a preferred embodiment of the invention.
  • An aspect of some preferred embodiments of the invention relates to using a rescuer as a "smart weight", whereby the rescuer performs a significant portion of the CPR task by shifting his/her weight to and from the victim.
  • a significant portion of the mechanical energy required to move a chest of the victim is provided by a mechanized device. Altematively or additionally, such a device also assists the rescuer in shifting his weight.
  • the focus of the rescuer's activity is shifted from performing mechanical work to controlling the CPR activity.
  • one result of the shift in focus is that the rescuer performs higher quality CPR.
  • another result of the shift in focus is that the rescuer is required to perform less work, thereby he is less fatigued by the CPR and may be able to keep it up longer.
  • An aspect of some preferred embodiments of the invention relates to human interaction in the CPR process.
  • the human functions as a "smart weight", as part of a complete CPR system which includes a mechanical device and the rescuer.
  • the CPR process may be controlled by the shifting of the rescuer's weight.
  • the rescuer can change his activities so that the CPR being performed is what the rescuer wants to be performed.
  • the rescuer can more exactly match the CPR being performed to what is required by the victim, for example based on visual and/or other feedback from the victim.
  • An aspect of some preferred embodiments of the invention relates to an expected setup time of a CPR device.
  • the CPR device is simply placed at a proper location on the victims chest.
  • the set-up time is substantially the same as for purely manual CPR.
  • An aspect of some preferred embodiments of the invention relates to adjusting a CPR device and/or method for a particular rescuer/victim/CPR situation.
  • the adjustment is effected by a rescuer using the same CPR device in a slightly different manner, for example changing his timing and/or center of gravity.
  • the adjustment is effected by varying a vertical dimension of the CPR device, for example by changing a setting therein or by providing a telescopic support or a spacer therewith.
  • the adjustment is effected by changing device operating parameters, for example, waveform, frequency and/or response to sensed physiological variables.
  • An aspect of some preferred embodiments of the invention relates to assisting a rescuer in placing/removing his weight from a victim's chest.
  • the assistance enables a better impulse force to be applied to the chest, resulting in more effective CPR.
  • the assistance includes lifting up a rescuers weight from the victim. Altematively or additionally, the assistance includes lowering down the rescuers weight onto the victim's chest.
  • An aspect of some preferred embodiments of the invention relates to a limited-count- use attachment element.
  • the CPR device is attached to a victim's chest using an attachment element which can be used only once or a small number of times.
  • the attachment element is fixed to the victim's body by itself and then the CPR device is coupled to the attachment element. Preferably, one CPR is completed the CPR device is detached from the attachment element, which may remain connected to the chest.
  • the attachment element comprises a suction cup or an adhesive pad.
  • the attachment element comprises a strap which preferably encircles the victim's torso.
  • the attachment element includes physiological sensors such as chest displacement sensors or ECG electrodes.
  • the attachment element includes active elements, such as defibrillation electrodes and/or external pacing electrodes.
  • a system for assisted cardiopulmonary resuscitation to allow a rescuer to apply his/her body weight to the chest of a victim comprising: (a) a contact surface for contacting the victim's chest;
  • a displacer which raises or lowers the support member relative to the contact surface at a selectable frequency and speed and to a selectable height.
  • the system include a controller which activates said displacer.
  • a system for assisted cardiopulmonary resuscitation to allow a rescuer to apply his/her body weight to the chest of a victim comprising: (a) a cylinder assembly that includes a closed cylinder having a bottom section, and a piston assembly that includes a piston, and a piston rod slidably received within said cylinder;
  • a controller capable of activating said means for raising the piston such that the piston is raised at a selectable frequency and speed and to a selectable height.
  • the rescuer kneels next to the victim's chest and places the contacting surface of the cylinder assembly on the chest of the victim, for example with the piston at the bottom of its stroke cycle.
  • the rescuer transfers his body weight onto the support member.
  • the rescuer's head and shoulders are lifted so that the rescuer's gravitational potential energy is increased.
  • his knees and hips become more bent so that his body weight is shifted from the support member to his knees.
  • the transfer of the rescuer's body weight from the support member releases the pressure on the victim's chest, allowing the victim's chest to be decompressed.
  • the rescuer When the piston is at the top of its stroke cycle, the rescuer transfers his body weight onto the support member, causing the piston to descend rapidly thereby converting the rescuer's gravitational potential energy into kinetic energy. When the rapidly descending piston hits the bottom section of the cylinder assembly, the kinetic energy of the rescuer is transferred to the victim's chest which becomes compressed, and the cycle can begin again.
  • the CPR device is coupled to the victim's chest, for example, using a suction cup, adhesive and/or a strap.
  • the chest When the rescuer leans further back, the chest may be pulled up, to provide active decompression. Altematively or additionally, once the rescuer's weight is off the victim's chest, active shortening of the device may cause a decompression of the chest, if the rescuer maintains his position.
  • the invention may optionally comprise a lowering device for lowering the piston once the rescuer has transferred his body weight to the support member.
  • the lowering device thus imparts kinetic energy to the piston in addition to the kinetic energy imparted to the piston through application of the rescuer's body weight to the support member.
  • the frequency of the cycle, the height to which the piston is raised, as well as the speed at which the piston is raised or lowered are determined by the controller and can be selected by the rescuer to match the requirements of the victim. Altematively or additionally, the height of the device itself may be set, for example, using a telescopic support.
  • a system for assisted cardiopulmonary resuscitation to allow a rescuer to apply his/her body weight to the chest of a victim comprising: a contact surface for contacting the victim's chest; a support member for enabling the rescuer to apply his/her body weight to the contact surface; and a displacer operative to move the support member relative to the contact surface.
  • the system comprises a controller capable of activating the displacer to achieve a desired motion.
  • said desired motion comprises a desired direction.
  • said desired motion comprises a desired applied force.
  • said displacer increases a displacement between said support member and said contact surface.
  • said displacer decreases a displacement between said support member and said contact surface.
  • said displacer comprises an electric motor.
  • said controller comprises an electrical controller.
  • the controller comprises a pneumatic controller.
  • a system for assisted cardiopulmonary resuscitation to allow a rescuer to selectively apply his/her body weight to the chest of a victim comprising:
  • a cylinder assembly that includes a closed cylinder having a bottom section, and a piston assembly that includes a piston and a piston rod slidably received within said cylinder;
  • the system comprises a controller capable of activating said displacer to perform a desired motion.
  • said piston is moved at a selectable frequency.
  • said piston is moved at a selectable speed.
  • said piston is moved a selectable amount height.
  • the system comprises an electrocardiograph monitor and recorder coupled to the controller, wherein said controller activates and deactivating the raising means, responsive to said ECG.
  • the system comprises an electrocardiograph monitor and recorder coupled to the controller and capable of producing a signal sensible by the rescuer, which signal guides cardiopulmonary resuscitation.
  • said guidance comprises indicating to the rescuer when to stop said CPR.
  • said system includes a physiological sensor, which measures a physiological parameters of said victim.
  • said controller modifies said movement, responsive to values sensed by said sensor. Altematively or additionally, said controller generates an indication to said rescuer, responsive to values sensed by said sensor.
  • said displacer comprises a lowering device capable of lowering the piston so as to apply a selectable force to the victim's chest.
  • the piston is raised by the introduction of a pressurized gas below the piston's surface.
  • the pressurized gas is air.
  • the pressurized gas is oxygen.
  • the piston is raised using an electric motor. Altematively or additionally, the piston is lowered by the introduction of pressurized gas above the piston. Altematively or additionally, the piston is lowered by an electric motor. Altematively or additionally, the controller is operated by electricity. Altematively or additionally, the controller is pneumatic.
  • the system further comprises a ventilator coupled to the controller for the ventilation of the victim's lungs, said ventilation being coordinated with the cardiopulmonary resuscitation.
  • a ventilator coupled to the controller for the ventilation of the victim's lungs, said ventilation being coordinated with the cardiopulmonary resuscitation.
  • about 2 ventilations of the victim's lungs are administered following about every 15 compressions of the victim's chest.
  • the system comprises a defibrillator coupled to the controller for the defibrillation of the victim's heart, said defibrillation being coordinated with the cardiopulmonary resuscitation.
  • the system comprises a capnometer.
  • the system comprises a blood flow meter.
  • the system comprises a strap.
  • the strap fixes the system onto the chest of the victim.
  • the strap comprises defibrillator electrodes.
  • said contact surface comprises a suction cup.
  • said system is operative to be connected to said suction cup after said suction cup is attached to said victim.
  • said suction cup comprises defibrillation electrodes.
  • said suction cup comprises at least one physiological sensor.
  • the system further comprises a display for indicating a physiological parameter of the patient.
  • said display comprises an auditory display.
  • said physiological parameter comprises the victim's heart rate.
  • said physiological parameter comprises the victim's blood pressure.
  • said physiological parameter comprises the victim's blood flow rate.
  • said physiological parameter comprises the CO 2 concentration in the victim's exhaled breath.
  • said physiological parameter comprises the pressure being applied to the victim's chest.
  • said physiological parameter comprises the displacement of the victim's chest.
  • the system comprises a monitor capable of monitoring and storing information pertaining to the resuscitation.
  • Fig. 1 shows one embodiment of the invention
  • Fig. 2 shows a cross-sectional view of the cylinder assembly, support member, and contacting surface along plane A-A in Fig. 1;
  • Fig. 3 shows a generalized flow chart describing the functioning of the controlling unit
  • Fig. 4 shows use of the embodiment of Fig. 1 by a rescuer for the adudinistration of CPR to a victim, where, in (a) the piston of the embodiment is at the bottom of its stroke cycle, in (b) the piston is at the top of its stroke cycle and in (c) a superimposition of (a) and (b) is shown.
  • Fig. 1 shows a CPR device in accordance with a preferred embodiment of the invention, in which a closed cylinder 1 is fitted with a closely slidable piston.
  • the piston rod 2 is attached at its upper end to a support member 3, preferably suitable for grasping by a rescuer.
  • Cylinder 1 the piston (not shown) and piston rod 2 constitute together said cylinder assembly.
  • a contact surface 4 is associated with the bottom surface of the cylinder.
  • contact surface 4 comprises a suction cup, an adhesive pad and/or straps, to maintain contact between the device and a victim.
  • raising and/or lowering movement of piston 2 is effected by a source of compressed gas 8, for example, nitrogen, air or oxygen.
  • a cylinder of gas for example oxygen is supplied.
  • a compressor which compresses ambient air is provided.
  • Such a compressor may, for example, utilize a rechargeable battery power supply or a combustion engine.
  • other sources of external pressure may be used, for example, a wall supply of pressurized air or oxygen in a hospital.
  • other methods of moving piston 2 and/or support member 3 may be used, for example hydraulic or electrical motors.
  • cylinder 1 is connected via hoses 5, 6 and 7 to external pressure source 8.
  • a controller 9 is interposed between the external pressure source 8 and cylinder 1, to control the movement of the piston.
  • the control is by regulating the flow of gas from the external pressure source 8 to the cylinder 1.
  • the controller may be integrated into the cylinder assembly.
  • the controller comprises a mechanical controller.
  • the controller comprises an analog electrical controller (preferably with solenoid-type valves).
  • the controller comprises a pneumatic or hydraulic controller.
  • the controller comprises a digital controller.
  • the controller is programmable.
  • contact surface 4 may be attached to the victim before the rest of the CPR device is attached to the contact surface.
  • contact surface may comprise a suction cup.
  • the suction cup is attached at a correct location and then the rest of the CPR device is coupled to the suction cup, for example, using a ratchet connector. It is noted that the quality of the suction is not critical in some embodiments of the invention, as the suction cup is pressed anew against the victim's chest each chest compression.
  • the suction cup includes physiological sensors, such as ECG electrodes and/or active devices, such as defibrillation electrodes.
  • Fig. 2 shows a cross-sectional view of the cylinder assembly, support member, and contacting surface along plane A-A of Fig. 1.
  • the cylinder may be pressurized below the piston 10 by the introduction of pressurized gas via tube 6 through valve 15 and inlet 11' located at the bottom of the cylinder wall causing the piston 10 to rise.
  • the cylinder may be pressurized above the piston by introducing the pressurized gas via tube 7 through an inlet 11" and venting gas below the piston to the atmosphere through inlet 11' and valve 15, causing the piston to descend.
  • raising and lowering devices may share one or more components, such as the source of pressurized gas in Fig. 1, or may be completely separate and independent.
  • the controller and the cylinder assembly may be separate facilities as shown in Fig. 1 or may be integrated into a single unit.
  • the raising action and the lowering action may be provided by separate means, for example a hydraulic one for raising and a pneumatic one for lowering.
  • raising and/or lowering of piston 2 is achieved using an electric motor, which is powered by an integral battery, yielding a compact CPR device, possibly with no trailing cords or tubes.
  • Fig. 3 shows a generalized flow chart describing the functioning of the controller 6.
  • An oscillator which may for example be electric or pneumatic and whose frequency may be selected regulates the intermittent opening of valves a and b.
  • valve a When the signal produced by the function generator is greater than 0, valve a is open, valve b closed, and valve 15 is closed to the atmosphere, so that pressurized gas flows from the external source 8 shown in Fig. 1 via tube 5 to tube 6 and then into the cylinder 1 through inlet 11' causing the piston to rise. Simultaneously, gas leaves the cylinder through inlet 11' and tube 7 and is released to the atmosphere.
  • valve b is open, valve a closed and valve 15 is open to the atmosphere so that gas flows from the external source 8 via tube 5 to tube 7 and then into the cylinder 1 through valve 15 and inlet 11" causing the piston to descend. Simultaneously, gas leaves the cylinder through inlet 11' and valve 15 and is vented to the atmosphere.
  • Fig. 3 described an electrically based controller, those versed in the art will readily appreciate that the specific structure of Fig. 3, is only one out of many possible variants. Thus, by way of a non-limiting example the controller 3, may be partially or fully pneumatically operated.
  • Fig. 4 shows the administration of CPR, in accordance with a preferred embodiment of the invention.
  • the contact surface 4 of the cylinder 1 has been placed on the chest of the victim 12 with the piston 10 at the bottom of its stroke cycle.
  • An optional strap 13 around the victim's chest and/or shoulders preferably aids in fixing the device in place during operation.
  • the rescuer 14 has transferred most of his weight to the support member 3.
  • the rescuer's head and shoulders are lifted so that the rescuer's gravitational potential energy is increased.
  • pressurized gas below the piston 10 is allowed to rapidly escape via inlet 11', through valve 15.
  • the combination of the body weight of the rescuer being applied to the support member 3 and the pressurized gas above the piston cause the piston to descend rapidly thereby converting the rescuer's gravitational potential energy into kinetic energy.
  • the rapidly descending piston hits the bottom section of the cylinder assembly, the kinetic energy of the rescuer is transferred to the victim's chest which becomes compressed, and the CPR cycle can begin again.
  • the frequency of the cycle, the height to which the piston is raised, the range of motion of the piston and/or the speed at which the piston is raised or lowered are determined by the controller 9 and can be (if desired) selected by the rescuer to match the requirements of the victim, be modified during the rescue and/or be pre-configured. Selection of the frequency of the cycle, the height to which the piston is raised or the speed at which the piston is raised or lowered by the rescuer, allows the rescuer to control, for example, the displacement of the victim's chest and/or the pressure applied thereto. Altematively or additionally, other parameters of the piston motion may be controlled, for example a relationship between displacement and velocity or acceleration ( of the piston), applied force and/or delay between compressions. Fig.
  • FIG. 4c is a superimposition of Figs. 4a and b showing that only small vertical and rotational displacements of the rescuer's body are involved in the passage from the posture of Fig. 4a (shown in dotted line in Fig. 4c) to the posture of Fig. 4B (shown in solid line in Fig. 4c). Only small movements of the musculature are therefore required so that the physical exertion demanded of the rescuer, in some embodiments of the invention, is substantially less than for manual CPR.
  • Fig. l was tested on a state of the art CPR mannequin equipped with a computer and appropriate mechanical sensors by professional and non-professional rescuers. The results showed that the rescuer's oxygen consumption and elevation of heart rate are significantly less while using the CPR device and his/her endurance is significantly enhanced in comparison to manual CPR. Moreover, it is believed that the effectiveness of the CPR provided by the invention is at least equal to that of manual CPR.
  • the invention may optionally contain a defibrillator, which is coupled to the controller and capable of applying electrical shocks to the victim simultaneously with the administration of CPR as disclosed for example in U.S. Patent 4,928,674.
  • the invention may further optionally contain an electrocardiograph (ECG) monitor and recorder for monitoring the victim's heart which is coupled to the controller as described for example in U.S. Patent 4,927,674.
  • ECG electrocardiograph
  • the controller may utilize suitable means for analyzing the ECG signal so as to activate or deactivate the raising means, or produce a signal sensible by the rescuer informing him when (and/or if) to start and/or stop CPR.
  • the controller could, if desired, also regulate the timing, duration, waveform and/or intensity of the electric shock provided by the defibrillator, responsive to the ECG signals, the motion of the piston, the history of CPR application, ECG traces and/or defibrillation shocks applied and/or sensed physiological variables, current and/or historical values.
  • Such an analysis of present and/or past situations may also be used to guide a rescuer in applying CPR and or to determine settings or device parameters, possibly with the device automatically changing the settings.
  • the controller could indicate that defibrillation is about to be performed, so a rescuer will let go of the patient and possibly remove the CPR device, to avoid electrocution and or damage to the device.
  • the CPR device is double insulated.
  • tubes to an external pressure source are insulating.
  • the invention could be provided with an optional strap to be placed around the victim's chest so as to hold the device in place, or to apply the electrodes of a defibrillator to the victim's chest.
  • a strap may include a strain gauge, to estimate displacement of the victim's chest.
  • the displacement is estimated using an accelerator incorporated in the CPR device and/or in the strap.
  • the measured acceleration is can be used to determine impulse force.
  • a twice-integrated acceleration may be used to determine chest displacement.
  • the invention may optionally contain a ventilator for ventilating the victim's lungs simultaneously with the administration of CPR.
  • the ventilator could be regulated by the controller to coordinate the ventilation cycles with the CPR cycles as disclosed in U.S. Patent 4,928,674.
  • the ventilator could be coordinated with the raising means in such a fashion that two ventilations of the victim's lungs are administered following every 15 compressions of the victim's chest. Such ventilation may be automatically stopped once breathing of the victim is detected.
  • the invention may further be provided with an optional capnometer, to inform the rescuer and/or the controller of the concentration of CO 2 in the victim's exhaled breath, so as to provide an indication as to the quality of the CPR.
  • the invention may further be provided with a blood flow meter to inform the rescuer and/or the controller of the victim's blood flow rate so as to provide an indication as to the quality of the CPR.
  • the invention may further be provided with an optional pressure indicator, to inform the rescuer and/or the controller of the pressure being applied to the victim's chest during CPR, so as to allow the rescuer and/or the controller to modify the pressure being applied.
  • an optional pressure indicator to inform the rescuer and/or the controller of the pressure being applied to the victim's chest during CPR, so as to allow the rescuer and/or the controller to modify the pressure being applied.
  • the invention may further be provided with an optional device capable of informing the rescuer by means of a sensible signal of sensed physiological parameters, such as one or more of the following parameters: the victim's heart rate and or other ECG characteristics, blood pressure or blood flow rate, the CO, concentration in the victim's exhaled breath, the pressure being applied to the victim's chest, and the displacement of the victim's chest.
  • the sensible signal comprises an audio signal, for example a beep or synthetic speech.
  • the signal comprises a display.
  • the sensed parameters are analyzed and a composite signal is supplied, for example a green light if the CPR is progressing as it should and a red light if not.
  • the controller is capable of closed loop behavior, for example, if an applied impulse pressure to the chest is above a threshold, the controller stops and/or reduces its lowering action, to reduce the impulse pressure.
  • other parameters of the device may be automatically controlled, responsive to the above measured physiological variables, for example, range of motion, velocity profile of the piston, delay between compressions and/or application of external electrical stimulation.
  • the controller can determine if the CPR activity is meets certain criteria (such as the AHA guidelines) and provide a warning to a rescuer if not. For example, a warning may be displayed if the applied pressure is too high and/or if the compression rate is too low. Altematively or additionally, the CPR device may stop operation is incorrectly used. Altematively or additionally, the CPR device may suggest an action to the user, for example to increased the applied pressure. Altematively or additionally, the controller reports if the rhythm of the CPR is adequate.
  • certain criteria such as the AHA guidelines
  • the controller senses that a rescuer is not properly utilizing the device, for example, not shifting his weight properly, so the controller is required to assist the downward motion to a greater extent or if the rescuer's weight is never removed from the victim's chest.
  • the CPR device provides the rhythm for CPR (and/or ventilation) and the rescuer follows it (possibly being synchronized using an audio signal).
  • the motion of the piston is completely controlled by the controller.
  • the movement of the piston may follow the rescuer's lead.
  • a new raising/lowering cycle starts when a user shifts his weight onto the support member and/or compresses the piston by a predetermined amount.
  • such control may not require a controller, for example, by inlet and/or valves in the CPR device being directly opened and closed by the pressure on the support member.
  • the support member may include controls, such as buttons, for effecting the raising and or lowering of the piston.
  • the control may be by voice control.
  • the invention may further be provided with a monitor capable of monitoring and storing information pertaining to the resuscitation, such as the time the resuscitation commenced, the time when the resuscitation was terminated, the number of cycles performed, the frequency of the cycles, the percentage of defective cycles, the frequency and type of errors, the force applied during each cycle, events where the guidelines were not met and/or the displacement of the chest during each cycle.
  • the monitor may be on line or off line with an external computer.
  • the invention can be constructed having a raising or a lowering device not comprising a piston.
  • a raising or lowering device comprising an electrical motor instead of a piston may be used (not shown).
  • a multiplicity of various features, both of methods and of devices have been described. It should be appreciated that different features may be combined in different ways. In particular, not all the features shown above in a particular embodiment are necessary in every similar preferred embodiment of the invention. Further, combinations of the above features are also considered to be within the scope of some preferred embodiments of the invention. It should also be appreciated that many of the embodiments are described only as methods or only as apparatus. The scope of the invention includes devices for performing the methods and methods of using the devices.

Abstract

La présente invention concerne un dispositif de réanimation cardio-pulmonaire assistée permettant au sauveteur de faire peser son corps sur le thorax d'une victime. Ce dispositif, qui comporte une surface de contact (4) destinée à être en contact avec le thorax de la victime, comporte également un organe support (3) permettant au sauveteur de faire peser son corps sur la surface de contact (4), et comporte enfin un piston (9) dont la fonction est de déplacer l'organe support (3) par rapport à la surface de contact (3).
PCT/IL1998/000561 1997-11-18 1998-11-17 Dispositif de reanimation cardio-pulmonaire assistee WO1999025306A1 (fr)

Priority Applications (8)

Application Number Priority Date Filing Date Title
JP2000520741A JP2001522707A (ja) 1997-11-18 1998-11-17 補助心肺蘇生法のための装置
IL13601898A IL136018A0 (en) 1997-11-18 1998-11-17 Device for assisted cardiopulmonary resuscitation
CA002310618A CA2310618A1 (fr) 1997-11-18 1998-11-17 Dispositif de reanimation cardio-pulmonaire assistee
AU12565/99A AU748550B2 (en) 1997-11-18 1998-11-17 A device for assisted cardiopulmonary resuscitation
BR9814971-7A BR9814971A (pt) 1997-11-18 1998-11-17 Sistema para ressuscitação cardiopulmonar assistida para permitir a um resgatador aplicar seu peso corporal ao tórax de uma vìtima, e, uso do mesmo.
EP98955878A EP1033960A1 (fr) 1997-11-18 1998-11-17 Dispositif de reanimation cardio-pulmonaire assistee
KR1020007005379A KR20010032189A (ko) 1997-11-18 1998-11-17 심폐 소생용 보조 장치
NO20002458A NO20002458L (no) 1997-11-18 2000-05-12 Apparat for kardiopulmonal resuscitering

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IL122234 1997-11-18
IL12223497A IL122234A0 (en) 1997-11-18 1997-11-18 A device for assisted cardiopulmonary resuscitation

Publications (1)

Publication Number Publication Date
WO1999025306A1 true WO1999025306A1 (fr) 1999-05-27

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ID=11070862

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IL1998/000561 WO1999025306A1 (fr) 1997-11-18 1998-11-17 Dispositif de reanimation cardio-pulmonaire assistee

Country Status (11)

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EP (1) EP1033960A1 (fr)
JP (1) JP2001522707A (fr)
KR (1) KR20010032189A (fr)
CN (1) CN1279599A (fr)
AU (1) AU748550B2 (fr)
BR (1) BR9814971A (fr)
CA (1) CA2310618A1 (fr)
IL (1) IL122234A0 (fr)
NO (1) NO20002458L (fr)
PL (1) PL340830A1 (fr)
WO (1) WO1999025306A1 (fr)

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JP2001037740A (ja) * 1999-05-31 2001-02-13 Laerdal Medical As 救命状況又はその練習状況における胸部圧縮の際にパラメータを測定及び利用する装置
WO2002015836A2 (fr) 2000-08-23 2002-02-28 Cpr Devices Ltd. Dispositif de surveillance de reanimation cardio-respiratoire
EP1128795A4 (fr) * 1998-11-09 2004-07-14 Revivant Corp Moniteur de compression thoracique permettant de proceder a une reanimation cardio-vasculaire
WO2004066901A1 (fr) * 2003-01-27 2004-08-12 Isis Innovation Limited Stimulateur cardiaque mecanique externe
US6961612B2 (en) 2003-02-19 2005-11-01 Zoll Medical Corporation CPR sensitive ECG analysis in an automatic external defibrillator
US7220235B2 (en) 2003-06-27 2007-05-22 Zoll Medical Corporation Method and apparatus for enhancement of chest compressions during CPR
US7310553B2 (en) 2000-02-04 2007-12-18 Zoll Medical Corporation Integrated resuscitation
WO2007148059A1 (fr) * 2006-06-19 2007-12-27 Allan Hopkins Appareil de pompe pour appareil de réanimation cardio-pulmonaire
WO2008015624A2 (fr) * 2006-08-03 2008-02-07 Koninklijke Philips Electronics, N.V. Dispositif d'assistance à la réanimation cardio-respiratoire ayant un détecteur interne pour détecter une caractéristique physiologique
EP1904016A2 (fr) * 2005-07-15 2008-04-02 Thomas E. Lach Appareil de compression de la poitrine par action croisee en cas d'arret cardiaque
US7565194B2 (en) 2004-05-12 2009-07-21 Zoll Medical Corporation ECG rhythm advisory method
US7650181B2 (en) 2005-09-14 2010-01-19 Zoll Medical Corporation Synchronization of repetitive therapeutic interventions
EP2198823A1 (fr) * 2008-12-19 2010-06-23 Dräger Medical B.V. Dispositif de ventilation doté d'un mode de réanimation cardio-pulmonaire
WO2014026897A1 (fr) * 2012-08-14 2014-02-20 Schiller Ag Appareil d'aide à la réanimation cardiopulmonaire et procédé pour faire fonctionner ledit appareil
US8862228B2 (en) 2003-11-06 2014-10-14 Zoll Medical Corporation Using chest velocity to process physiological signals to remove chest compression artifacts
US9339436B2 (en) 2004-05-12 2016-05-17 Zoll Medical Corporation Automatic cardiac therapy advisor with hidden markov model processing
US9713445B2 (en) 2004-09-30 2017-07-25 Zoll Medical Corporation Integrated resuscitation
CN108024725A (zh) * 2015-09-21 2018-05-11 Zoll医疗公司 以胸部顺应性为指导的胸外按压
US10322060B2 (en) 2013-09-25 2019-06-18 Zoll Medical Corporation Mobile device control
US10406345B2 (en) 2015-10-16 2019-09-10 Zoll Medical Corporation Dual sensor electrodes for providing enhanced resuscitation feedback
USD926323S1 (en) 2020-03-30 2021-07-27 Zoll Medical Corporation Automated external defibrillator electrode pad
US11944582B2 (en) 2013-04-30 2024-04-02 Zoll Medical Corporation Compression depth monitor with variable release velocity feedback

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KR100740766B1 (ko) * 2006-05-08 2007-07-19 허대수 니들을 이용한 심폐소생기
US8010190B2 (en) 2006-05-26 2011-08-30 Cardiac Science Corporation CPR feedback method and apparatus
EP2157962A2 (fr) * 2007-06-01 2010-03-03 Cardiac Science, Inc. Système, procédé, et appareil d'assistance pour un sauveteur lors d'une réanimation
US9002427B2 (en) 2009-03-30 2015-04-07 Lifewave Biomedical, Inc. Apparatus and method for continuous noninvasive measurement of respiratory function and events
CN102421371A (zh) 2009-04-22 2012-04-18 莱夫韦弗公司 胎儿监视设备和方法
CN103210391B (zh) * 2010-11-12 2016-08-10 Zoll医疗公司 Cpr表现的实时评估
JP5993878B2 (ja) * 2011-02-22 2016-09-14 コーニンクレッカ フィリップス エヌ ヴェＫｏｎｉｎｋｌｉｊｋｅ Ｐｈｉｌｉｐｓ Ｎ．Ｖ． 患者状態の自動診断のための二酸化炭素モニタリングシステム
US20150164417A1 (en) * 2012-05-31 2015-06-18 Lifewave, Inc. Medical radar system for guiding cardiac resuscitation
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CN104368069A (zh) * 2014-10-15 2015-02-25 南阳市行知专利技术服务有限公司 一种呼吸与精确按压结合的心肺复苏系统
KR20160079324A (ko) 2014-12-26 2016-07-06 유재빈 심폐소생 보조기구
CN110368286A (zh) * 2018-04-12 2019-10-25 西安瑞新康达医疗科技有限公司 一种无线心肺复苏指导装置
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JP7306715B2 (ja) * 2020-09-10 2023-07-11 有限会社ティークラフト 胸骨圧迫補助装置
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EP1128795A4 (fr) * 1998-11-09 2004-07-14 Revivant Corp Moniteur de compression thoracique permettant de proceder a une reanimation cardio-vasculaire
JP4610693B2 (ja) * 1999-05-31 2011-01-12 レーダル・メディカル・エーエス 救命状況又はその練習状況における胸部圧縮の際にパラメータを測定及び利用する装置
JP2001037740A (ja) * 1999-05-31 2001-02-13 Laerdal Medical As 救命状況又はその練習状況における胸部圧縮の際にパラメータを測定及び利用する装置
EP1057451A3 (fr) * 1999-05-31 2004-03-24 Laerdal Medical AS Système pour la mesure et l'utilisation de paramètres pendant la compression du thorax pour la réanimation cardio-pulmonaire ou sa simulation
US7310553B2 (en) 2000-02-04 2007-12-18 Zoll Medical Corporation Integrated resuscitation
JP2009131639A (ja) * 2000-02-04 2009-06-18 Zoll Medical Corp 救急蘇生用システム
US9433554B2 (en) 2000-02-04 2016-09-06 Zoll Medical Corporation Integrated resuscitation
WO2002015836A2 (fr) 2000-08-23 2002-02-28 Cpr Devices Ltd. Dispositif de surveillance de reanimation cardio-respiratoire
WO2002015836A3 (fr) * 2000-08-23 2002-07-25 Cpr Devices Ltd Dispositif de surveillance de reanimation cardio-respiratoire
WO2004066901A1 (fr) * 2003-01-27 2004-08-12 Isis Innovation Limited Stimulateur cardiaque mecanique externe
US8160698B2 (en) 2003-02-19 2012-04-17 Zoll Medical Corporation CPR sensitive ECG analysis in an automatic external defibrillator
US6961612B2 (en) 2003-02-19 2005-11-01 Zoll Medical Corporation CPR sensitive ECG analysis in an automatic external defibrillator
US7220235B2 (en) 2003-06-27 2007-05-22 Zoll Medical Corporation Method and apparatus for enhancement of chest compressions during CPR
US10058477B2 (en) 2003-11-06 2018-08-28 Zoll Medical Corporation Method and apparatus for enhancement of chest compressions during CPR
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US9521978B2 (en) 2003-11-06 2016-12-20 Zoll Medical Corporation Using chest velocity to process physiological signals to remove chest compression artifacts
US8862228B2 (en) 2003-11-06 2014-10-14 Zoll Medical Corporation Using chest velocity to process physiological signals to remove chest compression artifacts
US7565194B2 (en) 2004-05-12 2009-07-21 Zoll Medical Corporation ECG rhythm advisory method
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US11850076B2 (en) 2004-05-12 2023-12-26 Zoll Medical Corporation Automatic cardiac therapy advisor with hidden Markov model processing
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EP1904016A2 (fr) * 2005-07-15 2008-04-02 Thomas E. Lach Appareil de compression de la poitrine par action croisee en cas d'arret cardiaque
EP1904016A4 (fr) * 2005-07-15 2010-10-20 Thomas E Lach Appareil de compression de la poitrine par action croisee en cas d'arret cardiaque
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WO2007148059A1 (fr) * 2006-06-19 2007-12-27 Allan Hopkins Appareil de pompe pour appareil de réanimation cardio-pulmonaire
WO2008015624A3 (fr) * 2006-08-03 2008-04-24 Koninkl Philips Electronics Nv Dispositif d'assistance à la réanimation cardio-respiratoire ayant un détecteur interne pour détecter une caractéristique physiologique
WO2008015624A2 (fr) * 2006-08-03 2008-02-07 Koninklijke Philips Electronics, N.V. Dispositif d'assistance à la réanimation cardio-respiratoire ayant un détecteur interne pour détecter une caractéristique physiologique
EP2198823A1 (fr) * 2008-12-19 2010-06-23 Dräger Medical B.V. Dispositif de ventilation doté d'un mode de réanimation cardio-pulmonaire
WO2014026897A1 (fr) * 2012-08-14 2014-02-20 Schiller Ag Appareil d'aide à la réanimation cardiopulmonaire et procédé pour faire fonctionner ledit appareil
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Also Published As

Publication number Publication date
AU1256599A (en) 1999-06-07
CN1279599A (zh) 2001-01-10
CA2310618A1 (fr) 1999-05-27
NO20002458L (no) 2000-07-14
KR20010032189A (ko) 2001-04-16
AU748550B2 (en) 2002-06-06
PL340830A1 (en) 2001-02-26
BR9814971A (pt) 2000-10-03
IL122234A0 (en) 1998-04-05
JP2001522707A (ja) 2001-11-20
NO20002458D0 (no) 2000-05-12
EP1033960A1 (fr) 2000-09-13

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