Patent Application
20200121552
This disclosure relates to chest compression devices for cardiopulmonary resuscitation (CPR) treatment, and more particularly to active compression-decompression devices and methods.
Cardiopulmonary resuscitation (CPR) is a well-known and valuable method of first aid used to resuscitate people who have suffered from cardiac arrest. CPR requires repetitive chest compressions to squeeze the heart and the thoracic cavity to pump blood through the body. In efforts to provide better blood flow and increase the effectiveness of bystander resuscitation efforts, various mechanical devices have been proposed for performing CPR. In one type of mechanical chest compression device, a belt is placed around the patient's chest and the belt is used to effect chest compressions. These devices have proven to be valuable alternatives to manual chest compression. The devices provide chest compressions at resuscitative rates and depths. A resuscitative rate may be any rate of compressions considered effective to induce blood flow in a cardiac arrest victim, typically 60 to 120 compressions per minute (the CPR Guidelines 2015 recommends 100 to 120 compressions per minute in adult victims), and a resuscitative depth may be any depth considered effective to induce blood flow, and typically 1.5 to 2.5 inches (the CPR Guidelines 2015 recommends 2 to 2.4 inches per compression in adults).
This document describes various systems and methods for performing an active compression and/or decompression (ACD) treatment on a patient. In some implementations, a system may include a platform for placement under a patient, a chest compression actuator comprising a belt configured to extend over a thorax of the patient, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, an upward force actuator, a coupling mechanism for coupling the upward force actuator to the thorax of the patient to transfer a decompressing force from the upward force actuator to the thorax of the patient, a controller, and a motor that is coupled to the belt and configured to receive one or more signals from the controller, the motor configured to respond to the one or more signals from the controller to cause the belt to tighten about the thorax of the patient and exert a compressing force on the thorax of the patient and cause the belt to loosen about the thorax of the patient and allow the upward force actuator to cause decompression of the patient.
In some implementations, the upward force actuator can be configured to affix to the thorax of the patient by the coupling mechanism. In some implementations, the upward force actuator can be configured to couple to the belt, and the belt can be configured to affix to the patient by the coupling mechanism.
In some implementations, the coupling mechanism may include one or more of suction cups, gel, and adhesive.
In some implementations, the upward force actuator includes one or more of a rigid arm, a leaf spring, and an elastic material.
In some implementations, an amount of the decompression of the thorax of the patient can be adjustable based on adjusting a magnitude of the decompressing force on the thorax of the patient by the upward force actuator. In some implementations, the magnitude of the decompressing force on the thorax of the patient by the upward force actuator can be adjustable by adjusting a tension in the upward force actuator.
In some implementations, the magnitude of the decompression of the thorax of the patient can be adjustable based on adjusting a range of motion of the upward force actuator relative to the platform. In some implementations, the upward force actuator can be formed by the motor and the belt. The coupling mechanism may include an adhesive configured to affix the belt to the thorax of the patient. The motor can be configured to respond to the one or more signals from the controller to cause the belt to loosen about the thorax of the patient and enable the belt to exert the decompressing force on the thorax of the patient.
In some implementations, the belt may include a rigid material. The belt may extend from a first actuator on the first side of the patient to a second actuator on the second side of the patient. One of the first actuator or the second actuator may include the motor.
In some implementations, at least one of the first and second actuators may include a rack and pinion configuration to couple the belt to the motor. At least one of the first and second actuators can be configured to affix to an end of the belt and retract into the platform.
In some implementations, the range of the decompressing force may include a magnitude between approximately 1-25 lbs.
In some implementations, causing the belt to tighten about the thorax of the patient and exert a compressing force on the thorax of the patient may include compressing the thorax from an initial state of zero compression past a state of neutral compression to a state of full compression. The upward force actuator may decompress the thorax from the state of full compression past the state of neutral compression to the initial state of zero compression.
In some implementations, the upward force actuator decompresses the thorax from a state of full compression past a state of neutral compression and past an initial state of zero compression to a state of positive decompression.
In some implementations, the upward force actuator may include a collapsible arm that can be coupled to the platform on the first side of the patient, the second side of the patient, or both the first and second sides of the patient. The collapsible arm can be coupled to the belt or to the thorax of the patient. The collapsible arm can be configured to deform when the motor causes the belt to tighten about the thorax of the patient. The collapsible arm can be configured to re-straighten when the motor causes the belt to loosen about the thorax of the patient thereby exerting the decompressing force on the thorax of the patient.
In some implementations, the upward force actuator may include at least one rigid arm configured to couple to the belt or couple to the thorax of the patient. The rigid arm may be coupled to the platform by a hinge. The rigid arm may be configured to rotate about the hinge from a position under the platform or alongside the platform to a position over the platform. In some implementations, the rigid arm may include an adjustable pivot point for the hinge.
In some implementations, the upward force actuator may include a leaf spring, a rigid arm, or a collapsible arm configured to couple to the belt. The leaf spring, the rigid arm, or the collapsible arm can be in tension when the motor causes the belt to tighten about the thorax of the patient. The leaf spring, the rigid arm, or the collapsible arm may be configured to cause the belt to exert the decompressing force on the thorax of the patient when the motor causes the belt to loosen about the thorax of the patient.
In some implementations, the upward force actuator comprises an elastic material configured to be in tension when the motor causes the belt to tighten about the thorax of the patient and configured to exert the decompressing force on the thorax of the patient when the motor causes the belt to loosen about the thorax of the patient.
In some implementations, the leaf spring can be a first leaf spring, and the system may include a second leaf spring that can be coupled to the belt, the first leaf spring being affixed to the platform on the first side of the patient and the second leaf spring being affixed to the platform on the second side of the patient.
In some implementations, the upward force actuator may include a leaf spring, a rigid arm, or a collapsible arm configured to couple to the thorax of the patient, the leaf spring, the rigid arm, or the collapsible arm being in tension when the motor causes the belt to tighten about the thorax of the patient, and wherein the leaf spring, rigid arm or collapsible arm can be configured to cause decompression of the patient when the motor causes the belt to loosen about the thorax of the patient.
In some implementations, the system may include an arm extending from the platform over the patient from the first side of the patient to the second side of the patient, the arm being coupled to the belt and being rigid or semi-rigid. In some implementations, the system may include an arm extending from the platform over the patient, the arm being coupled to the belt or to the thorax of the patient by the upward force actuator. In some implementations, a height or a position of the arm can be adjustable to adjust a magnitude of the decompressing force of the upward force actuator on the patient. In some implementations, the arm may include a first arm and a second arm, and the first arm extends from the platform substantially perpendicular to the platform and the second arm extends from the first arm substantially parallel to the platform, and partially over the patient. In some implementations, the second arm can be adjustable relative to the first arm.
In some implementations, the upward force actuator may include an elastic material configured to be in tension when the motor causes the belt to tighten about the thorax of the patient and configured to exert the decompressing force on the thorax of the patient when the motor causes the belt to loosen about the thorax of the patient. The elastic material can include a cord or a strap. A tension or a length of the elastic material can be adjustable. In some implementations, the arm or the upward force actuator may include a sensor for measuring the decompressing force of the elastic material.
In some implementations, the upward force actuator may include a spring configured to be in tension when the motor causes the belt to tighten about the thorax of the patient and configured to exert the decompressing force on the thorax of the patient when the motor causes the belt to loosen about the thorax of the patient. A tension of the spring can be adjustable. The arm or the upward force actuator can include a sensor for measuring the decompressing force of the spring. The controller can be configured to control the motor in response to a signal from the sensor. In some implementations, a measurement of the decompressing force can be displayed on a display of the system or a remote display. The sensor can include a strain gauge.
In some implementations, the system may include a force sensor configured to measure a tension in the arm or the upward force actuator.
In some implementations, the arm can be a first arm, and the system may include a second arm coupled to the belt and configured to intersect the first arm over the thorax of the patient. The first arm or the second arm can be adjustable relative to the other of the first and second arms. The first arm or second arm may include a telescoping rod to allow for adjustment of position or height of the first or second arm relative to the platform or thorax of the patient.
In some implementations, the arm can include a series of segmented sections to permit the arm to be collapsed into a roll and to enable the arm to form a rigid arch. In some implementations, the arm can include a series of segmented sections to permit the arm to be collapsed into a roll and to enable the arm to form a rigid arch.
In some implementations, the upward force actuator can include a plurality of rods affixed to the belt, wherein each rod of the plurality can be configured for insertion into a respective receptacle on the platform to couple the rod to the platform.
In some implementations, the upward force actuator may include a plurality of rods affixed to the platform, wherein each rod of the plurality can be configured for insertion into a respective receptacle on the belt to couple the rod to the belt.
In some implementations, the system may include a first arm extending from the platform on the first side and a second arm extending from the platform on the second side. The first arm and the second arm may each be configured to couple to the upward force actuator The upward force actuator may include a strap extending from the first arm to the second arm, the strap being affixed to the belt. In some implementations, a length of the strap between the first arm and the second arm can be adjustable.
In some implementations, the belt can be configured to couple to a structure that can be separate from the platform, the belt being configured to couple to the structure by an upward force actuator, wherein the upward force actuator can be configured to exert the decompressing force on the thorax of the patient when the motor causes the belt to loosen about the thorax of the patient. In some implementations, the upward force actuator may include an elastic material. In some implementations, the elastic material may include a spring, strap or cord. In some implementations, the system may include a lever arm affixed to the belt at a first end of the lever arm and affixed to the upward force actuator at a second end that can be opposite the first end.
In some implementations, the system may include a strain gauge in communication with the upward force actuator, wherein the controller can be configured to control the motor in response to a signal from the strain gauge indicative of the decompressing force exerted by the upward force actuator.
In some implementations, the belt may include a force-distributing mechanism configured to spread out the compressing force over an area of the thorax. In some implementations, the force-distributing mechanism may include a bladder that may include one or more of foam and a plurality of tension cords. In some implementations, the leaf spring, the rigid arm, or the elastic material can be coupled to the platform by an actuator.
In some implementations, a portion of the platform can be adjustable about a pivot to support at least a portion of the patient at an angle with respect to a floor surface, wherein the platform may include a center of gravity that can be below an interface surface of the patient to stabilize the platform when the portion of the platform can be angled.
In some implementations, the system may include a sensor or a force sensor configured to measure the decompressing force of the upward force actuator. In some implementations, the controller may be configured to control the motor in response to a signal from the sensor or force sensor.
In some implementations, an amount of the decompression of the thorax of the patient can be adjustable based on adjusting a magnitude of the decompressing force on the thorax of the patient by the upward force actuator. In some implementations, the amount of decompression of the thorax can be one selected from chest displacement to a neutral point, a zero point, or past zero point.
In some implementations, a belt for integration with an active compression decompression (ACD) treatment system can include a first portion configured to couple to a thorax of a patient and provide a compressive force on the patient, a second portion configured to couple to a chest compression actuator, a third portion configured to couple to an upward force actuator that provides a decompressing force to the belt, and a fourth portion comprising a coupling mechanism configured to attach to the patient, wherein the belt can be configured to transfer the decompressing force from the upward force actuator to the patient.
In some implementations, the first portion can include a force-distributing mechanism. The third portion can include a top surface configured to couple to the upward force actuator. The fourth portion can include a bottom surface of the belt that can be opposite the top surface. The top surface can be connected to the bottom surface by one or more tensile elements configured to transfer the decompressing force from the top surface of the belt to the bottom surface of the belt.
In some implementations, the upward force actuator can include a collapsible rod that can be integrated into the belt along a length of the belt, the collapsible rod configured to deform when a compressing force can be applied by the chest compression actuator and re-straighten when the chest compression actuator ceases application of the compressing force.
In some implementations, the coupling mechanism of the belt may include one or more of suction cups, adhesive, or a gel. In some implementations, the coupling mechanism of the belt can be configured to provide a force between 1-25 lbs. In some implementations, the upward force actuator can include a rigid rod integrated into the belt along a length of the belt, and wherein the belt may include a first end configured to couple to a first downward actuator, and a second end configured to couple a second downward actuator, the first end being opposite the second end. In some implementations, the first end and second end of the belt each include a linear gear rack.
In some implementations, the third portion may include a hook configured to couple to the upward force actuator, the upward force actuator comprising an elastic device. The third portion can include a lever, wherein the hook can be located at an end of the lever. The upward force actuator can include a plurality of semi-rigid rods affixed to the third portion of the belt, wherein each rod of the plurality can be configured for insertion into a respective receptacle on a platform to couple the belt to the platform. In some implementations, the belt can include a high-tensile strength material that may include one or more of fabric. In some implementations, the one or more tensile elements include one or more of an elastic cord or a spring. In some implementations, the force-distributing mechanism may include a bladder that may include one or more of foam and a plurality of tension cords. In some implementations, the bladder can be air filled or foam filled.
In some implementations, a system for performing an active compression decompression (ACD) treatment on a patient can include a platform for placement under a patient, a chest compression actuator configured to extend over a thorax of the patient, the chest compression actuator configured to extend from the platform, a first arm coupled to the platform on the first side of the patient, a second arm coupled to the platform on a second side of the patient, an upward force actuator coupled to the first arm and the second arm, a coupling mechanism for coupling the upward force actuator to the thorax of the patient to transfer a decompressing force from the upward force actuator to the thorax of the patient. A motor may be coupled to the chest compression actuator and may be configured to cause the chest compression actuator to compress the thorax of the patient and exert a compressing force on the thorax of the patient and cause the chest compression actuator to release the compressing force and allow the upward force actuator to cause decompression of the patient.
In some implementations, the chest compression actuator can include a belt configured to extend over a thorax of the patient, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, and wherein the motor causes the belt to tighten about the thorax of the patient and exert a compressing force on the thorax of the patient and causes the belt to loosen about the thorax of the patient and allow the upward force actuator to cause decompression of the patient.
In some implementations, the coupling mechanism can include one or more of suction cups, gel, and adhesive. In some implementations, the chest compression actuator can include a piston. In some implementations, the upward force actuator may include a strap. In some implementations, the upward force actuator can be configured to affix to the thorax of the patient.
In some implementations, the upward force actuator can be configured to couple to the chest compression actuator, and wherein the chest compression actuator can be configured to affix to the patient by a coupling mechanism.
In some implementations, the upward force actuator can include an elastic material. The elastic material can include one or more of an elastic cord, a spring, or a bungee. The upward force actuator can include a cord, and the cord can be coupled to each of the first arm and the second arm by a respective pulley.
In some implementations, the system may include a sensor for measuring the decompressing force of the upward force actuator. In some implementations, the controller can be configured to control the motor in response to a signal from the sensor.
In some implementations, an amount of the decompression of the thorax of the patient can be adjustable based on adjusting a magnitude of the decompressing force on the thorax of the patient by the upward force actuator. The magnitude of the decompressing force on the thorax of the patient by the upward force actuator can be adjusted by adjusting a tension in the upward force actuator. The magnitude of the decompression of the thorax of the patient can be adjustable based on adjusting a range of motion of the upward force actuator relative to the platform.
In some implementations, a system for performing an active compression decompression (ACD) treatment on a patient includes a platform for placement under a patient, a chest compression actuator configured to extend over a thorax of the patient, the chest compression actuator configured to extend from the platform, a structure that extends over the patient and that can be rigid, an upward force actuator coupled to the structure, a coupling mechanism for coupling the upward force actuator to a thorax of the patient to transfer a decompressing force from the upward force actuator to the thorax of the patient A motor may be coupled to the chest compression actuator and may be configured to cause the chest compression actuator to exert a compressing force on the thorax of the patient and cause the chest compression actuator to release the compressing force and allow the upward force actuator to cause decompression of the patient.
In some implementations, the chest compression actuator can include a belt configured to extend over a thorax of the patient, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, and wherein the motor causes the belt to tighten about the thorax of the patient and exert a compressing force on the thorax of the patient and causes the belt to loosen about the thorax of the patient and allow the upward force actuator to cause decompression of the patient. The coupling mechanism can include one or more of suction cups, gel, and adhesive. The chest compression actuator can include a piston. In some implementations, the structure can be attached to the platform. The structure can be a rigid arm or rod that extends partially over the patient, and the arm or rod can be adjustable relative to the platform such that the arm or rod includes a telescoping rod or adjustable hinge height. The structure can be separate from the platform. The upward force actuator can be coupled to the structure and affixed directly to the patient. The upward force actuator can be coupled to the structure and coupled to the belt, wherein the belt can be configured to affix to the patient by a coupling mechanism.
In some implementations, the upward force actuator can include an elastic material. The elastic material can include one or more of an elastic cord, a spring, or a bungee.
In some implementations, the system includes a sensor for measuring the decompressing force of the upward force actuator. In some implementations, the controller can be configured to control the motor in response to a signal from the sensor.
In some implementations, the structure can include a first arm and a second arm, wherein the first arm extends from the platform substantially perpendicular to the platform and the second arm extends from the first arm substantially parallel to the platform, and partially over the patient. The second arm can be adjustable relative to the first arm.
In some implementations, the upward force actuator can include an elastic material. The elastic material can include one or more of an elastic cord, a spring, or a bungee. An amount of the decompression of the thorax of the patient can be adjustable based on adjusting a magnitude of the decompressing force on the thorax of the patient by the upward force actuator.
In some implementations, the magnitude of the decompressing force on the thorax of the patient by the upward force actuator can be adjusted by adjusting a tension in the upward force actuator. In some implementations, the magnitude of the decompression of the thorax of the patient can be adjustable based on adjusting a range of motion of the upward force actuator relative to the platform.
In some implementations, a system for performing an active compression decompression (ACD) treatment on a patient includes a platform for placement under a patient, a chest compression actuator configured to extend over a thorax of the patient, the chest compression actuator configured to extend from the platform, a semi-rigid structure coupled to the platform, a coupling mechanism for coupling the upward force actuator to a thorax of the patient to transfer a decompressing force from the upward force actuator to the thorax of the patient. A motor may be coupled to the chest compression actuator and may be configured to cause the chest compression actuator to exert a compressing force on the thorax of the patient and cause the chest compression actuator to release the compressing force and allow the semi-rigid structure to cause decompression of the patient.
In some implementations, the chest compression actuator includes a belt configured to extend over a thorax of the patient. The belt may be configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side. The motor may cause the belt to tighten about the thorax of the patient and exert a compressing force on the thorax of the patient and cause the belt to loosen about the thorax of the patient and allow the upward force actuator to cause decompression of the patient. In some implementations, the coupling mechanism can include one or more of suction cups, gel, and adhesive. The chest compression actuator can include a piston. The semi-rigid structure can include a leaf spring. The semi-rigid structure can include a collapsible rod. The collapsible rod can include a telescoping rod. The semi-rigid structure can be affixed directly to the patient. The semi-rigid structure can be coupled to the belt, and the belt can be configured to affix to the patient by a coupling mechanism.
In some implementations, the system includes a sensor for measuring the decompressing force of the semi-rigid structure. The controller can be configured to control the motor in response to a signal from the sensor. In some implementations, an amount of the decompression of the thorax of the patient can be adjustable based on adjusting a magnitude of the decompressing force on the thorax of the patient by the upward force actuator. The magnitude of the decompressing force on the thorax of the patient by the upward force actuator can be adjusted by adjusting a tension in the upward force actuator. In some implementations, the magnitude of the decompression of the thorax of the patient can be adjustable based on adjusting a range of motion of the upward force actuator relative to the platform.
In some implementations, a method of providing active compression decompression (ACD) treatment includes providing a system for performing an active compression decompression (ACD) treatment to a patient. The system includes a platform for placement under a patient, a chest compression actuator comprising a belt configured to extend over a thorax of the patient, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, an upward force actuator, a coupling mechanism for coupling the upward force actuator to the thorax of the patient to transfer a decompressing force from the upward force actuator to the thorax of the patient, a controller, and a motor that can be coupled to the belt and configured to receive one or more signals from the controller, the motor configured to respond to the one or more signals from the controller to cause the belt to tighten about the thorax of the patient and exert a compressing force on the thorax of the patient and cause the belt to loosen about the thorax of the patient and allow the upward force actuator to exert a decompressing force on the thorax of the patient. The method may include placing the patient on the platform to align the thorax of the patient with the belt, coupling the upward force actuator to the thorax of the patient directly or via the belt, and initiating operation of the system to cause repeated cycles of tightening and loosening of the belt about the thorax of the patient.
In some implementations, the upward force actuator can include a strap. In some implementations, the upward force actuator can be configured to affix directly to the thorax of the patient.
In some implementations, the upward force actuator can be configured to couple to the belt, and the belt can be configured to affix to the patient by the coupling mechanism. The upward force actuator may include an elastic material. In some implementations, the elastic material can include one or more of an elastic cord, a spring, or a bungee. The upward force actuator can include a cord, and the cord can be coupled to each of a first arm and the second arm by a respective pulley. The system can include a sensor for measuring the decompressing force of the upward force actuator. The controller can be configured to control the motor in response to a signal from the sensor. An amount of the decompression of the thorax of the patient can be adjustable based on adjusting a magnitude of the decompressing force on the thorax of the patient by the upward force actuator. The magnitude of the decompressing force on the thorax of the patient by the upward force actuator can be adjusted by adjusting a tension in the upward force actuator. The magnitude of the decompression of the thorax of the patient can be adjustable based on adjusting a range of motion of the upward force actuator relative to the platform.
In some implementations, a system for performing an active compression decompression (ACD) treatment to a patient includes a platform for placement under a patient, a belt configured to extend over a thorax of the patient, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side, the belt being configured to couple to the thorax of the patient, the belt comprising a rigid or semi-rigid material that causes the belt to maintain an approximate shape when the belt can be coupled to the thorax of the patient, a first actuator affixed to the platform on the first side of the patient, the first actuator coupled to the belt on a first end of the belt, a second actuator affixed to the platform on the second side of the patient, the second actuator coupled to the belt on a second end of the belt that can be opposite the first end, and a controller configured for controlling the first actuator and the second actuator to cause the belt to tighten about the thorax of the patient and exert a compressing force on the thorax of the patient and cause the belt to loosen about the thorax of the patient and exert a decompressing force on the thorax of the patient.
In some implementations, a system for performing an active compression decompression (ACD) treatment to a patient includes a platform for placement under a patient, a chest compression actuator comprising a belt configured to extend over a thorax of the patient, the belt configured to extend from the platform on a first side of the patient to a second side of the patient opposite the first side the belt being configured to couple to the thorax of the patient, a coupling mechanism, an adjustable arm, wherein the arm extends from a side of the platform and partially over the patient, an elastic material extending from the arm and coupled to the belt, a controller, and a motor that can be coupled to the belt and configured to receive one or more signals from the controller, the motor configured to respond to the one or more signals from the controller to cause the belt to tighten about the thorax of the patient and exert a compressing force on the thorax of the patient, while tensioning the elastic material and cause the belt to loosen about the thorax of the patient, allowing the elastic material to lift the belt to exert a decompressing force on the thorax of the patient.
In some implementations, a system for performing an active compression decompression (ACD) treatment on a patient includes a platform for placement under a patient, a chest compression actuator configured to extend over a thorax of the patient, an upward force actuator, a coupling mechanism for coupling the upward force actuator to the thorax of the patient allowing the upward force actuator to exert a decompressing force on the thorax of the patient, a controller, a motor that can be coupled to the upward force actuator and configured to receive one or more signals from the controller, the motor configured to respond to the one or more signals from the controller to cause the chest compression actuator to exert a compressing force on the thorax of the patient and cause the chest compression actuator to cease exerting the compressing force on the patient and enable the upward force actuator to cause decompression of the patient.
In an aspect, a method for performing an active compression decompression (ACD) treatment on a patient, includes providing a system including a platform for placement under a patient. The system includes a chest compression actuator configured to extend over a thorax of the patient, the chest compression actuator configured to extend from the platform. The system includes a structure that extends over the patient and that is rigid, an upward force actuator coupled to the structure, and a coupling mechanism for coupling the upward force actuator to a thorax of the patient to transfer a decompressing force from the upward force actuator to the thorax of the patient. The system includes a motor that is coupled to the chest compression actuator and configured to cause the chest compression actuator to exert a compressing force on the thorax of the patient and cause the chest compression actuator to release the compressing force and allow the upward force actuator to cause decompression of the patient. The method includes placing the patient on the platform to align the thorax of the patient with the chest compression actuator, coupling the upward force actuator to the thorax of the patient directly or via the chest compression actuator, and initiating operation of the system to cause repeated cycles of tightening and loosening of the belt about the thorax of the patient.
The devices and methods for active compression-decompression (ACD) for use in cardiopulmonary resuscitation (CPR) treatment may provide at least one or more of the following advantages. The ACD device is configured to compress and decompress a patient's chest during CPR treatment. Decompression of the patient's chest (e.g., pulling up on the patient's chest) may increase negative intrathoracic pressure and may cause more blood to flow through the patient than performing compressions alone. For some patients, in some implementations, an impedance threshold device with a check valve may be positioned in an airway of the patient when the patient is intubated. For some patients, the valve allows air to exit the lungs of the patient when the patient's chest is compressed, and prevents air from entering the lungs when the patient's chest is decompressed. Preventing air from entering the chest during decompression may allow more blood to be pumped through the patient. The ACD device may include a load-distributing device that spreads a force of compression and/or decompression on the patient, further reducing a likelihood of injuring the patient (e.g., relative to manual compressions or decompressions with conventional devices).
The ACD device performs automatic ACD treatment of a patient. A user of the device need not perform compressions and decompression of the patient manually, but can program the ACD device to perform ACD treatment continuously or as needed. The ACD device may perform compressions and decompressions of consistent depth so as not to over compress the chest of the patient and over decompress the chest of the patient, each of which may potentially cause injury to the patient. The ACD device can be calibrated to a particular compression force, compression/decompression depth, and/or frequency to maximize the effectiveness of the ACD treatment on the patient. One or more sensors (e.g., force sensors, accelerometers, etc.) can be used to measure parameters (e.g., depth, frequency, force, etc.) of the compressions and/or decompressions and provide feedback to the ACD device. The ACD device may include a mechanism to limit the maximum decompression and/or compression of the ACD treatment. In some implementations, the limits can be adjusted based on the patient and can be applied based on feedback received from the one or more sensors. For example, if the force being applied in a compression or decompression exceeds a threshold as measured by the one or more sensors, the ACD device reduces the force being applied to the patient. In some implementations, hardware limitation(s) are included to prevent compression and/or decompression forces and/or depths from exceeding preset thresholds.
The ACD device can be modular such that the compression and/or decompression elements of the ACD device can be added or removed as required for treatment. For example, the ACD device can include a decompression device (arm, leaf spring, etc.) that can pivot or retract out of the way when not needed for treatment (e.g., during defibrillation or other treatment).
The details of one or more embodiments of the ACD devices and methods for ACD treatment are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the ACD devices and methods will be apparent from the description and drawings, and from the claims.
Like reference symbols in the various drawings indicate like elements.
The platform 102 is configured to support a patient. For ACD treatment, the platform 102 supports the patient such that a chest region (e.g., thorax) of the patient rests between the chest compression actuator 104 and the platform 102. The exact position of the patient can vary depending on the size of the patient relative to the platform 102. In some implementations, the platform includes a rotatable joint so that a portion of the platform 102 may bend and lift a head and shoulder region of the patient (e.g., during ACD treatment). The platform 102 may be sized such that a center of gravity of the ACD device 100 is underneath the thorax portion of the patient, which may not be lifted. The compression portion 114 of the platform that does not lift supports the thorax of the patient. This configuration balances the ACD device 100 under the patient's body and permits the head and shoulder regions of the patient to remain lifted by the ACD device 100 without external support.
The chest compression actuator 104 includes all elements of the ACD device 100 which work to compress the patient's thorax for the compression phase of the ACD treatment. The chest compression actuator 104 thus includes a belt 106, motors/actuators (not shown), and a force distributing mechanism 112. In some implementations, the chest compression actuator 104 includes a downward force actuator configured to exert a downward force on the patient. In some implementations, the chest compression actuator includes a compressive actuator that can exert a downward force on the patient but also other forces for compressing the chest of the patient, the other forces including some lateral portion (e.g., compressing the sides of the patient's chest inward).
In some implementations, the chest compression actuator 104 is configured to apply compressions to the patient with a compression belt 106. The belt 106 is coupled to the platform 102 at a first side 108 of the platform on a first side of the patient and at a second side 110 of the platform on a second side of the patient. The platform 102 provides a housing for a drive train of the chest compression actuator 104 and control system for the ACD device 100. The control system, provided anywhere in the device, can include a processor and may be operable to control tightening operation of the belt and to provide output on a user interface disposed on the housing. Operation of the device can be initiated and adjusted by a user through a control panel and/or a display operated by the control system to provide feedback regarding the status of the device to the user. The motor(s) that actually cause the belt to tighten about the patient to compress the patient's chest are controlled by a controller (described in further detail below). The controller causes the motor(s) to tighten and/or loosen the belt 106 by sending control signals to the motor(s). As described in further detail with respect to
The chest compression actuator 104 includes a load-distribution portion 112. In some implementations, the load distribution portion is located at the mid-portion of the belt and left and right belt ends. When fitted on a patient, the load distribution portion 112 is disposed over the anterior chest wall of the patient, and the left and right belt ends extend posteriorly over the right and left axilla of the patient, under the patient's arms (e.g., under the armpits of the patient) to connect to their respective actuators, e.g., lateral drive spools (e.g., to couple with the platform at first side 108 and second side 110). The drive spools at first side 108 and second side 110 are disposed laterally on either side of the housing. The belt 106 is secured to these drive spools. The lateral drive spools are in turn driven by a motor (not shown) also disposed within the housing, through a drive shaft and drive belt. The belt 106 can be attached to the lateral drive spools such that, upon rotation of the drive spools, the belt 106 is pulled into the platform and spooled upon the lateral spools, thereby drawing the belt downward to compress the chest of the patient. After the chest of the patient is compressed, the chest compression actuator 104, driven by the motor and controlled by the controller, loosens the belt 106 around the patient. The patient's chest is permitted to decompress as the chest compression actuator 104 ceases application of a compressing force and loosens the belt 106 around the patient. The cycle of controlling the chest compression actuator 104 to tighten the belt to compress the patient's chest and subsequently controlling the chest compression actuator 104 to loosen the belt and allow the patient's chest to decompress is one compression cycle of the ACD CPR treatment. The compression of the patient during this cycle is referred to as the compression phase, and the decompression of the patient during this cycle is referred to as the decompression phase. The chest compression actuator 104 can include one or more implementations of the AutoPulse® device of ZOLL Medical Corporation of Chelmsford, Mass., such as those described in U.S. application Ser. No. 15/942,292 and U.S. application Ser. No. 15/942,309, incorporated herein by reference in entirety.
In some implementations, the chest compression actuator 104 includes a piston-based compressing actuator instead of or an addition to the chest compressive belt 106. The piston-based chest compression actuator 106 delivers a compressive force to the chest of a patient. The piston-based chest compression actuator works with the upward force actuator to perform ACD treatment and is described in further detail below with respect to
The upward force actuator, e.g., upward force actuator 120, is a device that applies an upward force on the thorax (e.g., chest) of the patient. The upward force actuator includes a mechanical device configured to pull up on the patient's chest (either directly or via the chest compression actuator 104) to decompress the chest of the patient. The upward force actuator lifts the chest wall, decompresses the chest cavity of the patient, and decreases intrathoracic pressure in the patient.
Upward force actuator 120 includes an arm 122 having a first end coupled to the platform 102, on one side of the patient, and a second end extending over and above the patient. An elastic element 124 extends from the second end of the arm and is coupled via a coupling mechanism 126 directly to the patient's chest or is coupled to the belt 106 or load distribution portion 112 or plate, which is coupled to the patient's chest.
The arm 122 can be rigid or semi-rigid and supports the elastic element 124 over the chest of the patient 128. The arm 122 can include a single member or two or more members that can be assembled and/or moved relative to one another. The arm 122 can be configured to fold up from a stored position (e.g., next to or underneath the platform 102). The arm 122 can be configured to be a telescoping arm, a foldable arm, etc. The arm 122 can be set to different heights above the platform 102 to accommodate various chest sizes of patients. The arm 122 can be adjusted using a sliding mechanism, one or more notches, etc. In some implementations, the arm can be loosened and fixed into place with a thumbscrew, wingnut, or similar such mechanism. The elastic element 124 is configured to couple to the arm 122. In some implementations, the elastic element is detachable from the arm 122. In some implementations, the elastic element 124 is affixed to the arm 122. The arm can be arcuate, form a right angle, etc. over the patient. The position of the arm 122 over the patient can be adjustable (e.g., laterally adjustable) so that the elastic element 124 can be finely adjusted into place without requiring repositioning of the patient on the platform. For example, at least a portion of the arm 122 can swivel and lock into place as needed.
In some implementations, the ACD device 100 is combined with an intubation device (not shown) including a check valve that prevents air from entering the chest cavity during decompressions. During ACD CPR treatment, decompressing the chest cavity and decreasing intrathoracic pressure each help to increase the amount of blood pumped through the patient and thus improve the effectiveness of the compression treatment. The upward force actuator includes a mechanical device that is coupled to the platform 102 and to the thorax of the patient. The upward force actuator 120 is configured to decompress the thorax of the patient during the decompression phase. When the belt 106 of the chest compression actuator 104 is loosened, the upward force actuator 120 is able to lift the chest wall to decompress the patient. When the belt 106 of the chest compression actuator 104 is tightened, the upward force actuator 120 does not prevent the chest from compressing, though the upward force actuator 120 may remain coupled to the thorax of the patient through the entire compression cycle. The upward force actuator 120 can include a variety of embodiments for providing the upward force on the thorax of the patient. Various embodiments of the upward force actuator are described below in relation to
In some implementations, the ACD device 100 may not include the belt 106 or load distribution portion 112 as described with reference to
The upward force actuator 304 includes a rigid or semi-rigid structure 318, e.g., one or more rods or arms, and an elastic element 320. The structure 318 of the upward force actuator 304 is coupled to the platform 302 at a first side 314 of the platform and at a second side 316 of the platform, on first and second sides of the patient 312, respectively. The structure 318 thus extends over the thorax of the patient 312 when the patient is on the platform 302. In some implementations, the structure 318 need not extend completely from the first side 314 to the second side 316, but can extend partway (e.g., about halfway) from the first side to the second side over the thorax of the patient 312. In some implementations, the structure 318 couples to the platform by inserting into a corresponding slot in the platform 302 at the first side 314 and another corresponding slot in the platform at the second side 316, and subsequently fastened in place by a thumbscrew or similar mechanism. The structure 318 can be removed from the platform 302 to allow the patient 312 to lay down on the platform 302 and then placed over the patient for performing ACD treatment. The structure 318 may be adjustable, e.g., the height of the structure 318 relative to the platform 302 may be adjusted by changing the position of the structure in one or more of the notches or grooves 317. The tension of the elastic element 320 may also be adjustable.
In some implementations, at least a portion of the structure 318 is coupled to the platform 302 (e.g., at side 314, side 316, or both sides) by rotating hinges. The structure 318 can be rotated over the patient 302 from a position that is approximately planar with the platform to the approximately orthogonal position shown in
The elastic element 320 is coupled to the structure 318 and to the patient 312. The elastic element 320 includes one or more of a spring (e.g., a coil spring), a bungee cord, an elastic material, etc. The elastic element 320 is configured to couple to the thorax of the patient 312 by a coupling mechanism. The coupling mechanism of the elastic element 320 can include one or more of a gel, suction cup(s), or adhesive or other plate or base that sticks to the skin of the patient 302. The elastic element 320 of the upward force actuator 304 pulls up on the chest of the patient 312. During the decompression phase of the ACD compression cycle, when the belt 306 is loosened around the patient 312, the upward force actuator 304 pulls the chest wall upward and decompresses the chest of the patient 312. During the compression phase of the ACD compression cycle, the elasticity of the elastic element 320 of the upward force actuator 304 allows the chest compression actuator 104 to tighten the belt 106 and compress the thorax of the patient 312. The elastic element 320 extends during the compression phase and exerts an upward force on the chest wall of the patient.
In some implementations, the elastic element 320 is configured to couple with the chest compression actuator 104, such as to the belt 106. The elastic element 320 can couple to the chest compression actuator 104 using a hook, latch, or hook and loop mechanism, e.g., a Velcro® material, etc. Here, the belt 306 is configured to couple with the thorax of the patient by suction cups, an adhesive, etc. The elastic element 320 of the upward force actuator 304 pulls up on the belt 306 (or other portion of the chest compression actuator 104) affixed to the patient's chest, thereby pulling the chest wall upward during the decompression phase of the ACD compression cycle when the belt 306 is loosened around the patient 312. The elastic element 320 allows the chest compression actuator 104 to tighten the belt 106 and compress the thorax of the patient 312 during the compression phase of the ACD compression cycle.
The amount of decompression of the thorax of the patient may be adjustable by adjusting a magnitude of the decompressing force on the thorax of the patient to achieve a desired level of decompression. The zero position of the chest refers to the resting position of the chest before the commencement of compressions. After commencement of compressions, the shape of the thorax will remodel due to the breakdown of the sterno-costal cartilage, sternal and costal fractures, and changes in the biomechanical properties of other anatomical features. The neutral position of the chest refers to the static resting position that the chest returns to after the commencement of compressions when the compressions are paused.
The structure 318 and/or the elastic element 320 of the upward force actuator 304 can be tuned to provide a specific force or force curve for a desired amount of decompression of the patient. For example, the structure 318 and/or the elastic element 320 of the upward force actuator 304 can be configured to provide between 1-25 lbs. of predetermined decompression force. In some embodiments, the structure 318 and elastic element 320 are configured to provide maximum upward force (e.g. 3, 5, 10, 15, 20 lbs.) at the point of deepest compression, and that decreases as the depth approaches either the zero or neutral point during the decompression phase. In other words, at the start of the decompression phase, the force is greater than at the end of the decompression phase, e.g. the force at end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5%, or 1% of the force at the start of the decompression phase.
In some embodiments, the upward force actuator 304 can be configured to deliver a sufficient amount of force to achieve a specific depth at the point of maximum decompression upstroke that is either below or above either the zero point or neutral point. In some embodiments, the achieved upward displacement of the chest may be the zero or neutral position of the chest. In another example, the structure 318 and/or the elastic element 320 of the upward force actuator 304 can be configured to provide decompression force sufficient to achieve an upward displacement of the chest relative to the neutral or zero position of the chest of about 0.25 to 4 inches. On a typical patient, approximately 5-20 lbs. of upward force would be needed to achieve an upward displacement of 2 inches relative to the neutral or zero position.
In some implementations, the upward force actuator 360 works with the chest compression actuator 104 as a system of two belts with two motors, or one belt that is connected and a motor that spins clockwise or anticlockwise. The chest compression actuator 104 includes a belt 106 that is tightened with the motor (not shown) going a first direction (e.g., counterclockwise) for compression. The motor rotates in a second direction (e.g., clockwise) to tighten the belt 366 and lift the belt 104 to decompress the patient's chest. A coupling device 112 attaches to the patient's chest (e.g., by suction cup or other methods) for decompression. In some implementations, arm(s) 368 may provide a portion of the decompression force. The belts 106, 366 perform compression/decompression actively (e.g., rather than passively with an elastic element). In some implementations, belts 106 and 366 are a single continuous belt that loops though arm(s) 368, over pulleys 362, 364, fastening to the arm at 370, 372, and attaches to the patient at 112. Optionally, the belts 106, 366 can be a plurality of separate belts. In some implementations, the upward force actuator 360 can be a separate unit which may be retrofit to an existing chest compression device, or it may be integral to a chest compression device.
In some embodiments incorporating semi-rigid arms, when the belt 106 is loosened during the decompression phase, the arms 402, 404 each spring back to the original form shown in
In some implementations, the ACD devices described herein as utilizing a belt as the chest compression actuator for compressing a patient's thorax may not include the belt but instead may include another device for the chest compression actuator 104. For example, the ACD device may include a piston or other rigid device to compress the chest of the patient. Portions of the upward force actuator, such as arms 402, 404, and/or a spring or elastic element can couple to the piston device and exert the upward decompressing force on the piston, which is affixed to and pulls up upon the chest of the patient. Alternatively, the arms, spring or elastic element can be coupled directly to the patient's thorax and pull up upon the chest of the patient. An upward force actuator including a piston is described in further detail with respect to
The arms 402, 404 are coupled to the platform 102 by coupling mechanisms 412, 414, respectively. As stated above, the coupling mechanisms can include one or more of a rotating joint, ball-and-socket joint, etc. The arms 402, 404 can be stowed to the sides of the platform until the patient 408 is positioned for ACD treatment, whereupon the arms 402, 404 can then be moved into place and affixed to the patient and/or the belt 106.
The arms 402, 404 can be tuned to provide a specific force or force curve for a desired amount of decompression of the patient. For example, the arms 402, 404 can be configured to provide between 1-25 lbs. of predetermined decompression force. In some embodiments, the arms 402, 404 are configured to provide maximum upward force (e.g. 3, 5, 10, 15, 20 lbs.) at the point of deepest compression, and that decreases as the depth approaches either the zero or neutral point during the decompression phase. In other words, at the start of the decompression phase, the force is greater than at the end of the decompression phase, e.g. the force at end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5%, or 1% of the force at the start of the decompression phase.
In some embodiments, the upward force actuator 400 can be configured to deliver a sufficient amount of force to achieve a specific depth at the point of maximum decompression upstroke that is either below or above either the zero point or neutral point. In some embodiments, the achieved upward displacement of the chest may be the zero or neutral position of the chest. In another example, the arms 402, 404 of the upward force actuator 400 can be configured to provide decompression force sufficient to achieve an upward displacement of the chest relative to the neutral or zero position of the chest of about 0.25 to 4 inches. On a typical patient, approximately 5-20 lbs. of upward force would be needed to achieve an upward displacement of 2 inches relative to the neutral or zero position.
Turning to
Actuators 506, 508 on each side of the patient actuate the rigid material 502 both up and down relative to the platform 102 to compress the thorax of the patient and decompress the thorax of the patient. In some implementations, the rigid material 502 is inserted into the actuators 506, 508 in the platform 102 after the patient is positioned on the platform for ACD treatment.
The actuators 506, 508 each include a coupling mechanism to enable motors of the actuators to drive each end of the rigid material up and down (e.g., shown by arrows 514) to exert decompression and compression forces, respectively. For example, as shown in
The actuators 506, 508 can be tuned to provide a specific force or force curve for a desired amount of decompression of the patient. For example, the actuators 506, 508 can be configured to provide between 1-25 lbs. of predetermined decompression force. In some embodiments, the actuators 506, 508 are configured to provide maximum upward force (e.g. 3, 5, 10, 15, 20 lbs.) at the point of deepest compression, and that decreases as the depth approaches either the zero or neutral point during the decompression phase. In other words, at the start of the decompression phase, the force is greater than at the end of the decompression phase, e.g. the force at end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5%, or 1% of the force at the start of the decompression phase.
In some embodiments, the upward force actuator 500 can be configured to deliver a sufficient amount of force to achieve a specific depth at the point of maximum decompression upstroke that is either below or above either the zero point or neutral point. In some embodiments, the achieved upward displacement of the chest may be the zero or neutral position of the chest. In another example, the actuators 506, 508 of the upward force actuator 500 can be configured to provide decompression force sufficient to achieve an upward displacement of the chest relative to the neutral or zero position of the chest of about 0.25 to 4 inches. On a typical patient, approximately 5-20 lbs. of upward force would be needed to achieve an upward displacement of 2 inches relative to the neutral or zero position.
The rigid material 502 of the upward force actuator 500 extends from the actuator 506 to the actuator 508 when performing ACD treatment. The rigid material 502 can include one or more of plastic, fiberglass, aluminum, carbon fiber, glass-filled polycarbonate, carbon fiber, polyurethane, overmolded beryllium-copper leaf springs. The rigid material 502 of the upward force actuator 500 may be configured to affix to the thorax of the patient. The rigid material is affixed to the patient as described above. When the actuators drive the rigid material 502 up relative to the platform during the decompression phase of the compression cycle, the rigid material pulls upward on the chest wall, decompressing the chest. When the actuators drive the rigid material 502 down relative to the platform during the compression phase of the compression cycle, the rigid material pulls downward on the chest wall, compressing the chest. The rigid material 502 moves directly up and down to pull up/down on the chest wall, minimizing or avoiding squeezing the sides of the patient.
Turning to
The angle of the arm 600 can be tuned to provide a specific force or force curve for a desired amount of decompression of the patient. For example, the arm 600 can be configured to provide between 1-25 lbs. of predetermined decompression force. In some embodiments, the arm 600 is configured to provide maximum upward force (e.g. 3, 5, 10, 15, 20 lbs.) at the point of deepest compression, and that decreases as the depth approaches either the zero or neutral point during the decompression phase. In other words, at the start of the decompression phase, the force is greater than at the end of the decompression phase, e.g. the force at end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5%, or 1% of the force at the start of the decompression phase.
In some embodiments, the arm 600 can be configured to deliver a sufficient amount of force to achieve a specific depth at the point of maximum decompression upstroke that is either below or above either the zero point or neutral point. In some embodiments, the achieved upward displacement of the chest may be the zero or neutral position of the chest. In another example, the arm 600 can be configured to provide decompression force sufficient to achieve an upward displacement of the chest relative to the neutral or zero position of the chest of about 0.25 to 4 inches. On a typical patient, approximately 5-20 lbs. of upward force would be needed to achieve an upward displacement of 2 inches relative to the neutral or zero position.
The arms 722a-d can be inserted into slots in the platform 702, such as near positions 714a-d, respectively, of
In some implementations, the arms 722a-d are coupled to the platform 702 (e.g., by rotating joints, ball and socket joints, etc.). To couple the arms 722a-d with the central portion 724 or chest compression actuator 104, the arms can each be inserted into a sleeve or slot in the central portion (similar to a tent). In some implementations, two longer arms extend entirely across the platform 702, as shown in
The arms 722a-d each include materials or configurations configured to bend and provide a lifting force to the central portion 724 and/or the chest compression actuator 104. In some implementations, the arms 722a-d each include a pliable or flexible piece of material such as metal or plastic. In some implementations, the arms include telescoping rods that can be shortened or lengthened to tune the magnitude of the decompressing force that is to be exerted on the patient by the upward force actuator 720. In some implementations, the arms 722a-d each include fiberglass rods with an elastic cord as a shock core. The rods can be broken down into segments to lengthen or shorten the rods. In some implementations, the arms 722a-d can be stored in the platform 702 but be removable from the platform. In some implementations, the arms 722a-d are configured to fold in one direction but engage in another direction (e.g., a hinge that opens to 180 degrees).
Turning to
Turning to
One or more of the arms 722a-d can be tuned to provide a specific force or force curve for a desired amount of decompression of the patient. For example, one or more of the arms 722a-d can be configured to provide between 1-25 lbs. of predetermined decompression force. In some embodiments, the one or more of the arms 722a-d are configured to provide maximum upward force (e.g. 3, 5, 10, 15, 20 lbs.) at the point of deepest compression, and that decreases as the depth approaches either the zero or neutral point during the decompression phase. In other words, at the start of the decompression phase, the force is greater than at the end of the decompression phase, e.g. the force at end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5%, or 1% of the force at the start of the decompression phase.
In some embodiments, the upward force actuator 720 can be configured to deliver a sufficient amount of force to achieve a specific depth at the point of maximum decompression upstroke that is either below or above either the zero point or neutral point. In some embodiments, the achieved upward displacement of the chest may be the zero or neutral position of the chest. In another example, the one or more of the arms 722a-d of the upward force actuator 720 can be configured to provide decompression force sufficient to achieve an upward displacement of the chest relative to the neutral or zero position of the chest of about 0.25 to 4 inches. On a typical patient, approximately 5-20 lbs. of upward force would be needed to achieve an upward displacement of 2 inches relative to the neutral or zero position.
In some implementations, the ACD device 700 described herein as utilizing a belt as the chest compression actuator for compressing a patient's thorax may not include the belt but instead may include another device for the chest compression actuator 104. For example, the ACD device 700 may include a piston or other rigid device to compress the chest of the patient. The arms 722a-d can couple to the piston device and exert the upward decompressing force on the piston, which is affixed to and pulls up upon the chest of the patient. Alternatively, the arms can be coupled directly to the patient's thorax and pull up upon the chest of the patient.
Turning to
The leaf springs 908, 912, 914, and (if applicable) their respective actuators 918, 920, can be tuned to provide a specific force or force curve for a desired amount of decompression of the patient. For example, one or more of the leaf springs 908, 912, 914, and (if applicable) their respective actuators 918, 920 can be configured to provide between 1-25 lbs. of predetermined decompression force. In some embodiments, leaf springs 908, 912, 914, and (if applicable) their respective actuators 918, 920 are configured to provide maximum upward force (e.g. 3, 5, 10, 15, 20 lbs.) at the point of deepest compression, and that decreases as the depth approaches either the zero or neutral point during the decompression phase. In other words, at the start of the decompression phase, the force is greater than at the end of the decompression phase, e.g. the force at end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5%, or 1% of the force at the start of the decompression phase.
In some embodiments, the upward force actuator 910 can be configured to deliver a sufficient amount of force to achieve a specific depth at the point of maximum decompression upstroke that is either below or above either the zero point or neutral point. In some embodiments, the achieved upward displacement of the chest may be the zero or neutral position of the chest. In another example, the leaf springs 908, 912, 914, and (if applicable) their respective actuators 918, 920 of the upward force actuator 910 can be configured to provide decompression force sufficient to achieve an upward displacement of the chest relative to the neutral or zero position of the chest of about 0.25 to 4 inches. On a typical patient, approximately 5-20 lbs. of upward force would be needed to achieve an upward displacement of 2 inches relative to the neutral or zero position.
In some implementations, the ACD device described herein as utilizing a belt as the chest compression actuator for compressing a patient's thorax may not include the belt but instead may include another device for the chest compression actuator 104. For example, the ACD device 100 may include a piston or other rigid device to compress the chest of the patient. The leaf springs 908, 912, 914 can couple to the piston device and exert the upward decompressing force on the piston, which is affixed to and pulls up upon the chest of the patient. Alternatively, the leaf spring can be coupled directly to the patient's thorax and pull up upon the chest of the patient.
The force distributing mechanism 1000 is configured to spread the compressing force (and in some implementations, the decompressing force) of the chest compression actuator 104 during the compression cycle. The force distributing mechanism 1000 may include a bladder 1002 or other fluid filled container that is affixed to the belt 106. When the belt 106 tightens around the patient 1008, the compressing force is spread over the thorax of the patient by the bladder 1002. For example, the pressure exerted by the bladder on the patient can be less than 5.7 PSI.
The bladder 1002 may include a fluid filled (air or liquid) interior 1006. In some implementations, the interior 1006 can be foam instead of fluid. The interior 1006 may include a plurality of tension cords 1004a-c which transfer the force exerted by the upward force actuator (e.g., shown by arrow 1012) at point 1010 on the top surface of the bladder 1002 to the bottom surface 1014, and to the thorax of the patient 1008, which is affixed to the bottom surface 1014 of the bladder 1002.
The plurality of tension cords 1004a-c can include elastic elements such as springs, bungees, etc. The plurality of tension cords 1004a-c are distributed throughout the bladder 1002 interior 1006 so that the bladder 1002 does not deform substantially when transferring the decompressing force from the upward force actuator to the patient.
In some implementations, the upward force actuator is affixed to the bladder 1002 at a single point 1010 (as shown in
When the upward force actuator is coupled to the chest compression actuator 104, the chest compression actuator 104 is affixed to the patient's thorax by a coupling mechanism. This is because the upward force actuator couples with the patient's chest wall in order to pull up on the chest wall and decompress the patient 1008. The chest compression actuator 104 is affixed to the chest of the patient 1008. In some implementations, the force distributing mechanism 1000 is the portion of the chest compression actuator 104 that is affixed to the patient 1008.
In some implementations, the force distributing mechanism 1000 is affixed to the chest by an adhesive. The adhesive includes a dermal adhesive that affixes the bladder 1002 to the patient 1008. The adhesive can be selected to limit the amount of decompressing force that can be exerted on the patient. For example, an adhesive can be selected which supports up to 1-25 lbs of force before detaching from the patient 1008. Adhesives can include one or more dermal adhesives. Adhesives can include at least the materials shown in Table 1, above.
In some implementations, the adhesive is compliant with the chest surface of the patient, and is hydrophilic and can tolerate contaminants (e.g., hair, sweat, etc.) between the bladder 1002 bottom surface 1014 and the patient 1008. In some implementations, when a compression is performed (e.g., up to 120 lbs. of force), the adhesive is resealed on the patient during each cycle (e.g., if the adhesive starts to peel during the decompression phase).
In some implementations, the force distributing mechanism 1000 is adhered to the patient 1008 by suction cups. Similar to the adhesive, the suction of the suction cups can be reset during the compression phase of the compression/decompression cycle. The suction cups may include a natural leaking system such that the suction cups automatically vent during use. In some implementations, the suction cups can be large scale (e.g., on the order of several centimeters in diameter). In some implementations, the suction cups can be microscale cups (e.g., on the order of several micrometers in diameter). The number of suction cups can range from a single suction cup to several thousand suction cups.
In some implementations, the upward force actuator does not couple to the top of the chest compression actuator 104 (e.g., to the top surface of the force distributing mechanism 1000). Rather, the upward force actuator is configured to couple directly to the patient below the chest compression actuator 104 to eliminate the need for the tension cords
In some implementations, the arms can include metal, polymer or natural products, either alone or in composite, to generate areas of stiffness and flexibility for providing an upward force via the strap. In some implementations, the arms 1102, 1104 can include multiple segments combined with springs at the joints to generate forces. In some implementations, the arms 1102, 1104 include rigid members with an elastic strap 1106 to act as the force actuator.
A strap 1106 is affixed to each of arms 1102, 1104 on either side of the patient. The strap 1106 is also affixed to the patient 1108 directly or indirectly by the chest compression actuator 104 (e.g., as described above in relation to
In some implementations, the strap 1106 includes a single member with each end of the member attached to an arm 1102, 1104 and loosely passing through the anchor or rigidly affixed to the patient by the coupling mechanism. In some implementations, the strap 1106 includes discrete attachment point/points to the patient coupling mechanism to aid the coupling mechanism to resist peeling away from the patient. In some implementations, the strap 1106 connects to the arms 1102, 1104 are variable to adjust the force applied to the patient (e.g., based on patient size).
Turning to
The arms 1102, 1104 can be tuned to provide a specific force or force curve for a desired amount of decompression of the patient. For example, one or more of the arms 1102, 1104 can be configured to provide between 1-25 lbs. of predetermined decompression force. In some embodiments, the arms 1102, 1104 are configured to provide maximum upward force (e.g. 3, 5, 10, 15, 20 lbs.) at the point of deepest compression, and that decreases as the depth approaches either the zero or neutral point during the decompression phase. In other words, at the start of the decompression phase, the force is greater than at the end of the decompression phase, e.g. the force at end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5%, or 1% of the force at the start of the decompression phase.
In some embodiments, the upward force actuator 1100 can be configured to deliver a sufficient amount of force to achieve a specific depth at the point of maximum decompression upstroke that is either below or above either the zero point or neutral point. In some embodiments, the achieved upward displacement of the chest may be the zero or neutral position of the chest. In another example, the arms 1102, 1104 of the upward force actuator 1100 can be configured to provide decompression force sufficient to achieve an upward displacement of the chest relative to the neutral or zero position of the chest of about 0.25 to 4 inches. On a typical patient, approximately 5-20 lbs. of upward force would be needed to achieve an upward displacement of 2 inches relative to the neutral or zero position.
The elastic device 1202 can include one or more of a spring, elastic material, bungee cord, etc. The elastic device 1202 is configured to couple to a portion of the external structure 1200. For example, the external structure 1200 can include a hook, latch or loop, and the elastic device 1202 can include a corresponding hook, latch or loop to couple to the external surface. In some implementations, the elastic device 1202 can include an adhesive, suction cup, etc. so that the elastic device can couple to a variety of external surfaces.
In some implementations, the elastic device 1202 is affixed directly to the patient, and when the belt 106 is loosened by the chest compression actuator 104, the elastic device is allowed to decompress the patient's chest. In this example, the elastic device 1202 can be affixed to the patient by a coupling mechanism such as a dermal adhesive, one or more suction cups, etc.
As described above, the elastic device 1202 includes a first end configured to couple to the external structure and a second end configured to couple to the patient. For one or both ends of the elastic device 1202, the strength of the coupling mechanism can be configured to remain coupled up to a maximum magnitude of force exerted on the patient. For example, the elastic element 1202 can include an adhesive configured to support 1-25 lbs. of force before detaching from the patient (e.g., breaking away from the patient). Adhesives can include one or more dermal adhesives. Adhesives can include at least the materials shown in Table 1 above, suction cups or other. In some implementations, the coupling mechanism can be designed to break away when the force exceeds the maximum decompressing force. For example, a breakaway hinge, hook, loop, etc. can be built into the elastic device 1202 and/or structure 1204 to limit the maximum decompressing force.
The external structure 1204 can be provided with the ACD device 100 or can be a standalone structure. The structure 1204 can be any rigid structure that is supported by a mechanism other than the platform 102. Turning to
The lever arm 1404 includes a rigid material that transfers a force from the elastic device 1408 to the patient (e.g., by the chest compression actuator 1406 and/or directly to the patient 1412). The length of the lever arm 1404 is sized to tune the magnitude of the decompression force on the patient 1412. Adjusting the length of the lever arm 1404 can allow more tolerance in the characteristics of the elastic device 1408 so that the magnitude of the decompressing force can be finely tuned without requiring a particular elastic device. For example, the lever arm 1404 can be a telescoping structure that can extend and contract. The length of the lever arm 1404 can be adjusted based on the size of the patient and/or the magnitude of decompressing force desired. The length of the lever arm 1404 can also be adjusted based on the relative position of the external structure 1410 or other rod or arm (e.g., based on a distance of the external structure from the patient's chest).
The lever arm 1404 forms an anatomical hinge with the center of the patient's rib cage and thus can provide a greater decompressing force on the chest wall of the patient. The lever arm 1404 acts as a class I lever, pulling upward on the patient's chest with relatively large force while requiring a relatively small force from the elastic device 1408. For example, a tension force of the elastic device 1408 can be applied to obtain a decompression force in the range of 1-25 lbs on the thorax of the patient.
Turning to
The independent decompression device 1500 can be tuned to provide a specific force or force curve for a desired amount of decompression of the patient. For example, the independent decompression device 1500 can be configured to provide between 1-25 lbs. of predetermined decompression force. In some embodiments, the decompression device 1502 is configured to provide maximum upward force (e.g. 3, 5, 10, 15, 20 lbs.) at the point of deepest compression, and that decreases as the depth approaches either the zero or neutral point during the decompression phase. In other words, at the start of the decompression phase, the force is greater than at the end of the decompression phase, e.g. the force at end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5%, or 1% of the force at the start of the decompression phase.
In some embodiments, decompression device 1502 can be configured to deliver a sufficient amount of force to achieve a specific depth at the point of maximum decompression upstroke that is either below or above either the zero point or neutral point. In some embodiments, the achieved upward displacement of the chest may be the zero or neutral position of the chest. In another example, the decompression device 1502 can be configured to provide decompression force sufficient to achieve an upward displacement of the chest relative to the neutral or zero position of the chest of about 0.25 to 4 inches. On a typical patient, approximately 5-20 lbs. of upward force would be needed to achieve an upward displacement of 2 inches relative to the neutral or zero position.
In some implementations, the independent decompression device 1500 can affix to the patient under the compression belt 106. The belt 106 tightens to pull the upward force actuator down. When the chest compression actuator causes the belt to loosen, the upward force actuator pulls the patient's chest upward and decompresses the chest of the patient.
In some implementations, the chest compression actuator includes a piston. The piston mechanism is positioned over the patient's chest and is configured to apply a compressing force to the patient's chest. A motor coupled to the piston mechanism is configured to cause a piston to compress the patient's chest by moving downward against the patient's chest. The motor is configured to move the piston upward away from the patient's chest and allow the upward force actuator to exert a decompressing force on the thorax of the patient.
Processors suitable for the execution of a computer program include, by way of example, both general and special purpose microprocessors, and any one or more processors of any kind of digital computer. Generally, a processor will receive instructions and data from a read-only memory or a random-access memory or both. The essential elements of a computer are a processor for executing instructions and one or more memory devices 1720 for storing instructions and data. Generally, a computer will also include, or be operatively coupled to receive data from or transfer data to, or both, one or more mass storage devices 1730 for storing data, e.g., magnetic, magneto optical disks, or optical disks. Data can be transferred via one or more communication protocols including Bluetooth, TCP/IP, RFID (or other near field communications), WIFI, etc. Computer readable media for embodying computer program instructions and data include all forms of non-volatile memory, including by way of example semiconductor memory devices, e.g., EPROM, EEPROM, and flash memory devices; magnetic disks, e.g., internal hard disks or removable disks; magneto optical disks; and CD ROM and DVD-ROM disks. The processor and the memory can be supplemented by, or incorporated in special purpose logic circuitry. Any of the foregoing can be supplemented by, or incorporated in, ASICs (application-specific integrated circuits).
To provide for interaction with a user, embodiments can be implemented on a computer having a display device, e.g., a LCD (liquid crystal display) monitor, for displaying information to the user and a keyboard and a pointing device, e.g., a mouse or a trackball, by which the user can provide input to the computer. Other kinds of devices can be used to provide for interaction with a user as well; for example, feedback provided to the user can be any form of sensory feedback, e.g., visual feedback, auditory feedback, or tactile feedback; and input from the user can be received in any form, including acoustic, speech, or tactile input. The display device can be used for inputting instructions (e.g., decompression and/or compression magnitude settings) for the devices of
The computing device 1700 can form the controller for controlling the ACD treatment of the ACD device. The computing device 1700 can control the frequency of the compression cycles of the ACD treatment as well as the depth, force magnitude, period, and number of cycles of the ACD treatment.
For example,
The upward force actuator 1820 is shown as being similar to upward force actuator 120 of
The piston mechanism 1804 can include one or more sensors for measuring a position of the piston and a force being exerted by the piston. For example, the piston can include an encoder that is coupled to the actuating device (e.g., a motor) that drives the piston into the patient's chest. A force sensor can be positioned on the end of the piston element 1842 to measure the compressive force being exerted by the piston on the patient 128. When the piston is driven downward, the upward force actuator 1820 is configured to exert a decompressing force on the patient 128. When the piston mechanism 1804 is released by the downward force actuator 1802, the upward force actuator 1820 pulls the piston back up and decompresses the patient's chest. The sensor may communicate the position of the piston to a controller of the ACD device to control the upward force actuator such that the upward force actuator exerts enough force to effect sufficient decompression.
The chest compression actuator 1802 and upward force actuator 1820 can be tuned to provide specific forces or force curves for a desired amount of compression and/or decompression of the patient. For example, the upward force actuator 1820 can be configured to provide between 1-25 lbs. of predetermined decompression force. In some embodiments, the upward force actuator 1820 is configured to provide maximum upward force (e.g. 3, 5, 10, 15, 20 lbs.) at the point of deepest compression, a force that decreases as the depth approaches either the zero or neutral point during the decompression phase. In other words, at the start of the decompression phase, the force is greater than at the end of the decompression phase, e.g. the force at end of the decompression phase is, for example, 80%, 50%, 20%, 10%, 5%, or 1% of the force at the start of the decompression phase.
In some embodiments, the upward force actuator 1820 can be configured to deliver a sufficient amount of force to achieve a specific depth at the point of maximum decompression upstroke that is either below or above either the zero point or neutral point. In some embodiments, the achieved upward displacement of the chest may be the zero or neutral position of the chest. In another example, the upward force actuator 1820 is configured to provide decompression force sufficient to achieve an upward displacement of the chest relative to the neutral or zero position of the chest of about 0.25 to 4 inches. On a typical patient, approximately 5-20 lbs. of upward force would be needed to achieve an upward displacement of 2 inches relative to the neutral or zero position.
An arm 1832 extends over a piston mechanism 1804. The arm can be similar to the arm 318 of
Turning to
In various embodiments described herein, the upward force actuator may be configured to provide 1-35 lbs. of decompression force.
A number of embodiments of the ACD device have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the ACD devices. Accordingly, other embodiments are within the scope of the following claims.
This application claims priority under 35 U.S.C. § 119(e) to U.S. Patent Application Ser. No. 62/749,035, filed on Oct. 22, 2018, the entire contents of which are hereby incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 62749035 | Oct 2018 | US |
