Patent Application
20210228441
The present disclosure is related to cardiac resuscitation and, more specifically, to systems and techniques for assisting rescuers in performing cardio-pulmonary resuscitation.
Defibrillators are commonly used to treat Sudden Cardiac Arrest by applying a defibrillating shock to the heart of a cardiac arrest patient via electrodes placed on the chest of the patient. The ECG signal of a cardiac arrest patient, properly measured and analyzed, provides a strong indication of whether the patient's heart is exhibiting a shockable rhythm or a non-shockable rhythm. A shockable rhythm refers to an aberrant ECG signal where a defibrillation shock is advised for restoration of a normal heartbeat, while a non-shockable rhythm refers to an ECG signal where a defibrillation shock is not advised. Ventricular fibrillation, for example, is a shockable rhythm, while pulseless electrical activity is an example of a non-shockable rhythm. Defibrillators are also capable of treating other dysrhythmias (irregular heartbeats), such as atrial fibrillation, bradycardia, and tachycardia. An ECG signal may be obtained through electrodes placed on the chest of the patient, and the defibrillating or cardioverting shock may be applied through the same electrodes.
During resuscitation, treatment protocols recommended by the American Heart Association and European Resuscitation Council advise for the rescuer to regularly check the patient's pulse or to evaluate the patient for signs of circulation. If no pulse or signs of circulation are present, the rescuer may be often instructed to perform CPR on the victim for an appropriate period of time between shock analyses, where CPR involves applying both chest compressions and ventilations to the victim. Chest compressions and/or ventilations may be monitored during the course of CPR, for example, through systems and technologies that incorporate real-time CPR feedback (e.g., REAL CPR HELP® marketed by ZOLL® Medical Corporation) and which may implement resuscitation assemblies (e.g., CPR-D-PADZ®, CPR STAT-PADZ® marketed by ZOLL® Medical Corporation) having a sensor for obtaining CPR related information for manual CPR providers. For example, ZOLL's CPR-D-PADZ® and CPR STAT-PADZ® include a pair of electrode pads and a single chest compression sensor.
The system and methods disclosed in the present disclosure advantageously improves chest compression sensor measurement accuracy and functionality, and allows for flexible pad designs that provide for more enhanced usability than have otherwise been available in the past. The present disclosure provides a system that includes a pair of motion sensors where the pair of motion sensors are incorporated into a streamlined, low-profile design where at least one of the motion sensors is covered with a padding having a textured surface. This allows for a sensor system that is easy to use by the rescuer while also providing a comfortable, slip resistant surface upon which the rescuer can deliver chest compressions. The textured surface may also have a mechanical structure that is arranged so as to intrinsically provide tactile feedback that encourages or otherwise assists a user to position the hands/fingers in a manner desirable for administering chest compressions (e.g., placing the fingers or thumbs in a balanced position around the center of the sensor housing).
According to one aspect of the present disclosure, provided is a system for assisting a user in providing chest compressions to a patient. The system comprises: a first motion sensor configured for measuring motion of a first region of a thorax of the patient; and a first housing physically coupled with the first motion sensor. The first housing comprises: a first frame for holding the first motion sensor in place, and a textured padding for receiving at least a portion of at least one hand of the user during chest compressions. The textured padding covers the first frame and the first motion sensor. The textured padding comprises an exterior having a plurality of raised surface features. The system also comprises: a second motion sensor configured for measuring motion of a second region of the thorax of the patient; and a second housing physically coupled with the second motion sensor and comprising a second frame for holding the second motion sensor in place.
The textured padding may be configured to provide tactile feedback for the user as to where the hands of the user are positioned or oriented relative to the first housing. In addition, the textured padding may be configured to provide a slip resistant surface that enhances comfort for the user when providing chest compressions to the patient. In one example, the plurality of raised surface features may comprise a plurality of protrusions extending outwardly from the exterior of the textured padding. The plurality of protrusions may comprise at least four protrusions extending outwardly from the exterior of the textured padding. The plurality of protrusions may be arranged according to a concentric pattern. In some examples, the plurality of protrusions may have an average height per protrusion of between about 0.005 inches and about 0.1 inches (e.g., average height per protrusion of between about 0.0075 inches and about 0.025 inches). The plurality of protrusions may cover an average area per protrusion of between about 0.0001 square inches and about 0.01 square inches (e.g., average area per protrusion of between about 0.0005 square inches and about 0.002 square inches).
In some examples, the first frame may comprise a thermoplastic polymeric material comprising at least one of: polycarbonate, polypropylene, polystyrene, polyethylene, ABS, nylon, silicone, elastomer, neoprene, santoprene, and polyurethane. The polymeric material may exhibit a Shore OO durometer of between 60 and 100 (e.g., between 70 and 90, between 75 and 90), a Shore A durometer of between 20 and 100 (e.g., between 20 and 50, between 25 and 45), or a Shore D durometer of between 1 and 60 (e.g., between 1 and 20, between 5 and 15, between 5 and 10), and/or a Young's modulus of between 1 MPa and 20 MPa (e.g., 1-10 MPa, 1-5 MPa, 1-2 MPa). The textured padding may comprise an upper surface and a lower surface with a thickness between the upper surface and the lower surface of between about 0.1 inches and about 2.5 inches. When used with pediatric patients, the textured padding may comprise a substantially circular shape. The first frame may also comprise a substantially circular shape having a radius smaller than a radius of the textured padding. The radius of the textured padding may be between about 0.5 inches and about 2.0 inches (e.g., between 0.75 inches and 2.0 inches). The textured padding may comprise an overmold encasing the first frame and the first motion sensor. In addition, the textured padding may comprise a central region designated by a cross-shaped marking. The first frame may be more rigid than the textured padding. . The textured padding may comprise a thermoplastic polymeric material including one or more of: polycarbonate, polypropylene, polystyrene, polyethylene, ABS, nylon, silicone, elastomer, neoprene, santoprene, polyurethane, or another suitable material. The textured padding may exhibit a Shore OO durometer of between 60 and 100 (e.g., between 70 and 90, between 75 and 90), a Shore A durometer of between 20 and 100 (e.g., between 20 and 50, between 25 and 45), or a Shore D durometer of between 1 and 60 (e.g., between 1 and 20, between 5 and 15, between 5 and 10), and/or a Young's modulus of between 1 MPa and 20 MPa (e.g., 1-10 MPa, 1-5 MPa, 1-2 MPa).
In certain examples, the first frame may comprise a first receptacle for receiving the first motion sensor, and the second frame comprises a second receptacle for receiving the second motion sensor. In addition, the system may further comprise a first adhesive material located within the first receptacle for adhering the first motion sensor and the first frame, and a second adhesive material located within the second receptacle for adhering the second motion sensor and the second frame. The adhesive may provide an additional function for protecting the electronics mechanically and electrically (e.g., protection from electrostatic discharge and/or electromagnetic interference). The system may also further comprise a connector and a cable for providing electrical communication between the first and second motion sensors and a computing device. The computing device may comprise at least one of: a patient monitor, a defibrillator, and a mobile computing device. In addition, the first receptacle may be configured to receive a first portion of the cable, and the second receptacle may be configured to receive a second portion of the cable.
In some examples, the first region may comprise an anterior portion of the thorax of the patient, and the second region may comprise a posterior portion of the thorax of the patient. The first motion sensor may comprise a first accelerometer and the second motion sensor may comprise a second accelerometer.
In one example, at least one processor and memory may be communicatively coupled with the first motion sensor and the second motion sensor. The at least one processor and memory may be configured to: receive and process signals from the first motion sensor and the second motion sensor to estimate compression depth during administration of chest compressions by the user. The system may also further comprise an output device configured to provide chest compression feedback for the user. The at least one processor and memory may be further configured to: compare the estimated compression depth to a desired compression depth range; and cause the output device to provide an indication of the estimated compression depth and provide the chest compression feedback for the user.
In another example, the system may further comprise a first electrode configured to be adhered to the first sensor, and a second electrode configured to be adhered to the second sensor. The first and second electrodes may be configured to measure ECG signals of the patient and/or to provide a defibrillation shock to the patient.
When used with pediatric patients, the textured padding may comprise a substantially circular shape. Such a shape may be preferable for applying a variety of chest compression techniques for pediatric patients, in particular for example, two thumbs encircling hands, two fingers, and single palm techniques. Alternatively, when used with adult patients, the textured padding may comprise an oval shape. Similarly, this shape may be preferable for applying various chest compression techniques for adult patients, for example, single palm and two hand techniques. The first frame may comprise a substantially circular shape. As discussed further below, such a frame shape may be suitable for both pediatric and adult sensors (where the overmold shape differs; pediatric being circular and the adult being oval in shape); for example, in the adult compression situation, the frame may provide a relatively rigid central portion so that the motion sensor is able to provide accurate measures of compression depth, while also having relatively flexible surroundings to accommodate the topography of varying chest surfaces. In some examples, the first motion sensor may be positioned at a center of the first housing.
According to another aspect of the present disclosure, provided is a system for assisting a user in providing chest compressions to a patient. The system comprises: a first motion sensor configured for measuring motion of a first region of a thorax of the patient; and a first housing physically coupled with the first motion sensor. The first housing comprises: a first frame for holding the first motion sensor in place, and a padding for receiving at least a portion of at least one hand of the user during chest compressions. The padding covers the first frame and the first motion sensor. The padding has an upper surface and a lower surface with a thickness between the upper surface and the lower surface of between about 0.1 inches and about 2.5 inches. The system also comprises: a second motion sensor configured for measuring motion of a second region of the thorax of the patient; and a second housing physically coupled with the second motion sensor and comprising a second frame for holding the second motion sensor in place.
In one example, the padding may comprise a textured exterior having a plurality of raised surface features. The plurality of raised surface features may comprise a plurality of protrusions extending from the textured exterior of the padding. The plurality of protrusions may be arranged according to a concentric pattern. The padding may also comprise central region designated by a cross-shaped marking. Such a marking may be preferable so as to assist in properly aligning the sensor to the patient's sternal midline and nipple line during compressions, using the center of the cross as the origin of three-dimensional (along X-Y-Z axes) motion during chest compressions.
When used with a pediatric patient, the padding may comprise a substantially circular shape. The first frame may comprise a substantially circular shape having a radius smaller than a radius of the padding. The radius of the padding may be between about 0.5 inches and about 2.5 inches (e.g., between 0.75-2.5 inches). When used with an adult patient, the textured padding may comprise an oval shape. The first motion sensor may be positioned at a center of the first housing.
In some examples, the padding may comprise an overmold encasing the first frame and the first motion sensor. The first frame may be more rigid than the padding. In other examples, the first frame may comprise a first receptacle for receiving the first motion sensor, and the second frame may comprise a second receptacle for receiving the second motion sensor. A first adhesive material may be located within the first receptacle for adhering the first motion sensor and the first frame, and a second adhesive material may be located within the second receptacle for adhering the second motion sensor and the second frame. The system may further comprise a connector and a cable for providing electrical communication between the first and second motion sensors and a computing device. The computing device may comprise at least one of: a patient monitor, a defibrillator, and a mobile computing device. The first receptacle may be configured to receive a first portion of the cable, and the second receptacle is configured to receive a second portion of the cable.
In some examples, the first region may comprise an anterior portion of the thorax of the patient, and the second region may comprise a posterior portion of the thorax of the patient. The first motion sensor may comprise a first accelerometer and the second motion sensor may comprise a second accelerometer.
The system may further comprise at least one processor and memory communicatively coupled with the first motion sensor and the second motion sensor. The at least one processor and memory may be configured to: receive and process signals from the first motion sensor and the second motion sensor to estimate compression depth during administration of chest compressions by the user. In some examples, the system may further comprise an output device configured to provide chest compression feedback for the user. The at least one processor and memory may be configured to: compare the estimated compression depth to a desired compression depth range, and cause the output device to provide an indication of the estimated compression depth and provide the chest compression feedback for the user.
In further examples, the system may further comprise a first electrode configured to be adhered to the first sensor, and a second electrode configured to be adhered to the second sensor. The first and second electrodes may be configured to measure ECG signals of the patient and/or provide a defibrillation shock to the patient. As discussed further below, such a physical coupling of the sensors to electrodes allows for the system to provide electrode placement feedback in various positions such as anterior-anterior (A-A), anterior-posterior (A-P), or lateral-lateral (L-L) positions.
Various aspects of the dual sensor implementations for providing resuscitative chest compression feedback are disclosed in one or more of the following numbered clauses:
Clause 1: A system for assisting a user in providing chest compressions to a patient, the system comprising: a first motion sensor configured for measuring motion of a first region of a thorax of the patient; a first housing physically coupled with the first motion sensor, the first housing comprising: a first frame for holding the first motion sensor in place, and a textured padding for receiving at least a portion of at least one hand of the user during chest compressions, the textured padding covering the first frame and the first motion sensor, the textured padding comprising an exterior having a plurality of raised surface features; a second motion sensor configured for measuring motion of a second region of the thorax of the patient; and a second housing physically coupled with the second motion sensor and comprising a second frame for holding the second motion sensor in place.
Clause 2: The system of clause 1, wherein the textured padding is configured to provide tactile feedback for the user as to where the hands of the user are positioned or oriented relative to the first housing.
Clause 3: The system of one of clauses 1 or 2, wherein the textured padding is configured to provide a slip resistant surface that enhances comfort for the user when providing chest compressions to the patient.
Clause 4: The system of any one of clauses 1-3, wherein the plurality of raised surface features comprise a plurality of protrusions extending outwardly from the exterior of the textured padding.
Clause 5: The system of clause 4, wherein the plurality of protrusions comprise at least four protrusions extending outwardly from the exterior of the textured padding.
Clause 6: The system of one of clauses 4 or 5, wherein the plurality of protrusions are arranged according to a concentric pattern.
Clause 7: The system of any one of clauses 4-6, wherein the plurality of protrusions have an average height per protrusion of between about 0.005 inches and about 0.1 inches.
Clause 8: The system of any one of clauses 4-7, wherein the plurality of protrusions cover an average area per protrusion of between about 0.0001 square inches and about 0.01 square inches.
Clause 9: The system of any one of clauses 1-8, wherein the first housing comprises a thermoplastic polymeric material comprising at least one of: polycarbonate, polypropylene, polystyrene, polyethylene, ABS, nylon, silicone, elastomer, neoprene, santoprene, polyurethane.
Clause 10: The system of clause 9, wherein the thermoplastic polymeric material has a Shore OO durometer of between about 60 and about 100, a Shore A durometer of between about 20 and about 100, or a Shore D durometer of between about 1 and about 60.
Clause 11: The system of any one of clauses 1-10, wherein the textured padding comprises an upper surface and a lower surface with a thickness between the upper surface and the lower surface of between about 0.1 inches and about 2.5 inches.
Clause 12: The system of any one of clauses 1-11, wherein the textured padding comprises a substantially circular shape.
Clause 13: The system of clause 12, wherein the first frame comprises a substantially circular shape having a radius smaller than a radius of the textured padding.
Clause 14: The system of one of clauses 12 or 13, wherein the radius of the textured padding is between about 0.5 inches and about 2.0 inches.
Clause 15: The system of any one of clauses 1-14, wherein the textured padding comprises an overmold encasing the first frame and the first motion sensor.
Clause 16: The system of any one of clauses 1-15, wherein the textured padding comprises a central region designated by a cross-shaped marking.
Clause 17: The system of any one of clauses 1-16, wherein the first frame is more rigid than the textured padding.
Clause 18: The system of any one of clauses 1-17, wherein the first frame comprises a first receptacle for receiving the first motion sensor, and the second frame comprises a second receptacle for receiving the second motion sensor.
Clause 19: The system of clause 18, further comprising a first adhesive material located within the first receptacle for adhering the first motion sensor and the first frame, and a second adhesive material located within the second receptacle for adhering the second motion sensor and the second frame.
Clause 20: The system of one of clauses 18 or 19, further comprising a connector and a cable for providing electrical communication between the first and second motion sensors and a computing device.
Clause 21: The system of any one of clauses 18-20, wherein the computing device comprises at least one of: a patient monitor, a defibrillator, and a mobile computing device.
Clause 22: The system of any one of clauses 18-21, wherein the first receptacle is configured to receive a first portion of the cable, and the second receptacle is configured to receive a second portion of the cable.
Clause 23: The system of any one of clauses 1-22, wherein the first region comprises an anterior portion of the thorax of the patient, and the second region comprises a posterior portion of the thorax of the patient.
Clause 24: The system of any one of clauses 1-23, wherein the first motion sensor comprises a first accelerometer and the second motion sensor comprises a second accelerometer.
Clause 25: The system of any one of clauses 1-24, further comprising at least one processor and memory communicatively coupled with the first motion sensor and the second motion sensor, the at least one processor and memory configured to: receive and process signals from the first motion sensor and the second motion sensor to estimate compression depth during administration of chest compressions by the user.
Clause 26. The system of clause 25, further comprising an output device configured to provide chest compression feedback for the user, wherein the at least one processor and memory are configured to: compare the estimated compression depth to a desired compression depth range; and cause the output device to provide an indication of the estimated compression depth and provide the chest compression feedback for the user.
Clause 27: The system of any one of clauses 1-26, further comprising a first electrode configured to be adhered to the first sensor, and a second electrode configured to be adhered to the second sensor.
Clause 28: The system of clause 27, wherein the first and second electrodes are configured to measure ECG signals of the patient.
Clause 29: The system of one of clauses 27 or 28, wherein the first and second electrodes are configured to provide a defibrillation shock to the patient.
Clause 30: The system of any one of clauses 1-29, wherein the textured padding comprises an oval shape.
Clause 31: The system of clause 30, wherein the first frame comprises a substantially circular shape.
Clause 32: The system of any one of clauses 1-30, wherein the first motion sensor is positioned at a center of the first housing.
Clause 33. A system for assisting a user in providing chest compressions to a patient, the system comprising: a first motion sensor configured for measuring motion of a first region of a thorax of the patient; a first housing physically coupled with the first motion sensor, the first housing comprising: a first frame for holding the first motion sensor in place, and a padding for receiving at least a portion of at least one hand of the user during chest compressions, the padding covering the first frame and the first motion sensor, the padding having an upper surface and a lower surface with a thickness between the upper surface and the lower surface of between about 0.1 inches and about 2.5 inches; a second motion sensor configured for measuring motion of a second region of the thorax of the patient; and a second housing physically coupled with the second motion sensor and comprising a second frame for holding the second motion sensor in place.
Clause 34: The system of clause 33, wherein the padding comprises a textured exterior having a plurality of raised surface features.
Clause 35: The system of clause 34, wherein the plurality of raised surface features comprise a plurality of protrusions extending from the textured exterior of the padding.
Clause 36: The system of one of clauses 34 or 35, wherein the plurality of protrusions are arranged according to a concentric pattern.
Clause 37: The system of any one of clauses 33-36, wherein the padding comprises central region designated by a cross-shaped marking.
Clause 38: The system of any one of clauses 33-37, wherein the padding comprises a substantially circular shape.
Clause 39: The system of clause 38, wherein the first frame comprises a substantially circular shape having a radius smaller than a radius of the padding.
Clause 40: The system of clause 39, wherein the radius of the padding is between about 0.5 inches and about 2.5 inches.
Clause 41: The system of any one of clauses 33-40, wherein the padding comprises an overmold encasing the first frame and the first motion sensor.
Clause 42: The system of any one of clauses 33-41, wherein the first frame is more rigid than the padding.
Clause 43: The system of any one of clauses 33-42, wherein the first frame comprises a first receptacle for receiving the first motion sensor, and the second frame comprises a second receptacle for receiving the second motion sensor.
Clause 44: The system of clause 43, further comprising a first adhesive material located within the first receptacle for adhering the first motion sensor and the first frame, and a second adhesive material located within the second receptacle for adhering the second motion sensor and the second frame.
Clause 45: The system of one of clauses 43 or 44, further comprising a connector and a cable for providing electrical communication between the first and second motion sensors and a computing device.
Clause 46: The system of clause 45, wherein the computing device comprises at least one of: a patient monitor, a defibrillator, and a mobile computing device.
Clause 47: The system of one of clauses 45 or 46, wherein the first receptacle is configured to receive a first portion of the cable, and the second receptacle is configured to receive a second portion of the cable.
Clause 48: The system of any one of clauses 33-47, wherein the first region comprises an anterior portion of the thorax of the patient, and the second region comprises a posterior portion of the thorax of the patient.
Clause 49: The system of any one of clauses 33-48, wherein the first motion sensor comprises a first accelerometer and the second motion sensor comprises a second accelerometer.
Clause 50: The system of any one of clauses 33-49, further comprising at least one processor and memory communicatively coupled with the first motion sensor and the second motion sensor, the at least one processor and memory configured to: receive and process signals from the first motion sensor and the second motion sensor to estimate compression depth during administration of chest compressions by the user.
Clause 51: The system of clause 50, further comprising an output device configured to provide chest compression feedback for the user, wherein the at least one processor and memory are configured to: compare the estimated compression depth to a desired compression depth range, and cause the output device to provide an indication of the estimated compression depth and provide the chest compression feedback for the user.
Clause 52: The system of any one of clauses 33-51, further comprising a first electrode configured to be adhered to the first sensor, and a second electrode configured to be adhered to the second sensor.
Clause 53: The system of clause 52, wherein the first and second electrodes are configured to measure ECG signals of the patient.
Clause 54: The system of one of clauses 52 or 53, wherein the first and second electrodes are configured to provide a defibrillation shock to the patient.
Clause 55: The system of any one of clauses 33-54, wherein the textured padding comprises an oval shape.
Clause 56: The system of clause 55, wherein the first frame comprises a substantially circular shape.
Clause 57: The system of any one of clauses 33-56, wherein the first motion sensor is positioned at a center of the first housing.
These and other features and characteristics of the present disclosure, as well as the methods of operation and functions of the related elements of structures and the combination of parts and economies of manufacture, will become more apparent upon consideration of the following description and the appended claims with reference to the accompanying drawings, all of which form a part of this specification, wherein like reference numerals designate corresponding parts in the various figures. It is to be expressly understood, however, that the drawings are for the purpose of illustration and description only and are not intended as a definition of the limit of the subject matter presented herein.
The present disclosure relates to a system for assisting a user in providing chest compressions to a patient. The system and methods described in the present disclosure allow for more flexible pad designs that are intuitive to use while holding in place on the patient during chest compressions. The present disclosure provides a system that includes a pair of motion sensors where the pair of motion sensors include a streamlined, low-profile design (e.g., having a thickness of less than 0.5 inches) where at least one of the motion sensors is covered with a padding having a textured surface. The textured surface may be created by providing the surface of the padding with a roughened feel. In addition, the textured surface may be created by adding grip features, such as a plurality of protrusions, to the surface of the padding. These protrusions may be provided in a variety of different configurations as will be discussed below. This allows for a sensor system that is easy to use by the rescuer while also providing a comfortable, slip resistant surface upon which the rescuer can deliver chest compressions. In some examples, the textured surface has a mechanical structure having raised features/protrusions that provide tactile feedback for the user to properly position the fingers/hand in a desired manner.
The American Heart Association (AHA) and the European Resuscitation Council (ERC) have established guidelines for the performance of CPR, which more recently recommend compression depths of 2.0 to 2.4 inches on adults with rates of 100 to 120 compressions per minute (cpm), compression depths between 5.0-6.0 cm for children 8-18 years of age, compression depths of at least one-third the diameter of the chest for children under 8 years of age, compression depths of about 5.0 cm for children 1-8 years of age, or compression depths of about 4.0 cm for infants less than 1 year of age. These guidelines require higher accuracy from chest compression sensor measurements and lead to a need to significantly reduce sources of measurement error, such as compressible foam layers, sensor tilt or rotation, and mattress compression. These sources of error are particularly noticeable on pediatric patients in the hospital environment, as the error is oftentimes a higher percentage of the total measurement and as the patients are often treated when laying on a mattress. Accordingly, a need exists for an improved system for assisting a user in providing chest compressions to a patient that improves the accuracy chest compression sensor measurements and further to also provide overall ease and comfort of use by the rescuer for a variety of patients.
According to one aspect of the present disclosure, the system comprises: a first motion sensor configured for measuring motion of a first region of a thorax of the patient; and a first housing physically coupled with the first motion sensor. The first housing comprises: a first frame for holding the first motion sensor in place, and a textured padding for receiving at least a portion of at least one hand of the user during chest compressions. The textured padding covers the first frame and the first motion sensor. The textured padding comprises an exterior having a plurality of raised surface features. The padding may have an upper surface and a lower surface with a thickness between the upper and lower surfaces of, for example, less than 1 inch (0.1-1 inch), less than 0.5 inches (0.1-0.5 inches), between 0.005 inches and 0.3 inches. The system also comprises: a second motion sensor configured for measuring motion of a second region of the thorax of the patient; and a second housing physically coupled with the second motion sensor and comprising a second frame for holding the first motion sensor in place.
In addition, the system for assisting the user in providing chest compressions to the patient of the present disclosure may be incorporated into a resuscitation assembly that may be used for a wide variety of patients in need of resuscitation, such as for small (e.g., pediatric, infant) or large (e.g., adult) patients. In various embodiments, the resuscitation assemblies may include at least a pair of electrode assemblies usable for monitoring ECG of the patient and/or providing electrotherapy to the patient (e.g., defibrillation upon detection of a shockable ECG rhythm), along with the first and second motion sensors.
Resuscitation assemblies and systems described herein may provide for improved resuscitation over prior devices and methods, for example, by providing sensors designed with shape and material features that provide for an intuitive feel during use, and which also provide for improved accuracy, detection and/or correction in determining resuscitation related parameters, such as chest compression depth, angle of chest compressions, the presence of an error-inducing surface (e.g., compressible surface between the patient and the sensor, such as foam, or a compressible surface under patient, such as a soft mattress, etc.), chest compression rate and/or timing, ventilation rate, etc. Systems and resuscitation assemblies in accordance with the present disclosure provide improved accuracy in determining chest compression depth than previously possible with single sensor arrangements, for example, by detecting and/or correcting for errors in resuscitation parameters as a result of external sources, e.g. error-inducing surface, patient is in transport (e.g., traveling on a gurney or within an ambulance), etc. Accordingly, such systems may advantageously provide improved feedback on whether chest compressions are appropriately applied and/or whether the rescuer needs to correct for error from an external source (e.g. change the surface on which the patient is placed, reduce other motion induced error, etc.).
Measurement of chest compressions during Cardiopulmonary resuscitation (CPR) is a valuable feedback tool for both trained and untrained rescuers to ensure adequate compression depth and rate. Compression quality is quantified by placing an accelerometer anteriorly on the chest and calculating depth and rate from the measured acceleration. Inaccuracies in depth calculations may arise from several potential sources; external motion of the patient (such as ambulance motion), compressible layers such as foam or clothing between the sensor and the patient while compressions are being performed, and chest compressions being performed while the patient is on a compressible surface such as a mattress. One proposed solution to reduce the influence of patient motion unrelated to chest compression motion is to add a second accelerometer located posteriorly. The posterior accelerometer would measure any external movement and compression of a mattress. The difference in motion between anterior and posterior electrodes would allow the calculation of true compression depth into the chest. Details of resuscitation assemblies utilizing a pair of motion sensors to provide feedback to a user are disclosed in U.S. Pat. No. 10,406,345, entitled “Dual Sensor Electrodes for Providing Enhanced Resuscitation Feedback,” assigned to the assignee of the present application, and which is hereby incorporated by reference in its entirety. Design decisions such as minimizing the compressibility of or removing any layers between the accelerometer and the patient chest such as those presented in this disclosure can reduce measurement inaccuracies. In accordance with aspects of the present disclosure, the design of such motion sensors should be small so as to reduce overall bulk while also providing a comfortable surface upon which a user can administer chest compressions and minimizing hand slippage from the sensor surface. Such motion sensors may also be designed so that users may be able to naturally position their fingers/hands in an appropriate manner so as to effectively administer chest compressions.
In certain examples, as illustrated in
It is desirable to reduce the overall size of the board upon which the first and second motion sensors 3, 5 are mounted because, in some clinical settings, particularly when the patients are small children upon which two-finger or two-thumb CPR techniques (discussed in greater detail hereinafter) are used, there may otherwise be a tendency for chest compressions to be performed off-center on the first motion sensor 3. However, in order to record more accurate measurements, compressions should be performed directly over and perpendicular to the first motion sensor 3, so that the actual motion of the chest is tracked. As shown in
The first motion sensor 3 is encapsulated within a first housing 7 physically coupled with the first motion sensor 3. The first housing 7 comprises: a first frame 9 for holding the first motion sensor 3 in place, and a textured padding 11 for receiving at least a portion of at least one hand of the user (i.e., rescuer) during chest compressions. The frame 9 provides protection for the first motion sensor 3 and also rigidity in case the hands/fingers apply compressive pressure at a location other than where the motion sensor 3 is positioned. For example, if the compression force is applied at the edge of the frame 9, then the motion sensor 3 is still able to move along with the frame 9, subject to the compression. This way, it is not necessary for the hands/fingers to press at the exact position of the motion sensor 3 so long as the resultant motion is perpendicular to the sensor/chest.
The textured padding 11 covers the first frame 9 and the first motion sensor 3. The combination of the textured padding 11 and first frame 9 is made so as to be as thin as possible. For instance, when performing CPR using the two-thumb technique on a small infant or neonatal patient (shown in
A problematic issue that has arisen in the field with current CPR sensors is that the user's hands may have a tendency to slip off the sensor when performing chest compressions. This is particularly a problem in the presence of fluids (e.g., rain, vomit, blood, neonatal fluid, or bodily fluids), which is a common occurrence in an emergency event, and/or with infants/neonates. In order to minimize this issue, the textured padding 11 comprises an exterior having a plurality of raised surface grip features 13 that protrude from the base surface. These raised surface features may provide added friction for the user to better grip the sensors during compressions, lessening the chance of slippage. Accordingly, the textured padding 11 may provide tactile feedback for the user as to where the hands of the user are positioned or oriented relative to the first housing 7. As a result, without having to look at the sensors during compressions, the user may be able to better position the thumbs in the appropriate manner by feel only. Such tactile feedback provides a means for the user to learn the feel of adequate versus inadequate hand placement. Also, such non-visual feedback is advantageous in that it allows the user to view other parts of the scene, for example, a viewing monitor that provides chest compression feedback (e.g., visual indications of depth, rate, release, quality of compressions, etc.) and/or the actions of other people nearby. In addition, the textured padding 11 is configured to provide a slip resistant surface that enhances comfort for the user when providing chest compressions to the patient.
In one example, the plurality of raised surface features 13 comprise a plurality of protrusions extending outwardly from the exterior of the textured padding 11. With reference to
While the arrangement of the protrusions in a concentric pattern is discussed hereinabove and illustrated in
In some examples, as shown in
The first frame 9 includes a first receptacle 15 for receiving the first motion sensor 3. The first motion sensor 3 may be friction fit within the first receptacle 15 or a first adhesive material may be located within the first receptacle 15 for adhering the first motion sensor 3 and the first frame 9. In addition, the first frame 9 may also comprise a substantially circular shape having a radius smaller than a radius of the textured padding 11, so that the textured padding may be able to cover the frame. The radius of the textured padding 11 may be between about 0.5 inches and about 2.0 inches while the radius of the first frame 11 may be between about 0.4 inches and about 1.9 inches.
In one non-limiting example, the first frame 9 is manufactured from a material that is substantially more rigid than the material used to form the textured padding. For example, the first frame 9 may comprise a polymeric material comprising at least one of: polycarbonate, polypropylene, polystyrene, polyethylene, ABS, nylon, silicone, elastomer, neoprene, santoprene, polyurethane, or any other suitable material. The polymeric material may have a Shore OO durometer of between 60 and 100 (e.g., between 70 and 90, between 75 and 90), a Shore A durometer of between 20 and 100 (e.g., between 20 and 50, between 25 and 45), or a Shore D durometer of between 1 and 60 (e.g., between 1 and 20, between 5 and 15, between 5 and 10), and/or a Young's modulus of between 1 MPa and 20 MPa (e.g., 1-10 MPa, 1-5 MPa, 1-2 MPa), so as to provide for a comfortable, slip resistant surface material. Shore durometer measures the depth of an indentation in the material created by a given force on a standardized presser foot. This depth is dependent on the hardness of the material, its viscoelastic properties, the shape of the presser foot, and the duration of the test. The ASTM D2240 standard recognizes twelve different durometer scales using combinations of specific spring forces and indentor configurations. These scales are referred to as durometer types. The Shore A durometer Type utilizes a 35° truncated cone having a 1.40 mm (0.055 in) diameter and a 8.05 N (821 gf) spring force. The Shore D durometer Type utilizes a 30° cone having a 1.40 mm (0.055 in) diameter and a 44.45 N (4,533 gf) spring force. The Shore OO durometer Type utilizes a 1.20 mm (0.047 in) spherical radius presser foot having a 2.40 mm (0.094 in) diameter and a 1.111 N (113.3 gf) spring force. The final value of the hardness depends on the depth of the presser foot after it has been applied for 15 seconds on the material.
The textured padding 11 is configured to encapsulate the first frame 9 and the first motion sensor 3 in any suitable manner. For example, the textured padding may be overmolded onto the first frame 9 and the first motion sensor 3. The textured padding may include a thermoplastic polymeric material comprising one or more of: polycarbonate, polypropylene, polystyrene, polyethylene, ABS, nylon, silicone, elastomer, neoprene, santoprene, polyurethane, and/or another suitable material. The textured padding may exhibit a Shore OO durometer of between 60 and 100 (e.g., between 70 and 90, between 75 and 90), a Shore A durometer of between 20 and 100 (e.g., between 20 and 50, between 25 and 45), or a Shore D durometer of between 1 and 60 (e.g., between 1 and 20, between 5 and 15, between 5 and 10), and/or a Young's modulus of between 1 MPa and 20 MPa (e.g., 1-10 MPa, 1-5 MPa, 1-2 MPa).
By making the first frame 9 from a material that is more rigid than the textured padding 11 and providing the first motion sensor 3 at the center of the textured padding, another mechanism is provided for allowing the user to self-center his/her hands over the first motion sensor 3, or at least balanced on either side of the motion sensor, during application of chest compressions such that the most accurate measurements can be achieved. One reason for such hand positioning is that if the user positions his her/hand off of a central location, the chest compressions may be more likely to be applied to an edge of the more rigid material of the first frame 9, thereby causing discomfort to the rescuers hand. Accordingly, this material difference will assist the user to move his/her hands to a central location.
For some embodiments, such as for neonatal resuscitation, it may be preferable for the system 1 to exhibit a relatively low profile. For example, when treating an infant, the rescuer may wrap his/her hands around the infant's chest and squeeze from both the front and back (i.e., using the two-thumb technique as discussed further below). Hence, the first motion sensor 3, the first frame 9, and the textured padding 11 may be thin enough for there to be enough space allowing the hands to wrap sufficiently around the infant's body. Less padding may also be required for neo-natal resuscitation because less force is generally applied to infants in comparison to pediatric/adult compressions. In some embodiments, the combination of the first motion sensor 3, the first frame 9, and the textured padding 11 has a thickness of between about 0.1 inches and about 2.5 inches, between about 0.01 inches and about 3.0 inches, or between about 0.25 inches and about 2.0 inches. In other words, the thickness from an upper surface to a lower surface of the textured padding 11 is between about 0.1 inches and about 2.5 inches, between about 0.01 inches and about 3.0 inches, between about 0.25 inches and about 2.0 inches, between about 0.1 inches and about 1 inch, or between about 0.1 inches and about 0.5 inches. It is also beneficial for the system 1 to exhibit a relatively low profile when used with adult patients because it is desirable to have the sensor be as thin as possible such that if hands larger than the sensor apply compressions, the edges and surface difference between the sensor and the chest are not harsh enough to cause discomfort or pressure to the rescuer.
With continued reference to
With continued reference to
In certain examples, as illustrated in
As described herein, each electrode assembly placed on the patient may incorporate a chest compression sensor, for example first and second motion sensors 3, 5 (e.g. accelerometers, velocity sensors, ultrasonic sensors, infrared sensors, other sensors for detecting displacement). In certain examples, the motion sensors may be single axis or multiple axis accelerometers. Single axis accelerometers may be used to determine chest compression parameters (e.g. depth, rate, velocity, timing, etc.) by measuring and/or providing signals that assist in determining acceleration, velocity and/or displacement. Multi-axis accelerometers, e.g. a three-axis accelerometer, may be able to provide signals that further determine relative orientation of their respective electrode assemblies by measuring parameters indicative of motion along each axis, in addition to determining chest compression parameters. The motion sensors 3, 5 may also include a gyroscope for determining orientation of the sensor (and, in some cases, the electrode assembly) by way of tilt or rotation. In additional examples, two or more accelerometers may be arranged orthogonally with respect to each other, to determine electrode and/or chest acceleration in multiple orthogonal axes. While an accelerometer senses acceleration or gravity, motion or displacement of the accelerometer can be determined through a series of calculations, such as double integration, filtering and/or other appropriate processing steps.
As discussed herein, by incorporating motion sensors in both electrode assemblies, resuscitation related parameters may be more accurately determined than would otherwise be the case if only one electrode assembly incorporated a motion sensor. For instance, the electrode assemblies may serve as reference points for one another, based on their respective displacement and orientation. Accordingly, the manner in which the electrode assemblies (e.g., electrode pads) are placed and/or how they move relative to one another may inform the type of instructions output to a rescuer. As an example, discussed further below, based on their orientation and/or distance relative to one another, it can be determined whether the electrode assemblies are placed in an A-A or A-P position, or not in any recommended position at all. In addition, based on the pattern of movement of both electrode assemblies, the type of surface on which the patient resides can be determined, or the angle with respect to the vertical axis (when the patient is lying down) at which chest compressions are being administered can also be estimated. Additional details of dual sensor electrodes and the manner in which such electrodes operate can be found in U.S. Pat. No. 10,406,345.
The resuscitation assembly of
With continued reference to
In addition, the location of the first motion sensor 3 with respect to the electrode pad 49 is aimed at providing proper positioning of the first motion sensor 3 above the sternum of the patient and the flexible electrode pad 49 above the heart for the majority of the population. In order to provide proper electrode pad and motion sensor positioning for those cases where the patient is larger than the placement that the standard design provides, the first motion sensor 3 may be designed to be removed from the flexible electrode pad 49. Since chest compressions are a mechanically stressful action onto the electrode assembly 41, the mechanisms for separating the first motion sensor 3 from the flexible electrode pad 49 must be secure enough so that it would not detach during the administration of chest compressions, yet easy enough to engage such that when desired, it would be simple to separate the first motion sensor 3 from the flexible electrode pad 49. Non-limiting examples of suitable attachment mechanisms between the first motion sensor 3 and the flexible electrode pad 49 are perforations along the attachment region 53, hook and loop fasteners for holding the motion sensor in place on the flexible electrode pad yet allowing for easy detachment and reattachment when needed, and an adhesive layer connected the housing 7 of the first motion sensor 3 to a side of the electrode assembly 49 opposite the therapy side.
The second motion sensor 5 is embedded within the flexible electrode pad 51. Accordingly, the second motion sensor 5 is made as thin as possible so that it can be effectively hidden in the electrode pad 51 and to minimize pressure points and discomfort to a patient lying on it. The first electrode assembly 41 is intended to be positioned on an anterior portion of the thorax of the patient, such as the sternum, and the second electrode assembly 43 is intended to be positioned on a posterior portion of the thorax of the patient. In addition, the resuscitation assembly 40 shown in
The flexible electrode pads 49, 51 may be any type of electrode suitable for use in defibrillation, and generally includes a conductor, such as tin, silver, AgCl or any other suitable conductive material, provided at the therapy side; a conductive electrolyte gel, such as a hydrogel; and lead wires to connect the conductor to the cable 27. The flexible electrode pads 49, 51 of electrode assemblies 41, 43 may be similar in their layered construction, although as illustrated in
With continued reference to
By providing a suitable motion sensor in both the anteriorly positioned electrode assembly 41 and the posteriorly positioned electrode assembly 43, the signals obtained therefrom can be processed by control circuitry provided in the defibrillator 45 to provide information that enhances overall resuscitation care to the patient. For example, data from both motion sensors may be processed to determine more accurate compression depth, particularly when compressions are performed on a compressible surface and/or when, on an infant, a rescuer wraps his/her hands around the infant's chest and squeezes from both the front and back, as will be discussed in greater detail hereinafter.
As one mechanism to ensure proper placement of the electrode assemblies 41, 43 of the resuscitation assembly onto the patient's anatomy, one or both of the electrode assemblies, or a substrate connected to the assemblies, may be provided with pictograms, diagrams, or printed instructions 55 describing the correct position for the electrode assemblies 41, 43. For example, pictograms, diagrams, or printed instructions 55 may be provided on an upper surface of the first motion sensor or the side of the flexible electrode pads 49, 51 opposite the therapy side. In addition, signals from the motion sensors 3, 5 may be utilized by the control circuitry of the defibrillator 45 to prompt the user in the manner in which the resuscitation assemblies, including the electrode assemblies 41, 43, should be placed as discussed in United States Patent Application Publication No. 2016/0279405, entitled “ECG and Defibrillator Electrode Detection and Tracking System and Method,” which is hereby incorporated by reference in its entirety.
A first method for administering CPR chest compressions to an infant, which may be preferable in some instances, is the two-thumb method as shown in
A first method for administering CPR chest compressions to an infant, which may be preferable in some instances, is the two-thumb method as shown in
A second method for administering CPR chest compressions to an infant is often referred to as the two finger method as shown in
In certain situations, the two-thumb-encircling hands technique is preferred over the two-finger technique because the two-thumb technique has been suggested to give rise to higher coronary artery perfusion pressure, resulting more consistently in appropriate depth or force of compressions, and may generate higher systolic and diastolic pressures in the patient.
By positioning the second motion sensor 5 on the back of the infant 57 and the first motion sensor 3 on the chest of the infant 57 through the use of electrode assemblies 43 and 41, respectively, the compression depth of compressions performed on the infant 57 using either the two-thumb or two finger technique can be accurately determined by placing the thumbs or fingers over the first motion sensor 3 and subtracting a distance traveled by the motion sensor 5 of the second electrode assembly 43 from a distance traveled by the motion sensor 3 of the resuscitation assembly 40. In some cases, the use of the two sensor configuration in the A-P position to estimate chest compression depth may be even more effective when using the two-thumb method because this method often results squeezing of the patient between the thumbs and the fingers, resulting in movement both on the front and back. Though, it can be appreciated that the two sensor configuration may also be effective when using the two finger technique, particularly when the patient is held by a rescuer or lying on a compressible surface.
By implementing a dual sensor approach in accordance with the present disclosure, the estimated chest compression depth may be compared with desired chest compression ranges (e.g., based on AHA/physician recommendations), and appropriate feedback and/or instructions can be provided to a rescuer via display 47, for example, as to the quality of chest compressions administered based on the comparison of estimated compression depth and desired compression ranges. Such feedback may include, for example, prompts that provide instruction(s) to the rescuer of whether to provide deeper or shallower compressions, or to maintain the current depth, or simply an indication of the current chest compression depth and rate (e.g., display of numerical values of chest compression depth and rate, or other visual indication such as one or more bar graphs or waveforms). Any appropriate prompts may be employed, such as audio prompts (e.g., voice/spoken cues, beeps of varying tone/pattern, etc.), visual (e.g., display screen with text, colors and/or graphics), tactile (e.g., vibrations), or prompts according to another suitable method.
It should also be appreciated that while several of the embodiments described hereinabove may apply to pediatric or small patients, such configurations may also apply, or may be more preferable, for adult or larger patients. In addition, it should be understood that embodiments of a resuscitation assembly may employ other arrangements. For example, with reference to
With specific reference to the illustrative embodiment of
As with the pediatric first motion sensor 3 described above, the textured padding 65 comprises an exterior having a plurality of raised surface features 73. Accordingly, the textured padding 65 is configured to provide tactile feedback for the user as to where the hands of the user are positioned or oriented relative to the first housing 64. In addition, the textured padding 65 is configured to provide a slip resistant surface that enhances comfort for the user when providing chest compressions to the patient. In one example, the plurality of raised surface 73 features comprise a plurality of protrusions extending outwardly from the exterior of the textured padding 65. With reference to
The first frame 67 may comprise a substantially circular shape and may be manufactured from a material that is substantially more rigid than the material used to form the textured padding. For example, the first frame 67 may comprise a polymeric material comprising at least one of: polycarbonate, polypropylene, polystyrene, polyethylene, ABS, nylon, silicone, elastomer, neoprene, santoprene, polyurethane, or any other suitable material. In various embodiments, the polymeric material has a Shore OO durometer of between 60 and 100, a Shore A durometer of between 20 and 100, or a Shore D durometer of between 1 and 60, and/or a Young's modulus of between 1 MPa and 20 MPa so as to provide for a comfortable, slip resistant surface material. The textured padding 65 is configured to encapsulate the first frame 67 and the first motion sensor 3A in any suitable manner. For example, the textured padding may be overmolded onto the first frame 67 and the first motion sensor 3A. The textured padding 65 may have a similar or different material composition than the first frame 67. In certain embodiments, it may be preferable for the first frame 67 to be more rigid relative to the textured padding 65 so that the textured padding 65 provides a soft feel for the user while the first frame 67 provides underlying structure and rigidity for the overall sensor. The textured padding 65 may include one or more materials such as polycarbonate, polypropylene, polystyrene, polyethylene, ABS, nylon, silicone, elastomer, neoprene, santoprene, polyurethane, and/or another suitable material. The textured padding 65 may exhibit a Shore OO durometer of between 60 and 100 (e.g., between 70 and 90, between 75 and 90), a Shore A durometer of between 20 and 100 (e.g., between 20 and 50, between 25 and 45), or a Shore D durometer of between 1 and 60 (e.g., between 1 and 20, between 5 and 15, between 5 and 10), and/or a Young's modulus of between 1 MPa and 20 MPa (e.g., 1-10 MPa, 1-5 MPa, 1-2 MPa).
By making the first frame 67 from a material that is more rigid than the textured padding 65 and providing the first motion sensor 3A at the center of the textured padding, another mechanism is provided for allowing the user to self-center his/her hands over the first motion sensor 3A, or at least balanced on either side of the motion sensor, during application of chest compressions such that the most accurate measurements can be achieved. A reason for this configuration is that if the user positions his her/hand off of a central location, the chest compressions will be applied to an edge of the more rigid material of the first frame 67, thereby causing discomfort to the rescuers hand. This will help the user to move his/her hands to a central location.
Chest compressions depth and rate measurements during CPR have been made in the past using a single sensor, for example an accelerometer contained in a housing placed on the chest of the patient at an anterior position, typically above the sternum. In such methods, the measured acceleration into the chest is twice integrated to determine chest displacement which is used to assess depth and rate of compressions. An example of such a method is described in U.S. Pat. No. 9,125,793, entitled “System for determining depth of chest compressions during CPR,” which is hereby incorporated by reference in its entirety. However, such measurements may contain error that cannot be accounted for, for example, error due to movement of a surface under the patient, patient motion and/or movement during transport, etc. As one example, if the patient is lying on a soft compressible surface, such as a mattress, the measured displacement will include not only the compression into the chest but also the depth of the deformation of the compressible surface. This can lead to an overestimation of compression depth. As another example, if the patient is in a moving ambulance the outside motion may further affect the compression measurements and contribute to error in estimating compression depth.
The systems of the present disclosure may be utilized to provide feedback to a user regarding resuscitation activities (e.g., chest compressions, ventilations) being performed on the patient by the rescuer with improved accuracy. More specifically, with reference to
Once the electrode assemblies 61, 63 included with the resuscitation assembly 60 of the present disclosure are properly placed, they are operatively connected to a defibrillator 45 having control circuitry (not shown) and an output device, such as display 47 and/or a speaker (not shown), to provide output to a user. Such assemblies may be connected via cables 27, or alternatively one or more of the motion sensors may be operatively coupled to the defibrillator and/or other devices using wireless technology (e.g. Bluetooth, WiFi, radio frequency, near field communication, etc.). The control circuitry used in the defibrillator 45 may be any suitable computer control system, and may be disposed within the housing of the defibrillator. Alternatively, the control circuity may be disposed within an associated defibrillator, within an associated mechanical chest compression device, or it may be a general purpose computer or a dedicated single purpose computer. The control circuitry may comprise at least one processor and at least one memory including program code stored on the memory, where the computer program code is configured such that, with the at least one processor, when run on the processor, it causes the processor to perform the functions assigned to the control circuitry throughout this disclosure. These functions include interpreting the signals from the motion sensors 3A, 5, and/or signals produced by other sensors, to determine compression depth, and produce signals indicative of the calculated compression depth, and operate outputs such as speakers or displays to provide feedback to a rescuer.
In one example, the output device of the defibrillator 45 provides information about patient status and CPR administration quality during the use of the defibrillator 45. The data is collected and displayed in an efficient and effective manner to a rescuer. For example, during the administration of chest compressions, the output device may display on display 47 information about the chest compressions.
The information about the chest compressions may be automatically displayed in display 47 when compressions are detected. The information about the chest compressions displayed may include indications for estimated values of rate 110 (e.g., number of compressions per minute) and depth 112 (e.g., depth of compressions in inches or millimeters). Information about chest compressions displayed on display 47 may also include an intuitive indication of the quality of chest compressions, for example, a perfusion performance indicator (PPI) 114. The PPI 114 may be provided as a graphical indicator, such as a shape (e.g., a diamond) that fills according to whether the rate and/or depth of compressions are within target range(s), to provide feedback regarding both the rate and depth of compression. The entire indicator is filled when compressions are performed at a particular target range for rate (100-120 CPM) and the depth of compressions falls within 2.0-2.4 inches. As the velocity and/or depth decreases below the acceptable limit, the amount that is filled decreases. The PPI 114 provides a visual indication of the quality of the CPR so that the rescuer can aim to keep the PPI 114 fully filled. That is, the rate and depth of compressions may be provided as inputs for whether the graphical PPI 114 fills, indicating that the overall quality of compressions at that particular moment is acceptable. The rate and depth of compressions can be determined by analyzing readings from the motion sensors 3A, 5. Displaying the actual rate and depth data (in addition to or instead of an indication of whether the values are within or outside of an acceptable range) is believed to provide useful feedback to the rescuer. For example, if an acceptable range for chest compression depth is between 2.0-2.4 inches, providing the rescuer with an indication that his/her compressions are only 0.5 inches, can allow the rescuer to determine how to correctly modify his/her administration of the chest compressions.
More specifically, the control circuitry of the defibrillator 45 is operatively connected to and programmed to receive and process signals from the motion sensors 3A, 5 of the electrode assemblies 61 and 63 to determine whether at least one of a chest compression depth and rate during administration of CPR falls within a desired range. The output device of the defibrillator 45 then provides feedback instructions to the user to maintain the chest compression depth and rate during CPR within the desired range.
With the electrode assemblies 61 and 63 positioned in an anterior-posterior position as shown in
With reference to
As noted herein, it can be appreciated that other configurations of resuscitation assemblies may be employed. In some embodiments, an electrode assembly including an electrode pad and a motion sensor might not require the motion sensor to be directly attached to the electrode pad. For example, the motion sensor may be coupled to the electrode pad via a cable or some other extension that allows for an electrical connection to the overall system. Alternatively, the motion sensor may be completely free of mechanical attachment to the electrode pad. For instance, the motion sensor may be in wireless communication with the defibrillator or another computing device and be configured to be coupled to the body in any suitable manner (e.g., adhesively attached). In addition, the motion sensors described herein may be provided with a memory that stores data from time of activation. For example, the motion sensors may be provided with a removable tab to activate the sensor to begin storing data in the memory. In addition, the motion sensors may be provided with an audible/visual output system to provide a light to indicate that the system is active or a chest compression metronome to guide the rescuer in providing chest compressions. Once the motion sensor is paired to a device (for example a defibrillator, a desktop top computer, a table computer, a mobile phone, a patient monitor, etc.), the data stored in the memory of the motion sensor is transmitted to the device and integrated in a case record for post-case review. In certain examples, the motion sensors may be wireless with an option for wired communication with a device for real-time feedback. Alternatively, communication between the motion sensors and the device may be exclusively wireless.
It is common for a patient to be lying on a substantially rigid surface (e.g., a floor, gurney, backboard) prior to initiating chest compressions. However, if the patient is not on such a surface and is instead on a compressible surface (e.g., adults in hospitals are commonly treated on compressible surfaces, and mattresses for pediatric patients mattress can be especially compressible, even more so than adult mattresses), such as a soft mattress, the rescuer may need to perform more intense work to achieve the required compression depth. As a result, the rescuer may either have difficulty achieving sufficient compression depth and/or fatigue quickly. Or, without the feedback mechanism, the rescuer may have the impression of reaching a sufficient depth without actually achieving it when the whole body of the patient is moving downward with the compressible surface.
With reference to
In addition, with reference to
In still another example, the motion sensors 3A, 5 of resuscitation assemblies in accordance with the present disclosure may be used to determine whether the electrode assemblies are placed in an A-A, A-P or lateral-lateral position based on the orientation of the motion sensors 3A, 5 and/or distance relative to one another. Once the position of the electrode assemblies is determined, the system may adjust one or more resuscitation parameters, e.g., feedback and/or information provided to the rescuer.
With reference to
While various examples and configurations of the electrode assemblies incorporating motion sensors have been described hereinabove, this is not to be construed as limiting the present disclosure as various other examples and configurations have been envisioned in which each of the electrode assemblies includes at least one motion sensor. For instance, various other configurations have been envisioned for use with various patients. With reference to
In certain forms of treatment, rather than placement in the A-A position shown in
By providing the electrode assemblies 61, 63 with motion sensors 3A, 5, the control circuitry used in the defibrillator 45 can be configured to determine the location of each of the electrode assemblies 61, 63 based on the orientation of the motion sensors 3A, 5 and/or distance relative to one another as described hereinabove. If the control circuitry determines that first electrode assembly 61 is positioned on the patient's sternum and the electrode assembly 63 on the patient's back as shown in
While various examples and configurations of the electrode assemblies incorporating motion sensors have been described hereinabove, this is not to be construed as limiting the present disclosure as various other examples and configurations have been envisioned in which each of the electrode assemblies includes at least one motion sensor. For instance, various other configurations have been envisioned for use with pediatric patients, infant patients, and adult patients as disclosed in U.S. Pat. No. 10,406,345.
Although a dual motion sensor resuscitation assembly having sensors with textured surfaces has been described in detail for the purpose of illustration based on what is currently considered to be the most practical examples, it is to be understood that such detail is solely for that purpose and that the subject matter provided herein is not limited to the disclosed examples, but, on the contrary, is intended to cover modifications and equivalent arrangements. For example, it is to be understood that this disclosure contemplates that, to the extent possible, one or more features of any example can be combined with one or more features of any other example.
As used herein, the singular form of “a”, “an”, and “the” include plural referents unless the context clearly dictates otherwise.
As used herein, the terms “right”, “left”, “top”, and derivatives thereof shall relate to the subject matter provided herein as it is oriented in the drawing figures. However, it is to be understood that the subject matter provided herein can assume various alternative orientations and, accordingly, such terms are not to be considered as limiting. Also, it is to be understood that the subject matter provided herein can assume various alternative variations and stage sequences, except where expressly specified to the contrary. It is also to be understood that the specific devices and processes illustrated in the attached drawings, and described in the following specification, are examples. Hence, specific dimensions and other physical characteristics related to the embodiments disclosed herein are not to be considered as limiting.
This application claims priority to U.S. Provisional Patent Application Ser. No. 62/966,089, entitled “Dual Sensor Implementations for Providing Resuscitative Chest Compression Feedback”, filed Jan. 27, 2020, the entire contents of which are incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 62966089 | Jan 2020 | US |
