The present invention is directed to an improved device to assist in continuous-chest-compression (CCC) to assist in CPR situations involving sudden cardiac arrest (SCA).
Historically a cardiac arrest victim was aided by a life-saving procedure called cardiopulmonary resuscitation (CPR) which involved a number of chest compressions interrupted by mouth-to-mouth resuscitation, typically 30 compressions and 2 ventilations. This “pump and blow” procedure was complicated and very fatiguing for the person conducting CPR. Typically classes were provided and CPR certificates of training were given after successful completion of a training course.
The entire CPR procedure was also believed by many to be a dangerous practice due to the possible contraction of aids (HIV) or other diseases attributed to the mouth to mouth contact of saliva from a stranger. These and other concerns greatly reduced the number of people willing to attempt the procedure.
Recent studies have shown that continuous-chest-compression (CCC) by comparison is far more critical than the mouth-to-mouth resuscitation aspect of blowing air into the lungs.
The studies show it is critical to immediately get the blood circulating to have any chance of survival according to the American Heart Association. The survival rates from a cardiac arrest are greatly improved with immediate intervention using chest compressions. This rate of survival falls off dramatically with delay, a stoppage of blood circulation of only a few minutes results in the start of tissue damage. Death is a likely outcome when the blood flow is stopped for over 4-6 minutes, except in extremely cold or freezing situations.
The use of life-saving CPR or CCC is not limited to heart attack victims. Heart pumping and blood flow stoppages occur from electric shock, drowning, choking, suffocation, drug overdose or severe allergic reactions in addition to heart failure.
The American Heart Association estimates 100,000 to 200,000 lives of adults and children in the United States could be saved if timely CPR were performed, more particularly if timely CCC was given to pump blood.
Recently, the Sudden Cardiac Arrest Foundation issued an article entitled “Continuous Chest Compressions Shown To Save More Lives”. This article confirms that emphasizing CCC is more beneficial and saves more lives than the old guidelines for CPR. This new guideline still refers to CPR, but in fact CPR is now a Continuous Chest Compression intervention.
A remarkable benefit of the new CPR guidelines is the ability of 9-1-1 emergency dispatchers to remotely coach bystanders over the telephone. The Sudden Cardiac Arrest Foundation published this finding on Jan. 10, 2012. In this article, it points out that people who lack CPR training who were afraid to intervene can be coached over the phone and are able to begin compression about a minute sooner using only CCC. In this situation, one minute sooner could be the difference between surviving and dying. In the article, it is noted breaths are still recommended for all infants and children and adults where asphyxia is the cause. In any situation, however, continuous chest compressions are critical and in almost all other cardiac arrest situations, the only intervention required.
In metropolitan areas, Seattle boasts a 34% survival rate from cardiac arrest. New York City and Chicago have a 4% survival rate. Nationally the survival rate is 14%. This high to low rate is attributable to training, cultural difference and response time required for trained personnel to arrive. Clearly, the goal should strive to be at least as good as Seattle, preferably better with outcomes of 50% or better being reasonable to expect.
Attempts to replace the use of hand delivered chest compression have been attempted; however, such automated devices have proven to be expensive and not as reliable as hand compression. The main problem of using one's hands is the fatigue issue. Providing compressions for a few minutes at high rates can be fatiguing. CPR must be maintained until the patient recovers to consciousness or trained help arrives with defibrillator equipment. This can take well over 10 minutes or more. Without multiple people taking turns, the administrator of CPR will quickly be exhausted and the patient could die.
As these life threatening situations often occur at home, there may only be a spouse or child to assist. In these situations, the problem is very difficult, unless the person providing CPR can be assisted in some safe and reliable fashion. When delivering hand compressions, the hands are placed one over the other and one of the heels of the hand pushes on the chest near the sternum or breastbone to a deflection of about 2 inches (5 cm), this amount of compression yields about 120 psi pressure when measured on CPR mannequin devices. This is repeated at ideally 100-120 beats or continuous compressions per minute. As can be appreciated, this is very demanding. Small children or elderly persons have trouble achieving this and even trained personnel can't do this consistently. Also, adults have been known to crush the chest and break ribs and injure the victim as their adrenaline levels spike during this emergency.
It is an object of the present invention to make continuous chest compressions less fatiguing, more reliable in administering and with self-signaling interactive prompts so even the unskilled person can safely and more effectively deliver CPR with a high level of confidence.
The device as described herein achieves all of these objectives.
The subject matter of the invention is a manual CPR or CCC continuous chest compression assist device for use on a person suffering cardiac arrest. The assist device has a body structure and an audible signal element or visual signal assembly or both. The compressible body structure has a compressible upper body portion to which a person administering CPR or CCC places his hand to exert a downward force and a bottom compressible portion which is positioned over a breastbone of the person suffering cardiac arrest. The bottom compressible portion is aligned with the upper compressible portion. The audio signal element is interposed in the body structure to announce or generate an audible sound or “click” at a predetermined deflection of the compressible portions. The activation of the audio signal corresponds to a predetermined deflection distance of the compressible portions pressing against the breastbone and alerts the person administering to relax the hands stopping downward force which initiates decompressing the body structure for the next compression. The visual signal assembly is interposed in the body structure to announce or generate a visible light or flash at a predetermined deflection of the compressible portions. The activation of the visual signal corresponds to a predetermined deflection distance of the compressible portions pressing against the breastbone and alerts the person administering to initiate decompressing to relax the body structure for the next compression.
The audio signal element announces a second signal upon relaxation of downward force as the device decompresses to reset the device for the next compression. The compressible body structure moves toward an uncompressed condition as the downward force is removed and the second signal is made to signal a reset. The second audio sound or “click” is an echo or mimics the first sound.
The audio signal element is a domed plate or disk supported on the perimeter by the compressible body structure and with a domed center positioned and suspended in a cavity or hollow to allow the dome to snap as the deflection distance is achieved to annunciate the first signal. The audio signal element has an upper surface and a lower surface and the dome projects outwardly from one of the upper or lower surfaces in a sealed cavity in said body structure and wherein said opposite surface is in a vented cavity. Compression of the body structure increases pressure on the dome causing the dome to snap toward the vented cavity at a predetermined pressure. The predetermined pressure is achieved at the predetermined deflection of the body structure. The dome snaps back toward the sealed cavity as the compressible body is unloaded decompressing causing the internal pressure to lower in the sealed cavity thereby resetting the device for the next compression.
The compressible upper body portion has a cylindrical shape and a hollow central cavity or opening. The compressible upper body portion has a tube shape with the opening extending along a central axis of the tube. The body structure has an end seal affixed to an end of the upper body structure closing the hollow cavity. The hollow cavity of the upper body portion extends between the audio signal element up to a closed sealed end in the upper body portion.
The compressible lower body structure portion has a hollow cavity and a plurality of vent openings extending into the hollow cavity to allow air pressure within the cavity to vent to atmosphere upon compression. The lower body portion is a cylindrical shape wherein the upper body portion and lower body portion are aligned and joined to form the compressible body structure having two compressible portions, the upper and lower body portions. The body structure has an intermediate compressible body structure having a tubular shape positioned between the upper and lower body portions forming the body structure having three compressible portions. The bottom of the lower body portion is a non-slip elastomeric surface. The body structure is made of a compressible elastomer; preferably the body structure is made of a closed cell foam. The preferred elastomeric closed cell foam is a polyethylene foam.
The visual signal assembly is a light assembly that activates a light in response to a compression of the body structure to a predetermined deflection of the compressible portions, wherein the light assembly lights on the downward compression and shuts off when the hands relax to reset the assembly. The visual signal assembly comprises an LED lamp, a switch and one or more batteries. The visual signal assembly further has a housing structure holding the LED lamp, the switch and the batteries in a self-contained light assembly, the light assembly being inserted in a cavity in the body structure. The light assembly lights in synchronization with the activation of the audio signal and shuts off in synchronization with the second audio signal on the relaxation of the compressible body structure to reset the device in one embodiment. The most preferred embodiment is a manual CPR or CCC continuous chest compression assist device for use on a person suffering cardiac arrest. The assist device has a compressible body structure and an audio signal element and a visual signal assembly. The compressible body structure has a compressible upper body portion to which a person administering CPR or CCC places his hand to exert a downward force and a bottom compressible portion which is positioned over a breastbone of the person suffering cardiac arrest. The bottom compressible portion is aligned with the upper compressible portion. The audio signal element and a visual signal assembly are interposed in the body structure to announce or generate an audible sound or “click” and a light or flash at a predetermined deflection of the compressible portions. The activation of the audio and visual signals corresponds to a predetermined deflection distance of the compressible portions pressing against the breastbone and alerts the person administering to relax their hands stopping downward force which initiates decompressing to relax the body structure and resets the device for the next compression. A method of performing CCC continuous chest compressions with a manual CPR or CCC assist device on a person suffering cardiac arrest. The method comprising the steps of positioning the person to be treated on his or her back; taking a CPR or CCC device and placing the device on the chest over the sternum or breastbone, the CPR device having a compressible body structure; placing hands on the top of the device and applying a downward force compressing the device and the chest until a visual signal or audible signal or both occurs; relaxing exerting no downward force as the compressible device and the patient's chest decompresses while listening or observing a second sound occurs or the visual signal shuts off signalling the device is reset; repeating a downward force on the device to accomplish a next chest compression; and repeating the method while being prompted to apply downward force or relaxing by audio signal or visual signal or both emitted from the device. The method further has the steps of continuing chest compression using the assist device as an electric shock from a defibrillator is applied to the patient. The assist device is an electrical insulator.
The invention is described by way of example and with reference to the accompanying drawings in which:
Prior to proceeding to the more detailed description of the present invention, it should be noted that, for the sake of clarity and understanding, identical components which have identical functions have been identified with identical reference numerals throughout the several views illustrated in the drawing figures.
Now in reference to
A generally closed hollow or cavity chamber 50 is disposed axially in the first portion 30. An aperture or a cavity 60 is disposed axially in the second portion 40. There is vent means, generally designated as 70, for connecting the aperture or cavity 60 in air communication with an external environment. Preferably, such vent means 70 is at least one vent passageway 72 intersecting the cavity 60 and extending through the exterior surface of portion 40. As shown, the passageways 72 are inclined or disposed normal to the longitudinal axis 22. It is understood the vent passageways 72 can be oriented at virtually any inclined angle, with the illustrated normal inclination simply being the shortest path. The device 10 further including an audio signal element or means, generally designated as 8, for annunciating a predetermined compression of the device, 10 that is sufficient to depress rib cage without inflicting damages thereto.
With particular reference to the first embodiment of the invention as shown in
This compression of the body structure stops when the hands relax and the downward force ceases and the compressible portions 30, 40 and 42 recover like a spring, decompressing and returning to close to the starting or reset height of the body 20. Most importantly, as the body structure resets the pressure inside the sealed cavity 50 drops back to ambient and the deflected dome snaps back causing a second sound or “click” signifying the device 10 is reset and ready for the next chest compression. In this use of an audible sound 8S, the person performing CPR is alerted when a desired predetermined pressure is achieved in the chest cavity as evidenced by the 2 inch deflection of the chest. The sound 8S annunciates and effectively confirms this has occurred. Testing of the device on a medical mannequin hooked to a light sensor indicator and a pressure gauge confirms the click sound and end of stroke compression by the user 2 nicely coincides with 120 psi and this occurrence can be repeatedly maintained at 100 to over 120 beats or compressions per minute. As one will appreciate, this means each entire compression cycle occurs within 0.5 seconds. Accordingly, the device's 10 ability to spring back and reset during relaxation is very fast measuring in tenths of a second. The reset causes a second audible signal 8S prompting the user to start the next compression. The device basically teaches the user to press, relax, press, relax on each set of sounds 8S. The device 10 upon achieving this first sound signal has been tested to confirm adequate chest deflection and therefore pressure has been delivered. This provides added confidence to the user.
With further reference to
In
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In
Importantly, unlike manual hand CPR, the arrest patient can be lying on a sofa, a recliner or in bed and the device 10 will function delivering proper chest compression regardless of the surface. Normally, the manual unassisted CPR giver must first lay the victim on a hard flat surface. Remarkably, the device 10 will work as long as the device can see enough resistance to deflect to trigger the sound element 8. This has been confirmed in testing. This feature saves time.
A second important feature is a person under cardiac arrest can be fully clothed at the chest region and CPR can be initiated without wasting time exposing the chest. The device works well through shirts, blouses, bras, sweaters. Often untrained persons are reluctant to remove clothing exposing a person's breast to conduct CPR or CCC. The present device avoids this time consuming procedure allowing CPR/CCC to be started immediately.
In
With reference to
As shown in
The person 2 applying CPR with the device 10 sees the light beam 18L and stops the downward force relaxes his or her hands as the compressible body 20 having the compressible portions 30, 40 and optional intermediate portion 42 if used, recover springing back toward the devices decompressed original height. As soon as the device 10 is unloaded and recovers, the switch 16 also returns shutting off the lamp 18. The lamp 18 going off is a second visual signal that the device is reset to repeat the next compression.
The use of the light assembly 12 alone is ideal in situations where the audio signal 8S is undesirable or clearly not audible due to extreme background noise.
Most preferably, the best mode of practicing the present invention is shown in
As shown, the device 10 in every embodiment has an uncompressed height of 3 inches (76.2 mm) or more and when configured as a cylinder has a diameter of about 3.5 inches (88.9 mm). At the top of the device 10 the spanned area for the hand to press is about 9.6 square inches. Similarly, the spanned area for the chest contacting compression is 9.6 square inches, it being understood the column shape in the center is a cavity or void thus effectively lowering the center pressure, but as can be appreciated, the tubular wall thickness of the column of the body portion 40 moves the entire underlying breastbone regardless of the concavity at the center. It is believed the height of the device 10 ensures the fingers can wrap around or hang suspended from the top without contacting the person 1 receiving CPR. This elevated support of the hands focuses the downward force making it much easier and less fatiguing. The device 10 insures the user does not over exert himself as a result elderly and young children can properly administer CPR for times of 10 to 12 minutes or more without being completely exhausted. This allows sufficient time to get first responders on site to help. Without the assist device, these elderly and young simply cannot provide CPR reliably in terms of chest deflection and pace and as a result survival chances are diminished. Even trained professionals find the assist gives them longer staying power and confidence that each compression made is optimized to avoid over exertion. Naturally, injury by untrained CPR givers is virtually eliminated as the device 10 not only insures proper compressions, it also acts as a shield by damping the hand impact through the compressible foam structure. This means eliminating CPR related injuries like broken ribs.
In accordance with one form of the invention, annunciating means 80 includes a membrane 84 disposed at end 52 of the generally closed chamber 50 being opposite from end 54 disposed adjacent inner or proximal end 32 of the first portion 30. The membrane 84 is mounted for axial movement toward the end 52 of the generally closed chamber 50 during compression of the first portion 30. A movable contact member 86 is disposed on the membrane 84 and is capable transferring electric energy. There is also a stationary sec contact member 88 that is axially aligned with the move contact member 86. In operation, as the device 10 is being compressed, pressure is increasing within the closed chamber proportional to the compression distance. As the pressure increases, membrane 84 moves toward the stationary contact and urges or biases the movable contact 86 to directly contact the stationary contact 88 when the pressure reaches predetermined value.
In accordance with another form of the invention, annunciating means 80 includes a pressure switch 90 that positioned in communication with the closed chamber 50 adjacent the end 52 thereof and that is responsive to increase of pressure in the closed chamber 90 to generate electric signal indicative of the pressure reaching the predetermined value.
Preferably, either stationary contact 88 or the pressure switch 90 is disposed on attached to a printed circuit board (PCB) 92. In such embodiment, the pressure switch 90 may be of PX70 series type as available from OMEGA, Inc. of Stamford, Conn. or model 50 as manufactured by Measurement Specialties of Fremont, Calif.
In either form, the annunciating means 80 further includes a source 94 of the electric energy that is disposed in the first portion 30, in electric communication with the movable contact Member 86. Preferably, the source 94, being at least one conventional battery, is also being mounted on the PCB 92.
It is contemplated for the annunciating means 80 to include at least one visual indicator, such as light emitting device 96, that is mounted in electrical communication with the stationary contact member 88, wherein contact between the contacts 86 and 88 causes the electric energy from the source 94 to energize the least one light emitting device 96 and emit a light visible by a user of the device 10.
In addition to or independently from the at least one light emitting device 96, the annunciating means 80 may include at least one audible indicator, such as a sound emitting device 98, that is energized upon contact between contacts 86 and 88, wherein the sound is received by the user of the device 10. Accordingly, the body 20 may be provided with at least one sound port 99.
In yet another form of the invention, the annunciating means 80 provided as a generally thin member 100 disposed between the first and second portions, 30 and 40 respectively, and having a curved portion 102 sized to fit within each of the chamber 50 and the aperture or cavity 60 disposed axially in the second portion 40. The curved portion 102 is adapted for axial movement, due to pressure, between a first position extending slightly into the chamber 50 disposed axially in the first portion 30 during normal condition of the device 10 and a second position extending into the aperture or cavity 60 disposed axially in the second portion 40 during application of the manual force and a “click” sound generated by the axial movement of the curved portion 102 at least from the first position into the second position. It would be appreciated that the generally thin member 100 may be provided in an addition to the previously described embodiments of the annunciating means 80.
The device 10 may further include optional processor 108 and means 110 for transmitting absolute geographical position of the device. Such means 110 is provided by a conventional Global Positioning Systems (GPS) technology. Such means 110 is preferably mounted on the PCB 92 and is activated upon first contact between the movable contact member 86 with the stationary contact member 88. Operation of the means 110 either continues for entire duration of use of the device 10 or terminates after a preselected period of time, either during or after use of the device 10.
Thus, the instant invention provides a method of annunciating location of a person receiving manual cardiopulmonary resuscitations (CPR). The method includes the step of providing the above described device 10 having a compressible body 20 defining a longitudinal axis 22 of the device 10 and having a pair of axial ends 24, 26 spaced apart from each other to define length of the device 10, wherein one of the pair of axial ends is sized for direct abutment with one of a skin and clothing of a person receiving the CPR, a closed chamber 50 disposed axially in close proximity to an opposite one of the pair of axial ends, the opposite one of the pair of axial ends receiving a manual force directly applied thereto by a person performing the CPR, an aperture or a cavity 60 disposed axially in the compressible body 20 in close proximity to the one of the pair of axial ends, means 70 for communicating the aperture or cavity 60 to an external environment of the device, and a GPS member 110 disposed within the device and responsive to change of pressure in the closed chamber to transmit location of the device. Next, positioning one end of the device 10 in direct contact with one of a skin and clothing of the person receiving the CPR.
Then, applying a force axially to the opposite one of the pair of axial ends of the device 10. Increasing pressure, with a continuing application of the force, in the closed chamber 50 to a predetermined value. Finally, generating, with the GPS member 110, in response to the predetermined pressure, a signal indicative of absolute location of the person receiving the CPR. The device 10 may also include a transceiver circuitry 120 for generating a wireless transmission to an emergency response network. For example the circuitry 120 may be adapted to generate a call to 911 number and may further provide a voice communication capability so that person performing CPR can directly communicate with emergency response operator and/or medical personnel. Furthermore, if needed, the operator can provide instructions on how to perform CPR using the device 10 as well as monitor the compressions by hearing “click” or audible annunciation every time the compression is completed.
The device 10 may also include at least one non-slip means 130 disposed on the axial end of the body 20 for at least substantially minimizing slippage of the device 10 placed onto a skin or closing of a person receiving CPR or slippage to the person performing CPR.
In each of these embodiments the preferred device 10 was made of a cellular foam and assembled. Alternatively, the entire device could be molded using expandable foam as a single body structure 20. The advantage of molding the body structure allows the exterior surface to have an outer flexible skin or simulated leather look. These materials can have the electronic devices or the light assembly installed later or insert molded into the device. This molding is well known in the automotive art and used in steering wheel assemblies. In any device the exterior surface must be flexible to allow compression of the body structure.
While the present invention used the terms upper or lower when referring to the body structures 30, 40 it is important to note the device 10 was designed with a preferred orientation so the non-slip end 130 was on the chest and the sealed cavity 50 at the top near the hands. Interestingly, during testing the device 10 was inverted or used with the sealed end 32 on the chest and the CPR and CCC chest compressions along with the audio signal and light assembly worked exactly as required with no apparent loss of function. While this seems trivial, in an emergency situation it is ideal that the user 2 given two options of orientation cannot make a mistake. In this high stress situation, the person 1 under a cardiac arrest life depends on proper CPR delivery and the device 10 as described above provides this even if used upside down.
Variations in the present invention are possible in light of the description of it are provided herein. While certain representative embodiments and details have been shown for the purpose of illustrating the subject invention, it will be apparent to those skilled in this art that various changes and modifications can be made therein without departing from the scope of the subject invention. It is, therefore, to be understood that changes can be made in the particular embodiments described, which will be within the full intended scope of the invention as defined by the following appended claims.
The present application claims priority to U.S. Provisional Application 61/533,901 filed Sep. 13, 2011 entitled, “Device For Assisting In Manual Cardiopulmonary Resuscitations”.
Number | Date | Country | |
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61533901 | Sep 2011 | US |