This disclosure is directed to systems and methods related to mechanical cardiopulmonary resuscitation (CPR) devices, and in particular, to compression devices have an adjustable compression point.
Mechanical compression devices for CPR are being increasingly adopted by emergency medical services around the world. Traditionally, CPR has been performed manually by a rescuer. However, during longer duration resuscitations, a rescuer can become fatigued and provide inadequate compressions. Mechanical compression devices have been adopted by many emergency medical services to address these potential drawbacks of manual CPR by a rescuer.
Conventional mechanical CPR devices repeat the same compression at the same location on a patient's chest repeatedly. This precise consistency is non-physiological and there may be benefits to moving or adjusting the location of the chest compression either before CPR begins or during CPR.
Configurations of the disclosed technology address shortcomings in the prior art.
Aspects, features and advantages of examples of the present disclosure will become apparent from the following description of examples in reference to the appended drawings in which:
Examples of the disclosure are directed to mechanical compression devices that can adjust the compression point or compression location on a chest of a patient, either manually or automatically. In some examples, the compression point may be changed during CPR based on feedback from physiological sensors attached or connected to a patient or feedback from patient positioning sensors.
As illustrated in
The support legs 106 may be configured to support central unit 104 at a distance from the base member 108. For example, if the base member 108 is underneath the patient, who is lying on the patient's back, then the support legs 106 may support the central unit 104 at a sufficient distance over the base member 108 to allow the patient to lay within a space between the base member 108 and the central unit 104, while positioning a compression mechanism 112 over the patient's chest or abdomen. The base member 108 may be configured to be placed underneath the patient, for example when the patient is lying on the patient's back.
The central unit 104 may be configured to deliver CPR compressions to the patient. The central unit 104 may include, for example, a compression mechanism 112 that has a motor-driven piston 114 configured to contact the patient's chest through a suction cup 116 or other interface to provide CPR compressions. The central unit 104 may also include a number of electronic components to drive the motor-driven piston 114. In the example illustrated in
The central unit 104 also may include an adjustment mechanism 118 surrounding the compression mechanism 112. The adjustment mechanism 118 may be, for example, a rectangular shape and be structured to adjust the compression mechanism 112 and the resulting compression point in any location within the adjustment mechanism 118. That is, the adjustment mechanism 118 may adjust the compression position in an adjustment plane that is generally parallel to the patient.
The controller 204, as will be discussed in more detail below, provides instructions to the compression mechanism 206 to operate the compression mechanism 206 at a number of different rates, waveforms, depths, heights, duty cycles or combinations thereof that change over time. Example chest and/or abdomen manipulation instructions or protocols include compressing a chest and/or abdomen and decompressing and/or expanding of a chest and/or abdomen of a patient. The controller 204, as will also be discussed in more detail below, also provides instructions to the adjustment mechanism 208 to position the suction cup 116 or any other interface at a particular or desired compression position.
The controller 204 may include a processor 210, which may be implemented as any processing circuity, such as, but not limited to, a microprocessor, an application specific integration circuit (ASIC), programmable logic circuits, etc. The controller 204 may further include a memory 212 coupled with the processor 210. Memory 212 can include a non-transitory storage medium that includes programs 214 configured to be read by the processor 208 and be executed upon reading. The processor 208 is configured to execute instructions from memory 212 and may perform any methods and/or associated operations indicated by such instructions. Memory 212 may be implemented as processor cache, random access memory (RAM), read only memory (ROM), solid state memory, hard disk drive(s), and/or any other memory type. Memory 212 acts as a medium for storing data 216, such as instructions for the adjustment mechanism 208 or compression mechanism 206, event data, patient data, etc., computer program products, and other instructions.
The controller 204 may be located separately from the compression mechanism 206 and/or adjustment mechanism 208 and may communicate with the compression mechanism 206 and/or adjustment mechanism 208 through a wired or wireless connection. The controller 204 also electrically communicates with a user interface 218. As will be understood by one skilled in the art, the controller 204 may also be in electronic communication with a variety of other devices, such as, but not limited to, a communication device, another medical device, etc.
Operations of the mechanical compression device 200 may be effectuated through the user interface 218 in some examples. The user interface 218 may be external to or integrated with a display. For example, in some examples, the user interface 218 may include physical buttons located on the mechanical compression device 200, while in other examples, the user interface 218 may be a touch-sensitive feature of a display. The user interface 218 may be located on the mechanical compression device 200, or may be located on a remote device, such as a smartphone, tablet, PDA, and the like, and is also in electronic communication with the controller 204. In some examples, controller 204 can receive a rate, a waveform, and/or depth input from the user interface 218 and, responsive to the rate, the waveform, and/or depth input, cause the compression mechanism 206 to move to adjust the rate, waveform, and/or depth of the compression, decompression, or expansions during a session.
Additionally or alternatively, one or more sensors 220 may transmit information to controller 104. The one or more sensors 220 may be, for example, physiological sensors for sensing a physiological parameter of a patient and to output a physiological parameter sensor signal that is indicative of a dynamic value of the parameter. The physiological parameter can be an Arterial Systolic Blood Pressure (ABSP), a blood oxygen saturation (SpO2) or plethysmograph, a ventilation measured as End-Tidal CO2 (ETCO2) or capnography waveform, invasive blood pressure data, a temperature, a detected pulse, inspired oxygen (O2), air flow volume, blood flow, etc. In addition, this parameter can be detected by defibrillator electrodes that may be attached to patient, such as electrocardiogram (ECG) and transthoracic impedance, and transmitted to the controller 204. The one or more sensors 220 may also include patient positioning sensors that are configured to detect the position of the patient, such as, but not limited to a chest height or a centerline of a patient. With reference to
Returning to
If the sensors 220 are patient positioning sensors, the controller 204 can adjust the compression position by the adjustment mechanism 208 based on the feedback from the patient positioning sensors, which may be able to detect, for example, a chest height of a patient, as well as a centerline of the chest of the patient.
If the sensors 220 are visual sensors, the controller 204 can adjust the compression position by the adjustment mechanism 208 based on feedback from the visual sensors, which may include image analysis to optimize the location of the compression position relative to the patient's thorax. If the sensors 220 are RFID sensors, the controller 204 can adjust the compression position by the adjustment mechanism 208 based on feedback from the RFID tag.
In some examples, the controller 204 may continually adjust the compression point based on the information transmitted by the one or more sensors 220 to ensure that an optimal compression point is achieved. In other examples, the controller 204 may adjust the compression point by the adjustment mechanism 208 incrementally to determine which direction of movement of the compression point results in an improvement of the physiological signals from the patient.
The exterior edges 302 of the adjustment mechanism 118 may include a slot or other mechanism to allow the guide rods 300 to move along the x-axis and y-axis. For example, the guide rods 300 may be manually movable within the slot and include a stopper or other locking mechanism, such as a clamp, to position the suction cup 116 in the desired location. In some examples, the guide rods 300 may be movable along rails in the exterior edges 302 of the adjustment mechanism 118 or may be attached to linear actuators.
In other examples, the guide rods 300 are automatically movable by a controller 204 of the mechanical compression device. The guide rods 300 may be linear actuators and the exterior edges 302 of the adjustment mechanism may also include linear actuators. In concert, the linear actuators can position the suction cup 116 in a desired location based on an input received as user interface 210. Drivers (not shown) may be attached to the linear actuators which are driven based on instructions received from the controller 204. The linear actuators may be any known linear actuators, such as, but not limited to, hydraulic, electrical, pneumatic, magnetic, etc.
The mechanical compression device 500 can include a support frame 502 and a back plate 504. The support frame 502 includes two support columns 506 and 508 that support a compression beam 510 at a distance from the back plate 504. The compression beam 510 includes an attachment 512 for a suction cup 514 to attach to a chest of a patient 516 during mechanical compression and/or decompressions or expansions. Although a suction cup 514 is illustrated in
The compression beam 510 can be attached to actuators located along or inside the support columns 506 and 508. The actuators may be any known actuators, such as, but not limited to, hydraulic, electrical, pneumatic, magnetic, etc. The actuators are structured to translate the compression beam 510 vertically with respect to the back plate 504 from a starting position during compressions. The actuators are driven by the controller 204 and can be driven independently or in concert. The actuators are driven by the controller 204 from a starting position to a compression position and then back up to the starting position. A rescuer may adjust the start position of the compression beam 510 either manually or through the user interface 210. The start position of each of the actuators in the support columns 506 and 508 may either be symmetrical, as illustrated in
The length of the attachment 512 may be set either manually by a user or may include an actuator or other electrical component which can set the distance of the attachment 512 to the desired height. The suction cup 514, or other interface, may include a sensor 220 which transmits information to the controller 204 to determine when the suction cup 514 has attached to the chest of the patient and what length to set the attachment 512.
A lateral position of the compression point on the patient may be adjusted, as illustrated in
The starting point of each of the actuators in the support columns 506 and 508 may be set independently so the starting positions are asymmetrical. This can allow the compression position on the chest of the patient to be adjusted laterally, or side-to-side, with respect to a centerline 702 of the mechanical compression device 500, as illustrated in
During compressions, the controller 204 can drive the actuators of the support columns 506 and 508 from their starting positions to compress a chest of a patient, and then back up to the starting position while maintaining the laterally adjusted compression point. As mentioned above, the starting positions of the actuators may be set manually or may be set automatically by the controller 204. Additionally or alternatively, in some examples, the controller 204 can adjust the starting position during a chest compression session of one or both of the actuators to laterally adjust the position of the compression point. The adjustment may be done based on feedback from either a user interface 218 or from one or more sensors 220 connected to the patient.
Additionally or alternatively, as illustrated in
The support columns 506 and 508 can tilt relative to the back plate 504 either manually or be driven by the controller 204. Once in the desired tilt position, the support columns 506 and 508 are locked and made rigid in the tilted position, such as by clamping or otherwise providing a stop to prevent the support columns 506 and 508 from tilting further in either direction during operation of the mechanical compression device 500.
Additionally or alternatively, as will be understood by one skilled in the art, the support columns 506 and 508 may have adjustable independent starting positions, as well as be able to tilt relative to the back plate 504, either perpendicularly or parallel to the centerline 702 to provide numerous options for adjusting a compression position. Further, such tiling and adjusting the start of the compression positions can allow the mechanical compression device 500 to provide compressions at an angle relative to the chest of the patient, which may be beneficial in some rescue situations. Chest compressions using conventional mechanical compression devices are generally performed substantially perpendicular, or 90 degrees, relative to the patient. However, tiling and adjusting the starting position of the compression positions to be asymmetrical can allow the mechanical compression device 500 to provide compressions with a force angle other than 90 degrees relative to the patient. That is, the force angle of the compression may between 10 and 170 degrees relative to the chest or abdomen of the patient, either laterally or medially.
Additionally or alternatively to each of the above-discussed examples, in some examples, the compression beam 510 may pivot or tilt relative to the support columns 506 and 508. That is, the compression beam 510 may pivotably or rotatably attach to the actuators in the support columns 506 and 508 to provide compressions at an angle. For example, the compression beam 510 may attached to the actuators by a hinge that can allow the compression beam 510 to pivot and be locked in a pivoted or rotates position for performing compressions at an angle. The compression beam 510 may pivot or rotate about an axis that is parallel to an axis extending between the two support columns 506 and 508. In some examples, the compression beam 510 pivot angle can be set manually or may be set by the controller 204 based either one user input or feedback from one or more sensors 220.
Additionally or alternatively to each of the above-discussed examples, in some examples, one or both of the support columns 506 and 508 may bend.
Additionally or alternatively to each of the above-discussed examples, in some examples the attachment 512 may move relative to the compression beam 510, as illustrated in
For example, the starting position of both the actuators in the support columns 506 and 508 may be set independently and may be symmetrical or asymmetrical, as shown, for example in
Additionally or alternatively, the support columns 506 and 508 may tilt relative to the back plate 504, in some examples. This can provide a number of different options for changing the compression position as well as providing compressions. As one example, with the support columns 506 and 508 titled, as well as the compression point adjusted by the adjustment mechanism 118, the mechanical compression device 1000 may provide compressions at an angle relative to the compression point set by the adjustment mechanism 118.
The mechanical compression device 1000 can include the controller 204 and other components discussed above with respect to
Additionally or alternatively, the compression beam 510 with the adjustment mechanism 118 may also rotate relative to the support columns 506 and 508 in some examples, as discussed above with respect the compression device 500. The support beam 510 may rotate about an axis that extends between the support columns 506 and 508 to change an angle of the compression provided to the patient. The support beam 510 may be manually adjusted or adjusted automatically by the controller 204.
Each stand 1302 is connected to two actuators 1306 and 1308. The actuators 1306 and 1308 can be any type of actuator, such as, but not limited to, hydraulic, electrical, pneumatic, magnetic, etc. The actuator 1306 is attached or coupled to an end of the stand 1302 furthest from the back plate 1304. The actuator 1308 is connected to the stand 1302 closer to the back plate 1304. In some examples, the actuator 1308 is connected to the stand 1302 at approximately the middle of the stand 1302. However, other attachment locations may be used on the stands 1302.
Similar to examples discussed above, the components illustrated in
Each of the actuators 1306 and 1308 attach to a compression member 1310, which has an attached compression pad or suction cup 1313. Each of the actuators 1306 can be adjusted to change the compression point position, as best illustrated in
After the compression position has been set using actuators 1306, actuators 1308 can be driven by the controller 204 to compress the chest or abdomen of the patient. The actuators 1308 are driven in concert to cause the compression member 1310 to provide the compressions to the chest of patient.
In some examples, the actuators 1308 can also be engaged or driven to set the compression position. For example, for smaller patients, the compression position may be need to be set lower and a starting point for the compressions may be set using the actuators 1308. Compressions may then be performed from the starting position. The controller 204 can cause the actuators 1308 to start from the starting position and perform a compression and then return to the starting position.
Additionally or alternatively, attachment point of the actuators 1306 and 1308 to the stands 1302 may be adjustable. For example, actuators 1306 and 1308 may be moved up or down relative to the back plate 1304 to move the compression member 1310 closer or further from the patient. This may be done, for example, by having a clamping member that can clamp the actuators 1306 and 1308 to the stands 1302 at the desired positions. The actuators 1306 and 1308 may move in tandem along the stand 1302 or in other examples, the actuators 1306 and 1308 may move independently along the stand 1302.
Additionally or alternatively, the actuators 1306 and 1308 of each stand 1302 may be set at different heights along the stands 1302 relative to the other stands 1302. For example, the actuators 1306 and 1308 of one stand 1302 may be in lower positions than the actuators 1306 and 1308 attached to the other stands 102. Having different heights for the actuators 1306 and 1308 in one or more of the stands 1302 can allow the mechanical compression device 1300 to provide compressions at an angle, similar to some of the examples of the mechanical compression device 500 discussed above. Additionally or alternatively, each stand 1302 itself may be any type of actuator, such as, but not limited to, hydraulic, electrical, pneumatic, magnetic, etc.
Additionally or alternatively, small adjustments to the position of the piston may be accomplished by allowing the position of the suction cup or other interface to be fine-tuned relative to the position of the piston. Configurations illustrating examples this fine-tuning feature are shown in
While the discussion of
As illustrated in
As best illustrated by the broken lines in
Accordingly, the disk 1504 may be rotated relative to the carrier 1506 such that a vertical centerline 1512 of the suction cup 116 or other interface is substantially coextensive with a longitudinal centerline 1514 of the motor-driven piston 114. As used in this context, “substantially coextensive” means largely or essentially coinciding in space, without requiring perfect coincidence. An example of this is shown in
In addition, the disk 1504 may be rotated relative to the carrier 1506 such that the centerline 1512 of the suction cup 116 or other interface is substantially offset from and parallel to the centerline 1514 of the motor-driven piston 114. As used in this context, “substantially offset from and parallel to” means that the centerlines are not substantially coextensive but are largely or essentially equidistant at all points, without requiring perfect parallelism. An example of this is shown in
Accordingly, by rotating the disk 1504 within the carrier 1506, the position of the suction cup 116 or other interface may be fine-tuned.
As illustrated in
As illustrated the disk 1908 may include a button 1912 to facilitate securing the end 1902 of the motor-driven piston 114 within the disk 1908. The button 1912 may include a spring 1914 to bias the button 1912 toward the toothed ring 1904. In configurations, the button 1912 may include a projection, or tooth, 1924 configured to engage the toothed ring 1904. When engaged, the projection 1924 helps to prevent rotation of the toothed ring 1904 (and, hence, the motor-driven piston 114) within the chamber 1910 of the disk 1908. In configurations, the button 1912 may also or instead facilitate rotating the disk 1908 within the carrier 1909.
The button 1912 may include a lip or ridge 1916 configured to overhang the toothed ring 1904 when the end 1902 of the motor-driven piston 114 is within the opening 1906 of the disk 1908. The lip or ridge 1916 may help to secure the toothed ring 1904 (and, hence, the end 1902 of the motor-driven piston 114) within the disk 1908. As illustrated, the disk 1908 may include a lip or ridge 1918 configured to overhang the toothed ring 1904 when the end 1902 of the motor-driven piston 114 is within the opening 1906 of the disk 1908. The lip or ridge 1918 may help to secure the toothed ring 1904 (and, hence, the end 1902 of the motor-driven piston 114) within the disk 1908.
Accordingly, the disk 1908 may be rotated relative to the carrier 1909 such that a centerline 1920 of the suction cup 116 or other interface is substantially coextensive with a longitudinal centerline 1922 of the motor-driven piston 114. An example of this is shown in
In addition, the disk 1908 may be rotated relative to the carrier 1909 such that the centerline 1920 of the suction cup 116 or other interface is substantially offset from and parallel to the centerline 1922 of the motor-driven piston 114. An example of this is shown in
Accordingly, by rotating the disk 1908 within the carrier 1909, the position of the suction cup 116 or other interface may be fine-tuned.
As illustrated in
The bracket 2408 is coupled to a disk 2412. The disk 2412 is configured to rotate relative to a carrier 2413. The carrier 2413 is configured to retain the disk 2412 and to permit the disk 2412 to rotate relative to the carrier 2413. In configurations, there may be a friction fit between the disk 2412 and the carrier 2413 to minimize undesired rotation of the disk 2412 within the carrier 2413. The carrier 2413 is affixed to the suction cup 116 or other interface. As illustrated, the end 2404 of the motor-driven piston 114 is not centered on the disk 2412.
Accordingly, the disk 2412 may be rotated relative to the carrier 2413 such that a centerline 2418 of the suction cup 116 or other interface is substantially coextensive with a centerline 2420 of the motor-driven piston 114. An example of this is shown in
In addition, the disk 2412 may be rotated relative to the carrier 2413 such that the centerline 2418 of the suction cup 116 or other interface is substantially offset from and parallel to the centerline 2420 of the motor-driven piston 114. An example of this is shown in
Accordingly, by rotating the disk 2412 within the carrier 2413, the position of the suction cup 116 or other interface may be fine-tuned.
As illustrated in
The configuration illustrated in
Accordingly, the disk 2412 may be rotated relative to the carrier 2413 such that a centerline 2418 of the suction cup 116 or other interface is substantially coextensive with a centerline 2420 of the motor-driven piston 114. An example of this is shown in
In addition, the disk 2412 may be rotated relative to the carrier 2413 such that the centerline 2418 of the suction cup 116 or other interface is substantially offset from and parallel to the centerline 2420 of the motor-driven piston 114. An example of this is shown in
Accordingly, by rotating the disk 2412 within the carrier 2413, the position of the suction cup 116 or other interface may be fine-tuned.
In addition to what is described above for
Specifically, the feature illustrated in
In configurations, the wheel 2422 and the inner diameter 2424 of the carrier 2413 may include gear teeth, such as is illustrated, to enmesh and assist the wheel 2422 to smoothly roll around the inner diameter 2424 of the carrier 2413 without slipping. (An example of the wheel 2422 with gear teeth is the toothed ring 1904 illustrated in
For purposes of this description, certain aspects, advantages, and novel features of the examples of this disclosure are described herein. Features, integers, characteristics, compounds, chemical moieties or groups described in conjunction with a particular aspect, configuration, or example of the disclosure are to be understood to be applicable to any other aspect, configuration or example described herein unless incompatible therewith. All of the features disclosed in this specification (including any accompanying claims, abstract and drawings), and/or all of the steps of any method or process so disclosed, may be combined in any combination, except combinations where at least some of such features and/or steps are mutually exclusive. The disclosure is not restricted to the details of any foregoing examples. The disclosure extends to any novel one, or any novel combination, of the features disclosed in this specification (including any accompanying claims, abstract and drawings), or to any novel one, or any novel combination, of the steps of any method or process so disclosed.
Although the operations of some of the disclosed methods are described in a particular, sequential order for convenient presentation, it should be understood that this manner of description encompasses rearrangement, unless a particular ordering is required by specific language. For example, operations described sequentially may in some cases be rearranged or performed concurrently. Moreover, for the sake of simplicity, the attached figures may not show the various ways in which the disclosed methods can be used in conjunction with other methods.
As used herein, the terms “a”, “an”, and “at least one” encompass one or more of the specified element. That is, if two of a particular element are present, one of these elements is also present and thus “an” element is present. The terms “a plurality of” and “plural” mean two or more of the specified element. “Generally” or “approximately” as used herein means a variance of 10%.
As used herein, the term “and/or” used between the last two of a list of elements means any one or more of the listed elements. For example, the phrase “A, B, and/or C” means “A,” “B,” “C,” “A and B,” “A and C,” “B and C,” or “A, B, and C.”
As used herein, the term “coupled” generally means physically coupled or linked and does not exclude the presence of intermediate elements between the coupled items absent specific contrary language.
Additionally, this written description makes reference to particular features. It is to be understood that the disclosure in this specification includes all possible combinations of those particular features. Where a particular feature is disclosed in the context of a particular aspect or example, that feature can also be used, to the extent possible, in the context of other aspects and examples.
Also, when reference is made in this application to a method having two or more defined steps or operations, the defined steps or operations can be carried out in any order or simultaneously, unless the context excludes those possibilities.
Although specific examples of the disclosure have been illustrated and described for purposes of illustration, it will be understood that various modifications may be made without departing from the spirit and scope of the disclosure.
Aspects may operate on a particularly created hardware, on firmware, digital signal processors, or on a specially programmed general purpose computer including a processor operating according to programmed instructions. The terms “controller” or “processor” as used herein are intended to include microprocessors, microcomputers, ASICs, and dedicated hardware controllers. One or more aspects may be embodied in computer-usable data and computer-executable instructions, such as in one or more program modules, executed by one or more computers (including monitoring modules), or other devices. Generally, program modules include routines, programs, objects, components, data structures, etc. that perform particular tasks or implement particular abstract data types when executed by a processor in a computer or other device. The computer executable instructions may be stored on a non-transitory computer readable medium such as a hard disk, optical disk, removable storage media, solid state memory, RAM, etc. As will be appreciated by one of skill in the art, the functionality of the program modules may be combined or distributed as desired in various configurations. In addition, the functionality may be embodied in whole or in part in firmware or hardware equivalents such as integrated circuits, field programmable gate arrays (FPGA), and the like. Particular data structures may be used to more effectively implement one or more aspects of the disclosed systems and methods, and such data structures are contemplated within the scope of computer executable instructions and computer-usable data described herein.
The previously described versions of the disclosed subject matter have many advantages that were either described or would be apparent to a person of ordinary skill. Even so, all of these advantages or features are not required in all versions of the disclosed apparatus, systems, or methods.
Additionally, this written description makes reference to particular features. It is to be understood that the disclosure in this specification includes all possible combinations of those particular features. For example, where a particular feature is disclosed in the context of a particular example configuration, that feature can also be used, to the extent possible, in the context of other example configurations.
Also, when reference is made in this application to a method having two or more defined steps or operations, the defined steps or operations can be carried out in any order or simultaneously, unless the context excludes those possibilities.
Furthermore, the term “comprises” and its grammatical equivalents are used in this application to mean that other components, features, steps, processes, operations, etc. are optionally present. For example, an article “comprising” or “which comprises” components A, B, and C can contain only components A, B, and C, or it can contain components A, B, and C along with one or more other components.
Also, directions such as “vertical,” “horizontal,” “right,” and “left” are used for convenience and in reference to the views provided in figures. But the described apparatus may have a number of orientations in actual use. Thus, a feature that is vertical, horizontal, to the right, or to the left in the figures may not have that same orientation or direction in actual use.
Although specific example configurations have been described for purposes of illustration, it will be understood that various modifications may be made without departing from the spirit and scope of the disclosure.
This patent application claims the benefit of U.S. provisional patent application No. 63/105,683 filed Oct. 26, 2020, which is incorporated into the present disclosure by this reference.
Number | Date | Country | |
---|---|---|---|
63105683 | Oct 2020 | US |