US3241551A - Machine for external cardiac massage - Google Patents

Description

March 22, 1966 TAMBASCIA 3,241,551

MACHINE FOR EXTERNAL CARDIAC MASSAGE Filed Sept. 13, 1961 2 Sheets-Sheet 1 IN VEN TOR.

ATTORNEYS.

March 22, 1966 J. J. TAMBASCIA MACHINE FOR EXTERNAL CARDIAC MASSAGE 2 Sheets-Sheet 2 Filed Sept. 13, 1961 INVENTOH; Join J Zamfiamam ATTORNEY-S.

United States Patent M 3,241,551 MACHINE FOR EXTERNAL CARDIAC MASSAGE John Joseph Tambascia, Bloomfield, N.J., assignor to Medi Tech Laboratories, Summit, N.J., a corporation of New Jersey Filed Sept. 13, 1961, Ser. No. 137,904 11 Claims. (Cl. 128-51) This invention relates to a machine for external cardiac massage, a resuscitative technique which has recently come to the fore. Open-chest cardiac massage has been used for quite some time for the management of sudden cardiac arrest. The closed-chest technique was resorted to because tho racotomy is a formidable procedure which must be carried out in an operating room under the most opportune circumstances and which frequently results in trauma, blood loss, shock and infection.

Closed-chest cardiac massage consists of the rhythmic application of manual pressure to the lower third of the sternum with simultaneous ventilation of the lungs, either mouth to mouth or mouth to nose, begun shortly after cardiac arrest. Depression of the sternum from 1 /2 to 2 inches compresses the heart and forces blood into the pulmonary and systemic arteries. When pressure is released, the chest expands and the heart fills with oxygenated blood, which is circulated to the tissues. The cycle is repeated about 60 to 80 times per minute. The results have been favorable.

Although closed-chest cardiac massage overcomes the common sequelae of emergency thoracotomy as noted above, it is not without complications, such as rib fractures, liver injury, marrow emboli, hemothorax and hemopericardium.

The primary object of the invention is to provide an external cardiac massage device which minimizes the complications of the manual technique noted above. This is accomplished by incorporating means therein for the application of a proper amount of depression only to the lower third of the sternum.

Another object of the invention is to provide an external cardiac machine which, because of the mechanical advantage it enjoys, lessens the strain on the operator and thereby permits more efficient application of repetitive compressive force to the sternum.

Another object of the invention is to provide an external cardiac machine which obviates the need to place the patient on a hard surface as it employs an adjustable means to engage the back between the vertebra opposite the sternum and thereby provide a pressure point to localize the compressive action on the lower ventricle of the heart.

Yet another object is to provide a machine of the character described which is relatively inexpensive, easy to operate, light and portable so that the same can be used at bedside, in an ambulance, at the seashore and other places where cardiac arrest has occurred.

These and other objects will become more apparent as the following description proceeds in conjunction with the accompanying drawings, wherein:

FIGURE 1 is a perspective view of the invention;

FIGURE 2 is a sectional view taken on the line 2-2 of FIGURE 1;

FIGURE 3 is a diagrammatic view illustrating the compressive action; and

FIGURE 4 is a fragmentary perspective view of a modified form of the invention.

Specific reference is now made to the drawings in which similar reference characters are used for corresponding elements throughout.

The machine is indicated at 19 and comprises an elongated base 12 to one end of which is secured a pedestal 14 carrying a pair of uprights 16, the upper ends 3,241,551 Patented Mar. 22, 1966 of which are provided with a carrying handle 17. The base includes an elongated groove with inwardly sloping sides 18 which extends the length of the base and opens through the pedestal. Mounted for sliding movement in the groove is a bar 24 whose side edges are sloped complementarily to the sides 18 of the groove to restrain upward movement of the bar relative to the base. The upper face of the bar is flush with that of the base and mounted on said upper face of the bar is a fixation block or protuberance 22 which is preferably semi-circular in form as shown.

A member 24 is provided which consists of a pair of clamping blocks 26 and 28 with complementary vertical grooves receiving the uprights or posts 16. Threaded bolts 30 extend through the plates adjacent the posts and receive wing nuts 32 by which the member 24 may be releasably retained in an adjusted fixed position vertically of the posts.

The member 24 is provided with a transverse or through bore 34 which slidably receives an arm 36 whose crosssectional dimension is somewhat less than that of the bore. To fixedly adjust the position of the arm in the member 24, a pressure plate 38 is retained in the bore against the arm, the same having a screw or threaded bolt 40 which extends vertically through the member 24 and receives a thumb nut 42 to tighten or loosen the gripping pressure of the plate on the arm.

The arm 36 is enlarged at one of its ends as at 44 and mounts thereat for reciprocating vertical movement a sternum compressor. Extending vertically through the arm is a toothed rack 46 to the lower end of which is secured, preferably removably as by a set or Allen screw (not shown), a collar 48. Glued or otherwise secured to the collar is a rubber compressor disk 50 whose diameter approximates /a the overall length of the sternum. Journaled transversely in the arm is a stub shaft 52 to one external end of which is secured a collar 54 carrying an operating arm 56. Intermediate its ends, the stub shaft mounts a pinion or gear 58 which is disposed in a cavity 60 in the enlarged end of the arm and is in engagement with the teeth of the rack 46. A coil spring 62 is wound about the shaft to one side of the pinion which is terminally secured to the arm and the shaft as at 64 and 66. Thus when the arm 56 is rotated downwardly, the rack also moves downwardly winding up the spring which therefore normally urges the rack and compressor upwardly away from the base.

To adjustably limit the downward stroke of the compressor to avoid compressing the sternum of a given patient beyond 1 /2 to 2", a plate 68 is secured to the rack 46 adjacent the compressor, the plate extending beyond the side face of the arm 36. At said end the plate 68 fixedly mounts as at 70 a vertical threaded shaft 72 which extends loosely through the yoke end 74 of a further plate 76 which is secured to the enlarged end 44 of the arm 36. Movably threaded on the shaft is a nut 78 which is adapted to be positioned at a selected one of the scale markings 80 along the length of the shaft, the markings representing the limitation of the compressor stroke required for the infant, child, adolescent and adult.

The modification shown in FIGURE 4 differs from that described above solely in the fact that the slide bar 20 is provided with a scale 82 which is to be indexed against the rear edge of the pedestal 14 and another scale 84 on the arm 36 correlative with scale 82 and also to be indexed against the rear edge of the clamping member 24.

In use, the patient (shown diagrammatically as 86 in FIGURE 3) is laid across the base with one side against the pedestal 14 and the slide bar 20 is moved until the fixation block or protuberance 22 is positioned in the 1ongitudinal groove 88 of the back along the vertebral column 90 and until the block 22 is positioned between the pair of vertebra directly opposite the sternum. The clamping block 24 is then adjusted to a desired height by the nuts 32 and the arm 36 is similarly adjusted by the nut 42. so that the compressor will engage the lower third of the sternum in opposition to the fixation block 22. To assist in this adjustment the arm 36 may be moved to the marking or its scale 84 which corresponds to that on scale 82. Then the nut 78 is moved on the shaft 72 to the desired scale marking 80 and the operating handle 56 rotated to lower the compressor against the sternum. The action, as shown in FIGURE 3, compresses the left ventricle of the heart 92 because, in arrest, the heart is considerably enlarged. This action is greatly enhanced by the fact that the fixation block presses against the back directly behind the lower third of the sternum and thereby acts as a counter-pressure point. To avoid injury to the ribs or liver, the downward stroke should be limited so that the sternum is compressed no more than 1%. to 2". The adjustment nut 78 is effective for this purpose as it strikes the plate 74 and prevents further downward movement of the compressor beyond the stroke required for the particular patient. Of course, the device may be used in conjunction with a defibrillator when required.

While preferred embodiments of the invention have here been shown and described, minor variations may be made by skilled artisans without departing from the spirit of the invention and the scope of the appended claims.

I claim:

1. An external heart massage device comprising an elongated base and an upright member secured thereto, means mounted on said base for longitudinal adjustable movement thereof and including a protuberance adapted to engage the back of a person at a point opposite the sternum, an elongated arm, means mounting said arm on said upright for vertical adjustable movement thereof, means for adjusting said arm longitudinally of said base, a sternum compressor and means mounting said compressor on said arm for reciprocating vertical movement towards and away from said base.

2. The device of claim 1 and adjustable means limiting the downward stroke of said compressor.

3. The device of claim 1 wherein said first-named means includes an open-ended groove in said base and a bar slidable in said groove, said protuberance being carried by said bar and extending above said base.

4. The device of claim 3 and correlated scales on said arm and slide bar whereby adjustment of said arm and slide bar may be readily effected so that the compressor is directly opposite the protuberance.

5. The device of claim 1 wherein said compressor mounting means includes a rack bar slidable vertically through said arm, said compressor being secured to the lower end of said rack bar, a pinion rotatably mounted on said arm engaging said rack bar, and resilient means urging said rack bar upwardly.

6. The device of claim 5 and adjustable means limiting the downward stroke of said compressor, said limiting means including a vertically extending member carried by said rack bar and a stop on said member adjustable along its length and adapted to abut a portion of said arm on the downstroke.

7. The device of claim 1 wherein said means mounting said arm on said upright for vertical adjustable movement includes a member including a split clamp embracing said upright and means to releasably close said clamp on said upright in a selected position.

8. The device of claim 7 wherein said means for adjusting said arm longitudinally of said base includes a bore transversely through said clamp member loosely receiving said arm, a pressure plate in said bore against said arm and releasable means to press said plate against said arm and retain it in a fixed selected position.

9. In an external heart massage device including a base mounting an arm above the base for adjustment lengthwise thereof, and a vertically reciprocal sternum compressor carried by said arm, a protuberance adapted to engage the back of a person between vertebra opposite the sternum and means mounting said protuberance on said base for adjustment along the length thereof.

10. The device of claim 3 and adjustable means limiting the downward stroke of said compressor.

11. An external heart massage device comprising a base, an elongated arm, means mounting said arm above said base for adjustment vertically towards and away from said base, a sternum compressor carried by said arm, means to reciprocate said sternum compressor vertically, adjustable means limiting the downward stroke of said sternum compressor, and a protuberance on said base vertically opposite said sternum compressor and adapted to engage the back of a person opposite the sternum.

References Cited by the Examiner UNITED STATES PATENTS 1,918,546 7/1933 Johnson 128-28 FOREIGN PATENTS 33,302 6/1908 Austria. 673,551 3/1939 Germany.

OTHER REFERENCES Boehm, R.: V. Arbeiten aus dem pharmakologischen Institute der Universitat Dorpat: 13. Ueber Weiderbelebung nach Vergiftungen und asphyxite, Arch. exper. Path u. Pharmakokol 8: 69l0l, 1878.

Kouwenhoven, W. B., Jude, I. R.. Knickerbocker, G. G.: Closed Chest Cardiac Massage, J.A.M.A. 173, 106401067, July 9, 1960.

RICHARD A. GAUDET, Primary Examiner.

R. J. HOFFMAN, Examiner.

Claims (1)

1. AN EXTERNAL HEART MESSAGE DEVICE COMPRISING AN ELONGATED BASE AND AN UPRIGHT MEMBER SECURED THERETO, MEANS MOUNTED ON SAID BASE FOR LONGITUDINAL ADJUSTABLE MOVEMENT THEREOF AND INCLUDING A PROTUBERANCE ADAPTED TO ENGAGE THE BACK OF A PERSON AT A POINT OPPOSITE THE STERNUM, AN ELONGATED ARM, MEANS MOUNTING SAID ARM ON SAID UPRIGHT FOR VERTICAL ADJUSTABLE MOVEMENT THEREOF, MEANS FOR ADJUSTING SAID ARM LONGITUDINALLY OF SAID BASE, A STERNUM COMPRESSOR AND MEANS MOUNTING SAID COMPRESSOR ON SAID ARM FOR RECIPROCATING VERTICAL MOVEMENT TOWARDS AND AWAY FROM SAID BASE.

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