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WO2009147659A1 - Dispositif de massage cardiaque - Google Patents

Dispositif de massage cardiaque Download PDF

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Publication number
WO2009147659A1
WO2009147659A1 PCT/IL2009/000539 IL2009000539W WO2009147659A1 WO 2009147659 A1 WO2009147659 A1 WO 2009147659A1 IL 2009000539 W IL2009000539 W IL 2009000539W WO 2009147659 A1 WO2009147659 A1 WO 2009147659A1
Authority
WO
WIPO (PCT)
Prior art keywords
plunger
patient
sensors
structural elements
thorax
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IL2009/000539
Other languages
English (en)
Inventor
David Weintraub
Yoram Eshel
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
POEMS Ltd
Original Assignee
POEMS Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by POEMS Ltd filed Critical POEMS Ltd
Publication of WO2009147659A1 publication Critical patent/WO2009147659A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00—Artificial respiration by a force applied to the chest; Heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5064—Position sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/04—Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
    • A61H2230/06—Heartbeat rate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/20—Blood composition characteristics
    • A61H2230/205—Blood composition characteristics partial CO2-value
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/20—Blood composition characteristics
    • A61H2230/207—Blood composition characteristics partial O2-value
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/30—Blood pressure

Definitions

  • the present invention relates to a compact, light weight, portable cardiac message device (CMD) for use in cardiopulmonary resuscitation (CPR)
  • CMD cardiopulmonary resuscitation
  • Cardiopulmonary resuscitation is a well-known and valuable life- saving method of first aid.
  • CPR is used to resuscitate people who have suffered from cardiac arrest after suffering a heart attack, electric shock, chest injury and other causes for cardiac arrest or disorder.
  • the heart stops pumping blood, and a person suffering cardiac arrest will soon suffer brain damage from lack of blood supply to the brain.
  • CPR requires repetitive chest compression to mechanically squeeze the heart and the thoracic cavity to pump blood through the body.
  • CPR is usually followed by defibrillation that is intended to reset heart fibrillation.
  • the patient is not breathing, and mouth to mouth artificial respiration or a bag valve mask is used to supply air to the lungs while the chest compression pumps blood through the body.
  • CPR should be initiated as quickly as possible after cardiac arrest to maximize its effectiveness and avoid neurologic damage due to lack of blood flow to the brain. Hypoxia sets in about two minutes after cardiac arrest, and irreversible brain damage may occur after about four minutes of oxygen deficiency.
  • CPR when applied immediately after cardiac arrest, can often save cardiac arrest patients.
  • CPR requires that the person providing chest compressions repetitively pushes down on the sternum of the patient at a rate of 80 to100 compressions per minute.
  • the compression of the sternum in CPR treatment is referred to as "cardiac massaging" thus, the device for "cardiac massaging” is referred from herein after as "CMD”.
  • CPR can be applied anywhere, wherever the cardiac arrest patient is stricken. Out-doors, away from medical facilities, it may be accomplished by either ill-trained bystanders or highly trained paramedics and ambulance personnel. In efforts to provide better blood flow and increase the effectiveness of bystander resuscitation efforts, instrumentation of the basic manual CPR procedure have been previously proposed and used.
  • US 4,570,615 (Barkolow) describes a piston that is placed over the chest cavity and supported by an arrangement of beams.
  • the piston is placed over the sternum of a patient and set to repeatedly push downward on the chest under pneumatic power.
  • the patient must first be placed within the device, and the height and stroke length of the piston must be adjusted for the patient before use, which may lead to delayed chest compression.
  • US 5,257,619 (Everette) describes a device for hand operated action on the sternum.
  • the device is composed of a simple chest pad mounted on a pivoting arm supported over a patient, which can be used to compress the chest by pushing down on the pivoting arm.
  • Everette's device, as well as other hand operated chest compressing devises are not clinically more successful than manual chest compression (see Taylor, et al.: External Cardiac Compression, A Randomized Comparison of Mechanical and Manual Techniques, 240 JAMA 644 (March 1978)).
  • a response to cardiac arrest generally comprises four phases: by bystander CPR, Basic Cardiac Life Support (BCLS), Advanced Cardiac Life Support (ACLS), and Emergency Room procedures.
  • BCLS Basic Cardiac Life Support
  • ACLS Advanced Cardiac Life Support
  • Emergency Room procedures Bystander CPR occurs, if at all, within the first few minutes after cardiac arrest.
  • BCLS is provided by first responders who arrive on scene, in average 10 minutes after being dispatched to the scene. First responders include ambulance personnel emergency medical technicians, firemen and police.
  • An aim of the present invention is to provide a cardiac-massage-device (CMD) that is compact, light weight and portable, is efficient in providing external cardiac compressions, easy to operate and simple to store, carry along and transport in public as well as domestic premises.
  • CMD cardiac-massage-device
  • Another aim of the present invention is to provide a cardiac-massage- device (CMD) with enhanced patient safety protection features that include a support-structure that can easily be adjusted to the physiological parameters of any individual and a plunger that applies the required force and depth of compressions suitable to the specific elasticity of any given patient's thorax.
  • CMD cardiac-massage- device
  • a cardiac massage device comprising: [0014] a plunger coupled to a driver for driving the plunger; and [0015] a structure comprising at least two structural elements, wherein in a deployed state, a first element of the structural elements is adapted to be at least partially inserted below a back of a patient, and a second element of the structural elements is adapted to position the plunger over the thorax of the patient to perform cardiac massage, and wherein in a stored state all structural elements are arranges substantially in a compact state.
  • the structure comprises a strain release mechanism for unloading overload implied by the plunger on the thorax of the patient.
  • the device comprises a controller.
  • the controller is adapted to monitor a compression force applied by the plunger on the thorax of the patient and vary the compression force or the compression depth.
  • the structure comprises three structural elements, wherein the second element is connected to a third element of the structural elements, which is connected to the first element.
  • At least one of the structural elements is length adjustable.
  • the driver comprises an electrical motor.
  • the weight of the device is no more than 3 kilograms.
  • the device in a compact state the device volume in no more than one thousand cubic centimeters.
  • the device is provided with locking latches for locking the structural elements in the deployed state.
  • the structural elements are separable.
  • the device comprises one or more sensors.
  • said one or more sensors are selected from a group of sensors comprising: compression sensors, load sensors, strain sensors, pulse sensors, blood pressure sensors, ECG sensors, CO 2 sensors and oximetry sensors.
  • the device comprises a speaker for providing audible guidance to a caregiver.
  • the plunger includes at least one energy storing element.
  • said at least one energy storing element comprises at least one preloaded spring.
  • the device further comprises a communication module for communication with a remote location.
  • the communication module comprises a microphone and a speaker.
  • the device comprises a memory for storing and retrieving operation data of the device.
  • the device comprises a defibrillator.
  • the device is adapted to communicate with a cardiac defibrillator.
  • a cardiac massage device comprising:
  • a cardiac massaging element for providing controlled compression of a thorax of a patient
  • a controller for controlling the compression based on characteristics of the patient [0039] a controller for controlling the compression based on characteristics of the patient.
  • Fig. 1 is an isometric illustration of a three-parts support-structured CPR-treatment cardiac-massage-device (CMD) in accordance with embodiments of the present invention, viewed from the front.
  • CMD cardiac-massage-device
  • Fig. 2 is an isometric illustration of the CMD illustrated in Fig. 1 viewed from the rear with defibrillation pads connected that enable it to function also as a defibrillator.
  • Fig. 3 is an isometric illustration of the CMD illustrated in Fig. 1 in a fully folded state.
  • Fig. 4 is an isometric illustration of the CMD illustrated in Fig. 1 in the state of being partially unfolded and deployed.
  • Fig. 5 is an isometric illustration, viewed from the front, of an embodiment of a CMD in accordance with the present invention, having springs connected to the plunger driving mechanism.
  • Fig. 6 is an illustration of a two-parts support-structured CPR-treatment CMD in accordance with embodiments of the present invention, viewed from the side.
  • Fig. 7 is an isometric illustration of the two-parts support-structured CMD shown in Fig. 6.
  • Fig. 8A is an illustration of an embodiment of a full-circle plunger driving wheel mechanism of a CMD
  • FIG. 8B is an illustration of an embodiment of an arc-motion plunger driving wheel mechanism of a CMD.
  • Fig. 9 is an illustration of the CMD illustrated in Fig. 1 positioned over the chest of a lying patient for commencing of CPR treatment.
  • Fig. 10 is a cross section view of an embodiment of a length-adjustable element of CMD illustrated in Fig. 1.
  • Fig. 11 is an illustration of the locking mechanism between length- adjustable elements and an upper hinge-unit of the CMD illustrated in Fig. 1.
  • Fig. 12 is a block diagram of the controls of a CMD in accordance with embodiments of the present invention.
  • a compact, light weight (less than 2 kg) and portable automatic mechanical CMD is provided.
  • the device When a situation arises in which a person is in cardiac arrest (i.e. no spontaneous breathing and no pulse is detected) the device is deployed. First, a preliminary deployment of the device is done, followed by a personal fitting of the device to the patient's thorax dimensions. Thus, the device is fitted and affixed to the patient by a caregiver (e.g. the operator of the device). Upon being affixed to the patient the device operation is initiated by the caregiver.
  • the device is simple and quick to adjust to the anatomical built of any patient in need of CPR and is simple to operate by people who may have had no previous experience.
  • the CMD comprises a rigid or a semi-rigid foldable structure that is adapted to transform from a folded state to a deployed state. While folded the device is compact for storage and easy to carry along. In a specific embodiment the folded device is pocket sized and is suitable to be carried in a pocket or on the waist belt of a caregiver.
  • the CMD is further adapted to facilitate a size adaptation of its structure in a deployed state to the anatomical built of the patient.
  • Such adaptation may be performed in various ways.
  • the device's structure comprises longitudinally extendable elements that are capable to extend or to be minimized, such as but not necessarily telescopic rods that allow the caregiver to fit the device size in a deployed state to a specific patient.
  • the CMD may be mounted on the patient from his left-hand or right hand side.
  • the CMD may be mounted on the patient from the shoulders downward towards the thorax.
  • the device structure may be partially or fully dismantled for compact storage (not shown), and be assembled upon use.
  • the CMD in accordance with embodiments of the present invention may include a mechanical plunger driven by a motor such as an electric power-packed DC motor (with one or more batteries serving as its power source), optionally, with a planetary gear.
  • the motor is preferably but not necessarily integrated in the device structure.
  • the motor incorporated in the device is characterized by being a high speed motor with at least 10,000 rpm.
  • the plunger is driven by the motor, to thereby perform cardiopulmonary chest compressions.
  • the motor forces the plunger, preferably but not necessarily, via a crankshaft, to move in a repetitive predetermined vertical travel course of compression and release of the thorax.
  • the motion is between two opposite positions of the plunger in a range of 3 to 8 cm. In order to compress the thorax approximately 3 to 8 cm deep (which is typically the desired compression depth) an approximate typical force load of about 50 kg on the thorax is required.
  • an energy storing element such as preloaded spring (or springs), a memory flex material, pneumatic or hydraulic piston that is adapted to function as a spring, or any other energy storing material known in the art that is suitable for the purposes of the present invention, is used to assist the motor in forcing the plunger movement (illustrated in Fig. 5).
  • the energy storing element may be connected to different parts of the device such as the plunger, the crank, the motor, the structure and any other part of the device that is related to the compression/release mechanism.
  • a pre-loaded spring is connected to the plunger itself or to the plunger mechanism and applies constant force on the plunger in the same direction as the motor does.
  • the spring is acting as an energy storing element, and thus, the spring load is added to the motor force load on the plunger and the accumulated force of the motor and spring is applied to the patient's thorax.
  • the force-load required from the motor is substantially reduced, enabling the use of a smaller, lighter and less expensive motor while utilizing lower power supply consumption of the batteries used to operate the motor.
  • the device comprises a control unit that controls the motor and thus the motions of the plunger.
  • the control unit comprises an electronic controller and control circuitry adapted to monitor and govern the rate of compression/release cycles, the compression force and any other relevant parameter to the performance of the CPR procedure.
  • the information concerning the plunger's motion is obtained from sensors connected to the plunger mechanism or to the structure (hereinafter: "compression indication sensors").
  • the compression indication sensors are adapted to provide indication regarding the plunger motion or the load applied by the plunger. Said indication may be used in accordance with embodiments of the invention to monitor and control the compression load on the patient's thorax. Alternately, said indication may be retrieved from an encoder means incorporated in the motor.
  • the CMD of the present invention may further comprise a "life-signs" sensor or sensors, for example a pulse sensor, an ECG monitoring module and/or blood pressure, a CO 2 sensor and an oximetry sensor.
  • the controller can optionally process data fed to the controller from said "life-signs" sensors applied to a CPR patient, and direct commands to the driving mechanism) to initiate the automated CPR or advise the caregiver to initiate CPR.
  • the term “plunger driving mechanism” is used from herein after to refer to the mechanical mechanism that enables the motion and stability of motion of the plunger.
  • the control unit is further adapted to operate a man-machine interface.
  • the man- machine interface comprises at least an operation "ON 1 TOFF" button and optionally an LCD or an LED display, a speaker for audio feedback or guidance and a microphone.
  • the audio speaker and microphone may be used by untrained caregivers to communicate with medical professionals to thereby assist him in dealing with a cardiac arrest case.
  • the microphone may also be used for recording scene ambient sounds for documenting the process of CPR events.
  • the control unit is further adapted to govern the device state, for example the battery state, the load on the motor, the pre-tensioning of the plunger against the patient's thorax, the state of communication link with a remote location and the adequate deployment of the device.
  • a CMD may also include a memory for storing data relating to the operation of the device or data relating to the patient.
  • This data may include, for example, data concerning the motor operation, the plunger travel, the plunger load on the patient's thorax, the device state, pulse rate of the patient, blood pressure of the patient, and other data.
  • a CMD When performing CPR procedure, a CMD, in accordance with embodiments of the present invention, may take the following actions (through control unit commands): It may apply compressions at a predetermined rate and depth; It may sense the pretension of the plunger against the thorax using a sensor such as but not limited to, a pressure sensor; It may count the number of compression and compares the count to a target number of compressions per cardiac message cycle; It may monitor the patient's blood circulation to determine necessity and effectiveness of the massage; It may establish and manage a communication link with an automated external defibrillator (AED), either integrated in the CMD or separated thereof, to assure synchronized performance of CPR and defibrillation (defibrillation module and pads, elements 78 and 71 , respectively, in Fig.12); It may send and receive data from a remote location such a cardiac monitoring service center (designated 64 in Fig.12) using a communication module; It may upload or download data from or to the controller; It may provide audio and
  • Fig. 1 is an isometric illustration of a three-part support-structured CMD 10 in accordance with embodiments of the present invention, viewed from the front.
  • Fig. 2 illustrates an isometric view of CMD 10 from the rear having defibrillation pads 80 connected to the device via cords 76.
  • Adaptor 73 bridges the connection between the cords and device 10.
  • CMD 10 is constructed of: a foldable and rigid support-structure 12 an electrical DC motor 14 incorporated into support-structure 12 and a plate- plunger 38 connected to motor 14 by a driving mechanism such as a crankshaft 18.
  • one or more life-signs sensors are connected to a control unit 20 which is built into or integrated with, support- structure 12.
  • support-structure 12 is composed of three elements: a length adjustable base-element 19, a height-adjustable- element 17 and a length-adjustable plunger-carrying element 15.
  • each of the three elements is composed of two two-parallel-bars-units bridged at their end by a perpendicular bar (each unit referred from herein after as "TPBU"), made of light yet strong and rigid material or materials such as aluminum, titanium, sturdy plastics, composite materials and the like. By sliding one of the TPBU over the other TPBU a desired length of each of the three elements of supporting structure 12 can be determined.
  • a latching mechanism illustrated in Fig.
  • one or more TPBU may be extracted automatically to a predetermined state, for example, by virtue of a mechanical guidance or spring load that forces the TPBU to extract to a predetermined position upon deployment of the device.
  • the automatic positioning of the TPBU assists the caregiver in the deployment process and thus, readiness for use of the device is improved.
  • plunger 38 is typically a 10 cm in diameter circular plate made of a rigid material and covered by a soft, cushioning and bio-compatible material, so as not to harm the treated CPR patient.
  • Plunger 38 can also be constructed in various shapes (not necessarily round) and have various diameters
  • the plunger 38 is formed as an integral part of the crankshaft 18 or connected directly to crankshaft.
  • height-adjustment-element 17 is connected at one end at an angle (typically, but not limited to, 90 degrees) to base-element 19 and at the other end to plunger-carrying-element 15 in an angle that positions element 15 in parallel to element 19.
  • base-element 19 is typically stretched (“length adjusted"), the length of element 17 is adjusted to the anatomical built of the CPR patient (shown in Fig. 9) and the length of element 15 is adjusted so as to be at the center of the thorax of the CPR patient (shown in Fig. 9).
  • connection-angles between the three elements of supporting structure 12 can be varied and fixed in place to the hinge-units (26 and 28).
  • the fixing in place in an angle of choice is done by a locking-mechanism based on reversibly inserted pins that run through several possibilities of aligned-holes between the end of the elements of support-structure 12 and the two hinge-units.
  • the three elements of supporting structure 12 are typically connected when device 10 is in either a folded or deployed state. When in a folded state the three elements are positioned substantially in parallel (shown in Fig. 3).
  • the elements may be designed so as to also be reversibly disconnected for the storage and maintenance of device 10.
  • length-adjustable base element 19 is made of a TPBU 22 that slide over fixed-in-place TPBU 24 (enabling the "stretching" of the element).
  • TPBU 24 is pivotally connected to hinge-unit 26.
  • Hinge-unit 26 connects to another hinge-unit 28 by a height adjustable mechanism comprising fixed-in-place TPBU 30 that has a TPBU 32 sliding over it.
  • TPBU 30 is fixed-in-place and having TPBU 32 fit into TPBU 30, thus having TPBU 30 slide over TPBU 32.
  • TPBU 30 and TPBU 32 together with hinge-units 26 and 28 comprise height-adjustable element 17.
  • Hinge-unit 28 pivotally connects to a suspended element comprising TPBU 34 that has TPBU 36 sliding over it.
  • TPBU 34 may slide over TPBU 36.
  • Electrical motor 14 is positioned between the bars of TPBU 36. At the end of TPBU 36, distanced from hinge-unit 28, motor 14 is connected and has a rotational crankshaft 18 pivotally connected to plunger 38 by bar 37.
  • a bridging plate 46 connects between bars of TPBU 36 and surrounds motor 14 and by so stabilizing it in place.
  • the downward- facing side of plunger 38 is optionally provided with a pressure ("compression") or load-sensor 62 (not directly seen in Fig.1).
  • the sensor measures and transmits data of the load of the plunger against the patient's thorax to control unit 20, as was previously explained, Plunger 38 is connected to two parallel arms 42 which are connected to a base-plate 40.
  • plunger 38 is connected to plunger-carrying element 15 directly.
  • Base-plate 40 is connected to bars 36 and stabilizes motor 14 in place.
  • TPBU 34 and TPBU 36 together with hinge 28 and bridging-plate 46 comprise plunger-carrying element 15.
  • Hinge-units 26 and 28 enable the folding of TPBUs 22 and 24, and TPBUs 34 and 36 towards TPBUs 30 and 32, respectively (as shown in
  • Control unit 20 is integrated into the structure of hinge-unit 28. Alternatively, control unit 20 may be connected to hinge unit 26 or be part of any other component of the CMD that is adapted to house the control unit. Control unit 20 also includes an 11 ON 1 T 1 OFF" button 54, an LCD display 21 (can also be a LED), a speaker (not shown) for audio feedback or guidance and a microphone (not shown).
  • Optionally pads 80, illustrated in Fig. 2 are attached to the CPR treated person for measuring physiological parameters such as pulse or blood pressure. The data is transmitted from the sensors via cords 76 and adaptor 73 to control-unit 20 for processing and commanding the activity of the plunger.
  • FIG. 3 is an isometric illustration of CMD 10 illustrated in Fig. 1 viewed in a fully folded, compact state, fn a folded state device 10 is conveniently stored and easily transported.
  • Plunger-carrying element 15 and height- adjustable element 17 are folded to be substantially parallel to base element 19.
  • devices 10 and 75 have a length of less than 30 cm, a width less than 20 cm and thickness less than 10 cm, and typically have a weight less than 2 kg, thus the CMD does not burden the person carrying the device.
  • Fig 4 is an isometric illustration of partially folded CMD 10 shown in Fig. 3.
  • Base element 19 having TPBU 22 slid from TPBU 24 and element 19 distanced (withdrawn) from height-adjustable element 17.
  • TPBU 32 are slid from TPBU 30 enabling the lengthening of element 17.
  • Plunger-carrying element 15 is shown positioned vertically and in a parallel position to element 17.
  • Fig. 5 is an isometric illustration, viewed from the front, of CMD 75 in a fully deployed state. Reference is now made to the plunger driving mechanism of device CMD 75.
  • Illustrated in Fig. 5, an embodiment of CMD comprising a plunger driving mechanism utilizing energy storing elements intended to assist the motor in driving the plunger while applying compressions to the patient's thorax.
  • springs 44 are positioned vertically and connect between arms 42 and plate 46. The springs are made of rigid material that does not lose its resilience after many repeats of being compressed and relaxed. Arms 42 are pivotally connected at one end to plate 40 and at the other end to plunger 38.
  • crankshaft 18 drives plunger 38 in a fixed linear and vertically oscillation course (further illustrated in Fig. 8a).
  • plunger 38 is drawn towards plate 46 springs 44 are compressed, when the direction is reversed the springs expand adding the stored energy to the force of motor 14.
  • Fig. 6 is an illustration of a two-part support-structured CMD device 99 in accordance with embodiments of the present invention, viewed from the side.
  • Fig. 7 is an isometric illustration of the two-part support-structured CMD 99 shown in Fig. 6.
  • the support- structure, 12 is composed of thee connected elements: a length-adjustable base 19, a height adjustable element 17 and, a plunger carrying element 15.
  • support-structure 98 is composed of (J us t) *w° connected elements: a length-adjustable base element 19 identical to that found in support-structure 12 and a plunger-application length-adjustment element 85 that functions as both a height adjustable element and a plunger carrying element.
  • Element 85 is composed of two TPBUs, 91 and 93, that slide over each other and are fixed in-place relative to each other in accordance with the desired total length of the element, as illustrated in Fig.8. 14 and the plunger driving mechanism are connected to element 85 in the same manner they are connected the plunger carrying element 15 as explained in Fig. 1 and Fig. 5.
  • FIG. 8A is an illustration of an embodiment of a full-circle plunger driving wheel mechanism of which an embodiment is illustrated in Figs. 1 and 5 (rotation of crankshaft 18 by motor 14).
  • the full-circle plunger driving wheel 86 turns a full rotation of 360 degrees and thus, the plunger 38 compresses the chest of a CPR patient within predetermined boundaries, designated A and B in the Figure.
  • FIG. 8B Another embodiment for the driving mechanism of plunger 38 is illustrated in Fig. 8B consisting of an arc-motion plunger driving wheel mechanism.
  • the use of 90 degree arc-motion plunger driving wheel 86 that can rotate in both directions in accordance with the motor's motion direction, as illustrated in the Figure, enables rotating the driving wheel in an arc that is less than the full 90 degrees rotation, thereby enabling a variable and incremental adjustment of the distance traveled by the plunger.
  • the plunger does not necessarily reach the limit of the predetermined course boundaries, designated A and C.
  • the plunger is brought down to the chest of a CPR patient by traveling a fixed distance of approximately 1 cm, designated D in the Figure.
  • a compression-sensor in the plunger (designated 62 in Fig.1 and Fig. 5) measures the encountered resistance on-contact with the chest of the patient and relays the information to a controller (designated 20 in Fig. 12).
  • the controller processes the information and commands the motor (designated 14) to change the traveling distance of the plunger by changing the rotating-angle of the driving wheel 86. With additional contacts between the plunger and the chest of the patient the optimum traveling distance of the plunger is determined.
  • the plunger-motor feed-back mechanism enables the fine tuning of the compression of the plunger to be adjusted to the anatomical built of the treated patient.
  • Three possible boundaries of the motion of the plunger are designated C, D and E.
  • the plunger is initially operated on the treated CPR patient in a slow and delicate motion to obtain information regarding the optimal compression distance and force that is to be used.
  • At least one sensor may be located in a variety of locations in the CMD 10, including but not limited to the plunger 38, the crankshaft elements 18 or 37, plunger carrying element 15, height adjustable element 17 and on hinge-units 26 or 28.
  • the information is processed and the motor 14 is instructed to rotate the arc-motion plunger driving wheel 86 in a suitable angle and force.
  • the sensor may be a load sensor or a strain-gauge sensor and the optimal compression distance and force are determined according to information obtained from the sensor from at least one compression on the patient's thorax.
  • the information is compiled from a sequence of compressions, wherein each compression differs from the other compressions either by the travel of the plunger, the force of the motor or both.
  • the adjustment of the travel of the plunger to the elasticity of the patient's thorax is obtained by deriving information regarding said elasticity from the load on motor 14. Said load is obtained by measuring the power consumption of power source 56 (shown in Fig. 12), wherein a correlation between the thorax elasticity and the load on the motor is established.
  • At least one sensor is used to monitor the load on the patient's thorax.
  • a safety mechanism is initiated.
  • An exemplary of such safety mechanism may be established by electronic means to thereby halt the operation of the motor and by so to decease the compressions on the patient's thorax.
  • An alternate safety mechanism may be established by incorporating in the device 10 a mechanical strain relief element that is adapted to mechanically release an overload. Such element may be any mechanical strain relief element or mechanism that is known in the art.
  • Fig .9 is an illustration of the CMD 10 inserted over the chest of a lying patient 50 for commencing CPR treatment.
  • the length-adjustable base 19 is shown positioned under the back of patient 50 and TPBUs 30 and 32 slid so as to fit the device deployment to the anatomical built of patient 50.
  • Plunger carrying element 15 is positioned at the center of the thorax of patient 50 by adjusting the position of plunger 38 with respect to the center of the thorax by sliding TPBUs 36 over 34 (TPBU 34 is not seen in the Fig.).
  • TPBU 34 is not seen in the Fig.
  • TPBUs 22 and 24 The base of the device 19 (TPBUs 22 and 24) is stretched and positioned in place beneath the torso of patient 50.
  • the position and height of plunger 38 are adjusted to fit the anatomical built of the patient by adjusting the height of the by height-adjustment element 17 (TPBUs 30 and 32) and plunger carrying element 15 (TPBUs 34 and 36).
  • Fig. 10 schematically illustrates an embodiment of a latching mechanism that enables the adjustment of the CMD 10 to the anatomical built of a patient by fixing-in-position each of elements 15, 17 and 19.
  • the latching mechanism described above may also be uses in accordance with an embodiment of the invention as a locking mechanism between elements 15, 17 and 19 and hinge-units 26 and 28 in support- structure 12.
  • Fig. 10 is a cross section view of a length-adjustable element of CMD 10 illustrated in Fig. 1.
  • Each adjustable element (elements 15, 17 and 19) is constructed of two TPBUs (two parallel bar units) that slide one over the other, as was previously explained. The sliding is done by having in each element two matching sets of sliding bars.
  • Each set is composed of one bar 79 with a hollow-space, designated 81, a protruding central bar designated 82, and a second bar 77 with a hollow-core 84 into which protruding-bar 82 fits.
  • the solid-structure around hollow-core 84 (designated 87) in bar 77 fits into hollow-space in bar 79.
  • Solid-structure 87 has a longitudinal strip of teeth 88 along its upper section that fit precisely into a toothed latching-mechanism
  • Mechanism 90 positioned on bar 79.
  • Mechanism 90 is kept in place by the pushing force of a flexible spring-plate 92.
  • Latching mechanism 90 fits into and lock-in-place a selected tooth of strip 88, thus fixing the sliding motion of bar 77 into or out- of bar 79.
  • strip 88 is freed to move enabling the sliding motion of bar 77 into or out-of bar 79.
  • a desired length of the elements of support-structure 12 is obtained by releasing latching-mechanism 90, sliding the sliding bars 77 and 79 to desired length position and locking the position by releasing mechanism 90 to fit into the appropriate tooth in strip 88.
  • Fig. 11 is a schematic illustration of one embodiment of the locking mechanism between elements 15 and 17 and hinge-unit 28.
  • the locking mechanism between element 17 and 19 and hinge-unit 26 of the CMD is substantially the same.
  • Hinge-unit 28 connects element 17 with element 15.
  • element 17 and hinge-unit 28 can either be made as two separate elements connected together, or as a single element integrating the two components.
  • Element 15 is connected to hinge-unit 28 by a concealed hinge (not shown) to thereby enable the transformation of CMD 10 between a folded state to a deployed state and vice versa.
  • Hole 83 at the sides of hinge-unit 28 are set to align with holes in element 15 (not shown). By inserting a pin through hole 83 of hinge-unit 28 and into said hole in element 15, element 15 is locked and fixed in an angular position of choice relative to element 17.
  • Fig.12 illustrates a block diagram of CMD 10 shown in Fig. 1 in accordance with embodiments of the present invention.
  • the control of device 10 is done through a control unit 20 which is constructed of a controller and a control circuitry.
  • Control unit 20 obtains power from DC power source 56 and is provided with an "ON/OFF" power button 54.
  • Sensor 62 senses “compression” or “load” on the plunger) transmits data to control unit 20.
  • data communication signals 64 are (optionally) transmitted or received from/to an external device (not shown) as for example a CPR-event data downloading or programming the controller
  • Control unit 20 obtains information regarding the status of device 10, such as the battery state, the load on the motor, the pre-tensioning of the plunger against the patent's thorax and the adequate deployment of the device, and provides indication via STATUS INDICATOR 72. In a specific embodiment, said indications are provided via DISPLAY 21.
  • control unit 20 is adapted to monitor and govern the rate of compressions, the compression/release cycle and any other parameter relevant to the performance of the CPR.
  • data from "life-signs" sensors" 80 is processed in controller 20 which activates an electronic defibrillation module 78 that actives, in turn, defibrillation pads 71.

Landscapes

  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Emergency Medicine (AREA)
  • Pulmonology (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Percussion Or Vibration Massage (AREA)

Abstract

L'invention concerne un dispositif de massage cardiaque comprenant un piston plongeur couplé à un dispositif d'entraînement destiné à entraîner ledit piston plongeur; et une structure comprenant au moins deux éléments structuraux. A l'état déployé, le premier des éléments structuraux est conçu pour être au moins partiellement introduit en-dessous du dos d'un patient, et le second des éléments structuraux étant conçu pour positionner le piston plongeur sur le thorax du patient. A l'état rangé, tous les éléments structuraux sont disposés sensiblement à l'état compact.
PCT/IL2009/000539 2008-06-02 2009-05-31 Dispositif de massage cardiaque Ceased WO2009147659A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0810060.4 2008-06-02
GB0810060A GB0810060D0 (en) 2008-06-02 2008-06-02 Cardiac massage device

Publications (1)

Publication Number Publication Date
WO2009147659A1 true WO2009147659A1 (fr) 2009-12-10

Family

ID=39638033

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IL2009/000539 Ceased WO2009147659A1 (fr) 2008-06-02 2009-05-31 Dispositif de massage cardiaque

Country Status (2)

Country Link
GB (1) GB0810060D0 (fr)
WO (1) WO2009147659A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2500008A3 (fr) * 2011-03-17 2012-11-07 GS Elektromedizinische Geräte G. Stemple GmbH Appareil de réanimation d'un patient
CN111466896A (zh) * 2020-04-24 2020-07-31 西安市第一医院 心血管监测可穿戴设备
CN113057876A (zh) * 2021-03-23 2021-07-02 徐州医科大学 一种便携式心肺复苏保护装置
KR20240019139A (ko) * 2021-05-12 2024-02-14 에리얼 파비안 Adjustable automated cpr positioning apparatus

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5287846A (en) * 1990-06-12 1994-02-22 Medreco A.S. Resuscitation device
US5582580A (en) * 1992-07-30 1996-12-10 Temple University - Of The Commonwealth System Of Higher Education Direct manual cardiac compression device
US5792080A (en) * 1994-05-18 1998-08-11 Matsushita Electric Works, Ltd. Massaging apparatus having self-adjusting constant strength and non-adjust strength modes
US6447465B1 (en) * 1998-11-10 2002-09-10 Revivant Corporation CPR device with counterpulsion mechanism
US20030212352A1 (en) * 2002-04-03 2003-11-13 Rocky Kahn Manipulation device with dynamic intensity control

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5287846A (en) * 1990-06-12 1994-02-22 Medreco A.S. Resuscitation device
US5582580A (en) * 1992-07-30 1996-12-10 Temple University - Of The Commonwealth System Of Higher Education Direct manual cardiac compression device
US5792080A (en) * 1994-05-18 1998-08-11 Matsushita Electric Works, Ltd. Massaging apparatus having self-adjusting constant strength and non-adjust strength modes
US6447465B1 (en) * 1998-11-10 2002-09-10 Revivant Corporation CPR device with counterpulsion mechanism
US20030212352A1 (en) * 2002-04-03 2003-11-13 Rocky Kahn Manipulation device with dynamic intensity control

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2500008A3 (fr) * 2011-03-17 2012-11-07 GS Elektromedizinische Geräte G. Stemple GmbH Appareil de réanimation d'un patient
CN111466896A (zh) * 2020-04-24 2020-07-31 西安市第一医院 心血管监测可穿戴设备
CN111466896B (zh) * 2020-04-24 2022-10-14 西安市第一医院 心血管监测可穿戴设备
CN113057876A (zh) * 2021-03-23 2021-07-02 徐州医科大学 一种便携式心肺复苏保护装置
CN113057876B (zh) * 2021-03-23 2021-09-07 徐州医科大学 一种便携式心肺复苏保护装置
KR20240019139A (ko) * 2021-05-12 2024-02-14 에리얼 파비안 Adjustable automated cpr positioning apparatus
KR102742195B1 (ko) 2021-05-12 2024-12-11 에리얼 파비안 Cpr 위치설정 장치
US12213938B2 (en) 2021-05-12 2025-02-04 Ariel Fabian Adjustable automated CPR positioning apparatus

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