Shock determination based on prior shocks

• US 10,086,210 B2
• Filed: 12/13/2016
• Issued: 10/02/2018
• Est. Priority Date: 03/14/2013
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Quan, Weilun, Freeman, Gary A.
• Primary Examiner(s): Alter, Alyssa M
• Application Number:
  US15/377,266
• Publication Number:
  US 20170209706A1
• Time in Patent Office: 658 Days
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61N 1/39044 in combination with cardiopulmonary resuscitation [CPR] therapy
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3931 Protecting, e.g. back-up systems
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock
• CPC Class Codes: A61N 1/3993 User interfaces for automatic external defibrillators
• CPC Class Codes: H01L 23/53238 Additional layers associated with copper layers, e.g. adhesion, barrier, cladding layers
• CPC Class Codes: H01L 23/53257 the principal metal being a refractory metal
• CPC Class Codes: H01L 2924/00 Indexing scheme for arrangements or methods for connecting or disconnecting semiconductor or solid-state bodies as covered by H01L24/00
• CPC Class Codes: H01L 2924/0002 Not covered by any one of groups H01L24/00, H01L24/00 and H01L2224/00

Abstract

A system for managing care of a person receiving emergency cardiac assistance is disclosed that includes one or more capacitors for delivering a defibrillating shock to a patient; one or more electronic ports for receiving signals from sensors for obtaining indications of an electrocardiogram (ECG) for the patient; a patient treatment module executable on one or more computer processors to provide a determination of a likelihood of success from delivering a future defibrillating shock to the person with the one or more capacitors, using (a) information about a prior defibrillating shock, and (b) a value that is a function of current ECG signals from the patient.

Claims

1. An external defibrillator system for managing care of a person receiving emergency cardiac assistance, the external defibrillator system comprising:

one or more capacitors for delivering a defibrillating shock to the person;

one or more electronic ports for receiving signals from sensors for obtaining indications of an electrocardiogram (ECG) for the person;

a patient treatment module comprising one or more computer processors;

one or more computer readable media comprising instructions that, when executed by the one or more computer processors, cause the patient treatment module to carry out operations comprising;

determining a metric indicative of a likelihood of success from delivering a future defibrillating shock to the person with the one or more capacitors during a session of the emergency cardiac assistance, by using information about an indication of success associated with a prior defibrillating shock delivered during the session of the emergency cardiac assistance and a value that is a function of current ECG signals from the person; and

an output mechanism comprising a visual display that is configured to display one of multiple possible indications that each indicate a degree of the likelihood of success from delivering the future defibrillating shock with the one or more capacitors to the person.

2. The external defibrillator system of claim 1, wherein the output mechanism comprises an interlock that prevents delivery of the defibrillating shock unless the likelihood of success exceeds a determined value.

3. The external defibrillator system of claim 1, wherein the patient treatment module comprises an ECG analyzer for generating an amplitude spectrum area (AMSA) value, and wherein the patient treatment module uses the information about the indicator of success associated with the prior defibrillating shock to adjust the AMSA value.

4. The external defibrillator system of claim 1, wherein the patient treatment module comprises an ECG analyzer for generating an indication of heart rate for the person.

5. The external defibrillator system of claim 1, wherein the patient treatment module comprises an ECG analyzer for generating an indication heart rate variability for the person.

6. The external defibrillator system of claim 1, wherein the patient treatment module comprises an ECG analyzer for generating an indication of ECG amplitude for the person.

7. The external defibrillator system of claim 6, wherein the indication of ECG amplitude comprises an RMS measurement, measured peak-to-peak, peak-to-trough, or an average of peak-to-peak or peak-to-trough over a specified interval.

8. The external defibrillator system of claim 1, wherein the patient treatment module comprises an ECG analyzer for generating an indication of a first derivative of ECG amplitude for the person.

9. The external defibrillator system of claim 1, wherein the patient treatment module comprises an ECG analyzer for generating an indication of a second derivative of ECG amplitude for the person.

10. The external defibrillator system of claim 1, where the patient treatment module is programmed to determine whether the prior defibrillating shock was at least partially successful, and based at least in part on the determination of whether the prior defibrillating was at least partially successful, modifying a calculation of the likelihood of success from delivering the future defibrillating shock.

11. The external defibrillator system of claim 1, wherein determining the likelihood of success from delivering the future defibrillating shock to the person depends on a determination of whether the prior defibrillating shock delivered to the person resulted in a predetermined heart rhythm within a segment of ECG waveform corresponding to a time period following an application of the prior defibrillating shock.

12. The external defibrillator system of claim 1, wherein determining the likelihood of success from delivering the future defibrillating shock comprises performing a mathematical transform on data representing the ECG.

13. The external defibrillator system of claim 12, wherein the mathematical transform is selected form a group consisting of Fourier, discrete Fourier, Hilbert, discrete Hilbert, wavelet, and discrete wavelet methods.

14. The external defibrillator system of claim 1, wherein determining the likelihood of success from delivering the future defibrillating shock comprises performing a calculation by an operation selected form a group consisting of logistic regression, table look-up, neural network, and fuzzy logic.

15. The external defibrillator system of claim 1, wherein the patient treatment module is programmed to determine the likelihood of success from delivering the future defibrillating shock using at least one patient-dependent physical parameter separate from a patient ECG reading.

16. The external defibrillator system of claim 1, wherein the patient treatment module is programmed to determine the likelihood of success from delivering the future defibrillating shock using at a measure of trans-thoracic impedance of the person.