Synchronization of repetitive therapeutic interventions

• US 10,532,004 B2
• Filed: 10/29/2015
• Issued: 01/14/2020
• Est. Priority Date: 09/14/2005
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Freeman, Gary A., Lisogurski, Daniel M.
• Primary Examiner(s): Saint-Vil, Eddy
• Assistant Examiner(s): Ermlick, William D
• Application Number:
  US14/926,259
• Publication Number:
  US 20160199252A1
• Time in Patent Office: 1,538 Days
• Field of Search: 434265
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2201/501 connected to external computer devices or networks
• CPC Class Codes: A61H 2201/5043 Displays
• CPC Class Codes: A61H 2201/5048 Audio interfaces, e.g. voice or music controlled
• CPC Class Codes: A61H 2201/5084 Acceleration sensors
• CPC Class Codes: A61H 2201/5097 wireless
• CPC Class Codes: A61H 2230/04 Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
• CPC Class Codes: A61H 2230/205 partial CO2-value
• CPC Class Codes: A61H 2230/207 partial O2-value
• CPC Class Codes: A61H 2230/25 Blood flowrate, e.g. by Doppler effect
• CPC Class Codes: A61H 2230/42 Rate
• CPC Class Codes: A61H 31/00 Artificial respiration or heart stimulation, e.g. heart massage artificial respiration by treatment with gas or air, e.g. mouth-to-mouth respiration A61M16/00; applying electric currents by contact electrodes for stimulation, e.g. heart pace-makers A61N1/36 ; teaching or training models, demonstration models for medical purposes G09B23/288
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61H 31/006 Power driven
• CPC Class Codes: A61H 31/007 Manual driven
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61N 1/3625 External stimulators
• CPC Class Codes: A61N 1/3628 using sub-threshold or non-excitatory signals
• CPC Class Codes: A61N 1/39044 in combination with cardiopulmonary resuscitation [CPR] therapy
• CPC Class Codes: A61N 7/00 : Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

A medical device of the type used for assisting a user in manually delivering repetitive therapy to a patient (e.g., chest compressions or ventilations in cardiac resuscitation), the device comprising a feedback device configured to generate feedback cues to assist the user in timing the delivery of the repetitive therapy, at least one sensor or circuit element configured to detect actual delivery times, at which the user actually delivers the repetitive therapy, and a processor, memory, and associated circuitry configured to compare the actual delivery times to information representative of desired delivery times to determine cue times at which the feedback cues are generated by the feedback device.

Claims

1. A system for delivering cardiac stimulation during cardiopulmonary resuscitation (CPR) chest compressions comprising a memory, a processor, and associated circuitry wherein the processor is configured to:

receive, from a motion sensor located externally to a patient'"'"'s chest, a motion sensor signal indicative of chest wall motion that is caused by a series of repetitive externally applied chest compressions;

synchronize a delivery of at least one externally applied chest compression in the series of repetitive externally applied chest compressions to a myocardial response comprising an improvement in myocardial tone and induced by repetitive cardiac stimulation therapy pulses that cause an insufficient hemodynamic response from a metabolically compromised myocardium and are generated by an energy output device of an external defibrillator, and

adjust a start time of the at least one externally applied chest compression and a start time of the repetitive cardiac stimulation therapy pulses relative to one another in response to drug induced improvements in the myocardial tone,

wherein the repetitive cardiac stimulation therapy pulses precede the delivery of the at least one externally applied chest compression, and

wherein the synchronized delivery is based at least in part on the motion sensor signal indicative of the chest wall motion that is caused by the series of repetitive externally applied chest compressions.

2. The system of claim 1 wherein the repetitive cardiac stimulation therapy pulses comprise electrical pulses or magnetic pulses.

3. The system of claim 1 wherein the motion sensor is an accelerometer.

4. The system of claim 1 wherein the series of repetitive externally applied chest compressions are automated chest compressions.

5. The system of claim 1 wherein the series of repetitive externally applied chest compressions are manual chest compressions.

6. The system of claim 5 wherein the processor is configured to:

determine, based at least in part on the motion sensor signal, a latency between a feedback instruction to a rescuer to deliver the at least one externally applied chest compression and the delivery of the at least one externally applied chest compression by the rescuer; and

based on the determined latency, adjust a timing of the feedback instruction to the rescuer to deliver the at least one externally applied chest compression to adjust the start time of the at least one externally applied chest compression and the start time of the repetitive cardiac stimulation therapy pulses relative to one another.

7. The system of claim 6 wherein the processor is configured to determine the latency based, at least in part, on a tracking filter applied to the motion sensor signal.

8. The system of claim 1 wherein the energy output device comprises at least one of an electrical current generator and a magnetic pulse generator.

9. The system of claim 1, wherein the external defibrillator is configured to provide a perfusion performance indicator indicative of blood flow from the series of repetitive externally applied chest compressions, wherein the blood flow is based at least in part on the improvement in the myocardial tone.