Cooperating defibrillators and external chest compression devices

• US 20040162587A1
• Filed: 08/29/2003
• Published: 08/19/2004
• Est. Priority Date: 02/14/2003
• Status: Active Grant

• Current Assignee: Physio-Control Incorporated (Stryker Corporation)
• Original Assignee: Medtronic Physio-Control Corp. (Stryker Corporation)
• Inventors: Sullivan, Joseph L., Nova, Richard C., Edwards, D. Craig, Stickney, Ronald E., Hampton, David R., Jayne, Cynthia, Radons, Stephen W., Sjoquist, Steven E.
• Granted Patent: US 7,308,304 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61H 2201/0214 cooled
• 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 2201/5012 using the internet
• CPC Class Codes: A61H 2201/5048 Audio interfaces, e.g. voice or music controlled
• CPC Class Codes: A61H 2201/5058 Sensors or detectors
• 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 31/005 with feedback for the user
• CPC Class Codes: A61H 31/006 Power driven
• CPC Class Codes: A61H 31/008 Supine patient supports or bases, e.g. improving air-way access to the lungs
• CPC Class Codes: A61M 16/00 Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes stimulating the respiratory movement by mechanical, pneumatic or electrical means, iron lungs combined with gas breathing means A61H31/00
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61N 1/39044 in combination with cardiopulmonary resuscitation [CPR] therapy
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Devices, methods, and software implementing those methods for providing communicating external chest compression (ECC) devices and defibrillation (DF) devices, where the ECC and DF devices can be physically separate from each other. Both ECC and DF devices are able to operate autonomously, yet able to communicate with and cooperate with another device when present. Some ECC and DF devices are adapted to be physically and/or electrically coupled to each other. One ECC device includes a backboard, a chest compression member, a communication module, controller, and at least one sensor, electrode lead or electrode. One DF device includes a defibrillator module, a controller, and a communication module that can communicate with the ECC communication module. The communicating ECC and DF devices may deliver ECC, pacing, defibrillation, ventilation, and cooling therapies, and may deliver instructions to human assistants, in a coordinated and cooperative fashion.

Claims

1. A system comprising:

an external chest compression (ECC) device having a first communication module; and

a defibrillator having a second communication module,

in which the ECC device and the defibrillator are capable of communicating via the first communication module and the second communication module.

2. A system as in claim 1, in which the ECC device includes a backboard.

3. A system as in claim 2, further comprising wheels operably attached to the backboard.

4. A system as in claim 2, in which the ECC device includes at least one chest compression member operably coupled to the backboard.

5. A system as in claim 4, further comprising a chest pressure sensor.

6. A system as in claim 4, further comprising an electrode disposed on the chest compression member.

7. A system as in claim 6, further comprising a second defibrillation electrode.

8. A system as in claim 6, further multiple defibrillation electrodes coupled to the chest compression member.

9. A system as in claim 6, further comprising multiple ECG electrodes coupled to the chest compression member.

10. A system as in claim 6, in which the electrode includes a releasable electrolyte.

11. A system as in claim 6, in which the electrode can be electrically coupled to the defibrillator.

12. A system as in claim 4, in which the chest compression member includes a belt.

13. A system as in claim 6, further comprising a powered belt retractor coupled to the belt.

14. A system as in claim 4, in which the chest compression member includes a rigid member pivotally coupled to the backboard.

15. A system as in claim 14, further comprising a powered actuator for driving the chest compression rigid member.

16. A system as in claim 14, in which the chest compression rigid member is manually operable to effect ECC.

17. A system as in claim 1, in which the ECC device includes at least one sensor for outputting data and sensing physiological data from the patient.

18. A system as in claim 17, in which the ECC device communication module is coupled to the at least one sensor.

19. A system as in claim 17, in which the physiological data includes at least one attribute from the group consisting of pulse, heartbeat, breathing, body temperature, externally applied chest pressure and thoracic impedance.

20. A system as in claim 1, further comprising a first controller, in which the first controller is operably coupled to the ECC device.

21. A system as in claim 20, further comprising at least one sensor coupled to the first controller.

22. A system as in claim 20, further comprising a chest compression member and a powered chest compression actuator operably coupled to the chest compression member and operably coupled to the first controller.

23. A system as in claim 22 further comprising a second controller operably coupled to the defibrillators, further comprising at least one sensor coupled to at least of the first and second controllers, in which the first or second controller executes logic for generating an output to control the chest compression actuator responsive to sensor data indicative of cardiac arrest.

24. A system as in claim 1, further comprising a chest compression member, an electrode disposed on the chest compression member, and a first electrical connector electrically coupled to the chest compression member electrode and adapted to receive a defibrillation paddle electrode.

25. A system as in claim 1, in which the ECC device includes a backboard, further comprising an electrode coupled to the backboard and disposed to contact a person'"'"'s back, and a first electrical connector electrically coupled to the electrode and adapted to receive a defibrillator electrode.

26. A system as in claim 1, in which the ECC device includes a chest compression member, the chest compression member includes at least one pressure sensor disposed thereon, and the pressure sensor is coupled to the first communication module.

27. A system as in claim 1, in which the ECC device includes a chest compression member and the chest compression member is manually operable to effect ECC.

28. A system as in claim 1, in which the ECC device includes a ventilator operably coupled to the backboard.

29. A system as in claim 28, in which the ventilator is coupled to the first communication module.

30. A system as in claim 1, in which the ECC device further comprises a camera coupled to a transmitter.

31. A system as in claim 1, in which the data communication modules utilize a communications medium selected from the group consisting of wireless, radio frequency, infra-red light, light, hard-wired electrical, and coupled optical fibers.

32. A system as in claim 1, further comprising a first controller, in which the controller executes logic for coordinating ECC and defibrillation, in which the controller is operably coupled to at least one of the ECC device and defibrillator.

33. A system as in claim 1, further comprising a first controller and a second controller, in which the first controller is operably coupled to the ECC device and to the first communication module, in which the second controller is operably coupled to the defibrillator and to the second communication module.

34. A system as in claim 33, in which the first and second controllers are configured to designate a master controller from one of the first and second controllers.

35. A system as in claim 34, further comprising at least one sensor coupled to at least one of the first and second controllers, in which the master controller includes logic to initiate defibrillation responsive to sensor data indicative of cardiac arrest.

36. A system as in claim 34, further comprising at least one sensor coupled to at least one of the first and second controllers, in which the master controller includes logic to initiate defibrillation responsive to sensor data indicative of ventricular fibrillation.

37. A system as in claim 34, further comprising at least one sensor coupled to at least one of the first and second controllers, and further comprising a cooling module, in which the master controller initiates cooling using the cooling module responsive to sensor data indicative of cardiac arrest in the person.

38. A system as in claim 37, further comprising a human interface module for communicating with a human assistant, in which the master controller initiates the cooling through instructions issued to the human assistant through the human interface module.

39. A system as in claim 1, further comprising a chest compression member, an electrode disposed on the chest compression member, and a first electrical connector electrically coupled to the chest compression member electrode, in which the defibrillator includes a second electrical connector adapted to connect to the first electrical connector.

40. A system as in claim 1, further comprising a chest compression member, an electrode disposed on the chest compression member, and a first electrical connector electrically coupled to the electrode, in which the defibrillator includes a second electrical connector electrically coupleable to the first electrical connector.

41. A system as in claim 33, further comprising a voice output module coupled to the first or second controller.

42. A system as in claim 39, further comprising at least one sensor coupled to at least of the first and second controllers, in which the first or second controller executes logic to generate a voice instruction through the voice output module to deliver a precordial thump, responsive to sensor data indicative of ventricular fibrillation.

43. A system as in claim 39, further comprising at least one sensor coupled to at least of the first and second controllers, in which the first or second controller executes logic to generate a voice instruction to deliver more chest compression, responsive to sensor data indicative of insufficient chest compression.

44. A system as in claim 39, further comprising at least one sensor coupled to at least of the first and second controllers, in which the first or second controller executes logic to generate a voice instruction to ventilate a person, responsive to data indicative of no breathing.

45. A system as in claim 39, further comprising at least one sensor coupled to at least of the first and second controllers, in which the first or second controller executes logic to generate a voice instruction to administer drugs to a person, responsive to data indicative of cardiac arrest.

46. A system as in claim 39, further comprising at least one sensor coupled to at least of the first and second controllers, in which the first or second controller executes logic to monitor chest compressions over time and to generate an output to administer a defibrillation pulse in synchrony with the monitored chest compressions over time.

47. A system as in claim 39, further comprising at least one sensor for monitoring blood perfusion coupled to at least of the first and second controllers, in which the first or second controller executes logic to monitor blood perfusion over time using the sensor and to generate an output to change the degree of chest compression responsive to the monitored blood perfusion.

48. A system as in claim 39, in which the first or second controller executes logic to accept data indicative of the length of cardiac arrest, and in which the first or second controller executed logic to perform external chest compression prior to administering a defibrillation pulse if the length of cardiac arrest is greater than a time limit.

49. A system as in claim 39, further comprising at least one sensor for monitoring ECG signals coupled to at least of the first and second controllers, in which the first or second controller executes logic to administer pacing after the ECG signals indicate that a defibrillation pulse results in a perfusing ECG rhythm.

50. A system as in claim 39, further comprising at least one sensor for monitoring ECG signals coupled to at least of the first and second controllers, in which the first or second controller executes logic to administer external chest compression after the ECG signals indicate that a defibrillation pulse has not resulted in a perfusing ECG rhythm.

51. A system as in claim 39, further comprising at least one sensor coupled to at least of the first and second controllers, in which the first or second controller executes logic to monitor chest compressions over time and to generate an output to administer pacing pulses in synchrony with the monitored chest compressions over time.

52. A system as in claim 33, further comprising at least one sensor coupled to at least of the first and second controllers, in which the first or second controller executes logic to generate an output to administer pacing pulses responsive to sensor data indicative of Bradycardia.

53. A system as in claim 33, further comprising at least one sensor coupled to at least of the first and second controllers, in which the first or second controller executes logic to generate an output to administer a defibrillation pulse responsive to sensor data indicative of Ventricular Tachycardia.

54. A system as in claim 1, further comprising a cooling module.

55. A system as in claim 54, in which the cooling module includes a cooling garment.

56. A system as in claim 54, further comprising at least one sensor for sensing physiological signals, a controller coupled to the at least one sensor and executing logic to initiate cooling using the cooling module responsive to sensor data indicative of cardiac arrest.

57. A system as in claim 1, further comprising a defibrillator controller operably coupled to the defibrillator.

68. A system as in claim 57, further comprising means for delivering defibrillation energy through the back support means.

69. A system as in claim 68, further comprising means for electrically coupling the defibrillation means to the chest compression means.

138. The system of claim 22, further comprising a second controller operably coupled to the defibrillator, in which the first or second controller executes logic for generating an output to control the chest compression actuator, in which the executed logic causes the chest compression actuator to perform an action selected from the group consisting of initiating, pausing, terminating, and continuing external chest compression, responsive to communication from the defibrillator.

58. A system for performing external chest compression (ECC) and defibrillation on a person, the system comprising:

means for compressing the person'"'"'s chest;

means for defibrillating the person, in which the chest compression means and defibrillating means can be physically apart from each other; and

means for communicating data between the chest compression means and the defibrillating means.

59. A system as in claim 58, in which the chest compression means includes means for supporting the person'"'"'s back.

60. A system as in claim as in claim 58, further comprising means for sensing at least one physiological attribute of the person, in which the means for sensing is coupled to the communicating means.

61. A system as in claim 60, in which the physiological attribute is selected from the group consisting of pulse, heartbeat, breathing, body temperature, externally applied chest pressure and thoracic impedance.

62. A system as in claim 58, further comprising means for coordinating the chest compression means and the defibrillating means.

63. A system as in claim 58, further comprising means for electrically coupling the chest compression means and the defibrillating means.

64. A system as in claim 58, further comprising means for electrically coupling the back support means and the defibrillating means.

65. A system as in claim 58, further comprising means for delivering defibrillation energy through the chest compression means.

66. A system as in claim 58, further comprising means for delivering pacing through the chest compression means.

67. A system as in claim 66, further comprising means for electrically coupling the defibrillating means to the chest compression means.

70. A system as in claim 58, further comprising means for ventilating the person.

71. A system as in claim 58, further comprising means for cooling the person.

72. A method comprising:

placing a person on a first device;

establishing data communication between the first device and a second device that can be physically apart from the first device;

causing a chest compression member of the first device to compress a chest of the person against the backboard; and

causing a defibrillator of the second device to defibrillate the person responsive to the communication.

73. The method of claim 72, in which placing the person on a backboard of the first device results in the person contacting a defibrillator electrode of the first device.

74. The method of claim 72, in which the cooling includes cooling the person using a cooling garment.

75. The method of claim 74, in which the cooling is performed responsive to the signals.

76. The method of claim 72, further comprising cooling the person using a cooling module of the first device.

77. The method of claim 75, in which the cooling is performed automatically by the first device responsive to the communications.

78. The method of claim 72, further comprising ventilating the person using a ventilator of the first device.

79. The method of claim 78, in which the ventilating is performed responsive to the communications.

80. The method of claim 72, in which the first device transmits data from the chest compression member to the second device.

81. The method of claim 80, in which the data from the chest compression member is indicative of the position of the chest compression member.

82. The method of claim 80, in which the data from the chest compression member is indicative of pressure applied by the chest compression member to the person'"'"'s chest.

83. The method of claim 80, in which the data from the chest compression member is indicative of ECG signals measure by a sensor coupled to the chest compression member.

84. The method of claim 83, further comprising causing the chest compression member to compress the chest of the person responsive to ECG signals indicative of the lack of a perfusing ECG rhythm following defibrillating the person.

85. The method of claim 83, further comprising pacing the person'"'"'s heart responsive to ECG signals indicative of a perfusing ECG rhythm following defibrillating the person.

86. The method of claim 72, in which respiration signals are transmitted between the first device and the second device.

87. The method of claim 72, in which physiological signals are transmitted between the first device and the second device.

88. The method of claim 72, further comprising causing a pacing module of the second device to pace the person responsive to the communications between the first device and the second device.

89. The method of claim 72, further comprising causing the first or second device to sense physiological signals of the person by a sensor of the first or second device.

90. The method of claim 89, in which the signals are sensed by bringing the sensor in contact with the person and the signals are communicated between the first and second device.

91. The method of claim 90, in which the sensor is brought in contact with the person by bringing the chest compression member in contact with the chest of the person.

92. The method of claim 89, further comprising causing the defibrillator of the second device to defibrillate the person responsive to the signals.

93. The method of claim 89, in which the first device transmits sensor data to the second device.

94. The method of claim 89, in which the first device transmits data from an ECG sensor to the second device.

95. The method of claim 72, further comprising listening to a voice output of the first or second device.

96. The method of claim 72, further comprising establishing a master device as between the first device and the second device.

97. The method as in claim 96, in which the master device coordinates chest compression and defibrillation.

98. The method of claim 72, in which defibrillation instructions are transmitted between the first device and the second device.

99. The method of claim 72, in which pacing instructions are transmitted between the first device and the second device.

100. The method of claim 72, in which the second device transmits defibrillation instructions to the first device.

101. The method of claim 72, in which the second device sends a defibrillation pulse to the person.

102. The method of claim 72, in which the defibrillation pulse to the person is sent in synchrony with chest compression data received by the second device from the first device.

103. The method of claim 72, in which the second device is electrically coupled to the first device, and in which the defibrillation pulse is sent through the electrical coupling.

104. The method of claim 72, in which the second device is electrically coupled to the first device through defibrillation paddles of the first device being received by receiving electrodes on the second device, in which the receiving electrodes are electrically coupled to defibrillation electrodes coupled to the person, and in which the defibrillation pulse is sent through the defibrillation paddles, the receiving electrodes, and defibrillation electrodes.

105. The method of claim 72, in which the second device sends pacing pulses to the person.

106. The method of claim 72, in which the second device sends a defibrillation pulse to the person responsive to data received by the second device from the first device indicative of cardiac arrest in the person.

107. The method of claim 72, further comprising sending chest compression instructions between the second device and the first device.

108. The method of claim 107, in which the sending chest compression instructions is responsive to data received by the second device from the first device indicative of cardiac arrest in the person.

109. The method of claim 72, in which the second device sends a defibrillation pulse to the person in synchrony with sending chest compression instructions between the second device and the first device.

139. The method of claim 72, in which the second device transmits data from the defibrillator to the first device, in which the data is indicative of the occurrence of defibrillator activity, the method further comprising causing the external chest compression device to perform an action selected from the group consisting of initiating, pausing, terminating, and continuing external chest compression responsive to the indication of defibrillator activity.

110. A method comprising:

receiving an input that a person has been placed on an external chest compression (ECC) device;

generating instructions to establish communication between a first data communication module operably coupled to the ECC device and a second data communication module coupled to a defibrillator;

generating instructions to operate a chest compression member of the ECC device to compress the person against the backboard; and

operating the defibrillator to defibrillate the person in response to the communication.

111. The method of claim 110, further comprising receiving a physiological signal of the person.

112. The method of claim 111, further comprising generating instructions to initiate defibrillation responsive to physiological signals indicative of ventricular fibrillation.

113. The method of claim 111, further comprising generating instructions to initiate defibrillation responsive to physiological signals indicative of ventricular tachycardia.

114. The method of claim 111, further comprising generating instructions to deliver drugs responsive to physiological signals indicative of cardiac arrest.

115. The method of claim 111, further comprising generating instructions to ventilate the person responsive to physiological signals indicative of lack of breathing.

116. The method of claim 111, further comprising generating instructions to operate a pacing module responsive to physiological signals indicative of ventricular bradycardia.

117. The method of claim 111, further comprising generating instructions to operate a cooling module responsive to physiological signals indicative of cardiac arrest.

118. The method of claim 110, further comprising generating instructions to establish a master controller as between a first controller coupled to the first data communications module and a second controller coupled to the second data communications controller.

119. The method of claim 118, further comprising generating voice outputs initiated by the master controller.

120. The method of claim 110, further comprising further controlling the chest compression member in response to the communication.

121. The method of claim 119, further comprising generating voice outputs.

122. The method of claim 119, in which the voice outputs include chest compression instructions.

123. The method of claim 119, in which the voice outputs include drug delivery instructions.

124. The method of claim 119, in which the voice outputs include manual ventilation instructions.

125. The method of claim 119, in which the voice outputs include instructions to cool the person.

126. The method of claim 120, in which the voice outputs include instructions to deliver a precordial thump

127. The method of claim 119, in which the voice outputs include instructions to manually ventilate the person in synchrony with the chest compression instructions.

128. The method of claim 110, in which the defibrillation module is operated in synchrony with operation of the chest compression member.

129. The method of claim 110, further comprising generating outputs to control a ventilator of the ECC device.

130. The method of claim 110, further comprising monitoring chest compressions and generating instructions to operate a pacing module in synchrony with the monitored chest compressions.

131. The method of claim 110, further comprising generating instructions to monitor thoracic impedance over time.

132. An article comprising:

a storage medium, the storage medium having instructions stored thereon, in which when the instructions are executed by at least one device, they result in;

receiving an input that a person has been placed on an external chest compression (ECC) device and sending out the input as data;

generating instructions to operate a chest compression member of the ECC device to compress the person'"'"'s chest;

receiving a physiological signal of the person;

sending the physiological signal to the defibrillator; and

operating the defibrillator module to defibrillate the person in response to the sent signal.

133. An article comprising:

a storage medium, the storage medium having instructions stored thereon, in which when the instructions are executed by at least one device, they result in;

receiving an input that a person has been placed on an external chest compression (ECC) device and sending out the input as data;

establishing a master controller as between a first controller coupled to the ECC device and a second controller coupled to the defibrillator; and

generating instructions in the master controller to operate a chest compression member of the ECC device to compress the person'"'"'s chest.

134. An article as in claim 133, further comprising receiving a physiological signal of the person;

and

operating the defibrillator to defibrillate the person in response to the received signal.

135. An article as in claim 133, in which the operating the defibrillator is controlled by the master controller.

136. An article as in claim 133, further comprising establishing communication between the ECC device and the defibrillator.

137. An article as in claim 136, in which the operating chest compression is performed responsive to the communication.