Automated caregiving device with prompting based on caregiver progress

• US 20050251213A1
• Filed: 05/07/2004
• Published: 11/10/2005
• Est. Priority Date: 05/07/2004
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Freeman, Gary A.
• Granted Patent: US 7,706,878 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61B 2505/01 Emergency care
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61G 13/1215 with patient airway positioning devices guiding means for tracheal tubes A61M16/0488
• CPC Class Codes: A61G 7/07 for the head or torso, e.g. special back-rests pillows in general A47G9/10
• CPC Class Codes: A61H 2201/1604 Head
• CPC Class Codes: A61H 2201/1607 Holding means therefor
• CPC Class Codes: A61H 2201/1609 Neck
• CPC Class Codes: A61H 2201/1611 Holding means therefor
• CPC Class Codes: A61H 2201/1614 Shoulder, e.g. for neck stretching
• CPC Class Codes: A61H 2201/1616 Holding means therefor
• CPC Class Codes: A61H 2201/5058 Sensors or detectors
• CPC Class Codes: A61H 2201/5061 Force sensors
• CPC Class Codes: A61H 2201/5092 Optical sensor
• CPC Class Codes: A61H 2230/065 used as a control parameter for the apparatus
• CPC Class Codes: A61H 2230/405 used as a control parameter for the apparatus
• CPC Class Codes: A61H 31/004 Heart stimulation
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61N 1/3625 External stimulators
• CPC Class Codes: A61N 1/3968 Constructional arrangements, e.g. casings A61N1/375 takes precedence
• 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: G09B 23/288 : for artificial respiration or heart massage
• CPC Class Codes: G09B 5/06 : with both visual and audible presentation of the material to be studied
• CPC Class Codes: G16Z 99/00 : Subject matter not provided for in other main groups of this subclass

Abstract

A device for assisting a caregiver in delivering therapy to a patient, the device comprising a user interface configured to deliver prompts to a caregiver to assist the caregiver in delivering therapy to a patient; at least one sensor configured to detect the caregiver'"'"'s progress in delivering the therapy, wherein the sensor is other than an electrode in an electrical contact with the body; a memory in which a plurality of different prompts are stored; a processor configured to determine which of the different prompts should be selected for delivery based on the progress detected by the sensor.

Claims

1. A device for assisting a caregiver in delivering therapy to a patient, the device comprising

a user interface configured to deliver prompts to a caregiver to assist the caregiver in delivering therapy to a patient;

at least one sensor configured to detect the caregiver'"'"'s progress in delivering the therapy, wherein the sensor is other than an electrode in an electrical contact with the body;

a memory in which a plurality of different prompts are stored;

a processor configured to determine which of the different prompts should be selected for delivery based on the progress detected by the sensor.

2. The device of claim 1 wherein there are a plurality of sensors configured to detect the caregiver'"'"'s progress in delivering the therapy, wherein each of the plurality of sensor is other than an electrode connected to the body.

3. The device of claim 1 wherein the processor is configured to vary the time at which prompts are delivered based on the progress detected by the sensor.

4. The device of claim 1 further may comprise one or more additional sensors configured to detect the caregiver'"'"'s progress in delivering the therapy, wherein the one or more additional sensors comprise an electrode in electrical contact with the body.

5. The device of claim 1 wherein the at least one sensor comprises a photoelectric sensor on the electrode for assisting in detection of whether the electrode has been applied to clothing.

6. The device of claim 3 wherein the therapy comprises a series of steps in a protocol, and wherein at least two sensors are configured to detect whether at least two of the steps in the protocol have been successfully completed.

7. The device of claim 1 wherein the processor selects a series of more detailed prompts for delivery to a user when progress is slower than a predetermined pace.

8. The device of claim 3 wherein the processor is configured to slow down the rate at which prompts are delivered when progress is slower than a predetermined pace.

9. The device of claim 8 wherein the processor is configured to choose from a among at least three rates at which prompts are delivered, and the choice is based at least in part on the progress detected by the sensor.

10. The device of claim 6 wherein the progress detected by the sensors comprises whether a step in the protocol has been initiated and whether the step has been completed.

11. The device of claim 1 wherein the user interface delivers at least some of the prompts as oral instructions to be heard by the caregiver.

12. The device of claim 1 wherein the user interface delivers at least some of the prompts as visual instructions to be seen by the caregiver.

13. The device of claim 12 wherein the user interface comprises an electronic display.

14. The device of claim 13 wherein the electronic display provides a series of images.

15. The device of claim 12 wherein the user interface comprises a series of printed pages.

16. The device of claim 15 further may comprise one or more detectors configured to detect which page of the series of pages is being viewed by the caregiver.

17. The device of claim 16 wherein the detectors comprise magnetic sensors that detect the presence of magnetic members supported by the pages.

20. The device of claim 7 wherein the processor is configured to provide prompts with a first level of detail when progress is occurring at or faster than a predetermined rate, and with a second level of detail more specific than the first level of detail when progress is occurring at or slower than the predetermined rate.

21. The device of claim 1 wherein the sensor is configured to detect whether the caregiver has made a predetermined error in delivering the therapy, and wherein the processor is configured to deliver one or more prompts designed to assist the user in correcting the predetermined error.

22. The device of claim 21 wherein the progress detected by the sensors comprises whether a step in the protocol has been initiated and whether the step has been completed, and the processor is configured to pause in delivery of prompts if a step has been initiated but not completed, and no predetermined error associated with the step has been detected.

23. The device of claim 2, 6, 7, 8, 20, 21, or 22 wherein the device is configured to assist a caregiver in delivering therapy for one or more cardiac malfunctions.

24. The device of claim 1 wherein the device is configured to assist a caregiver in delivering therapy for one or more cardiac malfunctions.

25. The device of claim 24 wherein the device is configured to assist a caregiver in delivering chest compressions.

26. The device of claim 24 wherein the device is configured to assist a caregiver in delivering CPR.

27. The device of claim 24 wherein the device is configured to assist a caregiver in delivering an electrical stimulus to the heart.

28. The device of claim 27 wherein the electrical stimulus includes defibrillation.

29. The device of claim 27 wherein the electrical stimulus includes pacing.

65. A device of claim 1 wherein the prompts include instructions for performing first aid.

66. A device of claim 65 comprising

a cover to the device whose removal the processor is capable of detecting;

and

a series of bound pages on the face of the device under the cover with one or more sensors for determining to which page the bound pages have been turned.

67. A device of claim 65 further may comprise a portion of the device used specifically for storage of items commonly used in the course of providing aid such as bandaids, bandages, splints, antiseptic.

68. A device of claim 67, wherein the storage area of which is partitioned into individual wells in which each of the items is stored and a detections means is provided for determining which, if any, of the items has been removed by the user.

69. A device of claim 68, wherein the device further comprises photoelectric sensors in each of the wells.

70. A device of claim 65 in which the prompts and graphical interface illustrate the Red Cross First Aid treatment protocols.

71. A device of claim 1 further comprising:

a cover to the device whose removal the processor is capable of detecting;

a defibrillator for delivering defibrillation shocks;

electrodes configured to be attached to a patient, to acquire data indicative of the patient'"'"'s heart rhythm and to deliver a defibrillating shock if appropriate;

a storage area for said electrodes;

at least one sensor for determining if the electrodes have been removed from the storage area by the user.

72. A device of claim 71 wherein the storage area is a compartment that is part of the housing of the device.

73. A device of claim 71 wherein the storage area is a package removable from the housing of the device.

78. A device of claim 1 further may comprise a decision making system provided by a distributed network comprising a remotely located human expert, an electronic processor in the device, and an electronic communication link between the human and electronic processor.

79. A device of claim 78 wherein the information transmitted over the communication link is both voice and digital data.

80. A device of claim 79 wherein the data is bidirectional.

81. A device of claim 79 wherein the digital data contains information about the device'"'"'s location and the status of the device.

82. A device of claim 78 wherein the device is capable of being remotely controlled by the human expert.

83. A device of claim 78 wherein the electronic processor reverts to providing internally generated responsive feedback prompts if the communication link is lost to the remotely located human expert.

84. A device of claim 1 further may comprise a decision-making system comprising circuitry and an electronic processor located in the device.

85. A device of claim 1 further may comprise decision making system provided by a distributed network comprising a remotely located electronic processing system, a local electronic processing system in the device and an electronic communication link between the remote and local electronic processing system.

86. A device of claim 1 further may comprise a processing system that measures and records the times required for a user to complete a sequence of steps and/or sub-steps in a protocol, and, based on the measured times adjusting the rate of the prompting delivered by the processor and user interface.

87. A device of claim 86 wherein the adjusting is based on a comparison of the measured times with a set of stored values.

88. A device of claim 87 further may comprise decision-making circuitry for evaluating the difference between the measured times and the set of stored values.

89. A device of claim 1 further may comprise elements for correctly identifying a set of voice commands delivered by the user and performing a set of actions in response to those user voice commands.

18. An automatic external defibrillator for assisting a caregiver in delivering resuscitation therapy to a patient, the defibrillator comprising

a memory in which a plurality of different prompts are stored;

a processor configured to determine which of the different prompts should be selected for delivery;

a user interface configured to deliver the selected prompts to a caregiver to assist the caregiver in delivering therapy to a patient,

wherein the user interface comprises a series of printed pages and one or more detectors configured to detect which page of the series of pages is being viewed by the caregiver

19. The defibrillator of claim 18 wherein the detectors comprise magnetic sensors that detect the presence of magnetic members supported by the pages.

30. The device of 1 wherein the device comprises

a defibrillator;

and

electrodes constructed to acquire data, indicative of the heart rhythm of the patient and indicative of whether the electrodes are properly placed on the patient and to deliver a defibrillating shock if appropriate.

31. The device of claim 30 comprising:

on a portion of a housing for the device, a series of graphics configured to prompt a caregiver to perform a sequence of steps appropriate for treating a victim of suspected cardiac arrest.

32. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver to check the patient for responsiveness.

33. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver to call for emergency assistance.

34. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver to open the patient'"'"'s airway.

35. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver on how to open the patient'"'"'s airway.

36. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver to check the patient for signs of circulation.

37. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver to attach the electrodes to the patient.

38. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver on where the electrodes should be attached.

39. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver to stand clear of the patient.

40. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver to press a treatment button to cause the device to administer a defibrillating shock.

41. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver to perform CPR.

42. The device of claim 31 wherein the graphics include one or more pictures illustrating procedures for chest compressions and rescue breathing.

43. The device of claim 40 wherein the pictures includes a heart symbol indicating the location of the treatment button.

44. The device of claim 31 further may comprise a treatment button configured to be pressed by the caregiver to cause the defibrillator to administer a defibrillating shock.

45. The device of claim 31 further including a light source associated with each of the graphics in the series.

46. The device of claim 45 further may comprise electronics configured to sequentially illuminate the light sources.

47. The device of claim 46 wherein the graphics include one or more pictures selected from the group consisting of:

a picture configured to prompt the caregiver to check the patient for responsiveness;

a picture configured to prompt the caregiver to call for emergency assistance;

a picture configured to prompt the caregiver to open the patient'"'"'s airway;

a picture configured to prompt the caregiver to check the patient for signs of circulation;

a picture configured to prompt the caregiver to attach the electrodes to the patient;

a picture configured to prompt the caregiver to stand clear of the patient; and

a picture configured to prompt the caregiver to perform CPR.

48. The device of claim 46 wherein the graphics include a picture configured to prompt the caregiver to press a treatment button to cause the defibrillator to administer a defibrillating shock.

49. The device of claim 31 wherein the graphics include one or more pictures selected from the group consisting of:

a picture configured to prompt the caregiver to check the patient for responsiveness;

a picture configured to prompt the caregiver to call for emergency assistance;

a picture configured to prompt the caregiver to open the patient'"'"'s airway;

a picture configured to prompt the caregiver to check the patient for signs of circulation;

a picture configured to prompt the caregiver to attach the electrodes to the patient;

a picture configured to prompt the caregiver to stand clear of the patient; and

a picture configured to prompt the caregiver to perform CPR.

50. The device of claim 45 wherein the light sources comprise LEDs.

51. The device of claim 31 wherein the audio prompts are associated with the series of graphics and are given sequentially to guide the caregiver through the sequence of steps.

52. The device of claim 31 further may comprise electronics configured to sequentially illuminate the light sources, wherein the audio prompts are associated with the series of graphics and with the sequential illumination of the light sources, to guide the caregiver through the sequence of steps.

53. The device of claim 51 or 52 further may comprise electronics configured to measure the time elapsed from the time at which the caregiver turned the power on to activate the defibrillator, and at least some of the audio prompts are timed to occur based on the elapsed time.

54. The device of claim 31 wherein at least some of the graphics are provided on a cover portion of the defibrillator device housing.

55. The device of claim 31 wherein at least some of the graphics are provided on the outside of the cover portion of the device.

56. The device of claim 55 wherein the graphics on the cover portion include a picture indicating that the cover should be removed from the device.

57. The device of claim 55 wherein the cover portion includes a space provided for local emergency information.

58. The device of claim 57 wherein the cover portion includes a window behind which a card bearing local emergency information can be placed.

59. The device of claim 31 wherein at least some of the graphics are provided in the form of backlit, translucent images.

60. The device of claim 31 wherein at least some of the graphics are provided in the form of a decal.

61. The device of claim 31 further may comprise buttons, associated with at least some of the graphics, which, when pressed, cause more detailed audio prompts related to the associated graphic to be output by the device.

62. The device of claim 31 wherein the graphics include one or more pictures indicating that the caregiver should place a passive airway support under the shoulders of the patient.

63. The device of claim 31 wherein the graphics include a picture configured to prompt the caregiver to check to see if the patient is breathing.

64. The device of claim 31 wherein the prompts and graphical interface illustrate the entire sequence of resuscitation activities that are recommended by the American Heart Association.

74. A device of claim 31 whose cover is shaped for use as a neck rest for maintaining the patient'"'"'s airway in the necessary open condition during CPR.

75. A device of claim 74 in which a detection means is provided for determining if the patient'"'"'s head is correctly located on the cover while it is being used as a neck rest.

76. A device of claim 75 wherein the detection means is provided by a pressure sensor.

77. A device of claim 75 wherein the detection means is provided by a photoelectric sensor.