PULSE DETECTION APPARATUS, SOFTWARE, AND METHODS USING PATIENT PHYSIOLOGICAL SIGNALS

• US 20130338724A1
• Filed: 08/19/2013
• Published: 12/19/2013
• Est. Priority Date: 09/30/1999
• Status: Active Grant

• Current Assignee: Physio-Control Incorporated (Stryker Corporation)
• Original Assignee: Physio-Control Incorporated (Stryker Corporation)
• Inventors: Joo, Tae H., Stickney, Ronald E., Jayne, Cynthia P., Lank, Paula, O'Hearn, Patricia, Hampton, David R., Taylor, James W., Crone, William E., Yerkovich, Daniel
• Granted Patent: US 9,248,306 B2
• Time in Patent Office: Days
• US Class Current: 607/3
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/02438 with portable devices, e.g. worn by the patient
• CPC Class Codes: A61B 5/0535 Impedance plethysmography for measuring blood flow A61B5/0295
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0809 by impedance pneumography
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: A61B 7/04 Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61N 1/36578 controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• 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 1/3987 characterised by the timing or triggering of the shock

Abstract

A cardiac pulse in a patient is determined by evaluating physiological signals in the patient. A medical device evaluates two or more different physiological signals, such as phonocardiogram (PCG) signals, electrocardiogram (ECG) signals, patient impedance signals, piezoelectric signals, and accelerometer signals for features indicative of the presence of a cardiac pulse. Using these features, the medical device determines whether a cardiac pulse is present in the patient. The medical device may also be configured to report whether the patient is in a VF, VT, asystole, or PEA condition, in addition to being in a pulseless condition, and prompt different therapies, such as chest compressions, rescue breathing, defibrillation, and PEA-specific electrotherapy, depending on the analysis of the physiological signals. Auto-capture of a cardiac pulse using pacing stimuli is further provided. The medical devices, or any portion thereof, can be worn by the patient or may be attached to the patient.

Claims

1. A device for providing treatment to a patient, comprising:

a pulse sensor;

a breathing detection device;

a controller operatively coupled to the pulse sensor and the breathing detection device and structured to determine a defibrillation therapy protocol based on a first input from the pulse sensor and a second input from the breathing detection device; and

an output device operatively coupled to the pulse sensor and the breathing detection device and configured to issue a prompt to provide rescue breathing in the event the pulse sensor senses a pulse in the patient and the breathing detection device determines that the patient is not breathing.

2. The device of claim 1, wherein the pulse sensor comprises a phonocardiogram (PCG) electrode configured to sense PCG signals in the patient.

3. The device of claim 1, wherein the pulse sensor comprises a light source and a photodetector.

4. The device of claim 1, further comprising a motion detection device structured to detect a motion of the patient, wherein the motion detection device is coupled to the controller.

5. The device of claim 4, wherein the motion detection device includes a patient impedance measuring device to measure a patient impedance.

6. The device of claim 4, wherein the motion detection device transmits a motion detection input to the controller, and wherein, when motion is detected by the motion detection device and included in the motion detection input, the controller determines that the defibrillation therapy protocol includes an instruction that inhibits delivery of a defibrillation shock to the patient.

7. The device of claim 6, further comprising an output device configured to issue a prompt to reduce motion when the controller determines that there is motion detected by the motion detection device and included in the motion detection input.

8. The device of claim 1, wherein the device is a cardiac monitor.

9. The device of claim 8, wherein the cardiac monitor is electrically coupled to a defibrillator that is remote from the cardiac monitor, and wherein the controller is structured to transmit the defibrillation therapy protocol to the defibrillator.

10. The device of claim 1, wherein the device is electrically coupled to a defibrillator that is remote from the device, and wherein the controller is structured to transmit the defibrillation therapy protocol to the defibrillator.

11. A method for providing treatment to a patient, comprising:

sensing a pulse of the patient;

detecting by a breathing detection device whether the patient is breathing;

determining a defibrillation therapy protocol based on the sensed pulse and whether the patient is breathing; and

prompting a caregiver to provide rescue breathing when the patient'"'"'s pulse is sensed and the patient has no detected breathing.

12. The method of claim 11, further comprising:

determining whether the patient is moving; and

performing one of inhibiting defibrillation and prompting a caregiver to reduce motion when the patient is determined to be moving.

13. The method of claim 12, wherein determining whether the patient is moving comprises measuring a patient impedance.

14. The method of claim 11, wherein the breathing device comprises:

a rescue breathing sensor coupled to the controller; and

wherein

the controller determines a rescue breathing protocol based on the first input from the pulse sensor and an input from the rescue breathing sensor.

15. The method of claim 11, further comprising transmitting the defibrillation therapy protocol to a defibrillator, the defibrillator being configured to apply defibrillation therapy to the patient according to the defibrillation therapy protocol.

16. The method of claim 15, wherein sensing the pulse of the patient and detecting by a breathing detection device whether the patient is breathing are performed by a medical device.

17. The method of claim 16, wherein the medical device is a cardiac monitor.

18. The method of 16, wherein the medical device is remote from the defibrillator.