Interactive external defibrillation and drug injection system

• US 5,405,362 A
• Filed: 12/20/1993
• Issued: 04/11/1995
• Est. Priority Date: 04/29/1991
• Status: Expired due to Term

• Current Assignee: Board of Regents of the University of Texas System (University of Texas System)
• Original Assignee: Board of Regents of the University of Texas System (University of Texas System)
• Inventors: Jenkinson, Joel P., Kramer, George C.
• Primary Examiner(s): MANUEL, GEORGE C
• Application Number:
  US08/170,065
• Time in Patent Office: 477 Days
• Field of Search: 607/3, 607/4, 607/5, 607/115, 607/119, 607/120, 607/127, 128/696, 128/697, 128/705, 128/709
• US Class Current: 607/5
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61M 2005/2013 triggering of discharging means by contact of injector with patient body
• CPC Class Codes: A61M 2005/206 With automatic needle insertion
• CPC Class Codes: A61M 2005/3247 Means to impede repositioning of protection sleeve from needle covering to needle uncovering position
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61M 5/2033 Spring-loaded one-shot injectors with or without automatic needle insertion multishot dosing syringes A61M5/31525, needle insertion only A61M5/3287
• CPC Class Codes: A61M 5/315 Pistons; Piston-rods; Guiding, blocking or restricting the movement of the rod or piston; Appliances on the rod for facilitating dosing ; Dosing mechanisms
• CPC Class Codes: A61M 5/326 Fully automatic sleeve extension, i.e. in which triggering of the sleeve does not require a deliberate action by the user
• CPC Class Codes: A61M 5/3291 Shafts with additional lateral openings
• CPC Class Codes: A61N 1/0575 with drug delivery

Abstract

This invention involves an interactive external defibrillation and drug injection system for use by a human operator for treating cardiac conditions in a patient, particularly in an out-of-hospital or pre-hospital environment. The present invention may also be used within hospitals as well as where intravenous (IV) access has not been established. More specifically, this invention comprises measuring devices capable of measuring and monitoring various physiological indicators in a patient and an expert system capable of analyzing the measured data and making recommendations to an operator for treatment of the patient using any combination of defibrillation, cardioversion, transcutaneous pacing, or vascular drug delivery via intraosseous drug injection. This invention is designed to enable first responders to cardiac emergencies to provide care up to the standard of at least the beginning stages of Advanced Cardiac Life Support (ACLS).

Claims

1. An interactive external defibrillation and drug injection system for use by a human operator for treating cardiac conditions or medical emergencies in a patient, comprising:

(a) a measuring device attachable to a patient and capable of measuring a patient'"'"'s ECG;

(b) a CPU connected to receive input signals from said measuring device indicative of measurements taken by said measuring device, said CPU being further capable of analyzing said measurements and of transmitting control signals, and said CPU comprising a communication system capable of communicating information and instructions in a manner perceivable by a human operator and capable of receiving and analyzing data input by a human operator relating to the cardiological treatment and condition of a patient;

(c) at least two electrical leads connectable to a patient and capable of delivering a sufficient amount of electrical energy to a patient to cardiovert or defibrillate a patient'"'"'s heart;

(d) an electrical source comprising a discharge outlet electrically connected to said electrical leads and a control signal input electrically connected to said CPU, said source capable of storing and discharging electrical energy through the discharge outlet to said leads in sufficient predetermined selectable quantities and at sufficient predetermined selectable rates to defibrillate or cardiovert a patient'"'"'s heart in a manner consistent with selected control signals and instructions from said CPU; and

(e) at least one intraosseous autoinjector, each of said autoinjectors containing a premeasured amount of a predetermined drug and each of said autoinjectors comprising an identifier such that it can be promptly identified by a human operator in response to an instruction from said CPU.

2. The interactive external defibrillation and drug injection system of claim 1, wherein said measuring device is further capable of measuring a patient'"'"'s blood pressure.

3. The interactive external defibrillation and drug injection system of claim 2, wherein said CPU comprises:

(a) a programmable expert system that is capable of analyzing measurements from said measuring device to identify cardiac dysrhythmias, heart rate, and heart rhythm; and

(b) a signal processor capable of receiving an input signal indicative of a patient'"'"'s ECG, processing said signal and transmitting a control signal to said electrical source.

4. The interactive external defibrillation and drug injection system of claim 3, wherein the cardiac dysrhythmias that are identifiable by said programmable expert system include ventricular defibrillation, ventricular tachycardia, acute myocardial infarction, bradycardia, tachycardia, pulseless electrical activity, asystole, and acute pulmonary edema.

5. The interactive external defibrillation and drug injection system of claim 3, wherein said expert system comprises a multiplicity of cardiological treatment and diagnostic algorithms capable of receiving input data from said measuring device and from a human operator, and further capable of generating instructions to a human operator via said communication system.

6. The interactive external defibrillation and drug injection system of claim 1, wherein said communication system further comprises a data display device capable of displaying data received from said measuring device and instructions generated by said algorithms.

7. The interactive external defibrillation and drug injection system of claim 5, further comprising a data storage device electrically coupled to said CPU, said storage device being capable of storing all data received by the CPU and all instructions and control signals generated by said CPU.

8. The interactive external defibrillation and drug injection system of claim 1, wherein said communication system further comprises an audio communicator capable of communicating data and instructions to a human operator in an audibly perceivable manner.

9. The interactive external defibrillation and drug injection system of claim 6, wherein said communication system further comprises a data input terminal capable of receiving data input by a human operator and transmitting such data to said algorithms.

10. The interactive external defibrillation and drug injection system of claim 3, wherein said electrical source is further capable of discharging electrical energy through the discharge outlet to said leads in sufficient predetermined selectable quantities and at sufficient predetermined selectable rates to transcutaneously pace a patient'"'"'s heart in a manner consistent with control signals and instructions from the CPU.

11. The interactive external defibrillation and drug injection system of claim 1, wherein said electrical source and said CPU are housed in a portable console.

12. The interactive external defibrillation and drug injection system of claim 11, wherein said electrical source comprises:

(a) a rechargeable battery; and

(b) a multiplicity of control devices operable to permit a human operator to select the magnitude and duration of electrical energy discharged by said source.

13. The interactive external defibrillation and drug injection system of claim 11, further comprising:

(a) an intraosseous autoinjector containing a premeasured amount of epinephrine;

(b) an intraosseous autoinjector containing a premeasured amount of atropine;

(c) an intraosseous autoinjector containing a premeasured amount of morphine;

(d) an intraosseous autoinjector containing a premeasured amount of tissue plasminogen activator;

(e) an intraosseous autoinjector containing a premeasured amount of lidocaine; and

(f) an intraosseous autoinjector containing a premeasured amount of adenosine.

14. The interactive external defibrillation and drug injection system of claim 13, wherein each of said autoinjectors is removably housed in a portable autoinjector housing comprising a visual labeling system such that the drug contained within each autoinjector is readily perceivable by a human operator.

15. The interactive external defibrillation and drug injection system of claim 14, further comprising:

(a) a multiplicity of extendable jacks, each of said jacks installed in said autoinjector housing directly adjacent an autoinjector such that when said jack is extended, it extends the autoinjector directly above it into a more prominent position than that of the remaining autoinjectors in said housing; and

(b) a transducer electrically coupled to said CPU and mechanically coupled to said jacks such that said transducer can receive an extension signal for a specific autoinjector from said CPU and transmit said signal to the jack installed adjacent said selected autoinjector, resulting in the extension of said jack.

16. The interactive external defibrillation and drug injection system of claim 14, wherein said portable autoinjector housing is electrically coupled to said CPU such that it can receive a signal from said CPU indicative of which drug to administer to a patient.

17. The interactive external defibrillation and drug injection system of claim 16, further comprising an electrical light in close proximity to each of said autoinjectors, each of said lights being electrically connected to said CPU such that each light may be selectively illuminated by the CPU pursuant to instructions from the expert system to visually indicate which drug should be administered to a patient.

18. An interactive external defibrillation and drug injection system for use by a human operator for treating cardiac conditions in a patient, comprising:

(a) a measuring device attachable to a patient and capable of measuring a patient'"'"'s ECG and blood pressure;

(b) a CPU connected to receive input signals from said measuring device indicative of measurements taken by said measuring device, said CPU being further capable of analyzing said measurements and of transmitting control signals, and said CPU comprising a communication system capable of communicating information and instructions in a manner perceivable by a human operator and capable of receiving and analyzing data input by a human operator relating to the cardiological treatment and condition of a patient;

(c) at least two electrical leads connectable to a patient and capable of delivering a sufficient amount of electrical energy to a patient to cardiovert, defibrillate, or transcutaneously pace a patient'"'"'s heart;

(d) an electrical source comprising a discharge outlet electrically connected to said electrical leads and a control signal input electrically connected to said CPU, said source capable of storing and discharging electrical energy through the discharge outlet to said leads in sufficient predetermined selectable quantities and at sufficient rates to defibrillate, cardiovert, or transcutaneously pace a patient'"'"'s heart in a manner consistent with selected control signals and instructions from said CPU, said source further comprising a multiplicity of control devices for use in selectively controlling the magnitude and duration of electrical energy discharged by said source; and

(e) a portable container comprising at least six intraosseous autoinjectors, each of said autoinjectors containing a premeasured amount of a predetermined drug, said container further comprising an electrical light in close proximity to each of said autoinjectors, each of said lights being electrically connected to said CPU such that each light is illuminated in response to a signal from said CPU.

19. The interactive external defibrillation and drug injection system of claim 18, wherein said CPU comprises a programmable expert system that is capable of analyzing measurements from said measuring devices to identify heart rate, heart rhythm, and cardiac dysrhythmias.

20. The interactive external defibrillation and drug injection system of claim 18, further comprising a data storage device capable of storing all data and other input received by said CPU and all instructions and control signals generated by said CPU in a retrievable fashion such that an operator can determine the time at which all data received by said CPU was received and all instructions generated by said CPU were generated.

21. The interactive external defibrillation and drug injection system of claim 20, further comprising a printer electrically coupled to said CPU such that any retrievably stored data in said CPU can be printed out by said printer.

22. The interactive external defibrillation and drug injection system of claim 18, further comprising a digital data recorder electrically coupled to said CPU such that it can retrievably record all signals transmitted by measuring devices to the CPU, all input from an operator input to the CPU, all instructions generated by the CPU and the times that all such recorded data was received or generated by the CPU.

23. The interactive external defibrillation and drug injection system of claim 18, wherein said measuring device comprises:

(a) at least two ECG leads connectable to a patient and capable of transmitting a signal indicative of the patient'"'"'s ECG; and

(b) a blood pressure monitoring device.

24. The interactive external defibrillation and drug injection system of claim 18, wherein each of said autoinjectors comprise:

(a) a main housing having a front end and a rear end;

(b) a forward directed aperture on the front end of said main housing;

(c) a syringe body having a front end and a rear end, said syringe body being slidably positioned in said main housing;

(d) a needle having a central bore communicating with at least one opening proximate to a tip of said needle, said needle being attached to the front end of said syringe body, communicating with an interior of said syringe body and being positioned to extend through the aperture of said main housing;

(e) an actuation handle extending in telescoping fashion over the rear end of said main housing;

(f) a drive plunger extending from the rear ends of said syringe body and said main housing into said actuation handle;

(g) a drive spring capable of exerting and extending force between said drive plunger and said actuation handle;

(h) a needle return spring connected between the front end of said main housing for engaging said drive plunger in position at the rear end of said syringe body; and

(i) a means placed on the front end of said main housing for locking said drive plunger into position and for unlocking said drive plunger from the rear end of said syringe body, causing said needle to be releasably extended from the front end of said main housing.

25. The interactive external defibrillation and drug injection system of claim 24, wherein said autoinjector further comprises a protective covering having a front end and a rear end, said protective covering being positioned over the front end of said main housing, the front end of said protective cover extending beyond the front end of said main housing at least a distance equal to the distance said needle extends through the aperture of said main housing when said device is operated, said protective cover having a corresponding aperture to the aperture of said main housing, the rear end of said protective cover extending into said actuation handle, said protective cover being initially movable rearward along said main housing in telescoping fashion over the front end of said main housing and a locking mechanism on said protective cover for preventing said protective cover from being moved rearward along said main housing again, after initially being moved rearward along said main housing.