Method and apparatus for scoring the reliability of shock advisory during cardiopulmonary resuscitation
First Claim
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1. A medical device for determining the reliability of a cardiac rhythm analysis during the performance of cardiopulmonary resuscitation (CPR) comprising:
- a front end operable to obtain two or more time-sequential ECG data sets comprised of a first ECG data set and a second ECG data set;
an input sensor operable to acquire two or more time-sequential CPR reference signal data sets which correspond in time to the time-sequential ECG data sets;
a chest compression detector in communication with the input, operable to detect whether or not each of the ECG data sets contains CPR-related noise;
a shock advisory algorithm module in communication with the input and the chest compression detector and operable to analyze and classify each of the ECG data sets that do not contain CPR-related noise as a shock advice or a no-shock advice;
a reliability analyzer in communication with the chest compression detector and the shock advisory algorithm module operable to determine the reliability of the most recent shock or no-shock advice, wherein the reliability analyzer is configured to generate a reliability score at the end of each of the ECG data sets by operations including;
responsive to a number of consecutive ECG data sets that do not contain CPR-related noise being similarly classified as the shock advice, the reliability analyzer is configured to update a value of the reliability score in a direction corresponding to the shock advice until the reliability score reaches a scoring limit corresponding to the shock advice;
responsive to a number of consecutive ECG data sets that do not contain CPR-related noise being similarly classified as the no-shock advice, the reliability analyzer is configured to update the value of the reliability score in a direction corresponding to the no shock advice until the reliability score reaches a scoring limit corresponding to the no shock advice;
responsive to the most recent ECG data set not containing CPR-related noise and being classified as a switched shock or no shock advice, the reliability analyzer is configured to update the value of the reliability score toward a score value indicating an indeterminate condition; and
responsive to the most recent ECG data set containing CPR-related noise, the reliability analyzer is configured to update the value of the reliability score toward the score value indicating the indeterminate condition;
a shock decision generator in communication with the reliability analyzer and the shock advisory algorithm module operable to generate a shock decision based on the reliability score; and
an output generator for issuing a user-perceptible indication of the shock decision and the reliability of the ECG shock advice.
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Abstract
A method, system and device to detect and use clean ECG segments, which do not need filtering to remove artifact or CPR-induced noise, is described to provide a reliability score for the decision made by shock advisory algorithms. The method can be implemented in a system and/or device that is provided with a display for indicating to a user the relative quality of the determination of an electrotherapy analysis circuit.
69 Citations
18 Claims
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1. A medical device for determining the reliability of a cardiac rhythm analysis during the performance of cardiopulmonary resuscitation (CPR) comprising:
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a front end operable to obtain two or more time-sequential ECG data sets comprised of a first ECG data set and a second ECG data set; an input sensor operable to acquire two or more time-sequential CPR reference signal data sets which correspond in time to the time-sequential ECG data sets; a chest compression detector in communication with the input, operable to detect whether or not each of the ECG data sets contains CPR-related noise; a shock advisory algorithm module in communication with the input and the chest compression detector and operable to analyze and classify each of the ECG data sets that do not contain CPR-related noise as a shock advice or a no-shock advice; a reliability analyzer in communication with the chest compression detector and the shock advisory algorithm module operable to determine the reliability of the most recent shock or no-shock advice, wherein the reliability analyzer is configured to generate a reliability score at the end of each of the ECG data sets by operations including; responsive to a number of consecutive ECG data sets that do not contain CPR-related noise being similarly classified as the shock advice, the reliability analyzer is configured to update a value of the reliability score in a direction corresponding to the shock advice until the reliability score reaches a scoring limit corresponding to the shock advice; responsive to a number of consecutive ECG data sets that do not contain CPR-related noise being similarly classified as the no-shock advice, the reliability analyzer is configured to update the value of the reliability score in a direction corresponding to the no shock advice until the reliability score reaches a scoring limit corresponding to the no shock advice; responsive to the most recent ECG data set not containing CPR-related noise and being classified as a switched shock or no shock advice, the reliability analyzer is configured to update the value of the reliability score toward a score value indicating an indeterminate condition; and responsive to the most recent ECG data set containing CPR-related noise, the reliability analyzer is configured to update the value of the reliability score toward the score value indicating the indeterminate condition; a shock decision generator in communication with the reliability analyzer and the shock advisory algorithm module operable to generate a shock decision based on the reliability score; and an output generator for issuing a user-perceptible indication of the shock decision and the reliability of the ECG shock advice. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A defibrillator comprising:
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a host circuit operable to analyze ECG segments and determine whether each ECG segment is a clean ECG segment that does not contain chest compressions-related noise and to make a shock determination decision for each clean ECG segment; a reliability analyzing circuit operable to analyze each ECG segment to generate a reliability score at the end of the ECG segment by operations including; for each clean ECG segment that has a shock determination decision confirming the shock determination decision for the last clean ECG segment, updating the reliability score in a direction corresponding to the confirming shock determination decision until the reliability score reaches a scoring limit corresponding to the confirming shock determination decision; for each switched clean ECG segment that has a shock determination decision opposite to the shock determination decision for the last clean ECG segment, updating the reliability score toward a score value indicating an indeterminate condition; and for each ECG segment that is not a clean ECG segment, updating the reliability score toward the score value indicating the indeterminate condition; and a display disposed on the defibrillator operable to display the generated reliability score. - View Dependent Claims (14, 15, 16, 17)
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18. A defibrillator comprising:
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a computer programmed to analyze ECG segments and determine whether each ECG segment is a clean ECG segment that does not contain chest compressions-related noise and to make a shock determination decision for each clean ECG segment, and further programmed to analyze each ECG segment to generate a reliability score at the end of the ECG segment by operations including; for each clean ECG segment that has a shock determination decision confirming the shock determination decision for the last clean ECG segment, updating the reliability score in a direction corresponding to the confirming shock determination decision until the reliability score reaches a scoring limit corresponding to the confirming shock determination decision; for each switched clean ECG segment that has a shock determination decision opposite to the shock determination decision for the last clean ECG segment, updating the reliability score toward a score value indicating an indeterminate condition; and for each ECG segment that is not a clean ECG segment, updating the reliability score toward the score value indicating the indeterminate condition; a display disposed on the defibrillator operable to display a representation of the most recently generated reliability score; and a high voltage electrotherapy circuit configured to deliver a defibrillation shock to a patient in accordance with the shock determination decisions.
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Specification