Processing impedance signals for breath detection

• US 9,968,267 B2
• Filed: 03/07/2014
• Issued: 05/15/2018
• Est. Priority Date: 03/15/2013
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Geheb, Frederick J., Freeman, Gary A., Herken, Ulrich
• Primary Examiner(s): BLOCH, MICHAEL RYAN
• Application Number:
  US14/200,571
• Publication Number:
  US 20140276131A1
• Time in Patent Office: 1,530 Days
• Field of Search: None
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• 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 5/0809 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 5/6823 Trunk, e.g., chest, back, abdomen, hip
• CPC Class Codes: A61B 5/725 using specific filters therefor, e.g. Kalman or adaptive filters A61B5/316 take precedence
• CPC Class Codes: A61B 5/74 Details of notification to user or communication with user or patient indicating measured values G01D7/00; user input means input or output arrangements for computers G06F3/00
• CPC Class Codes: A61B 5/7405 using sound
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence

Abstract

An apparatus includes a computing device that includes a memory configured to store instructions. The computing device also includes a processor to execute the instructions to perform operations that include receiving a signal representative of electrical impedance in a chest of a patient, and, receiving a signal representative of the motion of chest compressions performed on the patient during a cardiopulmonary resuscitation (CPR) treatment. The operations also include processing the received signal representative of the motion of chest compressions to determine one or more characteristics of the motion, and, processing the received signal representative of the electrical impedance to determine parameters relevant to a production of a signal representative of airflow activities of the patient. Operations also include modifying the one or more determined parameters based on the one or more determined characteristics of the motion to produce the signal representative of airflow activities of the patient.

Claims

1. An apparatus comprising:

a medical device comprising a feedback device, a memory, and a processor;

a plurality of electrodes configured to provide at least an electrical impedance signal to the processor, wherein the electrical impedance signal corresponds to an electrical impedance measured at a chest of a patient; and

one or more sensors configured to provide a chest compression motion signal to the processor, wherein the chest compression motion signal is indicative of chest compressions performed by a rescuer on the patient during a cardiopulmonary resuscitation (CPR) treatment of the patient,

wherein the processor is configured to receive the electrical impedance signal and the chest compression motion signal and further wherein the processor is configured to execute instructions to;

determine one or more chest compression motion characteristics from the chest compression motion signal;

determine one or more threshold values based at least in part on the one or more chest compression motion characteristics;

based at least in part on the one or more chest compression motion characteristics, remove artifacts from the electrical impedance signal to generate a filtered electrical impedance signal;

determine a threshold signal from the filtered electrical impedance signal based on the one or more threshold values; and

detect airflow activities of the patient based at least in part on the threshold signal; and

present, via the feedback device, feedback for the rescuer to initiate appropriate action to modify the CPR treatment, based on the detected airflow activities of the patient, for adjusting the CPR treatment of the patient.

2. The apparatus of claim 1, wherein the instructions to remove the artifacts from the electrical impedance signal comprise instructions to:

determine filtering parameters based at least in part on the one or more chest compression motion characteristics; and

remove the artifacts from the electrical impedance signal based on the filtering parameters.

3. The apparatus of claim 2, wherein the processor is further configured to execute instructions to modify the filtering parameters based on changes in the chest compression motion signal over time.

4. The apparatus of claim 2 wherein the one or more chest compression motion characteristics comprise a compression rate and wherein the processor is further configured to execute instructions to determine the filtering parameters based on the compression rate.

5. The apparatus of claim 1, wherein the one or more chest compression motion characteristics indicate an absence of chest compressions being performed on the patient over a period of time.

6. The apparatus of claim 1, wherein the one or more chest compression motion characteristics comprise a compression depth and a compression rate.

7. The apparatus of claim 1, wherein the one or more sensors configured to provide the chest compression motion signal to the processor comprise an accelerometer adapted to be positioned to move in coordination with motion of the chest of the patient.

8. The apparatus of claim 1 wherein the one or more threshold values comprise a first threshold value and a second threshold value and wherein the processor is further configured to execute instructions to:

determine one or more first periods of time in which the filtered electrical impedance signal exceeds the first threshold value; and

determine one or more second periods of time in which the filtered electrical impedance signal is less than the second threshold value, wherein the threshold signal is indicative of the one or more first periods of time and the one or more second periods of time.

9. The apparatus of claim 1, wherein the feedback device comprises at least a visual display device or an audio speaker.

10. The apparatus of claim 1 wherein the one or more chest compression motion characteristics comprise a compression rate and a compression depth and wherein the processor is further configured to execute instructions to modify the one or more threshold values based on one or more of the compression rate and the compression depth.

11. The apparatus of claim 1 wherein the processor is further configured to execute instructions to modify the one or more threshold values based on changes in the chest compression motion signal over time.

12. The apparatus of claim 1 wherein the airflow activities of the patient comprise inflation of the lungs, deflation of the lungs, and a ventilation cycle comprising the inflation of the lungs and the deflation of the lungs.

13. The apparatus of claim 1 wherein the feedback comprises an instruction to modify a frequency of ventilations.

14. One or more non-transitory computer readable media storing processor executable instructions configured to cause a processor to perform operations comprising:

receiving, from a plurality of electrodes, an electrical impedance signal representative of electrical impedance of a chest of a patient;

receiving, from one or more motion sensors, one or more signals indicative of chest compression motion for chest compressions performed on the patient during a cardiopulmonary resuscitation (CPR) treatment;

determining one or more chest compression motion characteristics from the one or more signals indicative of the chest compression motion;

determining one or more threshold values based at least in part on the one or more chest compression motion characteristics;

based at least in part on the one or more chest compression motion characteristics, removing chest compression artifacts from the electrical impedance signal to generate a filtered electrical impedance signal;

determining a threshold signal from the filtered electrical impedance signal based on the one or more threshold values;

detecting airflow activities of the patient based at least in part on the threshold signal; and

presenting, via a feedback device, feedback for a rescuer to initiate appropriate action to modify the CPR treatment, based on the detected airflow activities, for adjusting the CPR treatment of the patient.

15. The computer readable media of claim 14, wherein the removing the chest compression artifacts from the electrical impedance signal comprises:

determining filtering parameters based at least in part on the one or more chest compression motion characteristics; and

removing the chest compression artifacts from the electrical impedance signal based on the filtering parameters.

16. The computer readable media of claim 15, wherein the processor executable instructions are further configured to cause the processor to perform operations comprising modifying the filtering parameters based on changes, over time, in the one or more signals indicative of chest compression motion.

17. The computer readable media of claim 15, wherein the one or more chest compression motion characteristics comprise a compression rate and wherein the processor executable instructions are further configured to cause the processor to perform operations comprising determining the filtering parameters based on the compression rate.

18. The computer readable media of claim 14, wherein the one or more chest compression motion characteristics indicate an absence of chest compressions being performed on the patient over a period of time.

19. The computer readable media of claim 14, wherein the one or more chest compression motion characteristics comprise a compression depth and a compression rate.

20. The computer readable media of claim 14, wherein the one or more signals indicative of chest compression motion comprise an acceleration signal.

21. The computer readable media of claim 14 wherein the one or more threshold values comprise a first threshold value and a second threshold value and wherein the processor executable instructions are further configured to cause the processor to perform operations comprising:

determining one or more first periods of time in which the filtered electrical impedance signal exceeds the first threshold value; and

determining one or more second periods of time in which the filtered electrical impedance signal is less than the second threshold value, wherein the threshold signal is indicative of the one or more first periods of time and the one or more second periods of time.

22. The computer readable media of claim 14 wherein the one or more chest compression motion characteristics comprise a compression rate and a compression depth and wherein the processor executable instructions are further configured to cause the processor to perform operations comprising modifying the one or more threshold values based on one or more of the compression rate and the compression depth.

23. The computer readable media of claim 14 wherein the processor executable instructions are further configured to cause the processor to perform operations comprising modifying the one or more threshold values based on changes, over time, in the one or more signals indicative of chest compression motion.

24. The computer readable media of claim 14 wherein the airflow activities of the patient comprise inflation of the lungs, deflation of the lungs, and a ventilation cycle comprising the inflation of the lungs and the deflation of the lungs.

25. The computer readable media of claim 14 wherein the feedback comprises an instruction to modify a frequency of ventilations.

26. A computing device implemented method comprising;

receiving, from a plurality of electrodes, an electrical impedance signal representative of electrical impedance of a chest of a patient;

receiving, from one or more motion sensors, one or more signals indicative of chest compression motion for chest compressions performed on the patient during a cardiopulmonary resuscitation (CPR) treatment;

determining one or more chest compression motion characteristics from the one or more signals indicative of the chest compression motion;

determining one or more threshold values based at least in part on the one or more chest compression motion characteristics;

based at least in part on the one or more chest compression motion characteristics, removing chest compression artifacts from the electrical impedance signal to generate a filtered electrical impedance signal;

determining a threshold signal from the filtered electrical impedance signal based on the one or more threshold values;

detecting airflow activities of the patient based at least in part on the threshold signal; and

presenting, via a feedback device, feedback for a rescuer to initiate appropriate action to modify the CPR treatment, based on the detected airflow activities, for adjusting the CPR treatment of the patient.

27. The computing device implemented method of claim 26, wherein the removing the chest compression artifacts from the electrical impedance signal comprises:

determining filtering parameters based at least in part on the one or more chest compression motion characteristics; and

removing the chest compression artifacts from the electrical impedance signal based on the filtering parameters.

28. The computing device implemented method of claim 27, further comprising modifying the filtering parameters based on changes, over time, in the one or more signals indicative of chest compression motion.

29. The computing device implemented method of claim 27 wherein the one or more chest compression motion characteristics comprise a compression rate, the method further comprising determining the filtering parameters based on the compression rate.

30. The computing device implemented method of claim 26, wherein the one or more chest compression motion characteristics indicate an absence of chest compressions being performed on the patient over a period of time.

31. The computing device implemented method of claim 26, wherein the one or more chest compression motion characteristics comprise a compression depth and a compression rate.

32. The computing device implemented method of claim 26, wherein the one or more signals indicative of chest compression motion comprise an acceleration signal.

33. The computing device implemented method of claim 26, wherein the one or more threshold values comprise a first threshold value and a second threshold value, the method further comprising:

determining one or more first periods of time in which the filtered electrical impedance signal exceeds the first threshold value; and

determining one or more second periods of time in which the filtered electrical impedance signal is less than the second threshold value, wherein the threshold signal is indicative of the one or more first periods of time and the one or more second periods of time.

34. The computing device implemented method of claim 26, wherein the one or more chest compression motion characteristics comprise a compression rate and a compression depth, the method further comprising modifying the one or more threshold values based on one or more of the compression rate and the compression depth.

35. The computing device implemented method of claim 26 further comprising modifying the one or more threshold values based on changes, over time, in the one or more signals indicative of chest compression motion.

36. The computing device implemented method of claim 26 wherein the airflow activities of the patient comprise inflation of the lungs, deflation of the lungs, and a ventilation cycle comprising the inflation of the lungs and the deflation of the lungs.

37. The computing device implemented method of claim 26 wherein the feedback comprises an instruction to modify a frequency of ventilations.