Pulse detection apparatus, software, and methods using patient physiological signals

• US 9,981,142 B2
• Filed: 12/21/2015
• Issued: 05/29/2018
• Est. Priority Date: 09/30/1999
• Status: Expired due to Fees

• 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
• Primary Examiner(s): EVANISKO, GEORGE ROBERT
• Application Number:
  US14/976,976
• Publication Number:
  US 20160106992A1
• Time in Patent Office: 890 Days
• 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

Appropriate cardiac therapy is determined by data sensed and analyzed by the disclosed defibrillators and other medical devices that one or both of treat and monitor a patient. The disclosed devices sense various patient physiological parameters including patient pulse and breathing data to determine whether the patient has a pulse and to determine if the patient is breathing. Depending on the analysis of the generated patient physiological data, the disclosed devices determine the appropriate therapy for the patient, which can include providing breathing assistance to the patient and providing electrotherapy and other therapies to the patient. Some of the disclosed medical devices can be wearable by the patient. The disclosed devices can include therapy modules like electrotherapy for delivering therapies to the patient while other devices monitor but do not deliver the therapies to the patient.

Claims

1. An external defibrillator, comprising:

a pulse sensor configured to sense a pulse of a patient and output patient pulse data;

a breathing detection device configured to detect whether the patient is breathing and to output patient breathing data;

a controller operatively coupled to the pulse sensor and the breathing detection device and configured to

analyze the output patient pulse data;

determine that the patient has a pulse based on the analyzed output patient pulse data;

analyze the output patient breathing data;

determine that the patient is not breathing based at least in part on the analyzed output patient pulse data; and

generate an instruction to provide breathing assistance to the patient based on the determination that the patient has a pulse and the determination that the patient is not breathing; and

an output device configured to issue a prompt to provide breathing assistance to the patient based on the generated instruction.

2. The external defibrillator of claim 1, wherein the pulse sensor is also configured to sense a further pulse of a patient and output further patient pulse data and wherein the controller is further configured to

analyze the further output patient pulse data;

and

determine the patient has no pulse based on the analyzed further output patient pulse data.

3. The external defibrillator of claim 2, wherein the controller is further configured to determine the patient has no pulse based on the analyzed further output patient pulse data and the output patient breathing data.

4. The external defibrillator of claim 2, wherein the controller is further configured to generate an instruction to deliver electrotherapy to the patient based on the determination that the patient has no pulse.

5. The external defibrillator of claim 4, wherein the electrotherapy includes defibrillation therapy.

6. The external defibrillator of claim 4, wherein the controller is further configured to cause the external defibrillator to deliver the electrotherapy to the patient.

7. The external defibrillator of claim 4, wherein the instruction to deliver electrotherapy includes an instruction to deliver pacing stimuli to the patient.

8. The external defibrillator of claim 7, wherein the controller is further configured to receive patient physiological data in response to the delivered pacing stimuli.

9. The external defibrillator of claim 8, wherein the controller is further configured to determine presence of a cardiac pulse of the patient based, at least in part, on the received patient physiological data.

10. The external defibrillator of claim 8, wherein the controller is further configured to send the pacing stimuli and repeatedly receive the patient physiological data multiple times.

11. The external defibrillator of claim 10, wherein the controller is further configured to compare each of multiple times of sending the pacing stimuli and receiving the patient physiological data to each other.

12. The external defibrillator claim 10, wherein the controller is further configured to analyze each of the multiple times to determine presence of a consistent cardiac pulse following each pacing stimuli.

13. The external defibrillator of claim 12, wherein the controller is further configured to alter one or more characteristics of the pacing stimuli based, at least in part, on the determination that a consistent cardiac pulse following each pacing stimuli is not present.

14. The external defibrillator of claim 12, wherein the controller is further configured to determine that a consistent cardiac pulse is not present and is further configured to increase current of the pacing stimuli based, at least in part, on the determination that the consistent cardiac pulse is not present.

15. The external defibrillator of claim 4, wherein the delivery of the electrotherapy to the patient is automatic.

16. The external defibrillator of claim 4, wherein the controller is further configured to generate a user prompt to initiate discharge of the electrotherapy to the patient.

17. The external defibrillator of claim 2, wherein the controller is further configured to generate an instruction to deliver cardiopulmonary resuscitation to the patient based on the determination that the patient has no pulse.

18. The external defibrillator of claim 1, wherein the external defibrillator is structured to be wearable by the patient.