Cardiac resuscitator and monitoring apparatus

• US RE30,750 E
• Filed: 05/07/1980
• Issued: 09/29/1981
• Est. Priority Date: 05/15/1972
• Status: Expired due to Term

• Current Assignee: Cardiac Resuscitator Corp.
• Original Assignee: Cardiac Resuscitator Corp.
• Inventors: Rullman, Robert G., Welborn, Warren S., Diack, Archibald W.
• Primary Examiner(s): KAMM, WILLIAM E
• Application Number:
  US06/148,159
• Time in Patent Office: 510 Days
• Field of Search: 128/419 D, 128/419 PG, 128/423, 128/671, 128/691, 128/639, 128/641, 128/642, 128/644, 128/650, 128/689, 128/693, 128/696, 128/702, 128/705, 128/706, 128/710 , 128/711, 128/712, 128/715, 128/716, 128/721, 128/724, 128/784, 128/786, 128/787, 128/789, 128/791, 128/798
• US Class Current: 607/5
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/39 Heart defibrillators

Abstract

The disclosed apparatus attaches to the patient for monitoring the patient'"'"'s condition and administering the correct electrical stimulation to a suspected heart attack victim as soon as possible after the occurrence of the attack and in the absence of medical personnel. The apparatus preferably includes an oro-pharyngeal airway provided with electrodes for ascertaining electrical activity of the heart. A microphone attached to the airway, or a strain gauge applied elsewhere to the patient'"'"'s body, detects bodily motion, for example respiration. If neither substantial electrical activity nor bodily motion is detected, the patient is considered to be in a cardiac arrest and a pacing impulse is applied to the patient via the aforementioned airway electrodes and/or other electrodes, while if electrical activity is ascertained in the absence of bodily motion, a defibrillating pulse is applied to the patient.

Claims

1. A cardiac resuscitator apparatus comprising:

an oro-pharyngeal airway for insertion into the pharynx of a patient, said airway having contact means mounted thereon for making electrical contact with tissue within the patient,

second electrode means for external placement on the patient in the chest-abdominal region for making electrical contact with the patient in said region,

circuit means for generating an electrical defibrillating pulse, said circuit means having first and second terminals between which said defibrillating pulse is supplied,

and conductor means respectively coupling said first and second terminals to said contact means and said second electrode means for delivering said defibrillating pulse to the patient through a current pathway in the trunk of the patient between said contact means mounted on said airway and said second electrode means for defibrillating the patient'"'"'s heart.

2. A cardiac resuscitator apparatus comprising:

an oro-pharyngeal airway for insertion into the pharynx of a patient, said airway having contact means mounted thereon for making electrical contact with tissue within the patient,

second electrode means for external placement on the patient in the chest-abdominal region for making electrical contact with the patient in said region,

first circuit means connected to said contact means on said airway for deriving an electrical input from the patient'"'"'s heart for detecting an abnormal heart condition,

second circuit means for generating a defibrillating pulse, said second circuit means having first and second terminals between which said defibrillation pulse is supplied, said second circuit means being responsive in its operation to detection of an abnormal heart condition by said first circuit means,

and conductor means for respectively connecting said first and second terminals to said contact means and said second electrode means for delivering said defibrillating pulse to the patient through a current pathway in the trunk of the patient between said contact means mounted on said airway and said second electrode means for defibrillating the patient'"'"'s heart.

3. A cardiac resuscitator apparatus comprising:

an oro-pharyngeal airway for insertion into the pharynx of a patient, said airway having contact means mounted thereon for making electrical contact with tissue within the patient,

second electrode means for electrically contacting the patient at another location remote from said contact means,

electrical detecting means mounted on said airway and responsive to the patient'"'"'s respiration by the detection of the flow of air past said detecting means on said airway,

first circuit means connected at least to contact means on said airway and to said electrical detecting means for ascertaining the presence of heart associated electrical activity above a predetermined level together with the absence of respiration above a predetermined level for thereupon making a logical determination of a fibrillation condition,

second circuit means for generating an electrical defibrillating pulse, said second circuit means being coupled to said first circuit means and responsive to said first circuit means for generating said defibrillating pulse in response to said logical determination of a fibrillation condition,

and conductor means for coupling said second circuit means to contact means on said airway and to said second electrode means for delivering said defibrillating pulse to the patient through a current pathway in the trunk of the patient between said contact means and said second electrode means for defibrillating the patient'"'"'s heart.

4. The resuscitator apparatus according to claim 3 wherein said electrical detecting means for detecting respiration comprises a microphone mounted on said airway responsive to the sound caused by said flow of air.

5. The resuscitator apparatus according to claim 4 wherein said microphone is mounted proximate the forward end of said airway in non-obstructive relation to the passage of air along said airway.

6. The resuscitator apparatus according to claim 4 further including amplifier means coupled to the said microphone and responsive to respiration of the patient due to the flow of air past said microphone, and means for coupling the output of said amplifier means in driving relation to said first circuit means.

7. The resuscitator apparatus according to claim 4 wherein said second electrode means comprises an abdominal electrode for placement on the patient in the chest-abdominal region for making electrical contact with the patient in said region.

8. The resuscitator apparatus according to claim 4 further including pacing means for supplying a regular pacing pulse to the patient via contact means on said airway and said second electrode means in the substantial absence of electrical activity and respiration as detected by said first circuit means.

9. The resuscitator apparatus according to claim 4 further including means for checking the electrical continuity between said contact means mounted on said airway and said second electrode means and the patient.

10. The resuscitator apparatus according to claim 4 wherein said second circuit means for generating said defibrillating pulse includes timing means, and means for ascertaining the output of said first circuit means a predetermined time after the generation of a defibrillating pulse for initiating a second defibrillating pulse.

11. The cardiac resuscitator apparatus according to claim 10 wherein said means for generating an electrical defibrillating pulse further includes timing means for disabling the generation of a defibrillating pulse after the generation of a predetermined number of defibrillating pulses.

12. A cardiac resuscitator apparatus comprising:

an oro-pharyngeal airway for insertion into the pharynx of a patient, said airway having contact means mounted thereon for making electrical contact with tissue within the patient,

second electrode means for external placement on the patient in the chest-abdominal region for making electrical contact with the patient in said region,

a microphone mounted on said airway for detecting the respiration of the patient by detecting a patient'"'"'s breath sounds caused by the flow of air past said microphone on said airway,

first circuit means connected to said contact means on said airway and to said second electrode means for ascertaining the presence of heart associated electrical activity above a predetermined level,

second circuit means connected to said microphone for detecting a patient'"'"'s respiration above a predetermined level,

logical circuit means coupled to said first circuit means and said second circuit means for making a logical determination of the presence of heart associated electrical activity above a predetermined level together with the absence of respiration above a predetermined level for indicating a fibrillation condition,

fourth circuit means for generating an electrical defibrillating pulse, said fourth circuit means being coupled to said logical circuit means and responsive to the logical determination thereof for generating said defibrillating pulse in response to determination of a defibrillation condition,

and conductor means for coupling said fourth circuit means to said contact means on said airway and to said second electrode means for delivering said defibrillating pulse to the patient through a current pathway in the trunk of the patient between said contact means and said second electrode means for defibrillating the patient'"'"'s heart.

13. The cardiac resuscitator apparatus according to claim 12 further including pacing means for generating a regular pacing pulse, said pacing means being responsive to said logical circuit means for generating said pacing pulse in the absence of heart associated electrical activity of the patient above a predetermined level together with the absence of respiration above a predetermined level,

and conductor means for coupling the output of said pacing means to said contact means on said airway and to said second electrode means for delivering said pacing pulse to the patient through a current pathway in the trunk of the patient between said contact means and said second electrode means for pacing the patient'"'"'s heart.

14. A cardiac resuscitator apparatus comprising:

first means for insertion into the region of a patient'"'"'s mouth, said insertion means comprising electrical contact means for contacting the patient'"'"'s tongue,

external electrode means for placement on the patient in the chest-abdominal region for making electrical contact with the patient in said region,

circuit means for generating an electrical defibrillating pulse, said circuit means having first and second terminals between which said defibrillation pulse is supplied,

and connection means respectively coupling said first and second terminals to said contact means and said external electrode means for delivering said defibrillating pulse to the patient through a current pathway in the trunk of the patient between said contact means and said external electrode means for defibrillating the patient'"'"'s heart.

15. The resuscitator according to claim 14 further including detection means connected to said contact means and electrode means for detecting the level of electrical heart activity of the patient, said circuit means being responsive in its pulse generating operation to said detection.

16. The resuscitator according to claim 15 further including means mounted on said first means for detecting respiration of the patient, said circuit means for generating an electrical defibrillating pulse being responsive thereto for inhibiting the application of a defibrillating pulse to the patient in the presence of respiration detection.

17. The resuscitator according to claim 16 further including means for generating a pacing pulse, and means for supplying said pacing pulse between said contact means and said electrode means.

21. The resuscitator apparatus according to claim 14 wherein said first means for insertion further comprises an intratracheal tube, said electrical contact means being mounted on said intratracheal tube. .Iaddend..Iadd. 22. A cardiac resuscitator apparatus comprising:

(a) an oro-pharyngeal airway for insertion into the pharynx of a patient, said airway having contact means mounted thereon for making electrical contact with tissue within the patient;

(b) second electrode means for external placement on the patient in the chest-abdominal region for making electrical contact with the patient in said region;

(c) circuit means for generating an electrical pacing pulse, said circuit means having first and second terminals between which said pacing pulse is supplied; and

(d) conductor means respectively coupling said first and second terminals to said contact means and said second electrode means for delivering said pacing pulse to the patient through a current pathway in the trunk of the patient between said contact means mounted on said airway and said second electrode means for pacing the patient'"'"'s heart. .Iaddend. .Iadd. 23. The resuscitator apparatus according to claim 22 wherein said circuit means further includes means for repetitively generating said pacing pulse at a predetermined rate. .Iaddend..Iadd. 24. A cardiac resuscitator apparatus comprising;

(a) an oro-pharyngeal airway for insertion into the pharynx of a patient, said airway having contact means mounted thereon for making electrical contact with tissue within the patient;

(b) second electrode means for external placement on the patient in the chest-abdominal region for making electrical contact with the patient in said region;

(c) first circuit means connected to said contact means on said airway for deriving an electrical input from the patient'"'"'s heart for detecting an abnormal heart condition;

(d) second circuit means for generating a pacing pulse, said second circuit means having first and second terminals between which said pacing pulse is supplied, said second circuit means being responsive in its operation to detection of an abnormal heart condition by said first circuit means; and

(e) conductor means for respectively connecting said first and second terminals to said contact means and said second electrode means for delivering said pacing pulse to the patient through a current pathway in the trunk of the patient between said contact means mounted on said airway and said second electrode means for pacing the patient'"'"'s heart. .Iaddend..Iadd. 25. A cardiac resuscitator apparatus comprising;

(a) an oro-pharyngeal airway for insertion into the pharynx of a patient, said airway having contact means mounted thereon for making electrical contact with tissue within the patient;

(b) second electrode means for electrically contacting the patient at another location remote from said contact means;

(c) electrical detecting means mounted on said airway and responsive to the patient'"'"'s respiration by the detection of the flow of air past said detecting means on said airway;

(d) first circuit means connected at least to contact means on said airway and to said electrical detecting means for ascertaining the substantial absence of heart associated electrical activity together with the absence of respiration above a predetermined level for thereupon making a logical determination of a cardiac arrest condition;

(e) second circuit means for generating an electrical pacing pulse, said second circuit means being coupled to said first circuit means and responsive to said first circuit means for generating said pacing pulse in response to said logical determination of a cardiac arrest condition; and

(f) conductor means for coupling said second circuit means to contact means on said airway and to said second electrode means for delivering said pacing pulse to the patient through a current pathway in the trunk of the patient between said contact means and said second electrode means for

18. A life sign monitoring system comprising:

a device for at least partial insertion into or onto a body cavity or passageway of a patient, said device having contact means mounted thereon for contacting tissue on the interior of said cavity or passageway,

second electrode means for contacting the patient, said second electrode means comprising means for securely fastening to the patient at a substantially external location remote from said contact means, said second electrode means comprising a ring adapted to grasp an extremity of the patient and provided with ball and socket means for holding the ring in an extended no-grasping condition for initial placement upon an extremity of a patient,

and output means coupled to said contact means and said second electrode means for providing cardiac information in response to electrical signals coupled from said contact means and said second electrode means.

19. A life sign monitoring system comprising:

an airway adapted to be passed into the pharynx of a patient,

contact means mounted on said airway,

first means connected to said contact means for responding to electrical activity associated with the patient'"'"'s heart,

second means for sensing bodily movement of said patient, said second means comprising a sensor applied elsewhere to the body of the patient and responsive to chest expansion of the patient with respiration, said sensor comprising a strain gauge mounted upon means extending at least part way around the patient'"'"'s chest comprising hinged tongs adapted to carry said strain gauge wherein said strain gauge is pressure-responsive and is disposed between said tongs and the patient'"'"'s body,

and logical means responsive to said first and said second means for indicating the presence of substantial electrical activity and whether bodily movement substantially accompanies said electrical activity.

20. A life sign monitoring system comprising:

an airway adapted to be passed into the pharynx of a patient,

contact means mounted on said airway,

first means connected to said contact means for responding to electrical activity associated with the patient'"'"'s heart,

second means for sensing bodily movement of said patient, said second means comprising means for detecting the flow of blood in the patient, the last mentioned means including sound-sensing means, amplifier means, and filtering means responsive to blood flow sounds indicative of a sign of life, and multivibrator means responsive to blood flow indicating input from said amplifier means for standardizing the input therefrom, and integrating means for receiving the output of said multivibrator means,

and logical means responsive to said first and second means for indicating the presence of substantial electrical activity and whether bodily movement substantially accompanies said electrical activity. .Iadd.

22. pacing the patient'"'"'s heart. .Iaddend..Iadd. 26. The resuscitator apparatus according to claim 25 wherein said electrical detecting means for detecting respiration comprises a microphone mounted on said airway responsive to the sound caused by said flow of air. .Iaddend..Iadd. 27. The resuscitator apparatus according to claim 26 wherein said microphone is mounted proximate the forward end of said airway in non-obstructive relation to the passage of air along said airway. .Iaddend.g 28. The resuscitator apparatus according to claim 26 further including amplifier means coupled to said microphone and responsive to respiration of the patient due to the flow of air past said microphone, and means for coupling the output of said amplifier means in driving relation to said first circuit means. .Iadd. 29. The resuscitator apparatus according to claim 25 wherein said second electrode means comprises an abdominal electrode for placement on the patient in the chest-abdominal region for making electrical contact with the patient in said region. .Iaddend..Iadd. 30. The resuscitator apparatus according to claim 25 further including means for checking the electrical continuity between said contact means mounted on said airway and said second electrode means and the patient. .Iaddend..Iadd. 31. The resuscitator apparatus according to claim 25 wherein said second circuit means includes means for repetitively generating said pacing pulse at a predetermined rate. .Iaddend..Iadd. 32. A cardiac resuscitator apparatus comprising:

(a) an oro-pharyngeal airway for insertion into the pharynx of a patient, said airway having contact means mounted thereon for making electrical contact with tissue within the patient;

(b) second electrode means for external placement on the patient in the chest-abdominal region for making electrical contact with the patient in said region;

(c) a microphone mounted on said airway for detecting the respiration of the patient by detecting a patient'"'"'s breath sounds caused by the flow of air past said microphone on said airway;

(d) first circuit means connected to said contact means on said airway and to said second electrode means for ascertaining the absence of heart associated electrical activity of the patient above a predetermined level;

(e) second circuit means connected to said microphone for detecting a patient'"'"'s respiration above a predetermined level;

(f) logical circuit means coupled to said first circuit means and said second circuit means for making a logical determination of the absence of heart associated electrical activity above a predetermined level together with the absence of respiration above a predetermined level for indicating a cardiac arrest condition;

(g) fourth circuit means for generating an electrical pacing pulse, said fourth circuit means being coupled to said logical circuit means and responsive to the logical determination thereof for generating said pacing pulse in response to determination of a cardiac arrest condition; and

(h) conductor means for coupling said fourth circuit means to said contact means on said airway and to said second electrode means for delivering said pacing pulse to the patient through a current pathway in the trunk of the patient between said contact means and said second electrode means for

23. pacing the patient'"'"'s heart. .Iaddend..Iadd. 33. A cardiac resuscitator apparatus comprising:

(a) first means for insertion into the region of a patient'"'"'s mouth, said first means comprising electrical contact means for contacting the patient'"'"'s tongue;

(b) external electrode means for placement on the patient in the chest-abdominal region for making electrical contact with the patient in said region;

(c) circuit means for generating an electrical pacing pulse, said circuit means having first and second terminals between which said pacing pulse is supplied; and

(d) connection means respectively coupling said first and second terminals to said contact means and said external electrode means for delivering said pacing pulse to the patient through a current pathway in the trunk of the patient between said contact means and said external electrode means for pacing the patient'"'"'s heart. .Iaddend..Iadd. 34. The resuscitator according to claim 33 further including detection means connected to said contact means and electrode means for detecting the level of electrical heart activity of the patient, said circuit means being responsive in its pulse generating operation to said detection. .Iaddend. .Iadd. 35. The resuscitator apparatus according to claim 33 wherein said circuit means includes means for repetitively generating said pacing pulse at a predetermined rate. .Iaddend..Iadd. 36. The resuscitator apparatus according to claim 33 further including means for detecting a heart beat, said circuit means for generating a pacing pulse being responsive thereto for inhibiting the generation of said pacing pulse in the presence of a patient heart beat of acceptable rate. .Iaddend..Iadd. 37. The resuscitator apparatus according to claim 33 wherein said first means for insertion further comprises an intratracheal tube, said electrical contact means being mounted on said intratracheal tube. .Iaddend..Iadd. 38. A life sign monitoring system comprising;

(a) a tube adapted to be passed at least into the pharynx of a patient;

(b) contact means mounted on said tube;

(c) first means connected to said contact means for responding to electrical activity associated with the patient'"'"'s heart;

(d) second means for sensing bodily movement of said patient, said second means comprising a sensor applied elsewhere to the body of the patient and responsive to chest expansion of the patient with respiration, said sensor comprising a strain gauge mounted upon means extending at least part way around the patient'"'"'s chest comprising hinged tongs adapted to carry said strain gauge wherein said strain gauge is pressure-responsive and is disposed between said tongs and the patient'"'"'s body; and

(e) logical means responsive to said first and said second means for indicating the presence of substantial electrical activity and whether bodily movement substantially accompanies said electrical activity. .Iaddend..Iadd. 39. The life sign monitoring system according to claim 38, wherein said tube is adapted to be passed into the trachea of a patient. .Iaddend..Iadd. 40. A life sign monitoring system comprising;

(a) a tube adapted to be passed at least into the pharynx of a patient;

(b) contact means mounted on said tube;

(c) first means connected to said contact means for responding to electrical activity associated with the patient'"'"'s heart;

(d) second means for sensing bodily movement of said patient, said second means comprising means for detecting the flow of blood in the patient, the last mentioned means including sound-sensing means, amplifier means, and filtering means responsive to blood flow sounds indicative of a sign of life, and multivibrator means responsive to blood flow indicating input from said amplifier means for standardizing the input therefrom, and integrating means for receiving the output of said multivibrator means; and

(e) logical means responsive to said first and second means for indicating the presence of substantial electrical activity and whether bodily movement substantially accompanies said electrical activity. .Iaddend..Iadd. 41. The life sign monitoring system according to claim 40, wherein said tube is adapted to be passed into the trachea of a patient. .Iaddend.