Coordinated resuscitation perfusion support

• US 8,781,577 B2
• Filed: 02/16/2012
• Issued: 07/15/2014
• Est. Priority Date: 04/08/2011
• Status: Expired due to Fees

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Freeman, Gary A.
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): MAHMOOD, NADIA AHMAD
• Application Number:
  US13/398,280
• Publication Number:
  US 20120259377A1
• Time in Patent Office: 880 Days
• Field of Search: 607 3- 6
• US Class Current: 607/6
• 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: A61H 2201/1253 driven by a human being, e.g. hand driven
• CPC Class Codes: A61H 2201/501 connected to external computer devices or networks
• CPC Class Codes: A61H 2201/5043 Displays
• CPC Class Codes: A61H 2201/5064 Position sensors
• CPC Class Codes: A61H 2201/5071 Pressure sensors
• CPC Class Codes: A61H 2201/5079 Velocity sensors
• CPC Class Codes: A61H 2230/045 used as a control parameter for the apparatus
• CPC Class Codes: A61H 2230/06 Heartbeat rate
• CPC Class Codes: A61H 2230/065 used as a control parameter for the apparatus
• CPC Class Codes: A61H 2230/208 used as a control parameter for the apparatus
• CPC Class Codes: A61H 2230/30 Blood pressure A61H2230/04 takes precedence
• CPC Class Codes: A61H 2230/305 used as a control parameter for the apparatus A61H2230/045 takes precedence
• CPC Class Codes: A61H 31/005 with feedback for the user
• CPC Class Codes: A61H 31/007 Manual driven
• CPC Class Codes: A61N 1/0452 Specially adapted for transcutaneous muscle stimulation [TMS]
• CPC Class Codes: A61N 1/046 Specially adapted for shock therapy, e.g. defibrillation
• CPC Class Codes: A61N 1/36003 of motor muscles, e.g. for walking assistance
• CPC Class Codes: A61N 1/3603 Control systems
• CPC Class Codes: A61N 1/3625 External stimulators
• CPC Class Codes: A61N 1/39044 : in combination with cardiopulmonary resuscitation [CPR] therapy
• CPC Class Codes: A61N 1/39046 : User protection from shock
• CPC Class Codes: A61N 1/3925 : Monitoring; Protecting
• CPC Class Codes: A61N 1/3987 : characterised by the timing or triggering of the shock
• CPC Class Codes: A61N 1/3993 : User interfaces for automatic external defibrillators

Abstract

This document relates to systems and techniques for the treatment of a cardiac arrest victim via electromagnetic stimulation of physiologic tissue.

Claims

1. A medical system for providing electromagnetic stimulation of a patient, comprising:

an electronic interface configured to receive data from one or more sensors; and

a processor arranged to;

detect an absence of chest compressions;

cause circuitry configured for delivery of electromagnetic stimulation to thoracic muscle groups via electrodes positioned along the patient'"'"'s ribs to stimulate blood flow in the patient to initiate delivery of the electromagnetic stimulation in response to the absence of chest compressions;

detect administration of chest compressions by a mechanical chest compressor based on the received data; and

cause the circuitry configured for delivery of electromagnetic stimulation to thoracic muscle groups to stimulate blood flow in the patient to cease delivery of the electromagnetic stimulation upon detection of the administration of chest compressions by the mechanical chest compressor.

2. The medical system of claim 1, wherein the one or more sensors include a sensor positioned to sense the presence of manual chest compressions administered to the patient;

and

the processor is further arranged to receive data generated by the one or more sensors and cause the circuitry configured for delivery of electromagnetic stimulation to initiate delivery of the electromagnetic stimulation upon detection of degradation in the quality of the chest compressions.

3. The medical system of claim 2, wherein the degradation in the quality of the chest compressions comprises one or more of a change in depth of the chest compressions and a change in compression release of the chest compressions.

4. The system of claim 2, wherein the processor is further configured to detect changes in the administration of manual chest compressions by detecting an absence of chest compressions for a period of time greater than a threshold.

5. The system of claim 1, wherein the one or more sensors include a sensor configured to detect motion of the patient'"'"'s sternum.

6. The system of claim 1, wherein the one or more sensors comprises a sensor selected from the group consisting of a motion sensor, a pressure sensor, and a velocity sensor.

7. The system of claim 1, wherein the circuitry configured for delivery of electromagnetic stimulation is further configured to deliver the electromagnetic stimulation automatically and without user intervention.

8. The system of claim 1, wherein the circuitry configured for delivery of electromagnetic stimulation comprises an electrode assembly affixed to the patient'"'"'s thorax.

9. The system of claim 1, wherein the circuitry configured for delivery of electromagnetic stimulation comprises an electrode assembly delivering a defibrillating shock to a patient.

10. The system of claim 1, wherein the circuitry comprises circuitry configured to deliver a pulse packet of 100-200 microsecond duration pulses with inter-pulse spacing of 5-15 milliseconds and an amplitude of 300-700 volts.

11. The system of claim 1, wherein the circuitry comprises circuitry configured to deliver a pulse packet of 20-1000 microsecond duration pulses with a duty cycle of 2-95 % and an amplitude of 50-2000 volts.

12. The system of claim 1, wherein the circuitry comprises circuitry configured to deliver a pulse packet of pulses with a time-varying duty cycle.

13. The system of claim 1, wherein the circuitry comprises circuitry configured to deliver a pulse packet of pulses having a variable duty cycle during a first time period and a constant duty cycle during a second time period.

14. The system of claim 1, wherein the circuitry is further configured to deliver stimulation with an effective DC value of the stimulation waveform being one of linearly increasing, exponentially increasing, or logarithmically increasing during the first time period.

34. The medical system of claim 1, wherein the processor is further arranged to, prior to ceasing delivery of the electromagnetic stimulation, detect an absence of chest compressions by the mechanical chest compressor based on the received data and cause circuitry configured for delivery of electromagnetic stimulation to thoracic muscle groups to stimulate blood flow in the patient to deliver electromagnetic stimulation upon detection of the absence of chest compressions.

15. A method comprising:

detecting an absence of chest compressions for a period of time greater than a threshold;

causing delivery of electromagnetic stimulation to thoracic muscle groups via electrodes positioned along a patient'"'"'s ribs to stimulate blood flow in the patient upon detection of the absence of chest compressions;

subsequent to causing the delivery of the electromagnetic stimulation, detecting the presence of chest compressions by a mechanical chest compressor; and

causing delivery of electromagnetic stimulation to cease upon detection of the presence of the chest compressions by the mechanical chest compressor.

16. The method of claim 15, wherein detecting the presence of chest compressions by the mechanical chest compressor comprises receiving data from a sensor in the mechanical chest compressor.

17. The method of claim 15, wherein detecting the absence of chest compressions for a period of time greater than a threshold comprises receiving data from a sensor positioned to sense chest compressions administered to the patient.

18. The method of claim 17, wherein the sensor comprises a sensor selected from the group consisting of a motion sensor, a pressure sensor, and a velocity sensor.

19. The method of claim 15, wherein causing delivery of electromagnetic stimulation comprises sending a signal to cause an electrode assembly affixed to the patient'"'"'s thorax to deliver the electromagnetic stimulation.

20. The method of claim 15, wherein causing delivery of electromagnetic stimulation comprises sending a signal to cause an electrode assembly affixed to the patient'"'"'s thorax to deliver a pulse packet of 100-200 microsecond duration pulses with inter-pulse spacing of 5-15 milliseconds and an amplitude of 300-700 volts.

21. The method of claim 15, wherein causing delivery of electromagnetic stimulation comprises sending a signal to cause an electrode assembly affixed to the patient'"'"'s thorax to deliver a pulse packet of 20-1000 microsecond duration pulses with a duty cycle of 2 -95 % and an amplitude of 50-2000 volts.

22. The method of claim 15, wherein causing delivery of electromagnetic stimulation to stimulate blood flow comprises causing delivery of electromagnetic stimulation having a pulse packet of pulses with a time-varying duty cycle.

23. The method of claim 15, wherein causing delivery of electromagnetic stimulation to stimulate blood flow comprises causing delivery of electromagnetic stimulation having a pulse packet of pulses having a variable duty cycle during a first time period and a constant duty cycle during a second time period.

24. The method of claim 15, wherein causing delivery of electromagnetic stimulation to stimulate blood flow comprises causing delivery of electromagnetic stimulation having an effective DC value with a first portion that is linearly increasing, exponentially increasing, or logarithmically increasing and a second portion that is constant.

25. A medical system for providing electromagnetic stimulation of a patient, comprising:

an electronic interface in electrical communication with a first set of electrodes configured to initiate blood flow based on a cardiac pump mechanism and a second of electrodes configured to be positioned at locations that primarily stimulate thoracic muscle groups to initiate blood flow based on a thoracic pump mechanism; and

a controller in communication with the electronic interface and programmed alternate delivery of electrical energy from the first set of electrodes and the second set of electrodes.

26. The system of claim 25, wherein controller is further programmed to alternate delivery of electrical energy from the first set of electrodes and the second set of electrodes by providing a signal via the interface to activate the first set of electrodes during a first time period of between 10 seconds to 1 minute and providing a signal to activate the second set of electrodes during a second time period of between 10 seconds to 1 minute.

27. The system of claim 25, wherein the controller is further programmed sequence delivery of electrical energy from the first set of electrodes and the second set of electrodes by delivering pulses from the second set of electrodes for a period of between 10 seconds and 1 minute after delivering a pulses from the first set of electrodes for a period of between 10 seconds and 1 minute.

28. A method for providing controlled shock to victims of heart problems, the external defibrillator comprising:

receiving data generated by a proximity sensor positioned to determine a location of a rescuer'"'"'s hands relative to the patient;

calibrating the proximity sensor by analyzing data from the proximity sensor received during a time period corresponding to delivery manual administration of chest compressions by a rescuer; and

providing a signal via an interface to cause an electrical storage device to deliver a defibrillating shock to the patient upon detection that the rescuer'"'"'s hands are not in contact with the patient.

29. The method of claim 28, wherein the proximity sensor comprises a capacitance sensor.

30. The method of claim 28, wherein providing the signal via the interface to cause the electrical storage device to deliver the defibrillating shock comprises providing the signal upon detection removal of the rescuer'"'"'s hands from the patient.

31. The method of claim 28, wherein providing the signal via the interface to cause the electrical storage device to deliver the defibrillating shock comprises providing the signal upon detection that the rescuer is at least two inches away from the patient.

32. The method of claim 28, wherein the proximity sensor comprises an ultrasonic sensor.

33. The method of claim 28, wherein the proximity sensor comprises a light emitter-receiver pair.