Systems and resuscitation components to facilitate resuscitation

Abstract

Systems and resuscitation components to facilitate resuscitation are provided. A system for facilitating resuscitation includes: a first electrode assembly including a treatment side and a first motion sensor; a second electrode assembly including a treatment side and a second motion sensor; processing circuitry operably connected and programmed to receive and process signals from the first and second motion sensors to estimate at least one of chest compression depth and rate during application of chest compressions, and compare the chest compression depth or rate to a desired range; and an output device to provide an indication to a user to apply chest compressions based on the comparison of the estimated chest compression depth or rate to the desired range. One or both of the electrode assemblies can be configured such that the conductive treatment portion is capable of maintaining general conformance to a patient's body structure when connected to the patient.

Description

[0001] This application is a divisional application of the application filed on September 30, 2016, with application number 201680057330.1 and invention title "Dual sensor electrode for providing enhanced recovery feedback". Technical Field

[0002] This invention relates to cardiac resuscitation, and more particularly to systems and techniques for assisting rescuers in performing cardiopulmonary resuscitation. Background Technology

[0003] Defibrillators are commonly used to treat sudden cardiac arrest by delivering a defibrillating shock to the heart of a cardiac arrest patient via electrodes placed on the chest. Properly measured and analyzed ECG signals from cardiac arrest patients provide a strong indication of whether the patient's heart is exhibiting a shockable or non-shockable rhythm. A shockable rhythm is an abnormal ECG signal that suggests a defibrillation shock to restore a normal heartbeat, while a non-shockable rhythm is an ECG signal that does not suggest a defibrillation shock. Ventricular fibrillation is an example of a shockable rhythm, while pulseless activity is an example of a non-shockable rhythm. Defibrillators can also treat other arrhythmias (irregular heartbeats) such as atrial fibrillation, bradycardia, and tachycardia. ECG signals can be obtained via electrodes placed on the patient's chest, and defibrillation or cardioversion shocks can be delivered via the same electrodes.

[0004] During resuscitation, treatment protocols recommended by the American Heart Association and the European Committee on Resuscitation advise rescuers to periodically check the patient's pulse or assess signs of circulation. If no pulse or signs of circulation are present, rescuers may often be instructed to perform an appropriate period of CPR on the victim between shock analyses, where CPR involves applying both chest compressions and ventilation to the victim. For example, chest compressions and / or ventilation can be monitored during CPR using systems and techniques that incorporate real-time CPR feedback (e.g., ZOLL). ® REAL CPR HELP sold by Medical Corporation ® ), and can implement a resuscitation component with sensors for obtaining CPR-related information used by the manual CPR provider (e.g., ZOLL). ® CPR-D-PADZ sold by Medical Corporation ® CPR STAT-PADZ ® For example, ZOLL's CPR-D-PADZ ® And CPR STAT-PADZ ® It includes a pair of electrode pads and a single chest compression sensor. Summary of the Invention

[0005] According to one aspect of the invention, a system for facilitating resuscitation is provided, comprising: a resuscitation assembly including: a first electrode assembly including a treatment side and a first motion sensor, and a second electrode assembly including a treatment side and a second motion sensor; processing circuitry operatively connected to the resuscitation assembly and configured to: identify the resuscitation assembly as either a pediatric or adult resuscitation assembly based on an identification signal; receive and process signals from at least one of the first and second motion sensors to estimate at least one of compression depth and compression rate (or other chest compression parameters such as release rate) during chest compressions; and receive and process signals from the first and second electrode assemblies to determine whether electrotherapy is required, and adjust the electrotherapy based on whether the resuscitation assembly is identified as pediatric or adult; and an output device for providing a user with one or more chest compression parameters including at least one of the estimated compression depth and estimated compression rate, wherein the output device is configured to adjust the presentation of the one or more chest compression parameters based on whether the resuscitation assembly is identified as pediatric or adult.

[0006] In one example, the processing circuitry may be configured to determine the placement orientation of the first electrode assembly and the second electrode assembly on the patient. For example, using an anterior-posterior orientation, the first electrode assembly may be positioned on a first portion of the patient's body structure and the second electrode assembly may be positioned on a second portion of the patient's body structure. In this configuration, the first portion of the patient's body structure may be the patient's sternum, and the second portion of the patient's body structure may be the patient's back. Alternatively, using an antero-anterior orientation, the first electrode assembly is positioned on a first portion of the patient's body structure and the second electrode assembly is positioned on a second portion of the patient's body structure, such that the first electrode assembly is a sternal electrode and the second electrode assembly is an apex electrode. In this configuration, the first portion of the patient's body structure may be between the right axilla and the sternum of the patient's chest, and the second portion of the patient's body structure may be above the lower rib on the left side of the patient's chest. In another example, the processing circuitry may be configured to adjust at least one of the displayed ECG signal and pacing vector based on the determined placement orientation of the first electrode assembly and the second electrode assembly.

[0007] In one example, at least one of the first motion sensor and the second motion sensor can be separated from the corresponding first electrode assembly or second electrode assembly. For example, the first motion sensor can be separated from the first electrode assembly, or the second motion sensor can be separated from the second electrode assembly.

[0008] In another example, the estimated compression depth is calculated by subtracting the distance traveled by the second motion sensor from the distance traveled by the first motion sensor. The first motion sensor may be configured to generate a first signal representing the acceleration caused by compression, and the second motion sensor may be configured to generate a second signal representing the acceleration caused by movement on a compressible surface. The processing circuitry may be configured to use the signals from the first and second motion sensors to determine the compression depth when performing frontal and back compressions on an infant or newborn patient during cardiopulmonary resuscitation (CPR).

[0009] In one example, the resuscitation component may include at least one of a memory from which the identification signal originates and a resistor. The processing circuitry may be configured to adjust the defibrillation algorithm based on whether the resuscitation component is identified as being for a child or an adult. The processing circuitry may be configured to compare at least one of the estimated compression depth and the estimated compression rate with a desired range, and the output device may be configured to, if the resuscitation component is identified as being for an adult, display at least one of the estimated compression depth and the estimated compression rate and provide a chest compression prompt to the user. Alternatively, if the resuscitation component is identified as being for a child, the output device may be configured to display at least one of the estimated compression depth and the estimated compression rate without providing a chest compression prompt to the user.

[0010] In one example, the processing circuitry and the output device may be housed within an external defibrillator. At least one of the first and second electrode assemblies may include a flexible electrode layer encompassing the treatment side. In another example, at least one of the first and second electrode assemblies includes a sensor housing with a mounting area attached to the flexible electrode layer. In this example, the sensor housing may at least partially enclose the first or second motion sensor. At least a portion of the flexible electrode layer may be constructed and configured to flex relative to the sensor housing at a location remote from the mounting area, such that the flexible electrode layer substantially conforms to the patient's anatomy. The sensor housing may be laminated together with the flexible electrode layer. The sensor housing may include a padding material. In one example, the sensor housing may include multiple layers comprising the padding material.

[0011] The output device may be configured to provide a user with instructions related to changing the surface on which the patient is situated, based on information sensed from the first and second motion sensors. In one example, at least one of the first and second motion sensors includes an accelerometer capable of measuring acceleration in multiple directions. In this example, the processing circuitry may be configured to estimate the orientation difference between the first and second electrode assemblies. More specifically, the processing circuitry may be configured to estimate the angle of the chest compression being applied by the user during CPR relative to the patient's vertical axis, based on signals received from the first and second motion sensors. The output device may be configured to provide a user with instructions for applying chest compressions based on the estimated orientation between the first and second electrode assemblies.

[0012] In another example, the processing circuitry may be configured to estimate the rate of ventilation applied to the patient (e.g., based on signals from one or more motion sensors, such as a front sensor). In this example, the output device may be configured to provide the user with an instruction to apply ventilation to the patient based on the estimated ventilation rate.

[0013] In yet another example, at least one of the first electrode assembly and the second electrode assembly may include an electrotherapy active area of ​​15-80 cm². 2 The conductive gel. Optionally, at least one of the first electrode assembly and the second electrode assembly may include an electrotherapy active area of ​​50-150 cm². 2 The conductive gel. At least a portion of the first electrode assembly or the second electrode assembly may be radiation-permeable. The resuscitation assembly may further include a cable extending from at least one of the first electrode assembly and the second electrode assembly toward the processing circuitry. The cable may include the processing circuitry for estimating at least one of the compression depth and compression rate. The cable may be a generally flat cable.

[0014] According to another aspect of the invention, a system for facilitating resuscitation is provided. The system includes: a resuscitation assembly comprising: a first electrode assembly including a treatment side and a first motion sensor; and a second electrode assembly including a treatment side and a second motion sensor; processing circuitry operatively connected to the resuscitation assembly and configured to: receive and process signals from at least one of the first and second motion sensors to estimate at least one of compression depth and compression rate during chest compressions, and to determine the placement orientation of the first and second electrode assemblies on the patient; and an output device for providing a user with guidance on applying chest compressions based on the estimated compression depth or compression rate and the determined placement orientation of the first and second electrode assemblies.

[0015] According to another aspect of the invention, a system for facilitating resuscitation is provided, comprising: a resuscitation assembly including: a first electrode assembly including a treatment side and a first motion sensor; and a second electrode assembly including a treatment side and a second motion sensor; processing circuitry operatively connected to the resuscitation assembly and configured to receive and process signals from at least one of the first and second motion sensors to estimate at least one of compression depth and compression rate during chest compressions; and an output device for providing a user with guidance on applying chest compressions based on the estimated compression depth or compression rate. At least one of the first and second motion sensors is separable from the corresponding first or second electrode assembly.

[0016] The first motion sensor is separable from the first electrode assembly, and / or the second motion sensor is separable from the second electrode assembly. For example, the first or second electrode assembly may include a pouch that holds the corresponding first or second motion sensor in a removable manner. In another example, at least one of the first and second motion sensors is adhesively connected to the corresponding first or second electrode assembly.

[0017] According to another aspect of the invention, a resuscitation assembly for a defibrillator is provided, the resuscitation assembly comprising: a flexible electrode pad having a treatment side; a sensor housing mounted to the flexible electrode pad; and a motion sensor at least partially enclosed within the sensor housing. The sensor housing has greater rigidity than the flexible electrode pad. At least a portion of the flexible electrode pad is configured to bend relative to the sensor housing such that the flexible electrode pad substantially conforms to the patient's anatomy when connected to the patient.

[0018] The sensor housing can be attached to the flexible electrode pad at a mounting area on the non-treatment side. In one example, the mounting area can be located in the central region of the flexible electrode pad. In another example, the mounting area can be located in at least one of the upper central region and the lower central region. In yet another example, the mounting area can be positioned along at least a portion of the outer periphery of the flexible electrode pad. The flexible electrode pad can be configured to bend relative to the sensor housing at a location away from the mounting area.

[0019] The flexible electrode pad may include a flexible base layer (e.g., made of foam, thin polymer material, electrode backing, and / or other flexible material) on the treatment side where the flexible electrodes are located. The treatment side may include a conductive material configured to provide treatment to the patient. The sensor housing may include a protective shield (such as a housing for the motion sensor). In one example, the sensor housing may include two or more layers. The two or more layers may be laminated together. In another example, the sensor housing may include a padding material. The sensor housing may include multiple layers containing the padding material. One or more electrode assemblies may include portions of varying thicknesses.

[0020] In one example, the motion sensor is an accelerometer, such as a triaxial accelerometer. The motion sensor may be encapsulated in a polymer material to provide protection against environmental influences. The sensor housing may be configured to distribute the compression force generated by chest compressions during cardiopulmonary resuscitation (CPR) substantially evenly across the flexible electrode pad. In one example, the sensor housing may be integrated into the flexible electrode pad. In another example, the sensor housing may be attached to the flexible electrode pad at the mounting area.

[0021] According to another aspect of the invention, a resuscitation assembly for a defibrillator is provided, the resuscitation assembly comprising: a flexible electrode pad having a treatment side, the flexible electrode pad being configured to substantially conform to the anatomy of a patient; and a sensor housing connected to the flexible electrode pad, wherein the projected contact area between the sensor housing and the flexible electrode pad is less than about 50 cm². 2 ; and a motion sensor, which is connected to the sensor housing.

[0022] In one example, the projected contact area between the sensor housing or casing and the flexible electrode pad can be approximately 10-50 cm². 2 The motion sensor may be located on the outer periphery of the conductive material. In another example, the motion sensor is located in the central region of the conductive material.

[0023] The motion sensor may be a triaxial accelerometer. In one example, the motion sensor may be encapsulated in a housing or enclosure comprising a suitable material such as a polymer material to provide protection against environmental influences. In another example, the motion sensor may be at least partially enclosed within the sensor housing. The sensor housing may have greater rigidity compared to the flexible electrode pad. At least a portion of the flexible electrode pad may be configured to bend relative to the sensor housing, such that the flexible electrode pad substantially conforms to the patient's anatomy when connected to the patient.

[0024] According to another aspect of the invention, a resuscitation assembly for a defibrillator is provided, the resuscitation assembly comprising two or more electrode assemblies. Each electrode assembly includes: a flexible electrode pad including a treatment side and a non-treatment side; and a motion sensor located within a sensor housing connected to the flexible electrode pad. At least a portion of the flexible electrode pad is configured to substantially conform to the patient's anatomy when placed on a patient. The two or more electrode assemblies are connected to each other.

[0025] For at least one of the electrode components, the sensor housing may have greater rigidity compared to the flexible electrode pad. Additionally, for at least one of the electrode components, the sensor housing may be attached to the flexible electrode pad in a mounting area on the non-treatment side. In one example, the mounting area may be located in the central region of the flexible electrode pad. The sensor housing may be attached to the flexible electrode pad in the mounting area.

[0026] For at least one of the electrode components, the sensor housing may include a protective cover or housing for the motion sensor. In one example, for at least one of the electrode components, the sensor housing may include a padding material. For at least one of the electrode components, the motion sensor may include an accelerometer. In another example, for at least one of the electrode components, the sensor housing may be integrated with the flexible electrode pad.

[0027] According to another aspect of the invention, a system for facilitating resuscitation is provided, comprising: a first electrode assembly including a first motion sensor on a treatment side; a second electrode assembly including a second motion sensor on a treatment side; a processing circuit operatively connected to and programmed to receive and process signals from the first motion sensor and the second motion sensor; and an output device for providing a user with instructions relating to changing the surface on which the patient is situated, based on information sensed from the first motion sensor and the second motion sensor.

[0028] In one example, the first motion sensor may be configured to generate a first signal representing acceleration caused by compression, and the second motion sensor may be configured to generate a second signal representing acceleration caused by movement on a compressible surface. Chest compression depth can be calculated by subtracting the second signal representing acceleration caused by movement on a compressible surface from the first signal representing acceleration caused by compression.

[0029] In one example, using an anterior-posterior orientation, the first electrode assembly is located on a first portion of the patient's body structure, and the second electrode assembly is located on a second portion of the patient's body structure. In this example, the first portion of the patient's body structure may be the patient's sternum, and the second portion of the patient's body structure may be the patient's back. Optionally, the first and second electrode assemblies may be configured to be positioned on the patient in an anterior orientation. The processing circuitry and the output device may be located within the external defibrillator.

[0030] According to another aspect of the invention, a system for facilitating resuscitation is provided, comprising: a first electrode assembly including a treatment side and a first motion sensor; a second electrode assembly including a treatment side and a second motion sensor, wherein at least one of the first motion sensor and the second motion sensor includes an accelerometer capable of measuring acceleration in multiple directions; processing circuitry operatively connected to and programmed to receive and process signals from the first motion sensor and the second motion sensor to estimate an orientation difference between the first electrode assembly and the second electrode assembly; and an output device for providing a user with an instruction to apply chest compressions based on the estimation of the orientation between the first electrode assembly and the second electrode assembly.

[0031] In one example, the processing circuitry may be configured to estimate at least one of the chest compression depth and rate (and / or other parameters such as release velocity) during chest compressions based on signals received from the first and second motion sensors, and to compare the chest compression depth or rate (or other parameters such as release velocity) with a desired range. The output device may be configured to provide the user with instructions related to changing the surface on which the patient is situated, based on information sensed from the first and second motion sensors. The processing circuitry may be configured to estimate the angle of the chest compression being applied by the user during CPR relative to the patient's vertical axis based on signals received from the first and second motion sensors.

[0032] In one example, the output device may be configured to provide a user with an instruction to apply chest compressions based on an estimate of the orientation between the first and second electrode assemblies. In another example, the processing circuitry may be configured to estimate the rate of ventilation applied to the patient. In this example, the output device is configured to provide a user with an instruction to apply ventilation to the patient based on the estimated ventilation rate.

[0033] According to another aspect of the present invention, a system for promoting resuscitation is provided, comprising: a resuscitation assembly configured for use with a patient weighing less than 55 pounds; processing circuitry; and an output device. The resuscitation assembly includes: a first electrode assembly comprising a treatment side and a first motion sensor, the treatment side of the first electrode assembly comprising an electrotherapy active area of ​​approximately 15-80 cm². 2 The first conductive gel; and a second electrode assembly, including a treatment side and a second motion sensor, wherein the treatment side of the second electrode assembly includes an electrotherapy active area of ​​approximately 15-80 cm². 2 The second conductive gel. The processing circuit is operatively connected to the resuscitation assembly and configured to receive and process signals from the first and second motion sensors to estimate at least one of the compression depth and compression rate during chest compressions. The output device is used to provide the user with guidance on applying chest compressions based on the estimated compression depth or rate.

[0034] In some examples, at least one of the first motion sensor and the second motion sensor can be separated from the corresponding first electrode assembly or second electrode assembly. The processing circuitry can be configured to identify the resuscitation assembly as either a pediatric or adult resuscitation assembly based on an identification signal. The processing circuitry can be configured to determine the placement orientation of the first and second electrode assemblies on the patient. The chest compression depth can be calculated by subtracting the distance traveled by the second motion sensor from the distance traveled by the first motion sensor. The first motion sensor can be configured to generate a first signal representing acceleration caused by compression, and the second motion sensor is configured to generate a second signal representing acceleration due to movement on a compressible surface. The processing circuitry can be configured to use the signals from the first and second motion sensors to determine the compression depth when performing frontal and back compressions on an infant or neonatal patient during cardiopulmonary resuscitation (CPR).

[0035] The processing circuitry and the output device may be disposed in an external defibrillator. At least one of the first and second electrode assemblies may include a flexible electrode layer encompassing the treatment side. The output device may be configured to provide the user with instructions related to changing the surface on which the patient is situated, based on information sensed from the first and second motion sensors. At least one of the first and second motion sensors may include an accelerometer capable of measuring acceleration in multiple directions. The processing circuitry may be configured to estimate the orientation difference between the first and second electrode assemblies. The processing circuitry may also be configured to estimate the angle of the chest compression being applied by the user during CPR relative to the patient's vertical axis, based on signals received from the first and second motion sensors. The output device may be configured to provide the user with instructions for applying chest compressions based on the estimated orientation between the first and second electrode assemblies.

[0036] According to another aspect of the present invention, a system for facilitating resuscitation is provided, comprising: a resuscitation assembly configured for a patient weighing greater than 55 pounds; processing circuitry; and an output device. The resuscitation assembly includes: a first electrode assembly comprising a treatment side and a first motion sensor, the treatment side of the first electrode assembly comprising an electrotherapy active area of ​​approximately 50-150 cm². 2 The first conductive gel; and a second electrode assembly, including a treatment side and a second motion sensor, wherein the treatment side of the second electrode assembly includes an electrotherapy active area of ​​approximately 50-150 cm². 2 The second conductive gel. The processing circuit is operatively connected to the resuscitation assembly and configured to receive and process signals from the first and second motion sensors to estimate at least one of the compression depth and rate during chest compressions. The output device is used to provide the user with guidance on applying chest compressions based on the estimated compression depth or rate.

[0037] These and other features and characteristics of the invention, as well as the methods of operation and functions of related elements and combinations of components and manufacturing economics, will become more apparent when considered with reference to the accompanying drawings and the appended claims (all three forming a part of this specification), wherein like reference numerals designate corresponding components in the figures. However, it should be clearly understood that the drawings are for illustrative purposes only and are not intended to be limiting of the invention. Attached Figure Description

[0038] Figure 1A and 1B An example of the resuscitation component according to the invention is placed on a cardiac arrest victim;

[0039] Figure 1C yes Figure 1A and 1B A 3D view of the recovery components;

[0040] Figure 2A and 2B This is a side view showing the placement of the resuscitation components;

[0041] Figure 2C yes Figure 1B Side view of the electrode assembly of the resuscitation component;

[0042] Figure 3 This is a perspective view of the electrode assembly of the resuscitation assembly according to an embodiment;

[0043] Figure 4 yes Figure 1B An exploded view of the electrode assembly of the resuscitation component;

[0044] Figure 5 This is a perspective view of an alternative example of an electrode assembly according to the present invention;

[0045] Figure 6 yes Figure 3 A partial 3D view of the electrode assembly with the layers removed;

[0046] Figure 7 This is a perspective view of the sensor assembly used in the resuscitation assembly according to various embodiments;

[0047] Figure 8 Show Figure 5 The electrode assembly was placed on the victim;

[0048] Figure 9 This is a perspective view of another example of the electrode assembly according to the embodiment;

[0049] Figure 10 It is used for Figure 9 A three-dimensional view of the electrode assembly and the sensor assembly;

[0050] Figure 11 Show Figure 9 The electrode assembly was placed on the victim;

[0051] Figure 12 Another example of a resuscitation component according to some embodiments is shown, alternatively placed on the victim;

[0052] Figure 13A This is a perspective view of the resuscitation component according to an embodiment;

[0053] Figure 13B This is a perspective view of a resuscitation component according to another embodiment;

[0054] Figure 14 This is a perspective view of a resuscitation component according to another embodiment;

[0055] Figure 15 This is a flowchart of an exemplary process for determining the placement of electrode assemblies and chest compression depth of a resuscitation kit, according to some embodiments.

[0056] Figure 16 The illustration shows a double-thumb technique for performing CPR on infants and young children using a resuscitation assembly, according to some embodiments.

[0057] Figure 17 This is a side view of compressions being applied to a patient using a resuscitation assembly, according to some embodiments;

[0058] Figure 18 This is a flowchart of an exemplary process for providing feedback to rescue personnel in relation to the surface where the patient is located, according to some embodiments;

[0059] Figure 19 An example of the resuscitation component according to the invention is placed on a cardiac arrest victim;

[0060] Figure 20A and 20B The invention is shown Figure 19 The resuscitation components are placed on the cardiac arrest victim instead;

[0061] Figure 21A and 21B An example of the resuscitation component according to the invention is placed on a cardiac arrest victim;

[0062] Figure 22 yes Figure 21B Side view of the electrode assembly of the resuscitation component;

[0063] Figure 23A and 23B An example of the resuscitation component of the present invention is placed on a cardiac arrest victim;

[0064] Figure 24A and 24B An example of the resuscitation component of the present invention is placed on a cardiac arrest victim;

[0065] Figure 24C Showing with Figure 24B Compared to the rear electrode, the placement of an alternative example of a rear electrode assembly with leads;

[0066] Figure 25A and 25B An example of the resuscitation component according to the invention is placed on a cardiac arrest victim;

[0067] Figure 26A and 26B An example of the resuscitation component according to the invention is placed on a cardiac arrest victim; and

[0068] Figure 27A and 27B An example of a resuscitation component according to the invention is shown placed on a cardiac arrest victim. Detailed Implementation

[0069] This invention relates to resuscitation components and systems applicable to a wide variety of patients requiring resuscitation, such as small-sized (e.g., children, infants) or large-sized (e.g., adults) patients. In various embodiments, the resuscitation component may include at least one pair of electrode assemblies, each electrode assembly including an electrode pad and a motion sensor. However, in some embodiments, the resuscitation component may include a single electrode assembly with an electrode pad and an associated motion sensor, or multiple electrode assemblies with an electrode pad and an associated motion sensor.

[0070] The resuscitation components and systems described herein can provide improved resuscitation compared to existing devices and methods, for example, by providing improved accuracy, checking, and / or correction in determining resuscitation-related parameters such as chest compression depth, release rate, chest compression angle, the presence of surfaces that cause error (e.g., a compressible surface beneath the patient, such as a soft mattress), chest compression rate and / or timing, ventilation rate, etc. The systems and resuscitation components according to the invention provide improved accuracy in determining chest compression depth, for example, by detecting and / or correcting errors in resuscitation parameters resulting from external sources (e.g., surfaces causing error, patient movement during transport (e.g., on a wheelchair / stretcher or in an ambulance)). Therefore, such systems can advantageously provide improved feedback related to whether chest compressions are applied appropriately and / or whether rescuers need to correct errors from external sources (e.g., changing the surface on which the patient is placed, reducing errors caused by other movements, etc.).

[0071] In a specific example, such as Figures 1A-1B As shown, the resuscitation assembly of the present invention includes two electrode assemblies, each comprising an electrode pad and one or more chest compression sensors. One electrode assembly may be placed in an anterior position of the patient (e.g., above the sternum), and the second electrode assembly may be placed in a posterior position of the patient (e.g., on the back opposite to the anterior electrode placement), i.e., at the AP position. Optionally, as... Figure 12 and 19As shown, the first electrode assembly can be placed in the anterior position of the patient, and the second resuscitation electrode assembly can be placed in the lateral position of the patient, i.e., in the AA position. In this context, it may be advantageous to be able to track the movement of each electrode assembly as it is connected to the patient. According to various embodiments, the resuscitation assembly described herein may be intended for use only in the AP position, only in the AA position, in either the AA or AP position, and / or in different positions such as lateral positions where the electrode assemblies are placed on either side of the patient (not shown in the figures).

[0072] As described herein, each electrode assembly placed on the patient may include one or more chest compression sensors, such as motion sensors (e.g., accelerometers, velocity sensors, ultrasound sensors, infrared sensors, other sensors for detecting displacement). In a particular example, the motion sensor may be a single-axis accelerometer or a multi-axis accelerometer. A single-axis accelerometer may be used to determine chest compression parameters (e.g., depth, rate, velocity, timing, etc.) by measuring and / or providing signals that aid in determining acceleration, velocity, and / or displacement. A multi-axis accelerometer (e.g., a triaxial accelerometer) is capable of providing signals that, in addition to determining chest compression parameters, further determine the relative orientation of the electrode assemblies by measuring parameters representing motion along each axis. The motion sensor may also include a gyroscope for determining the orientation of the sensor (and in some cases, the electrode assembly) using tilt or rotation. In an additional example, two or more accelerometers may be configured in a manner perpendicular to each other to determine electrode and / or chest acceleration on multiple orthogonal axes. Generally, during the period when an accelerometer senses acceleration or gravity, the motion or displacement of the accelerometer can be determined by a series of calculations (e.g., double integrals, etc.) known to those skilled in the art.

[0073] By incorporating motion sensors into two electrode assemblies, resuscitation-related parameters can be determined more accurately compared to incorporating only one electrode assembly with a motion sensor. For example, the electrode assemblies can be used as reference points to each other based on their respective displacement and orientation. Therefore, the way the electrode assemblies (e.g., electrode pads) are placed and / or how these electrode assemblies move relative to each other can inform the type of instructions output to rescuers. As an example further discussed below, based on the orientation and / or distance of the electrode assemblies relative to each other, it can be determined whether the electrode assemblies are placed in the AA or AP position, or whether the electrode assemblies are not placed in any typical position at all (such as lateral positions where the electrode assemblies are placed on either side of the patient). In addition, based on the movement patterns of the two electrode assemblies, the type of surface on which the patient is located can be determined, and the angle of the applied chest compressions relative to the vertical axis (when the patient is lying flat), or the direction perpendicular to the patient when the patient is lying flat on an inclined surface, can also be estimated.

[0074] As also presented herein, electrode assemblies can be configured to suitably conform to a patient's body. For example, an electrode assembly may include a sensor housing (e.g., housing one or more motion sensors, a housing, protective and / or padding material) and a flexible electrode pad, wherein the sensor housing has greater rigidity than the flexible electrode pad. The sensor housing may be attached to the electrode pad in a manner that allows the flexible electrode pad to maintain its flexibility, thereby enabling the electrode pad to conform to the patient's body. For example, the sensor housing may be mounted on a portion of the electrode pad, allowing another portion of the electrode pad (the portion of the assembly used to sense ECG and deliver therapeutic shocks) to maintain its flexibility to conform to the patient's anatomy.

[0075] In some embodiments, the sensor housing includes padding material and / or a protective shield surrounding the motion sensor. For example, such as Figure 2B , 3 As shown in Figures 4 and others, the motion sensor can be integrated into a portion of the padding of the electrode assembly (e.g., the motion sensor can be contained within an upper padding portion of conductive therapeutic material that does not include the electrode pad). However, for certain embodiments, the sensor housing does not include padding material. For example, as... Figure 7 and 10 As shown, the sensor housing may include a protective shield (e.g., a plastic / polymer sleeve) separate from the larger padding material. That is, the motion sensor may be configured as part of the electrode assembly and (e.g., wired or wirelessly) connected to the overall resuscitation system associated with the appropriate electrode pads, yet separate from or otherwise capable of being positioned independently of the electrode pads. It should also be understood that the sensor housing may include a protective shield (e.g., a polymer / plastic sleeve / shell) within which the motion sensor is configured, and a larger padding material further configured therewith within the protective shield.

[0076] Figures 1A-1C The resuscitation assembly of the present invention is described, wherein the resuscitation assembly includes a pair of electrode assemblies, generally designated as reference numerals 1A and 1B, placed on a patient 3 according to the present invention. The patient 3 is shown with the two electrode assemblies 1A and 1B secured anterior-posterior (AP) configuration to the chest and back, respectively. Although Figure 1A and 1B The electrode assembly shown is illustrated as being mounted to a patient in an AP configuration, but this should not be construed as limiting the invention, as the electrode assembly can also be configured in other ways (such as using...). Figure 12 The anterior-anterior (AA) structure, as shown and discussed in more detail below, is installed on the patient.

[0077] Figure 1A and 1BThe resuscitation assembly is operatively connected via cable 7 to a defibrillator 5, such as a ZOLL Medical R-Series or X-Series monitor defibrillator, wherein the defibrillator 5 can function as an AED, a semi-automatic defibrillator (SAD), and / or a manual defibrillator with a monitor, and can also be used for cardioversion and pacing (whereby an electrical pulse is delivered through the patient's chest according to a vector determined at least in part by the placement of the pads to stimulate cardiac contraction). However, this should not be construed as limiting the invention, as the resuscitation assembly of the present invention can also be used in any suitable defibrillator system. The defibrillator 5 is operatively capable of generating a defibrillation shock and delivering the shock to the patient via electrode assemblies 1A, 1B. In one example, the defibrillator 5 may include an ECG monitor and display for analyzing the ECG signal obtained through the electrode pads and displaying the ECG waveform to the user. As disclosed in U.S. Patent No. 14 / 499,617 entitled “Defibrillator Display”, which is assigned to the assignee of this application and whose entire contents are incorporated herein by reference, the display may also provide the user with feedback related to chest compressions.

[0078] refer to Figures 1A-4 The resuscitation assembly includes two (or more) electrode assemblies, each of which may include: a flexible electrode pad 9 having a treatment side 11 configured to connect to the patient 3; a sensor housing 13 mounted in a mounting region 17 to a side 15 of the electrode pad 9 opposite to the treatment side 11; and a motion sensor 19 enclosed within the sensor housing 13. In various embodiments, it may be more preferable that the motion sensor is embedded within the sensor housing, such that the sensor (and associated housing) is protected from damage and is securely held by the electrode assemblies in a manner that prevents unwanted movement within the housing. Although not explicitly shown in the figures, the sensor housing 13 may include both a padding material for the motion sensor 19 and an optional protective housing.

[0079] Despite the motion sensor 19 Figures 3-4 The sensor housing 13 is illustrated as being completely enclosed within the padding material of the sensor housing 13, but this should not be construed as limiting the invention, as the motion sensor 19 (and its sleeves) may only be partially enclosed within the padding of the sensor housing 13. For example, the motion sensor 19 and its sleeves may be at least partially exposed, such as in… Figure 6 Examples are shown in the embodiments. In these examples, the motion sensor and the sleeve may be configured to be removable, repositionable, and / or replaceable.

[0080] As provided in this article and as Figure 2CAs shown, the flexible electrode pad 9 can be mounted to a sensor housing 13 with relatively high rigidity in the mounting area 17, where the mounting area 17 only spans a small portion of the contact area between the flexible electrode pad 9 and the sensor housing 13. That is, the mounting area between the flexible electrode pad 9 and the sensor housing 13 can extend only on a portion of the surface of the electrode pad 9, thereby allowing the portion of the electrode pad 9 that is not mounted to remain flexible and conform to the patient's body. Therefore, by allowing the portion of the electrode pad 9 that is not mounted to the sensor housing 13 to flex or otherwise bend back and forth, the sensor housing 13 will not undesirably force the electrode pad 9 to detach from the patient's body.

[0081] The electrode pad 9 and sensor housing 13 can be mounted using any suitable method. For example, during mounting, the electrode pad and housing can be formed from the same material (e.g., foam padding), mechanically connected (e.g., interlocked), stapled, sewn, spliced, non-adhesively connected, adhesively connected, or otherwise attached. For example, as... Figure 2C As shown, the sensor housing 13 and the electrode pad 9 are directly mounted to each other. Therefore, particularly for patients of small stature (children, short stature) or those with conditions that may require this configuration (e.g., kyphosis), the flexible electrode pad 9 may be more suitable to conform to the surface contours of the patient's body compared to a configuration where the electrode pad 9 and sensor housing 13 are mounted along the entire contact surface between them (e.g., a completely flush mount between the non-treatment side of the electrode pad and the padding material of the sensor housing). Otherwise, as discussed above, without this configuration or a similar arrangement, the entire assembly may be more likely to detach from the patient's body. However, as further described herein, it should be understood that for some embodiments, the electrode pad and motion sensor (as well as the sensor housing and / or sensor casing) do not need to be directly mounted to each other.

[0082] The flexible electrode pad 9 can be any type of electrode suitable for defibrillation and typically includes: a conductor disposed on the treatment side 11, such as tin, silver, AgCl, or any other suitable conductive material; a conductive electrolyte gel (e.g., a solid adhesive polymer), such as a hydrogel; and leads for connecting the conductor to the cable 7. In various exemplary embodiments, for electrodes for children, the gel has an active (electrotherapy) area of ​​at least approximately 15 cm² for each electrode. 2 (For example, about 15-30cm) 2 Approximately 15-40cm 2 Approximately 15-50cm 2 Approximately 15-60cm 2 Approximately 15-70cm 2 Approximately 15-80cm 2 Approximately 15-90cm 2Approximately 15-100cm 2 Approximately 20-40cm 2 Approximately 20-50cm 2 Approximately 20-60cm 2 Approximately 20-70cm 2 Approximately 30-50cm 2 Approximately 30-60cm 2 Approximately 30-70cm 2 The combined area of ​​the two electrodes is at least approximately 45 cm². 2 (For example, approximately 45-60cm) 2 Approximately 45-70cm 2 Approximately 45-80cm 2 Approximately 45-90cm 2 Approximately 45-100cm 2 Approximately 45-120cm 2 Approximately 45-150cm 2 As an example, the treatment area of ​​the conductive gel electrode for anterior pediatric use can be at least approximately 15 cm². 2 (For example, a maximum length of approximately 5.5” and a maximum width of approximately 4.5”), and the conductive gel treatment area for the posterior pediatric electrode can be at least approximately 15 cm². 2 (For example, the maximum length is approximately 5.75” and the maximum width is approximately 3.5”). As another example, the conductive gel treatment area for the anterior pediatric electrode can be at least approximately 40 cm². 2 (For example, approximately 32cm in length and 27cm in width), and the conductive gel treatment area for the posterior pediatric electrode can be at least approximately 50cm². 2 (For example, approximately 36 cm in length and approximately 22 cm in width). In other exemplary embodiments, for adult electrodes, the gel provides an active (electrotherapy) area of ​​at least approximately 50 cm² for each electrode. 2 (For example, about 50-80cm) 2 Approximately 50-90cm 2 Approximately 50-100cm 2 50-110cm 2 Approximately 50-120cm 2 Approximately 50-130cm 2 Approximately 50-140cm 2 Approximately 50-150cm 2 The total area of ​​the combination is at least approximately 150 cm². 2 (For example, approximately 150-200cm) 2 Approximately 150-250cm 2 Approximately 150-300cm 2As an example, the treatment area of ​​the conductive gel electrode for anterior adult use can be approximately 80 cm². 2 Furthermore, the treatment area of ​​the conductive gel for the posterior adult electrode can be approximately 115 cm². 2 Considering the limits of measurement and typical sources of error, the dimensions and measurements defined above using terminology generally include specified dimensions and / or measurements.

[0083] The flexible electrode pads 9 of electrode assemblies 1A and 1B may be similar in layered construction; however, as shown, the lateral shape of the pad can vary depending on where it is to be placed on the patient. For example, the electrode pad of resuscitation electrode assembly 1A is shown with rounded edges, making it relatively easy to place on the chest region of the patient's thoracic cavity, while the electrode pad of electrode assembly 1B is shown as rectangular, providing a more intuitive alignment with the spine on the back region of the patient's thoracic cavity compared to other shapes. Additionally, in various embodiments, the electrode assemblies described herein may be made of a radiation-permeable and / or radiation-transmissive material, thus being translucent or transparent to X-rays. Therefore, the electrode material will not interfere with standard imaging techniques. For example, at least one of the flexible electrode pad 9, the treatment side 11, and the sensor housing 13 may be made of a radiation-permeable and / or radiation-transmissive material. In one example, the flexible electrode pad 9, the treatment side 11, and the sensor housing 13 are all made of a radiation-permeable and / or radiation-transmissive material. Typically, X-ray-permeable electrode pads can comprise materials that are both X-ray-transmitting and X-ray-opaque, wherein the main body of the electrode pad is transparent to X-rays, but the material of the sensor (e.g., electronics, cable connections, etc.) is opaque to X-rays. As a result, when a patient is subjected to X-rays or other imaging techniques, the electrode assembly or a portion thereof (except for the non-X-ray-transmitting material) attached to or otherwise applied to the patient's body will not appear in the image, thus allowing proper visualization of the patient's internal organs.

[0084] Each flexible electrode pad 9 may include an insulating base layer 21 (e.g., a flexible foam base layer) and a flexible conductor 23 (e.g., see [link]) disposed on its treatment side 11. Figure 3 The insulating base layer 21 comprises a layer of flexible, soft, closed-cell polymer foam, such as, but not limited to, medical-grade polyethylene or other suitable materials. The material of the base layer 21 may have a sufficiently high density to provide a barrier against liquids or hydrogels, such that the conductive gel is substantially held in place on the treatment side of the electrode pad. The material of the base layer 21 may also be flexible and / or compressible in nature to comfortably conform to the surface contours of the patient's body structure when the electrode is attached to the patient, without irritation or detachment from the body.

[0085] The size of the base layer 21 can be determined based on physiological considerations for both transcutaneous stimulation and defibrillation. The area of ​​the conductor 23 of the flexible electrode pad 9, which may be smaller than the corresponding base layer 21, can be configured to extend laterally across the heart, such that the entire heart is effectively “covered” by the defibrillation pulse. Alternatively, the size of the base layer 21 can be chosen to provide a certain area surrounding the conductor 23 for proper attachment to the patient's anatomy. For example, the area surrounding the conductor 23 can be coated with a hypoallergenic medical-grade acrylic adhesive designed for use on human skin. This adhesive provides a mechanism for temporarily attaching the flexible electrode pad to the appropriate location on the patient's anatomy. Using this adhesive, additional adhesive or manual force may not be required to maintain the electrode in place during the delivery of an electrical signal to the patient. Further details of the flexible electrode pad can be found in U.S. Patent 5,330,526, entitled “Combined defibrillation and pacing electrode,” assigned to the assignee of this application and incorporated herein by reference in its entirety.

[0086] The sensor housing 13 may include one or more layers of compressible padding material, wherein, as discussed above, the compressible padding material can be mounted in the mounting area 17 to the side 15 of the flexible electrode pad 9 opposite to the treatment side 11, such that the sensor housing 13 is not connected across the entire surface of the flexible electrode pad 9. As an example, such as Figure 2B and 4 As shown, the sensor housing 13 may include a single layer of compressible padding material that is thicker than the flexible electrode pad 9, thereby giving the sensor housing 13 a greater degree of rigidity compared to the electrode pad 9. In this case, the padding portion of the sensor housing 13 may be substantially thicker than the padding portion of the electrode pad 9, and thus the padding portion of the sensor housing 13 may have greater rigidity compared to the electrode pad 9.

[0087] In another example, and as Figure 3 As shown, the sensor housing 13 may include multiple layers of compressible padding material. These layers may be laminated together to form the sensor housing 13 and attached to the flexible electrode pad 9 in the mounting region 17. In some embodiments, these layers may be adhesively bonded, integrally formed, or otherwise mounted to each other and further mounted to the electrode pad 9 in the mounting region 17. In various embodiments, the compressible padding material of the sensor housing 13 is more rigid than the flexible electrode pad 9, yet is still compressible as padding material. Non-limiting examples of such materials include medical-grade polyethylene, foam, flexible polymer materials, gels, or other suitable materials.

[0088] Embodiments of the present invention allow the motion sensor 19 to be positioned directly above the flexible conductor 23 of the electrode pad 9 in the electrode assembly. This may be particularly advantageous for resuscitation assemblies for children or newborns that are relatively small compared to their adult counterparts due to the limited amount of available surface space. In context, conductive materials, such as those incorporated into the electrode pad 9 discussed herein, may be susceptible to wear and / or damage when subjected to directly applied, repeated compressive loads. Such wear or damage may include, for example, rough surfaces, jagged edges, displaced / displaced material, etc., which can result in the formation of areas with uneven resistance. Where a particular area of ​​the conductive material has a higher impedance than other areas, heat is more likely to be undesirably localized (e.g., “hot spots”) during defibrillation discharge. This localization of heat can cause pain, burning, or other problems for the patient. However, when the pressure applied during chest compressions is well distributed (e.g., directed substantially away from the conductive material) or otherwise reduced / minimized (e.g., via a cushioned construction), wear or damage to the conductive material is less likely, thus reducing the occurrence of hot spots along the patient's body during discharge. The electrode assembly described herein is constructed in a manner that allows the pressure to be distributed in a way that minimizes or otherwise reduces the likelihood of unintended damage to the conductive material.

[0089] refer to Figure 1A and 2A The sensor housing 13 of the electrode assembly 1A can be configured to allow rescuers to apply chest compressions to the sensor housing 13. In this configuration, the sensor of the resuscitation electrode assembly 1A is offset relative to the center of the conductive material of the electrode pad 9, making it more likely that the conductive material will remain undamaged during chest compressions. Furthermore, the sensor can be located at a suitable distance from the electrical wiring of the electrode pad, reducing the chance of the wiring itself being damaged during compressions. Additionally, the upper surface 24 of the sensor housing 13 of the electrode assembly 1A may include graphics such as a cross mark 25 to guide the user in properly placing the sensor housing 13 at an appropriate anterior position above the sternum of the patient 3.

[0090] In the additional example, Figure 1B and 2BThe electrode assembly 1B shown can be configured such that the motion sensor 19 is located on the central portion of the conductive material. Therefore, the sensor housing 13 of the electrode assembly 1B is configured such that the pressure applied during CPR is distributed substantially uniformly across the conductor 23 of the flexible electrode pad 9. That is, for the rear-positioned electrode assembly 1B, although the pressure is transmitted between the conductive material of the electrode pad 9 and the (relatively rigid) motion sensor 19, the potential damaging effects of these forces can be mitigated, for example, due to the enhanced cushioning provided by the sensor housing 13. For example, the thickness of the padding material of the sensor housing 13 may be sufficient to provide sufficient cushioning to keep the conductor 23 undamaged during chest compressions.

[0091] refer to Figure 4 The motion sensor 19 can be enclosed within a compressible padding layer of the sensor housing 13. The motion sensor 19 can be a triaxial accelerometer or any other suitable motion sensor. Figure 4 As shown, the motion sensor 19 can be located on the central region of the conductor 23 of the flexible electrode pad 9. The motion sensor 19 can have any suitable shape. For example, as Figure 4 As shown, the motion sensor 19 can have a square or rectangular shape. This shape can be the shape of the motion sensor 19 itself, or it can be formed by a housing or other enclosure (such as encapsulation or injection molding discussed below). Optionally, as... Figure 7 and 10 As shown, the motion sensor can have a circular shape. Other shapes and sizes are also possible; for example, the motion sensor can exhibit a polygonal, elliptical, or similar shape to a credit card or coin. As discussed above, the sensor housing 13 can be configured to distribute the compression force substantially evenly across the conductor 23 during CPR chest compressions. In further embodiments, such as those discussed in more detail below... Figure 6 and Figure 9 As shown, the motion sensor 19 can be located on the outer periphery of the conductor 23 of the flexible electrode pad 9.

[0092] To further protect the motion sensor 19 from environmental factors such as moisture, humidity, defibrillation shock, etc., a polymeric material such as moldable polyamide can be used to encapsulate or mold the motion sensor 19 to form a suitable sensor housing. Since the entire assembly may be stored for several years at a time, polymeric materials are suitable for providing long-term protection against extreme temperature and moisture conditions. A non-limiting example of such a material is Macromelt OM652 / Technomelt PA 752, provided by Henkel Corporation. The encapsulation material can be directly molded onto the motion sensor 19, or it can form a protective housing on which the motion sensor 19 is located. The material can also be flexible, textured, and / or slightly compressible to provide enhanced user comfort, while also possessing sufficient rigidity or strength to protect the sensor itself.

[0093] As discussed in this paper, the sensor housing not only provides protection for the sensor itself but also provides a traction source for the person performing chest compressions, especially in situations where the rescuer's hands may tend to slide on exposed skin, such as that covered with blood, fluids, sweat, or other lubricating materials. Any suitable materials and construction can be used. For example, the sensor housing may include multiple materials and / or layers, such as rigid plastics used to encapsulate the sensor itself to protect the internal parts of the electronics (e.g., accelerometer circuitry) and softer materials (e.g., silicone, rubber, elastomers, polyurethane, neoprene, gels, polymeric materials, etc.) used as a molding or thin coating for added comfort.

[0094] The material of the housing can exhibit an appropriate level of hardness. In certain embodiments, as described above, the housing may include a relatively rigid inner protective cover and a softer outer cover. For example, the Shore A hardness tester for the housing made of a relatively soft material to provide additional comfort to the user may be between about 40 and about 90, between about 40 and about 60, between about 50 and about 80, between about 60 and about 70, or the Shore A hardness tester may be outside these ranges. The Shore D hardness tester for the housing made of a relatively hard material to provide additional protection to the sensor circuitry may be between about 20 and about 80, between about 30 and about 60, between about 30 and about 50, or the Shore D hardness tester may be outside these ranges. In some embodiments, as described above, the sensor housing may include a relatively hard material coated with a thin layer of softer material or a laminate.

[0095] By incorporating appropriate motion sensors in both the front electrode assembly 1A and the rear electrode assembly 1B, the signals obtained from these motion sensors can be processed by the control circuitry within the defibrillator 5 to provide information for enhanced overall resuscitation care of the patient. For example, as will be discussed in more detail below, particularly in cases of compression on compressible surfaces and / or in cases where a rescuer wraps their hands around the infant's chest and compresses from both the front and rear, data from these two motion sensors can be processed to determine a more accurate compression depth.

[0096] As a mechanism to ensure proper placement of the electrode assemblies 1A and 1B of the resuscitation assembly on the patient's body structure, one or both of the electrode assemblies, or the substrate connected to these assemblies, may be provided with illustrations, diagrams, or printed instructions 27 depicting the correct position of the electrode assemblies 1A and 1B. For example, illustrations, diagrams, or printed instructions may be provided on the upper surface 24 of the sensor housing 13 or on the side 15 of the flexible electrode pad 9 opposite to the treatment side 11. Additionally, the control circuitry of the defibrillator 5 may use signals from the motion sensor 19 to prompt the user in a manner consistent with the manner in which the resuscitation assembly including electrode assemblies 1A and 1B should be configured, as described in U.S. Patent Application 15 / 083,044, filed March 28, 2016, entitled "ECG and Defibrillator Electrode Detection and Tracking System and Method," the entire contents of which are incorporated herein by reference.

[0097] As discussed herein, the sensor housing 13 can be configured to typically have greater rigidity compared to the flexible electrode pad 9. Therefore, as... Figure 2A , 2B As shown in 2C, at least a portion 29 of the flexible electrode pad 9 is constructed and configured to maintain its flexibility throughout the portion not corresponding to the mounting area 17, such that the electrode pad 9 substantially conforms to the patient's anatomy when connected to the patient 3. Figure 2A As shown, (when viewing the assembly from above) the mounting area 17 is positioned along a portion of the upper left outer periphery of the flexible electrode pad 9. Reference Figure 2B The mounting area 17 can be located in the central region of the flexible electrode pad 9, such that the sensor housing 13 is not attached to the outer periphery of the flexible electrode pad 9. In some embodiments, Figures 2A-2C The resuscitation components shown are intended for use in the AP position and may be particularly beneficial for pediatric patients.

[0098] It should be understood that various alternative mounting areas 17 can be used, such as, but not limited to, mounting in the upper central region and / or lower central region of the component. In each configuration, because the sensor housing 13, which has greater rigidity, is connected only at the mounting area 17 and not to the entire surface of the flexible electrode pad 9, the force causing the flexible electrode pad 9 to separate or detach from the patient's body structure due to the connection between the sensor housing 13 and the flexible electrode pad 9 is reduced, and at least a portion of the flexible electrode pad 9 can bend away from the sensor housing 13. Compared to the case where the flexible electrode pad is attached to the sensor housing in a completely flush manner, this allows the flexible electrode pad 9 to better follow the contours of the patient's body structure, thereby properly attaching to the patient's body structure while maintaining attachment to the sensor housing 13. The flexible electrode pad can also provide relatively uniform electrical contact between the electrode and the patient, thereby maintaining a sufficiently large effective contact area to deliver an appropriate amount of therapeutic (e.g., defibrillation) energy. Otherwise, if the electrode pads are not flexible enough to conform to the patient's body structure, the reduced surface area may lead to problems such as burns, skin damage, and / or inappropriate electric field lines between electrodes, resulting in inappropriate electrotherapy delivery.

[0099] It should be understood that embodiments of the resuscitation component may employ other configurations. (See reference...) Figures 5-8 This illustrates an alternative example of electrode assembly 51 of the resuscitation assembly. In this example, the resuscitation assembly includes one or more electrode assemblies. Figures 5-8 This illustrates how one of the electrode assemblies can be constructed. For example, electrode assembly 51 can be configured to be mounted in a posterior position on the back of a patient. Electrode assembly 51 includes: a flexible electrode pad 53 having a treatment side 55 configured to be connected to the patient 3; a sensor housing 57 mounted to the side of the electrode pad 53 opposite to the treatment side 55; and a motion sensor 59 (with an associated housing) enclosed within the sensor housing 57.

[0100] The flexible electrode pad 53 can be any type of electrode suitable for defibrillation and typically includes: a conductor such as tin, silver, AgCl or any other suitable conductive material disposed at the treatment side 55; an electrolyte such as hydrogel; and leads, as discussed herein, for connecting the conductor to a cable.

[0101] For various embodiments, and as shown in the figure, the sensor housing 57 may include a multilayer compressible padding material, wherein this multilayer compressible padding material is mounted in the mounting area (not explicitly shown) to the side of the flexible electrode pad 53 opposite to the treatment side 55, such that the sensor housing 57 and the flexible electrode pad 53 are not connected across the entire contact surface. Although in Figures 6-8 Not shown in the text, but similar to... Figure 2BThe sensor housing 13 of the electrode assembly 1B shown is mounted to the flexible electrode 9 in a similar manner, and the sensor housing 57 can be mounted to the flexible electrode pad 53. For example, the mounting area can be located in the central region of the flexible electrode pad 53, such that the flexible electrode pad 53 flexes or otherwise bends relative to the sensor housing 57 at a location around the central region away from the mounting area, so that the electrode pad 53 generally conforms to the patient's human anatomy when connected to the patient 3.

[0102] Electrode assembly 51 can be constructed according to any suitable structure. For example, specific portions of electrode assembly 51 may be shaped to accommodate and suitably conform to various parts of a human body structure when placed thereon. In some embodiments, sensor housing 57 and / or electrode pad 53 may be configured such that the assembly comprises columns of varying thicknesses, thereby allowing the assembly to better conform to the patient's human body structure. For example, as Figure 5 and 8 As shown, the sensor housing 57 can be patterned into three columns 58a, 58b, and 58c. As illustrated, the first column 58a and the third column 58c can exhibit similar thicknesses, while the second column 58b can have a smaller thickness, allowing the component 51 to be geometrically better suited to accommodate the space occupied by the spine of the patient 3. Alternatively, for specific implementations where it is preferable that the sensor is not placed directly on or above the spine, columns of varying thicknesses are not necessary. For example, an image of the spine can be formed on the rear component (e.g., the sensor housing or electrode pad) to avoid placing the component in a manner that would otherwise require placing the sensor directly on or above the spine.

[0103] In some embodiments, the sensor housing 57 may include multiple layers laminated together to form a monolithic sensor housing. These layers may be further laminated or otherwise mounted to the flexible electrode pad 53 in the mounting area. Optionally, these layers may be adhesively bonded to each other and to the electrode pad 53 in the mounting area. These layers may be mounted to each other using any other suitable method, such as using one or more fasteners (e.g., splicing, stitching, stapling) or a portion of these layers may be integrally formed. It is understood that a layered structure is not required, as the housing material can be shaped, molded, machined, pressed, modified, or manufactured in any other suitable manner.

[0104] The compressible padding material of the sensor housing 57 can have greater rigidity compared to the flexible electrode pad 53, yet it can still be compressible in nature. See details. Figure 6At least one layer of the sensor housing 57 may have a cutout region 61 or other recess, wherein the cutout region 61 or other recess has a size and shape substantially similar to that of the motion sensor 59 and is configured to internally accommodate the motion sensor 59. Therefore, the motion sensor 59 can be embedded in only a small portion of the compressible liner layer of the sensor housing 57 that is laterally offset relative to the conductor of the electrode pad 53. This allows the force from pressing to be evenly distributed across the sensor housing and substantially prevents the motion sensor from damaging the electrode pad 53.

[0105] As described herein, the resuscitation kit described herein can be used in conjunction with an electrode assembly placed in the AP position, AA position, or both, or in other positions (e.g., lateral position). The resuscitation kit can be configured to perform multiple functions, including, for example: defibrillation (e.g., non-manual defibrillation energy at an energy level set according to an appropriate defibrillator); ECG monitoring (e.g., continuously for at least 24 hours); non-invasive temporary pacing (e.g., non-manual non-invasive pacing energy of approximately 75 mA / 150 ppm or approximately 140 mA / 180 ppm for 1–8 hours); transmission of chest compression data to a medical device (e.g., defibrillator, monitor, CPR system); code readiness for self-testing; and an expiration date (valid for at least 24 months). For code readiness for self-testing, the electrodes of the resuscitation kit can be pre-connected to a defibrillator (such as a hospital defibrillator like the R SERIES defibrillator provided by ZOLL Medical), making the kit ready for use at any time. During code preparation and self-testing, the defibrillator can automatically test the presence of correct cables and electrodes, and verify the type, condition, and / or expiration date of the electrodes without disconnecting them. For the electrode assembly, according to IEC 60601-2-4 cls.201.108.1.1, the small-signal AC impedance of the electrodes is less than 3 kOhm at 10 Hz and less than 5 Ohm at 30 kHz, and the large-signal AC impedance is less than 3 Ohm for 200J biphasic defibrillation. According to IEC 60601-2-4 cls.201.108.1.4, after 4 seconds and 60 seconds of 200J biphasic defibrillation, the defibrillation recovery offset is less than 750 mV, and according to IEC 60601-2-4 cls.201.108.1.6, after 200J biphasic defibrillation, the DC offset voltage is less than 100 mV.

[0106] In certain embodiments, the resuscitation kit may be for single use and intended for specific types of patients. These patients to whom the resuscitation kit is intended may include pediatric patients aged 0-8 years and weighing less than 55 pounds (25 kg), adult patients aged 8 years and weighing more than 55 pounds, or both. The motion sensors (front or rear) associated with the resuscitation kit may be configured to withstand a compression force of at least 150 pounds applied directly to these motion sensors, and at least 200 compressions per minute. In addition to the compression force described above, these motion sensors may also withstand the patient's body weight.

[0107] The resuscitation assembly may also include one or more components that allow the medical system to identify whether the resuscitation assembly is configured for pediatric or adult resuscitation, or whether the resuscitation assembly has one or more motion sensor inputs (e.g., a single sensor or multiple sensors). In some cases, the resuscitation assembly may include a memory chip for identifying the type of electrode assembly, a resistor (e.g., a patient identification resistor of about 2.9 kOhm for pediatric electrode assemblies, and a patient identification resistor of about 1.3 kOhm for adult electrode assemblies), or other suitable identification components that can be analyzed and can transmit an identification signal. This identification signal can provide the system with information to determine which type of resuscitation assembly is being used. As an example, the resuscitation assembly according to the invention can be connected to a defibrillator or monitor, and the system can analyze and / or receive the identification signal based on the identification components of the resuscitation assembly using associated processing circuitry. In the case where the identification component is a resistor, the system can allow current to flow through the resistor, and based on the voltage thus generated, the type of resuscitation assembly can be identified. Optionally, in the case where the identification component is a memory chip, the system can read whether the resuscitation assembly is for pediatric or adult use based on the contents of the memory.

[0108] Once the system and associated processing circuitry determine the type of resuscitation component being connected, various resuscitation-related features of the system, such as electrical stimulation, CPR parameters, user interface display, shock analysis, and / or other aspects of resuscitation treatment, can be adjusted accordingly. For example, if the system detects a pediatric component in use, it can set a lower defibrillation energy level compared to if the system detects an adult component. Optionally, the user interface used to provide CPR feedback can be modified depending on whether a pediatric or adult resuscitation component is detected. For example, if an adult component is detected, the user interface can provide rescuers with estimated chest compression depth and rate values, and, according to current clinical guidelines, also provide instructions on applying chest compressions at a depth (e.g., 2.0–2.4 inches) and at a rate (e.g., 100–120 cpm). However, when a pediatric resuscitation module is detected, the user interface can provide only the estimated chest compression depth and rate values ​​without instructing rescuers on the appropriate application of chest compressions. This allows trained rescuers to apply chest compressions to the patient without guidance. Furthermore, the applied shock analysis algorithm may differ depending on whether the system detects a pediatric or adult resuscitation module. For example, a pediatric shock analysis algorithm can be calibrated to analyze a child's ECG signal rather than an adult's, allowing the defibrillator to more accurately determine whether a shock should be delivered to a pediatric patient. Typically, a defibrillator measures ECG baseline content, QRS rate, width and variability, amplitude, and temporal regularity, and determines the presence of a shockable rhythm. For pediatric patients, one or more measurements for shockable rhythms may differ from those for adult patients.

[0109] For details, please refer to the following: Figure 7In some cases, the motion sensor 59, which may be embodied as a triaxial accelerometer, is mounted on a printed circuit board 63 and encapsulated within a suitable housing 65 configured as a protective shield or sleeve. As described above, such a housing can provide the motion sensor 59 with an appropriate amount of protection, for example, from electrical discharges and / or environmental factors (e.g., moisture, humidity, temperature, people). The housing 65 may comprise any suitable material, such as polymer / plastic materials. The housing 65 is then positioned within a cutout area 61 such that leads 67 extend beyond multiple compressible padding layers of the sensor housing 57. The leads 67 are configured to transmit signals from the motion sensor 59 to the control circuitry of the defibrillator 5. The leads 67 may comprise cables with any suitable cross-sectional shape and, in some cases, may be circular or flat. In some examples, the leads 67 are generally flat (e.g., flat ribbon cables) because using a flat cable can provide a greater level of comfort to rescuers and patients when compressions are performed above the cable compared to other cases. For example, during chest compressions, a round or similarly shaped lead may have a tendency to unintentionally impact rescuers and / or the patient or otherwise protrude into their body, while a relatively flat lead is less likely to protrude into their body or even be noticed by them. As shown, the protective cover portion of housing 65 may, for example, have a shape generally similar to that of the motion sensor itself to limit the overall volume around the motion sensor and provide enhanced operability of the motion sensor.

[0110] Figures 9-11 Another example of an electrode assembly for inclusion in the resuscitation assembly of the present invention is shown. This exemplary electrode assembly, generally indicated by reference numeral 91, is configured to be mounted from the rear to the patient's back (see Figure 1). Figure 11 The electrode assembly 91 may include a flexible electrode pad 93 having a treatment side 95, wherein the flexible electrode pad 93 is configured to connect to the patient 3 and generally conforms to the patient's human anatomy. The treatment side 95 includes a conductive material 97, wherein the conductive material 97 faces the body of the patient 3 and is adapted to provide treatment to the patient.

[0111] In various embodiments, the sensor housing 99 may be connected to the electrode pad 93, such that the projected contact area between the sensor housing 99 and the electrode pad 93 is relatively small, such as about 1 to 100 cm². 2 As a result, the sensor housing 99, with its greater rigidity, is small enough that the upward force from the housing 99 is insufficient to cause the electrode pad 93 to detach from the patient's body. In one example, the projected contact area between the sensor housing 99 and the electrode pad 93 (or simply the projected area of ​​the sensor housing itself) is less than approximately 100 cm². 2 Less than approximately 80cm2 Less than approximately 50cm 2 Less than approximately 30cm 2 Less than approximately 20cm 2 Less than approximately 10cm 2 Or smaller than approximately 5cm 2 In some embodiments, the sensor housing 99 is approximately the size of a five-cent coin. In embodiments, the size of the sensor housing can be approximately less than 1.0 inch × 1.0 inch × 0.25 to 0.30 inches. In more embodiments, the projected area of ​​the housing can be approximately 0.1 to 4.0 inches. 2 (For example, a length of 1.0 to 2.0 inches and a width of 1.0 to 2.0 inches), and its height can be approximately 0.01 to 0.30 inches. Alternatively, as motion sensors become smaller (i.e., chipsets become smaller), the sensor housing 99 can be as small as the package line housing. Therefore, the sensor housing 99 can be embedded in only a small portion of the flexible electrode pad 93, thereby allowing greater flexibility for the remainder of the flexible electrode pad 93 when attached to the patient 3. That is, by incorporating a relatively small sensor housing 99 that encapsulates an appropriately sized motion sensor 101, the likelihood of the electrode pad 93 detaching from the patient 3 is reduced. In some embodiments, the outer surface of the sensor housing may include a suitable texture or a suitable material (e.g., a textured molded rigid, semi-rigid polymer material, ridges, etc.) to prevent slippage of the rescuer's hand during compression and to provide an enhanced level of comfort to both the rescuer and the patient. That is, while the housing can provide protection for the motion sensor, the housing is not required to be rigid. For example, the housing may provide a non-rigid and soft texture for the user / patient to touch as additional comfort.

[0112] As shown, motion sensor 101 is at least partially enclosed within sensor housing 99. Motion sensor 101 can be configured to be located on the outer periphery of conductive material 97, such that motion sensor 101 is offset relative to the patient's spine. In one example, sensor housing 99 is formed by encapsulating motion sensor 101 using a suitable polymer material. Leads 103 operatively connected to motion sensor 101 extend from sensor housing 99 and are configured to transmit signals from motion sensor 101 to control circuitry of defibrillator 5.

[0113] As discussed herein, the sensor housing 99 and motion sensor 101 may be disposed within a pocket or containment portion of the associated respective electrode pad. In some embodiments, although the sensor housing and motion sensor may initially be contained within a portion of the electrode pad (e.g., its housing, recess, or containment portion), the sensor housing and motion sensor may be removed from that portion, allowing rescuers to place the sensor housing and motion sensor in any suitable location. For example, it may be desirable to place the sensor away from the electrode pad (e.g., to avoid the wound and provide more accurate CPR measurements), thus allowing rescuers easy access to the sensor for subsequent placement. Alternatively, it may be desirable to use only the sensor without the electrode pad, thus providing rescuers with the flexibility to remove the sensor from the electrode pad and place it where needed. In some cases, it may be desirable to remove the sensor from the electrode pad and place it on the surface where the patient is located (e.g., a backrest, mattress, or wheelchair).

[0114] Traditionally, in instances where the sensor is part of an electrode assembly (e.g., mounted on or otherwise connected to an electrode pad), the system may require an indication to apply the electrode pad to the patient before measuring the signal from the sensor. As an example, an impedance measurement falling within an appropriate range or achieving a specific threshold could be an indication to confirm that the electrode pad is properly applied to the patient. However, in cases where an electrode pad is not used, the system may not require impedance (or another indication of pad placement) to be a prerequisite for collecting signals from the sensor. For example, a patient with a surgical dressing on their chest may limit the space available for electrode pad placement, thus it may be more preferable to apply the sensor to the patient's chest separately from the pad. In these cases where an electrode pad is not required, ECG can be monitored via other sources (e.g., a 3-lead ECG on a hospital monitor). Therefore, the system may include appropriate mechanisms to disable the need to measure patient impedance in order to send and process signals from the sensor. For example, a medical device (e.g., a defibrillator, a monitor) that communicates with sensors may have an input (e.g., a switch, a button, a software structure) in which a user can instruct the processing of signals from the sensors without first needing other parameters (such as appropriate measurements of patient impedance) to confirm that the pads and / or sensors are correctly positioned.

[0115] Optionally, for some embodiments (such as for neonatal resuscitation), it may be preferable that the electrode assembly of the resuscitation kit exhibits a relatively small profile. For example, when treating a newborn, a rescuer can wrap his / her hands around the infant's chest and squeeze from both the front and back (i.e., using the double-thumb technique as discussed further below). Thus, the electrode assembly of the resuscitation kit can be thin enough to allow sufficient space for the hand to fully wrap around the infant's body. For neonatal resuscitation, less padding may also be required because less force is typically applied to infants compared to chest compressions used by children / adults. In some embodiments, the thickness of the resuscitation kit may be less than about 30 mm (e.g., about 1–30 mm, about 5–30 mm), less than about 25 mm, less than about 20 mm (e.g., about 1–20 mm, about 5–20 mm), less than about 15 mm, less than about 10 mm, less than about 5 mm, less than about 2 mm, less than about 1 mm, or any other suitable range of thickness.

[0116] As further described herein, it can be understood that, in some embodiments, the motion sensor associated with a particular electrode assembly is not integrated into the liner. For example and reference Figure 13A The resuscitation assembly 131 includes a first electrode assembly 133a having an electrode pad 135a and a motion sensor 137a, and a second electrode assembly 133b having an electrode pad 135b and a motion sensor 137b, wherein the first electrode assembly 133a and the second electrode assembly 133b are separate from each other, but each can be connected to the overall system (e.g., via cable 139 or wirelessly). In some embodiments, a sensor housing containing the motion sensor (wherein the sensor housing is configured as a small protective shield (e.g., a foam-free padding material)) can be attached to or is detachable from the rest of the electrode assembly to a patient. As an example, the sensor housing and / or the motion sensor may include an adhesive or other material that allows the sensor to be mounted to and detached from the body, separate from the electrode pad.

[0117] If the preferred pressing position changes, or if it is otherwise desired that the motion sensor be located away from the electrode pad, then as Figure 13A The structure shown (in which motion sensors 137a, 137b can be freely mounted to and detached from the body, separate from electrode pads 135a, 135b) can be relevant. For example, if a patient has undergone chest surgery where the wound does not allow for the placement of standard pads, it can be advantageous to have one or more individually mountable motion sensors 137a, 137b installed independently of electrode pads 135a, 135b in any suitable location. Alternatively, in some cases, adjusting the location where chest compressions are applied may result in an increase in blood circulation levels. Optionally, as... Figure 13B As shown, motion sensors 137a and 137b can be completely separated from electrode pads 135a and 135b. For example, as shown, electrode pads 135a and 135b can be connected to a system for providing electrotherapy via the electrode pads, and motion sensors 137a and 137b can be individually connected to a system for obtaining signals from the motion sensors and determining one or more parameters related to chest compressions (such as chest compression depth, rate, and / or speed).

[0118] Processor circuitry for processing signals from motion sensors can be configured in any suitable location. Such processing may include, for example, integrating the acceleration signal to obtain displacement information, or subtracting subsequent acceleration or displacement information from preceding acceleration or displacement information. Other types of processing and analysis are also possible. In the example, the processor may be configured in a defibrillator, monitor, computing device, or other medical device. Thus, signals from motion sensors (e.g., wirelessly or via cable) can be transmitted to a processor on the medical device for analysis and, for example, feedback. Optionally, for signals transmitted via a wired cable system, the processor may be configured within a reusable portion of that cable system. For example, as discussed herein, the sensor housing, motion sensor, and associated cable may form a disposable assembly. This disposable assembly can be inserted into a reusable cable that electrically communicates with the corresponding medical device (e.g., defibrillator, monitor, etc.). By incorporating a processor for processing signals from motion sensors into a reusable cable, the processing of these signals can occur quickly and efficiently without unnecessary bandwidth usage, compared to more complex medical devices. As a result, the processor within the reusable cable can send one or more processed signals to a medical device (e.g., a defibrillator, monitor, CPR system) and / or back to the motion sensor and sensor housing. The medical device can collect the processed signals for further data analysis, reporting, or other functions. In some cases, the sensor housing itself may contain circuitry that receives processed compression information and provides the user with an appropriate level of feedback (e.g., LEDs, displays, audio signals to guide or assist the user in performing CPR). In other embodiments, the processor may be a disposable component, for example, located within the sensor housing or associated cable. As an example, the motion sensor and the processor for processing signals from the motion sensor may be located on the same circuit chip. Communication between the motion sensor and the associated processor can be digital and / or analog in nature.

[0119] In another alternative example and reference Figure 14The electrode pads 145a of electrode assembly 143a and 145b of electrode assembly 143b of resuscitation assembly 141 can be positioned in a specific configuration, such as the AA position, in which one electrode pad 145a, including a motion sensor 147a located on its upper surface, is placed on the sternum, and another electrode pad 145b, having a separate motion sensor 147b, is placed to the side of the patient. In this configuration, the separate motion sensor 147b can be placed, for example, on the patient's back or other suitable location, thereby obtaining more accurate or precise chest compression data even when the electrode pad 145b is placed to the side of the patient. Cable 149 is used to connect electrode assembly 143a and motion sensor 147a and to electrode assembly 143b and motion sensor 147b.

[0120] Measurements of chest compression depth, velocity, and rate during CPR are typically performed using a single sensor, such as an accelerometer housed in a casing placed in an anterior position on the patient's chest (typically above the sternum). In these methods, the measured inward acceleration is integrated twice to determine the external chest displacement used to assess the depth and rate of compression, or integrated once to determine the release velocity. An example of this method is described in U.S. Patent 9,125,793, entitled "System for determining depth of chest compressions during CPR," which is incorporated herein by reference in its entirety. However, these measurements may contain unexplained errors, such as those arising from movement of the surface beneath the patient, patient movement, and / or movement during transport. As an example, if the patient is lying on a soft, compressible surface (such as a mattress), the measured displacement will include not only the inward compression but also the depth of deformation of the compressible surface. This can lead to an overestimation of compression depth. As another example, if the patient is in a moving ambulance, external movement can further affect compression measurements and cause errors in estimating compression depth.

[0121] The resuscitation assembly of the present invention can be used to provide users with feedback related to resuscitation activities (e.g., chest compressions, ventilation) performed by rescuers on the patient with improved accuracy. More specifically, in operation, rescuers can place the electrode assemblies 1A and 1B of the resuscitation assembly in an AP orientation, wherein electrode assembly 1A is located on the patient's sternum and electrode assembly 1B is located on the patient's back. Optionally, as Figure 12As shown, the electrode assemblies 1A′ and 1B′ of the resuscitation assembly are positioned on the patient with an AA orientation. Specifically, in this configuration, electrode assembly 1A′ is located on the right side of the patient's chest, between the axilla and the sternum, with the portion of this electrode assembly including the motion sensor positioned approximately above the chest. Resuscitation assembly 1B′ is an apical electrode assembly and is located on the left side of the patient's chest, above the lower ribs. In any configuration, as described above, the motion sensor 19 of electrode assemblies 1A, 1B, 1A′, and 1B′ can be configured as a triaxial accelerometer, such that it simultaneously measures acceleration in the x, y, and z directions with two sensors incorporated within each electrode assembly.

[0122] As described herein, it will be understood that other resuscitation assemblies may be employed. In some embodiments, the electrode assembly, including the electrode pad and motion sensor, may not require the motion sensor to be directly mounted to the electrode pad or integrated within a padding material (part of a larger sensor housing) that is directly mounted to the electrode pad. For example, as Figure 13A , 13B As shown in Figure 14, the motion sensor can be connected to the electrode pad via a cable or other extension cable that allows electrical connection to the overall system. Alternatively, the motion sensor may not be mechanically mounted to the electrode pad at all. For example, the motion sensor may wirelessly communicate with the resuscitation system and be configured to connect to the body in any suitable manner (e.g., adhesively attached to the body). Additionally, the motion sensor described herein may be provided with a memory capable of storing data from the start of the motion sensor's use. For example, the motion sensor may be provided with a removable pad, which, upon removal, activates the sensor to begin storing data in the memory. Furthermore, the motion sensor may be provided with an audible / visual output system to provide lights or other visual displays or speakers or other audible outputs to indicate that the system is active. The motion sensor and / or associated housing may also include a chest compression metronome, an audible speaker (e.g., for providing verbal guidance), lights (e.g., red / green LEDs to indicate whether compressions are within acceptable limits), or other components to guide rescuers in performing chest compressions. Once the motion sensor is paired with a device (e.g., a defibrillator, desktop computer, tablet, mobile phone, patient monitor, etc.), the data stored in the motion sensor's memory is sent to the device and integrated into the medical record for post-case review. In a particular example, the motion sensor may be wireless, where the motion sensor may optionally communicate with the device via a wired connection for real-time feedback. Alternatively, communication between the motion sensor and the device may be dedicated wireless communication.

[0123] Therefore, if the motion sensor can be moved from one location to another, a resuscitation system communicatively connected to the motion sensor can provide the user with instructions regarding whether the motion sensor's position should be adjusted. For example, the motion sensor might be placed in a location unsuitable for collecting chest compression data. Thus, the system can provide the user with instructions to move the motion sensor to another location on the patient's body. Alternatively, where the preferred compression position changes periodically for each location, the user can be prompted to detach the motion sensor from the patient and reposition it in a different location for the purpose of increasing overall blood circulation.

[0124] Once the electrode assemblies included in the resuscitation assembly of the present invention are properly positioned, these electrode assemblies are operatively connected to a defibrillator 5 having control circuitry (not shown) and output devices (such as a display 6 and / or a speaker (not shown)) to provide output to a user. These assemblies may be connected via cable 7, or alternatively, one or more motion sensors may be operatively connected to the defibrillator and / or other devices using wireless technologies (e.g., Bluetooth, WiFi, radio frequency, near field communication, etc.). The control circuitry used in the defibrillator 5 may be any suitable computer control system and may be configured within the defibrillator housing. Optionally, the control circuitry may be configured within the associated defibrillator, within the associated mechanical chest compression device, or the control circuitry may be a general-purpose computer or a dedicated single-purpose computer. The control circuitry may include at least one processor and at least one memory storing program code, wherein the computer program code is configured to, when running on the at least one processor, cause the processor to perform functions assigned to the control circuitry within the present invention. These functions include: interpreting signals from motion sensor 19 and / or signals generated by other sensors to determine compression depth, generating a signal representing the calculated compression depth, and enabling outputs such as speakers or displays to provide feedback to rescuers.

[0125] In one example, the output device of defibrillator 5 provides information related to the patient's condition and the quality of CPR application during the use of defibrillator 5. This data is collected and displayed to rescuers in an efficient and effective manner. For example, during chest compressions, the output device can display information related to chest compressions on display 6.

[0126] Upon detection of chest compressions, information related to the chest compressions is automatically displayed on display 6. The displayed information may include rate (e.g., compressions per minute) and depth (e.g., compression depth in inches or millimeters). The rate and depth of compressions, and / or release rate, can be determined by analyzing readings from motion sensor 19. (In addition to displaying an indication that the actual rate and depth data values ​​are within or outside the acceptable range, or alternatively displaying such an indication) Displaying the actual rate and depth data is considered to provide useful feedback to rescuers. For example, if the acceptable range for chest compression depth is between 1.5 and 2 inches, providing the rescuer with an indication that his / her compressions are only 0.5 inches allows the rescuer to determine how to correctly modify the application of his / her chest compressions.

[0127] More specifically, the control circuitry of the defibrillator 5 is operatively connected to and programmed to receive and process signals from the motion sensors 19 of the electrode assemblies 1A and 1B to determine whether at least one of the chest compression depth and rate and / or release velocity during the CPR period falls within a desired range. The output device of the defibrillator 5 then provides the user with feedback instructions to maintain the chest compression depth and rate within the desired range during CPR.

[0128] In such Figure 1A and 1B As shown, with electrode assemblies 1A and 1B positioned anteriorly and posteriorly, in one example, the chest compression depth is calculated by subtracting the distance traveled by motion sensor 19 of electrode assembly 1B from the distance traveled by motion sensor 19 of electrode assembly 1A. More specifically, acceleration in the x, y, and z directions is measured simultaneously with both motion sensors 19. As described above, motion sensor 19 of electrode assembly 1A (i.e., the main sensor) is placed on the chest from the front, while motion sensor 19 of electrode assembly 1B (i.e., the reference sensor) is placed on the back from the rear as a reference. The main sensor is located in the center of the chest, where compressions occur in a direction substantially perpendicular to this sensor. The reference sensor can be positioned aligned with the main sensor, and the overall compression depth can be determined using the net acceleration of these sensors along the vertical y-axis (or other axes such as the z-axis, depending on how the patient is oriented relative to the accelerometer and the direction of gravity).

[0129] In another example, motion sensor 19 of electrode assembly 1B, located on the patient's back, provides a signal representing acceleration caused by external acceleration (such as during transport), and motion sensor 19 of electrode assembly 1A provides a signal representing acceleration caused by chest compressions performed on the patient by rescuers or mechanical devices. The signal representing the acceleration sensed by motion sensor 19 of electrode assembly 1A (i.e., device acceleration) is provided to the control circuitry of defibrillator 5. The device acceleration signal of electrode assembly 1A records the total acceleration representing the acceleration caused by compressions (compression acceleration) and the acceleration caused by external acceleration (external acceleration). Motion sensor 19 of electrode assembly 1B also provides a reference acceleration signal to the control circuitry of the defibrillator. The reference acceleration signal of electrode assembly 1B records only the external acceleration of the patient caused by transporting or otherwise moving the patient.

[0130] Therefore, the reference acceleration signal can be processed together with the device acceleration signal to generate an estimated actual acceleration. Once the estimated actual acceleration is obtained, as discussed in, for example, U.S. Patent 9,125,793, it can be double-integrated to generate an estimated actual chest compression depth. Further details of how vehicle motion artifacts can be removed from ECG signals based on information provided by auxiliary motion sensors can be found in U.S. Patent Application 14 / 216,225, entitled “ECG Noise Reduction System for Removal of Vehicle Motion Artifact,” which is incorporated herein by reference in its entirety. For example, motion sensors incorporated within resuscitation components 1B, 1B′ placed on the back or side of the patient can record movement associated with transport (e.g., based on detected acceleration), such as artifacts arising from surface features on the road encountered by the ambulance and / or wheelchair carrying the patient, and / or vehicle acceleration and deceleration. Therefore, artifacts that may otherwise introduce errors into the overall estimation of chest compressions (or other CPR parameters) due to patient transport can be estimated and / or mitigated.

[0131] Based on motion signals recorded by motion sensors from the electrode assembly of the resuscitation component of the present invention, processing circuitry in a system for providing resuscitation assistance can receive and process the recorded data to determine whether a patient is being transported. For example, if an acceleration signal is associated with patient transport, the system can instruct rescuers to take measures to ensure the patient is properly secured. Once the patient is properly secured, the system can instruct the user to apply chest compressions or other resuscitation activities. Alternatively, if rescuers are subjected to a scoring system (e.g., a report card) for evaluating their performance while performing resuscitation activities, the indicators used to evaluate the rescuers can be adjusted if it is determined that the patient is being transported. For example, performing manual chest compressions while the ambulance is in motion may be more difficult than when not in a moving vehicle, and a score reflecting this condition can be given to the rescuers. That is, to illustrate that the rescuers are subjected to conditions where applying CPR is more challenging or where the quality of CPR may be compromised (such as during vehicle movement or transport), the evaluation of the rescuers can be relaxed and the overall performance evaluation may be higher. Alternatively, for the purpose of evaluating the rescuers' performance, CPR measurements during transport can be discounted relative to the overall score. Therefore, the scoring criteria used to assess rescuers can explain whether chest compressions were being performed during transport.

[0132] For example, the system can also be configured to alert users when there are concerns about the safety of rescue personnel. For instance, in the event of a large amount of vehicle / transportation movement detected, to ensure that rescue personnel are not injured or become a potential liability to other passengers (as a large object that may suddenly move throughout the vehicle), it may be preferable for rescue personnel to stop CPR and instead place them under safety restraints (e.g., seat belts).

[0133] As described above, when electrode assemblies, each including one or more motion sensors, are placed in the AP position (front and back) with their orientations generally parallel to each other (and the xy planes of the 3-axis accelerometers are generally parallel to the direction of gravity), and the patient is lying on a compressible surface such as a mattress or thick padding, the system to which the electrode assemblies are connected can accurately estimate the depth of chest compressions by subtracting the distance traveled by the rear-placed assembly. When these electrode assemblies are placed in the AA position (front and side) with their orientations generally perpendicular to each other, the system to which these assemblies are connected can employ different algorithms for estimating the depth of chest compressions, instead of the subtraction technique described herein. Similarly, the system can identify electrode assemblies to be placed in lateral positions (side and side), where the 3-axis accelerometers are oriented generally parallel to each other, and the xy planes of these accelerometers are generally perpendicular to the direction of gravity. For example, when identifying pads placed in the AA or lateral positions, for the purpose of estimating the depth of chest compressions, the system can choose to process only the data received from the motion sensors located in the front of the patient, and not the data from the motion sensors located in the sides of the patient. Otherwise, using an incorrect calibration algorithm (e.g., using an algorithm corresponding to AP pad placement when the pad is actually placed in the AA position) could lead to inaccuracies. Alternatively, if the system determines the pad is in the AA position by acquiring and processing signals from sensors indicating the pad's orientation, the output mechanism of the defibrillator or other resuscitation equipment (e.g., monitors, CPR feedback systems) can alert rescuers that the pad is in the AA position, thus using only one of the motion sensors (e.g., a front-mounted motion sensor) to determine the depth of chest compressions. The output mechanism of the defibrillator or other resuscitation equipment (e.g., monitors, CPR feedback systems) can also recommend to the user that AP pad placement be used if the increased accuracy achieved by using two motion sensors is desired.

[0134] However, in some embodiments, even when the system recognizes that the electrode pads are placed in the AA position, the system may still choose to process data received from both motion sensors. That is, signals from both the motion sensor placed closest to the sternum and the motion sensor held by the other pads are processed for chest compression depth. As an example, for pads in the AA position, electrode pads placed on the patient's side may be configured such that the motion sensor extends far enough towards the patient's back that the signal from that motion sensor can be used as a reference for correcting chest compression depth.

[0135] When the separate motion sensors are oriented at an angle greater than a threshold angle relative to each other, the system can identify that the electrode assembly is placed at position AA. For example, electrode assemblies oriented approximately perpendicular to each other can be considered to be at position AA. Conversely, when the separate motion sensors are oriented at an angle smaller than a threshold angle relative to each other, the system can identify that the electrode assembly is placed at position AP. Thus, electrode assemblies oriented approximately parallel to each other can be considered to be at position AP. In various embodiments, the threshold angle is approximately 30 degrees, approximately 40 degrees, approximately 50 degrees, or approximately 60 degrees.

[0136] Regardless of the sensor orientation, the patient's overall orientation can be determined. For example, even if one of the sensors is misaligned or tilted in an undesirable manner, the patient's vertical axis (the direction perpendicular to the chest surface) can be determined by comparing the movement and / or position of the two sensors relative to each other.

[0137] refer to Figure 15 The following describes an example of a procedure for determining chest compression depth using the resuscitation assembly of the present invention. First, the rescuer positions electrode assemblies 1A and 1B (placed at the AP position) or electrode assemblies 1A′ and 1B′ (placed at the AA position) on the patient (see block 200). Once the electrode assemblies are placed on the patient, signals are obtained from each motion sensor 19 to provide baseline acceleration due to gravity (see block 202). By measuring the baseline acceleration due to gravity, the system determines the initial orientation of each motion sensor on the electrode assembly and rotates the reference sensor (i.e., the motion sensor 19 of the electrode assembly located at the front or rear) to the same plane as the main sensor (i.e., the motion sensor 19 located at the front of the patient's sternum). This procedure reduces errors caused by non-parallel alignment of the main sensor and the reference sensor. Additionally, the baseline acceleration measured by the reference sensor can be used to determine whether the reference sensor is placed from the rear or the front (see block 204). If the reference sensor is placed at the front (see block 204), the reference sensor is positioned at the front. Figure 12 In the case of a structure where the acceleration detected by the motion sensor 19 (i.e., the reference sensor) of the resuscitation assembly 1B′ is ignored, the compression depth is determined solely based on the signal from the motion sensor 19 (i.e., the main sensor as discussed above) of the electrode assembly 1A′ (see block 206). If the rear is placed for the reference sensor (see... Figure 1A and 1B As described above, the chest compression depth is calculated by subtracting the distance traveled by the motion sensor 19 (i.e., the auxiliary sensor) of the electrode assembly 1B from the distance traveled by the motion sensor 19 (i.e., the main sensor) of the electrode assembly 1A along the direction of applying chest compressions (see block 208).

[0138] Another use of the resuscitation assembly of the present invention, combined with the defibrillator 5, is to accurately detect compression depth when performing CPR on smaller patients, such as infants and young children. For adults, CPR chest compressions are performed with the patient supine (typically supported by a sufficiently rigid surface (floor, wheelchair, or hospital bed)). On the other hand, for infants and young children, CPR chest compressions can be performed using one of the two methods described below.

[0139] In some instances, the preferred first method for performing CPR chest compressions on infants and young children may be as follows: Figure 16 The double-thumb method is shown. This method requires grasping the infant's chest with both hands (with fingers supporting the infant's back), placing both thumbs on top of the sternum, and using the thumbs to apply pressure to the sternum. More specifically, the infant is positioned supine and supported on a surface. The CPR provider places his / her hands around the infant's chest, with his / her fingers encircling the infant's armpits and back, and his / her thumbs on top of the infant's sternum. In this method, the CPR provider compresses the infant's chest by pressing on the sternum with their thumbs to push the chest towards the spine. These compressions should be performed at a rate of 100 compressions per minute and to a depth of approximately one-third of the total thickness of the chest cavity (e.g., 1.5 inches (3.8 cm) for a chest cavity thickness of approximately 4.5 inches).

[0140] For solo rescuers, a second preferred method for performing CPR on infants and young children is often referred to as the two-finger method. This method involves using two fingers placed above the intercostal line (above the xiphoid process) to compress the infant's chest. It is generally recommended to compress approximately one-third of the chest cavity thickness (e.g., for a rough estimate of 4.5 inches (11.4 cm) of chest thickness in an infant, this is 1.5 inches (3.8 cm), although the chest thickness can vary depending on the infant's age / size). After each compression, the chest should be completely released.

[0141] According to the American Heart Association, the double-thumb encirclement technique is superior to the two-finger technique because the double-thumb technique has been shown to induce higher coronary perfusion pressure, thereby making the appropriate pressure depth or force more consistent and producing higher systolic and diastolic blood pressure in patients.

[0142] By positioning motion sensors 19 on both the back and chest of an infant using electrode assemblies 1A and 1B, the depth of compressions performed on an infant using one of several techniques (such as double thumb, double finger, and / or single palm (where the palm is placed under the patient as a backboard)) can be accurately determined by placing a thumb or finger over each motion sensor and subtracting the distance traveled by motion sensor 19 on electrode assembly 1B from the distance traveled by motion sensor 19 on resuscitation assembly 1A. In some situations, using a dual-sensor structure in the AP position to estimate chest compression depth may be more effective than using the double thumb method, as this method often involves squeezing the patient between the thumb and fingers, resulting in movement on both the front and back. However, it is understood that the dual-sensor structure can also be effective when using double finger and / or single palm techniques, especially when the patient is lying on a compressible surface. In fact, the dual-sensor structure can be effective when rescuers can switch between techniques (e.g., double thumb, double finger, single palm, etc.).

[0143] By implementing the dual-sensor method according to the invention (e.g., based on AHA / physician advice), the estimated chest compression depth can be compared with the desired chest compression range, and appropriate feedback and / or instructions related to the quality of the applied chest compressions can be provided to rescuers based on the comparison of the estimated compression depth and the desired compression range. Such feedback may include, for example, prompts to provide rescuers with instructions regarding whether to provide deeper or shallower compressions or to maintain the current depth. Any suitable prompt can be employed, such as audio prompts (e.g., voice / verbal prompts, beeping sounds of different tones / patterns, etc.), visual prompts (e.g., displays with text, colors, and / or graphics), tactile prompts (e.g., vibration), or prompts according to another suitable method. It should also be understood that while many embodiments described herein can be applied to children or small-sized patients, this configuration may also be applicable or potentially preferred for adults or larger patients.

[0144] It is understood that a pair of motion sensors disposed in the electrode assembly of the resuscitation kit described herein can be used to determine chest compression depth in several different ways. For example, the original acceleration signal can be subtracted and then processed (e.g., double integration) to calculate the net distance. Alternatively, the original acceleration signal can be processed (e.g., double integration) to produce a distance value before subtraction, and then each distance value can be subtracted accordingly. In other examples, one or both of the motion sensors may be a velocity sensor or a displacement sensor, and the signals obtained from these sensors can be processed to determine chest compression depth or other chest compression parameters such as rate, release velocity, etc.

[0145] To further illustrate one of the above examples, a motion sensor located on the patient's back provides a signal representing acceleration caused by external acceleration (such as the patient being transported, the patient being placed on a compressible surface, etc.), and another motion sensor located on the patient's chest provides a signal representing acceleration caused by chest compressions performed on the patient by a rescuer. The signal representing acceleration caused by compressions (compression acceleration) is subtracted from the signal representing acceleration caused by external acceleration (external acceleration) to produce a corrected acceleration value (e.g., an estimate of the actual acceleration). Once this corrected acceleration value is obtained, it can be double-integrated to produce a corrected chest compression depth (e.g., an estimate of the actual chest compression depth). This approach can save computational resources because only one processing step is performed: the signal representing the corrected acceleration is the only signal to be integrated, thus saving processing steps. Furthermore, the software and / or hardware components performing this processing (e.g., integration) may only require a single acceleration value as input, regardless of whether the acceleration signal has been previously subtracted or processed in another manner.

[0146] As another example, chest compression depth can be calculated by subtracting the distance traveled by the second motion sensor from the distance traveled by the first motion sensor. In this instance, the signal representing acceleration caused by external acceleration is double-integrated to determine the distance traveled by the second motion sensor, and the signal representing acceleration caused by chest compressions performed on the patient by a rescuer is double-integrated to determine the distance traveled by the first motion sensor. The distance traveled by the second motion sensor is then subtracted from the distance traveled by the first motion sensor to provide the compression depth.

[0147] The resuscitation components discussed herein can also be used to provide the user with feedback related to the surface on which the patient is placed. More specifically, the output device can provide the user with instructions regarding the change in the patient's position on the surface based on information sensed from the motion sensor 19 of electrode assembly 1A and the motion sensor 19 of electrode assembly 1B. For example, and referring to... Figure 17 and 18 During operation, the user can position electrode assemblies 1A and 1B in an AP orientation, such as... Figure 1A and 1B As shown, electrode assembly 1A is positioned on the patient's sternum and electrode assembly 1B is positioned on the patient's back (see Figure 1). Figure 18 Block 400).

[0148] Once the electrode assemblies 1A and 1B of the resuscitation unit are properly positioned, they are operatively connected via cable 7 to the defibrillator 5, which has control circuitry (not shown) and output devices (such as display 6 and / or speaker (not shown)) to provide output to the user. For example, and as discussed above, the output devices provide information related to the patient's condition and the quality of CPR application during the use of the defibrillator 5. Upon detection of compression, information related to chest compressions is automatically displayed on display 6. The displayed information related to chest compressions may include rate (e.g., compressions per minute) and depth (e.g., compression depth in inches or millimeters). The rate and depth of compressions, and / or release rate, can be determined by analyzing readings from motion sensor 19.

[0149] It is common practice to place the patient on a sufficiently firm surface (e.g., floor, wheelchair, backrest, or hospital bed) before initiating chest compressions. However, if the patient is placed on a compressible surface such as a soft mattress (e.g., adults in hospitals are typically treated on compressible surfaces, and mattresses for children can be particularly compressible compared to adult mattresses), rescuers may need to perform a much more strenuous operation to achieve the required compression depth. As a result, rescuers may struggle to achieve sufficient compression depth and / or tire quickly. Alternatively, without a feedback mechanism, rescuers may feel they have reached a sufficient depth when they have not actually achieved it.

[0150] refer to Figure 17 Patient 3 is illustrated as being positioned on a compressible surface 71, such as a mattress, with electrode assembly 1A having motion sensor 19 located at the front and electrode assembly 1B having motion sensor 19 located at the rear. In operation, the rescuer performs chest compressions on patient 3 as indicated by arrow F. The measured displacement (d) obtained by the motion sensor 19 of electrode assembly 1A is... A This includes not only the displacement (d1) caused by pressing into the chest, but also the displacement (d) caused by the deformation of the compressible surface. P As discussed above, this can lead to an overestimation of compression depth. By incorporating motion sensors in both the front electrode assembly 1A and the rear electrode assembly 1B, this overestimation of compression depth can be corrected to provide a more accurate assessment of chest compression depth. The actual compression depth can be calculated by subtracting the displacement of the motion sensor 19 (i.e., the auxiliary sensor) of the electrode assembly 1B from the displacement of the motion sensor 19 (i.e., the primary sensor) of the electrode assembly 1A. More specifically, the displacement of the motion sensor 19 of the electrode assembly 1A is compared with... Figure 17 displacement d ACorrespondingly, and including the displacement (d1) due to compression into the chest and the displacement (d2) caused by the deformation of the compressible surface. P Both of these. The displacement of the motion sensor 19 of electrode assembly 1B measures only the displacement (d) caused by the deformation of the compressible surface. P Therefore, by measuring the displacement (d) from the motion sensor 19 of the electrode assembly 1A... A =d1 + d P Subtract the displacement (d) caused by the deformation of the compressible surface from the total displacement. P This allows us to obtain the actual compression depth corresponding to the displacement (d1) of the compression into the chest.

[0151] Additionally, refer to Figure 18 The motion sensor 19 is positioned on the chest and back of the patient 3 by incorporating it into both the front electrode assembly 1A and the rear electrode assembly 1B. The control circuitry of the defibrillator 5 is operatively connected to and programmed to receive and process signals from the motion sensors 19 of the electrode assemblies 1A and 1B, and to determine whether the patient 3 is positioned on a compressible surface. More specifically, the motion sensor 19 of electrode assembly 1A can generate a first signal representing acceleration caused by compression, and the motion sensor 19 of electrode assembly 1B can generate a second signal representing other types of acceleration (such as acceleration due to movement on the compressible surface) (see block 402). These signals are then processed (see block 404) to determine whether the amount of displacement generated from the compressible surface meets a threshold large enough to suggest changing the surface beneath the patient (see block 406). This threshold may be related to the amount of work that rescuers must perform to achieve chest compressions within the desired range. For example, to reduce excessive effort by rescuers, a threshold can be set such that: if (e.g., compared to the total displacement of the front sensor) the displacement generated from the compressible surface is greater than 10% (e.g., between 10% and 100%) of the recommended compression depth or another indicator, greater than 25% (e.g., between 25% and 100%) of the recommended compression depth or another indicator, greater than 50% (e.g., between 50% and 100%) of the recommended compression depth or another indicator, greater than 75% of the recommended compression depth or another indicator, or greater than 100% of the recommended compression depth or another indicator, then a suggestion or instruction to change the base surface on which the patient is situated can be provided to the user. This instruction could be to place a backboard under the patient or to move the patient from an existing, relatively soft surface to a harder surface. The output device of the defibrillator 5 can provide feedback to the user as follows: if it is determined that the patient 3 is situated on a compressible surface that meets the set threshold, change the surface on which the patient 3 is situated (see...). Figure 18(Block 408). This feedback can be real-time feedback using audible, visual, or tactile cues, requesting rescuers to place the backboard under the patient 3 or move the patient 3 to a more rigid surface. Optionally, this feedback can be issued at the end of the rescue sequence, suggesting to rescuers the use of the backboard in future CPR situations. In cases where the displacement from the surface on which the patient 3 is placed is less than a predetermined threshold, the system assumes that the patient 3 is on a rigid surface and the defibrillator 5 provides feedback to the rescuers related to the quality of compressions discussed above.

[0152] One challenge in using two motion sensors, such as motion sensors 19 of electrode assemblies 1A and 1B or 1A′ and 1B′, is that the two sensors may not be in the same orientation. By measuring acceleration in three dimensions, with the motion sensors 19 configured as triaxial accelerometers, the baseline orientation of each motion sensor 19 can be determined, and then the reference sensor (i.e., the motion sensor 19 of the recovery assembly 1B) can be rotated to be in the same plane as the main sensor (i.e., the motion sensor 19 of the recovery assembly 1A). It will be understood that techniques known to those skilled in the art can be used to apply this reference rotation to the signals obtained from the two motion sensors.

[0153] For specific cases, the rotation of the baseline vectors of each motion sensor 19 can be determined by averaging over a period of stillness without movement. The angles (α, β, γ) between the master and reference sensors are calculated based on these vectors. Then, a rotation matrix is ​​calculated to first rotate the reference vector by an angle γ about the Z-axis (see Equation 1 below), and then rotate that vector again by an angle α about the X-axis (see Equation 2 below). The measurements on the reference sensor can then be multiplied by the rotation matrix R. x R z .

[0154] Equation 1

[0155] Equation 2

[0156] After rotation, the compression depth is calculated using acceleration components (e.g., y-axis acceleration) measured in a direction perpendicular to the chest surface from the main sensor and reference sensor. This depth is calculated by subtracting the acceleration in the same direction as that detected by the motion sensor 19 of the electrode assembly 1B located at the rear of the patient from the acceleration in the same direction as that detected by the motion sensor 19 of the electrode assembly 1A located at the front of the patient 3.

[0157] Alternatively, rotation calibration can be performed via a normalized cross product calculation, as described in the journal article entitled "Rotation about an arbitrary axis and reflection through an arbitrary plane" by Emod Kovacs, published in Annales Mathematicae et Informaticae (40), 2012, pp. 175–186. In this method, for rotation calibration, the baseline vectors of each sensor are determined by averaging over a period of stillness without movement. To rotate one vector to another, the vectors are first transformed so that the rotation axis is aligned with the Z-axis. Then, the angle between the two vectors is rotated about the Z-axis, and the inverse of this transformation is applied to both vectors. The rotation axis is the normalized cross product of the reference sensor vector and the master sensor vector.

[0158] When properly calibrated, the two motion sensors 19 can also be used to detect the direction of chest compressions, allowing control circuitry to determine whether the rescuer is performing compressions at an angle relative to the motion sensors 19 of the resuscitation assembly placed on the chest cavity. Chest compressions can preferably be performed in a direction perpendicular to the patient's (lying supine) position (i.e., approximately perpendicular to the chest surface). However, due to poor CPR habits / training, fatigue, etc., rescuers performing chest compressions may tend to push at an angle relative to the vertical direction.

[0159] Therefore, whether placed in an AP (Action) or AA (Action) configuration, a resuscitation system incorporating motion sensors into multiple electrode assemblies can be configured to sense the angle of the rescuer's forward chest compressions relative to the patient and make recommendations regarding whether the rescuer should change the direction of the applied chest compressions. For example, if the rescuer is applying chest compressions at a 45-degree angle relative to the vertical direction (perpendicular to the chest), the first motion sensor (placed on the patient's chest) can be expected to move in a direction approximately 45 degrees relative to the vertical direction referenced by a second motion sensor, such as one placed on the patient's back or side. Alternatively, the manner in which the rescuer applies chest compressions at a non-perpendicular angle relative to the patient may cause the first motion sensor to tilt or lateralize. For cases where the angle of chest compressions is determined based on the tilt or lateralization of the motion sensor, a gyroscope can be appropriately incorporated, and a correction algorithm can take into account the detected tilt or lateralization of the motion sensor. Thus, the resuscitation system can detect or otherwise estimate the angle of the forward chest compressions.

[0160] As a result, based on the acceleration information collected from the dual-sensor structure, the system can provide rescuers with instructions to change the manner and / or direction of chest compressions to minimize or otherwise reduce the compression angle. This instruction can be provided in the form of audio, visual, tactile feedback, or a combination thereof. As an example, the system can present rescuers with a display or interface relating to the existing compression angle, as estimated by the dual motion sensor structure. This display or interface can then provide the user with instructions regarding how the direction of chest compressions should be changed and how this change can be achieved. For example, the system can present a graphical display of the chest compression angle in real time, allowing rescuers to know how to immediately change the direction of chest compressions. Alternatively, the system can provide rescuers with explicit instructions on how to change the angle of chest compressions. Or, if a misalignment in the direction of chest compressions is sensed and the rescuer does not change the direction, the system can instruct the rescuer to push harder so that the chest compressions are deep enough. Another type of feedback can provide alerts or other notifications to rescuers that more work is being done than required.

[0161] In yet another example, the motion sensor 19 of the resuscitation assembly according to the invention can be used to sense the patient's ventilation rate. More specifically, ventilation (manual or automatic) applied to the patient between chest compressions and / or appropriately synchronized ventilation can cause movement of the patient's body. This movement resulting from ventilation can be detected using the motion sensor of the resuscitation assembly (e.g., a front sensor can detect ventilation-induced movement), thereby generating a waveform representing the back-and-forth movement of the motion sensor (e.g., displacement as a function of time). The frequency of peaks and troughs can provide an indication of the ventilation rate transmitted to the patient. Thus, the system through which the resuscitation assembly communicates can provide appropriate indications and / or feedback (e.g., audio, visual, tactile) regarding whether the ventilation rate should be faster or slower, or how better the ventilation can be synchronized with chest compressions.

[0162] In yet another example, as discussed above, the motion sensor 19 of the resuscitation assembly according to the invention can be used to determine whether the electrode assembly is placed in an AA, AP, or lateral position based on the orientation of the motion sensor 19 and / or its distance relative to each other. Once the position of the electrode assembly is determined, the system can adjust one or more resuscitation parameters, such as providing feedback and / or information to rescuers.

[0163] refer to Figure 19The resuscitation assembly 500 includes a first electrode assembly 502, a second electrode assembly 504, and a CPR pad 506 associated with the first electrode assembly 502. In various embodiments, each of the electrode assemblies 502 and 504 may incorporate a motion sensor 19 (e.g., the motion sensor may be embedded within a portion of the electrode assembly). The electrode assemblies 502 and 504 may be positioned in the AA position, wherein electrode assembly 502 is located on the upper right side of the patient 3's chest between the shoulder and sternum, and electrode assembly 504 is located on the lower left side of the patient 3's chest above the lower ribs.

[0164] In certain forms of treatment, alternatives Figure 19 As shown in the AA position, rescuers can place the first electrode assembly 502 and the second electrode assembly 504 in the AP position. In some cases, placing electrode assembly 502 in the patient's sternal region (as may happen during emergency care) and electrode assembly 504 in the patient's back may result in an inversion of the ECG signal, and / or the pacing vector associated with the electrode placement may be oriented in an undesirable direction across the heart. In these instances, placing the electrode assembly in a position such as... Figure 20A and 20B In cases involving the indicated AP location, or other structures that may cause an inverted ECG signal and / or a pacing vector oriented in an undesirable direction, the system can be configured to provide desired correction to the ECG signal and / or pacing vector to orient it in a preferred direction. Alternatively, the system can prompt rescuers to place the pad in an orientation that produces a more intuitive ECG signal and / or a pacing vector with preferred directionality.

[0165] By placing motion sensors 19 onto electrode assemblies 502 and 504, the control circuitry used in the defibrillator 5 can be configured to determine the respective positions of electrode assemblies 502 and 504 based on the orientation and / or distance of the motion sensors 19 relative to each other, as described above. If the control circuitry determines based on signals from the motion sensors 19 that... Figure 20A and 20B As shown, the first electrode assembly 502 is located on the patient's sternum and the electrode assembly 504 is located on the patient's back. In some embodiments, the control circuitry can reverse or otherwise adjust the ECG signal so that the ECG signal is correctly displayed on the display 6 of the defibrillator 5, and adjust the pacing vector (e.g., reverse the direction of the pacing vector) so that the pacing vector is set in the correct direction.

[0166] While various examples and structures of electrode assemblies incorporating motion sensors have been described above, this should not be construed as limiting the invention, as various other examples and structures are contemplated where each electrode assembly includes at least one motion sensor. For example, various other structures are contemplated for pediatric patients, infant patients, and adult patients.

[0167] refer to Figure 21A and 21B An example of a resuscitation kit for pediatric patients is shown. This resuscitation kit includes a pair of electrode assemblies 600 and 602. Electrode assembly 600 is configured to be installed from the front to the chest of the pediatric patient and is structurally identical to electrode assembly 1A described above. Electrode assembly 602 is configured to be installed from the rear to the patient's back (see [reference]). Figure 21B The electrode assembly 602 may include a flexible electrode pad 604 having a treatment side (not shown), configured to connect to the patient 3 and generally conforming to the patient's anatomy. The treatment side includes a conductive material (not shown), faces the patient 3's body, and is adapted to provide treatment to the patient.

[0168] The electrode assembly 602 may also include a motion sensor 101 located within the sensor housing 99. The motion sensor 101 and the sensor housing 99 can be coupled... Figure 10 The motion sensor 101 and sensor housing 99 shown are similar. The sensor housing 99 can be attached to the electrode pad 604 by positioning it on the bottom extension 606 of the upper surface of the electrode pad 604. The extension 606 can form a pocket or other receiving portion in which the sensor housing 99 can be disposed. In some embodiments, the sensor housing 99 can optionally be removed from the pocket and can be placed on or near the patient at any suitable location. A retaining portion 608 can be positioned above the sensor housing 99 to secure it to the bottom extension 606 on the upper surface of the electrode pad 604. In this configuration, the sensor housing 99 can be removably secured between the upper surface of the bottom extension 606 and the bottom surface of the retaining portion 608, thereby allowing the sensor to be easily replaced and / or moved to other locations.

[0169] It is understood that the sensor housing and electrode pad can be removably connected using any suitable means. As discussed above, the electrode pad may have a pouch or containment portion for holding the sensor housing in place, although the sensor housing can be easily detached from the pouch or containment portion if desired. In one example, the backing of the electrode pad may have perforations, minor scratches or notches, cut marks, etc., that allow the sensor to be removed by tearing away weakened areas. The electrode pad may also include a suitable adhesive that allows the sensor to be reinstalled or attached to the electrode pad. In another example, the sensor may be attached to the upper surface of the electrode pad backing, wherein the backing includes a lining material that allows the sensor to be peeled off and attached to other locations. Alternatively, the sensor housing and electrode pad may have complementary connection components, such as hook and loop fasteners, mutually attracting magnets, other fastening elements, etc. Alternatively, the sensor housing may have an adhesive material that allows repositioning from the electrode pad to a different surface (e.g., the patient's skin). In more embodiments, the adhesive used to mount the sensor to the electrode pad and / or the patient's surface may be effective in moist environments (such as in the presence of delivery fluid in newborns). For example, a water-active or water-based adhesive can be used, making it more effective at adhering to the contact point when the sensor housing is peeled off from the pad and reinstalled.

[0170] In addition, by utilizing features such as Figure 10 The small motion sensor 101 and sensor housing 99 are shown, and the sensor housing is positioned at the bottom extension 606 of the electrode pad 604. The remaining portion of the flexible electrode pad 104 has greater flexibility in attaching to the patient 3, thereby reducing the likelihood of the electrode pad 604 detaching from the patient 3. (Reference) Figure 22 The flexible electrode pad 104 can also be configured to be significantly thinner than the electrode assembly 1A shown in FIG1. ​​For example, the thickness of the flexible electrode pad can be less than about 10 cm, less than about 5 cm (e.g., about 1 mm to 5 cm), less than about 1 cm (e.g., about 1 to 10 mm), less than about 5 mm (e.g., about 0.1 to 5 mm), less than about 4 mm (e.g., about 0.1 to 4 mm), less than about 3 mm (e.g., about 0.1 to 3 mm), less than about 2 mm (e.g., about 0.1 to 2 mm), less than about 1 mm (e.g., about 0.1 to 1 mm), or fall within another suitable range.

[0171] refer to Figure 23A and 23B This illustrates another example of a resuscitation assembly for pediatric patients. In this example, the resuscitation assembly includes a pair of electrode assemblies 700 and 702. Electrode assembly 700 is configured to be mounted from the front to the chest of the pediatric patient, and in addition to the incorporated motion sensor, is such as... Figure 10Apart from the smaller motion sensor, such as the motion sensor 101 incorporated in the sensor housing 99, it is substantially the same as the electrode assembly 1A described above. Using this motion sensor is advantageous for use in pediatric patients because its small size occupies less space in the patient's anatomy. The electrode assembly 702 is configured to be mounted from the rear to the patient's back (see...). Figure 23B The electrode assembly 702 may include a flexible electrode pad 704 having a treatment side (not shown), configured to connect to the patient 3, and generally conforming to the patient's anatomy. The treatment side includes a conductive material (not shown), facing the patient 3's body, and is adapted to provide treatment to the patient.

[0172] As shown in this example, the motion sensor 101 associated with the electrode assembly is not integrated into the pad. Instead, the electrode assembly 702 and the motion sensor 101 are separate from each other, yet each can be connected to the overall system (e.g., via cable 706 or wirelessly). In some embodiments, a sensor housing 99 containing the motion sensor 101 (wherein the sensor housing 99 is configured as a small protective shield (e.g., a foam-free padding material)) can be attached to a patient separate from the rest of the electrode assembly 702. As an example, the sensor housing 99 and / or the motion sensor 101 may include adhesives or other materials that allow the sensor to be mounted to and / or removed from the body separate from the electrode pad. Additionally, in this example, as Figure 23B As shown, the sensor housing 99 can be mounted to various locations on the electrode pad 704. As an example, the sensor housing 99 can initially be attached to the electrode pad 704 and then be removable for subsequent installation onto a patient's body.

[0173] like Figure 23B The structure shown (in which the motion sensor 101 can be freely mounted to and detached from the body, separate from the electrode pad 704) may be relevant in cases where the preferred pressing position changes or in cases where it is otherwise desired to position the motion sensor away from the electrode pad.

[0174] refer to Figure 24A and 24BThis illustrates another example of a resuscitation assembly for a pediatric patient. The resuscitation assembly includes a pair of electrode assemblies 800 and 802. Electrode assembly 800 is configured to be mounted from the front to the chest of the pediatric patient and includes a flexible electrode pad 804 having a treatment side (not shown), configured to connect to the patient 3 and generally conforming to the patient's anatomy. The treatment side includes a conductive material (not shown), facing the body of the patient 3, and is adapted to provide treatment to the patient. Electrode assembly 800 may also include a motion sensor 806 located within a sensor housing 808. The motion sensor 806 and sensor housing 808 can be coupled with… Figure 10 The motion sensor 101 and sensor housing 99 shown are identical. The sensor housing 808 can be attached to the electrode pad 804 by positioning it on the upper surface of the electrode pad 804. As discussed herein, the outer surface of the sensor housing 808 may include texture or other materials to prevent slippage of the rescuer's hand during compressions or otherwise enhance overall comfort. Additionally, leads 810a extending from the electrode pad 804 and leads 810b extending from the sensor housing 808 are respectively configured to extend from the sides of these elements rather than from the bottom as in other examples. This configuration is desirable when the rescuer wants to keep the leads away from the patient's abdomen. For example, if the patient has undergone abdominal surgery (where the wound is in the area where wiring, tubing, or other instruments are located, close to conventional electrodes), it may be advantageous to use an electrode assembly such as electrode assembly 804 (where wiring 810a, 810b extends to the side away from the wound location). Furthermore, the lateral extensions can be more easily guided to a defibrillator, monitor, or other computing system for processing signals from the sensor. Otherwise, sensor wiring extending downwards towards the abdomen may be more cumbersome to manage. The posterior electrode pad may also include lateral extensions, which are typically used to reduce the overall contact area with the patient and are suitable for smaller patients with limited space on their backs.

[0175] Electrode assembly 802 is configured to be installed from the rear onto the patient's back (see [link]). Figure 24B Besides being smaller and more streamlined, the electrode assembly 802 is constructed in a manner similar to... Figure 21B The electrode assembly 602 shown is roughly similar. For example... Figure 24B As shown, lead 812 is configured to extend from the bottom of electrode assembly 802. Optionally, as... Figure 24C As shown, due to the above reference Figure 24A For the reasons stated above, lead 812 can extend from the side of electrode assembly 802.

[0176] refer to Figure 25A and 25BAn example of a resuscitation assembly for an adult patient is shown. This resuscitation assembly includes a pair of electrode assemblies 900 and 902. Electrode assembly 900 is configured to be installed from the front onto the chest of an adult patient and is substantially similar in construction to electrode assembly 1A described above, except that the electrode pad 904 is triangular rather than circular. Electrode assembly 902 is configured to be installed from the rear onto the patient's back (see [link to documentation]). Figure 25B Except that the sensor housing 13 is located at the upper corner of the flexible electrode pad 906 rather than covering most of the surface of the flexible electrode pad, the electrode assembly 902 is substantially similar in construction to the electrode assembly 1B.

[0177] refer to Figure 26A and 26B Another example of a resuscitation assembly for an adult patient is shown. This resuscitation assembly includes a pair of electrode assemblies 1000 and 1002. Electrode assembly 1000 is configured to be installed from the front onto the chest of an adult patient and is substantially similar in construction to electrode assembly 700 described above, except that electrode assembly 1000 is triangular in shape rather than circular and is larger in size. Electrode assembly 902 is configured to be installed from the rear onto the patient's back (see [link to documentation]). Figure 25B Except for its larger size, electrode assembly 902 is generally similar in construction to electrode assembly 600 described above. In some embodiments, these pads may include ECG electrodes, thereby allowing ECG monitoring without the need for separate leads for pacing. Additionally, the sensor housings 99 of each of these electrode assemblies 1000 and 1002 are removable and adjustable. For example, rescuers can remove the sensor housing 99 of the front electrode assembly 1000 from... Figure 26A The primary position shown is moved to another location. If the patient has a surgical wound, it may be necessary to leave the sensor housing near the sternum and move the electrode pads of the electrode assembly 1000 to a different location.

[0178] refer to Figure 27A and 27B An example of a resuscitation assembly for neonatal patients is shown. This resuscitation assembly is specifically designed for use in, as referenced... Figure 16The CPR procedure described herein is used for infants and young children. The resuscitation assembly includes a pair of electrode assemblies 1100 and 1102. Electrode assembly 1100 is configured to be installed from the front onto the chest of the pediatric patient. Electrode assembly 1100 may include a flexible electrode pad 1104, wherein the flexible electrode pad 1104 has a treatment side (not shown), is configured to connect to the infant / patient 3, and generally conforms to the patient's anatomy. The treatment side includes a conductive material (not shown), faces the body of the infant / patient 3, and is adapted to provide treatment to the patient. Electrode assembly 1100 may also include a motion sensor 101 located within a sensor housing 99. Motion sensor 101 and sensor housing 99 can be coupled to... Figure 10 The motion sensor 101 and sensor housing 99 shown are similar. The sensor housing 99 can be connected to the electrode pad 1104 by positioning it at the bottom of the upper surface of the electrode pad 1104.

[0179] Electrode assembly 1102 is configured to be installed from the rear onto the patient's back (see [reference]). Figure 27B Electrode assembly 1102 may include a flexible electrode pad 1106 having a treatment side (not shown), configured to connect to the infant patient 3, and generally conforming to the patient's anatomy. The treatment side includes a conductive material (not shown), facing the body of the infant patient 3, and is adapted to provide treatment to the patient. Electrode assembly 1102 may also include a motion sensor 101 located within a sensor housing 99. The motion sensor 101 and sensor housing 99 can be coupled to... Figure 10 The motion sensor 101 shown is similar to the sensor housing 99. The sensor housing 99 can be connected to the electrode pad 1106 by positioning the sensor housing 99 at the bottom extension of the upper surface of the electrode pad 1106.

[0180] Although the dual motion sensor resuscitation assembly has been described in detail based on what is currently considered the most practical example for illustrative purposes, it should be understood that such detail is for that purpose only, and the invention is not limited to the disclosed examples; rather, it is intended to cover modifications and equivalent configurations. For example, it should be understood that the invention considers that, to the extent possible, one or more features of any example can be combined with one or more features of any other example.

[0181] As used herein, unless the context explicitly states otherwise, the singular forms of “a,” “an,” and “the” include plural references.

[0182] As described herein, the terms “right,” “left,” “top,” and their derivatives should be used in connection with the invention due to their orientation in the accompanying drawings. However, it should be understood that the invention can take various alternative orientations, and therefore these terms should not be considered limiting. Furthermore, it should be understood that the invention can take various alternative variations and sequences of stages unless explicitly stated otherwise. It should also be understood that the specific devices and processes shown in the drawings and described in the specification are exemplary. Therefore, the specific dimensions and other physical characteristics relating to the embodiments disclosed herein should not be considered limiting.

[0183] Unless otherwise indicated, all numerical values ​​used in this specification and claims that are modified by the terms “about” or “approximately” to indicate dimensions, material parameters, or other values ​​are approximations that may vary depending on the desired properties sought to be obtained according to the invention. At the very least, rather than attempting to limit the application of the principle of equivalents to the scope of the claims, the interpretation of numerical parameters should take into account significant digits and common rounding methods.

[0184] As used herein, the terms “about” or “approximately” when referring to measurable values ​​such as quantities, dimensions, and material parameters are intended to include variations of + / -10%, more preferably + / -5%, even more preferably + / -1%, and still more preferably + / -0.1% relative to the specified value, as such variations are appropriate for carrying out the disclosed methods.

[0185] While the numerical ranges and parameters that illustrate the broad scope of the invention are approximate, the values ​​stated in the specific examples are reported as precisely as possible. However, any value inherently includes some error that must arise from the standard deviation found in the respective tests and tolerance measurements. Each data range given throughout this specification will include every narrower numerical range falling within such a broad range, as if all of these narrower ranges were explicitly stated herein.

[0186] This application claims priority to U.S. Provisional Patent Application No. 62 / 242,749, filed October 16, 2015, entitled “Dual Sensor Electrodes for Providing Enhanced Resuscitation Feedback,” the entire contents of which are incorporated herein by reference.

Claims

1. A system for facilitating recovery, comprising: Recovery components, which include: The first electrode assembly includes a treatment side and a first motion sensor, and The second electrode assembly includes a treatment side and a second motion sensor; A processing circuit operatively connected to the resuscitation assembly, the processing circuit being configured to receive and process signals from at least one of the first motion sensor and the second motion sensor to estimate at least one of the compression depth and compression rate during chest compressions; and The output device provides the user with guidance on applying chest compressions based on the estimated compression depth or rate. The processing circuit is also configured to determine the placement orientation of the first electrode assembly and the second electrode assembly on the patient. The estimation of at least one of the compression depth and compression rate during chest compressions includes: In response to determining that the placement orientation is anterior-anterior, the compression depth is estimated by processing only signals from the motion sensor located on the front of the patient, whichever is more advanced than the first motion sensor or the second motion sensor. In response to determining that the placement orientation is a front-back position, the pressing depth is estimated by processing signals from the first motion sensor and the second motion sensor.

2. The system according to claim 1, wherein, The compression depth is calculated by subtracting the distance traveled by the motion sensor located on the back of the patient from the distance traveled by the motion sensor located on the front of the patient.

3. The system according to claim 1, wherein, At least one of the first electrode assembly and the second electrode assembly includes an internal pocket that holds the corresponding first motion sensor or second motion sensor in a removable manner.

4. The system according to claim 1, wherein, At least one of the first motion sensor and the second motion sensor is adhesively connected to the corresponding first electrode assembly or the second electrode assembly.

5. The system according to claim 1, wherein, With the placement orientation in the front-back position, the motion sensor located on the front of the patient is configured to generate a first signal representing acceleration caused by pressure, and the motion sensor located on the back of the patient is configured to generate a second signal representing acceleration caused by movement on a compressible surface.

6. The system according to claim 1, wherein, The processing circuit and the output device are located in the external defibrillator.

7. The system according to claim 1, wherein, At least one of the first electrode assembly and the second electrode assembly includes a flexible electrode layer containing the treatment side.

8. The system according to claim 1, wherein, The output device is configured to provide the user with instructions on how to change the surface in which the patient is located, based on information sensed from the first motion sensor and the second motion sensor.

9. The system according to claim 1, wherein, At least one of the first motion sensor and the second motion sensor includes an accelerometer capable of measuring acceleration in multiple directions.

10. The system according to claim 9, wherein, The processing circuit is configured to estimate the orientation difference between the first electrode assembly and the second electrode assembly.

11. The system according to claim 10, wherein, The processing circuitry is configured to estimate the angle of the chest compressions being applied by the user during CPR relative to the patient's vertical axis, based on signals received from the first motion sensor and the second motion sensor.

12. The system according to claim 10, wherein, The output device is configured to provide the user with instructions for applying chest compressions based on an estimate of the orientation between the first electrode assembly and the second electrode assembly.

13. The system according to claim 1, wherein, It also includes a sensor housing that encapsulates at least one of the first motion sensor and the second motion sensor.

14. The system according to claim 13, wherein, The sensor housing includes a textured material to reduce slippage of a rescuer's hand relative to the sensor housing.

15. The system according to claim 1, wherein, The processing circuit is configured to receive and process signals from at least one of the first motion sensor and the second motion sensor to estimate the release velocity, and the output device is configured to provide guidance to the user based on the estimated release velocity.

16. The system according to claim 1, wherein, Estimating the compression depth by processing signals from the first motion sensor and the second motion sensor includes: The acceleration signal of the motion sensor located at the back of the patient is subtracted from the acceleration signal of the motion sensor located at the front of the patient in the first motion sensor and the second motion sensor in the second motion sensor to obtain the corrected acceleration value. The compression depth is estimated by double integration of the corrected acceleration value.

17. The system according to claim 1, wherein, Estimating the compression depth by processing signals from the first motion sensor and the second motion sensor includes: The acceleration signals from the motion sensors located on the patient's back are double-integrated from the first and second motion sensors to obtain the distance traveled by the back motion sensor. The acceleration signals from the motion sensors located in front of the patient in the first and second motion sensors are double-integrated to obtain the distance traveled by the frontal motion sensor. The pressure depth is estimated by subtracting the distance traveled by the rear motion sensor from the distance traveled by the front motion sensor.

18. A system for facilitating recovery, comprising: Recovery components, which include: The first electrode assembly includes a treatment side and a first motion sensor, and The second electrode assembly includes a treatment side and a second motion sensor; A processing circuit operatively connected to the resuscitation assembly, the processing circuit being configured to: identify the resuscitation assembly as either a pediatric resuscitation assembly or an adult resuscitation assembly based on an identification signal; and receive and process signals from at least one of the first motion sensor and the second motion sensor to estimate at least one of the compression depth and compression rate during chest compressions; and The output device provides the user with guidance on applying chest compressions based on the estimated compression depth or rate. Wherein, at least one of the first motion sensor and the second motion sensor can be separated from the corresponding first electrode assembly or second electrode assembly, and The output device is configured to adjust the instructions based on whether the resuscitation component is identified as a pediatric resuscitation component or an adult resuscitation component.

19. A resuscitation assembly for a defibrillator, the resuscitation assembly comprising: Flexible electrode pads with a treatment side; A sensor housing is mounted to the flexible electrode pad, and the sensor housing has greater rigidity compared to the flexible electrode pad; as well as A motion sensor, which is at least partially enclosed within the sensor housing. At least a portion of the flexible electrode pad is configured to bend relative to the sensor housing, such that the flexible electrode pad generally conforms to the patient's human anatomy when connected to the patient.

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