Device to assist a first aider during cardiopulmonary resuscitation

Description

[0001] The invention relates to a device for recording data and for instructing a helper in carrying out first aid measures for the resuscitation of a patient suffering from cardiac arrest according to the preamble of claim 1.

[0002] Survival after sudden cardiac death is only possible if chest compressions are performed within the first few minutes, usually before the arrival of emergency services, and if they are performed according to current guidelines. Furthermore, the patient must be ventilated. Delivering a defibrillation shock within the first minute in the presence of ventricular fibrillation or ventricular tachycardia also increases the probability of survival to approximately 90%.

[0003] For example, in Germany, lay rescuers initiate important resuscitation measures (especially chest compressions) in only about 40% of emergency cases. The quality of chest compressions is good after training and practical practice, but declines significantly after just three to six months. Furthermore, even during resuscitation, the quality of chest compressions drops significantly after just two minutes. Performing chest compressions also triggers significant stress reactions, at least in lay rescuers, so guidance from the rescuer can improve the quality of chest compressions.

[0004] The probability of survival of a patient in cardiac arrest depends largely on the first aid measures provided by lay rescuers, who are often overwhelmed by the situation and rarely adequately trained. Even with trained lay rescuers, the quality of the measures is often inadequate. For this reason, systems that support rescuers during resuscitation are very helpful.

[0005] EP 1 128 795 B1 discloses a system for measuring and initiating chest compressions. It comprises a mobile CPR compression monitor (CPR - cardiopulmonary resuscitation, heart-lung resuscitation) for monitoring chest compressions during resuscitation of a person suffering from cardiac arrest. The device is placed on the hand of the rescuer or on the patient and includes acceleration sensors and a data transmission interface. An evaluation unit with a screen, either integrated into the CPR compression monitor or a standalone one, is connected to this interface via a cable. This system is designed for trained and experienced medical personnel.

[0006] WO 2006 / 104977 A2, EP 2 255 845 A1, and DE 60 2004 002 147 T2 disclose a multi-layered professional medical system for supporting a first responder, who must be trained in resuscitation. The system includes, among other things, a defibrillator and a mobile display and control unit.

[0007] WO 2013 / 128 306 A1 discloses the features of the preamble of claim 1 and describes an automatic external defibrillator designed for use in cardiac emergencies. The defibrillator can be used in defibrillator mode, in which the defibrillator delivers electrotherapy to a patient. In addition to its electrical resuscitation function, the defibrillator can be deployed on the patient's chest to perform cardiopulmonary resuscitation compressions.

[0008] US 2018 / 169426 A1 discloses a device, software, and methodology related to a portable automated external defibrillator. The portable defibrillator interacts with a mobile device and includes two or more cardiac electrodes, a battery, and a special capacitor. When connected to a patient in cardiac arrest, the defibrillator contacts emergency services and records patient information, which is then transmitted to a medical provider for evaluation. The defibrillator is capable of analyzing heart rhythms, suggests administering one or more shocks if a cardiac arrhythmia is present, and instructs the user in proper CPR technique.

[0009] EP 2 653 146 A1 describes a correction instruction system for cardiac massage using an automated external defibrillator. This system comprises a sensor that receives compression measurement data from CPR chest compressions and a control system with a microprocessor programmed to perform a non-parametric, information-theoretic analysis of the compression measurement data.

[0010] EP 2 228 097 A1 discloses a defibrillator with a chest compression feedback device, which is designed in terms of shape and size to be placed directly on a patient's chest. The chest compression feedback device serves to obtain quantitative and qualitative data on chest compressions performed on the patient.

[0011] US 2016 / 287470 A1 describes a medical device comprising a service component for use in recognizing patient data, a care protocol module for providing healthcare to a patient, and a resource module for managing access to the service component and responding to a request by managing the service component.

[0012] CN 106 902 462 A discloses a portable device for automatic cardiopulmonary resuscitation, comprising a shell, a defibrillation module arranged in the shell for carrying out cardiopulmonary resuscitation, and a ventilation assistance module arranged in the shell for ventilation support.

[0013] WO 2019 / 015727 A1 describes a sensor device for acquiring data during first aid measures for the resuscitation of a person suffering from cardiac arrest. The sensor device is positioned on the patient's chest using a positioning aid and secured with a fastener. A motion sensor records the parameters of the chest compressions, such as the compression depth and compression frequency. A data transmission interface enables communication with a mobile device.

[0014] US 2017 / 0 259 054 A1 discloses an electrode assembly for use with a defibrillator, the electrode assembly comprising at least one electrode having a first surface that can be attached to either a pediatric patient or an adult patient, and a second surface, the majority of the second surface having illustrated instructions for use of the electrode assembly.

[0015] WO 2020 / 006355 A1 describes a system intended for cardiopulmonary resuscitation comprising a chest compression device, for example a defibrillator, and a computer device, wherein the computer device is configured to receive information about a patient being treated for cardiopulmonary arrest and to send commands to the chest compression device.

[0016] Likewise, EP 1 858 472 B1 describes a mobile, yet highly complex medical system for assisting rescuers during resuscitation, which also includes a defibrillator. The device is intended to be stationed at a few central locations with high levels of crowding so that first responders can access it quickly. However, this device can only be used effectively by trained rescuers.

[0017] Another disadvantage of the aforementioned devices is their size and weight, which make them impossible to carry around on a daily basis. Therefore, these devices are often kept in central locations, for example. However, in an emergency, a first responder often doesn't know where to find such a first aid device, or valuable minutes pass before the device is brought to them. Furthermore, a (first) responder is often overwhelmed, especially if they have not been adequately trained on the device before the emergency occurs.

[0018] Especially in systems with automatic defibrillators, it has been shown that a comparatively large amount of time—on average, almost two minutes—is lost due to preparatory measures before the first chest compressions can be initiated. However, this contradicts the recommendations for resuscitation measures, which state that chest compressions should be performed as quickly as possible, i.e., within less than 30 seconds.

[0019] The invention is based on the object of providing a device for assisting a first aider during cardiopulmonary resuscitation, which device comprises a sensor device for recording data when carrying out first aid measures for resuscitation, wherein the device should be so small and compact that it can be carried by any willing layperson or first aider at all times, and wherein the handling should be absolutely intuitive so that it can be used for immediate resuscitation even in stressful situations by an untrained layperson who has no prior medical knowledge.

[0020] The object is achieved by a device for assisting a first aider having the characterizing features according to claim 1; expedient embodiments of the invention can be found in the subclaims.

[0021] According to the invention, a device is provided to assist a first responder during resuscitation. Due to its dimensions and weight, it can be carried daily, e.g., in a handbag. The device comprises a sensor device including sensors for recording the data relevant to cardiac massage, as well as electrodes for measuring the patient's ECG data and for delivering defibrillation shocks.

[0022] The device is designed to support first responders, but especially also inadequately trained lay rescuers, in the resuscitation of patients with cardiac arrest.

[0023] The device according to the invention comprises a preferably rigid transport housing in which the sensor device, cables, and at least two electrodes are stored. This transport housing can be designed as a two-part, flat box, for example, in the shape of a key chain. According to the invention, the external dimensions are within 10 cm x 10 cm x 3 cm.

[0024] Due to its choice of materials and / or its construction, the transport case is designed as a container that is at least splash-proof, allowing its contents to be stored for at least four years, protected from dirt, for example.

[0025] The sensor device comprises a motion sensor, a storage device for electrical energy, hereinafter referred to as a battery, a microprocessor, a high-voltage storage device (e.g. in the form of a capacitor) for a defibrillation pulse, connections for the electrodes, an interface for transmitting and / or receiving data and / or commands, and an adhesive on its outer shell for attaching the sensor device to the patient's chest.

[0026] The electrodes have an adhesive surface on one side covered with a removable protective film. They also have folds so they can be folded during storage in the transport case. The electrodes are used to measure electrical currents / voltages, e.g., for recording an electrocardiogram (ECG), and / or deliver a defibrillation shock to the patient. The electrodes can be connected to the sensor device using cables.

[0027] The microprocessor is designed such that the data acquired by the sensors and electrodes can be evaluated and prepared in a form that can be displayed or further processed by a mobile device connected wirelessly or via cable to the sensor device via the interface. The mobile device communicating with the sensor device can be any type of commercially available portable small or microcomputer, for example, a smartphone, a phablet, a tablet, or a smartwatch, although the mobile device itself is not part of the invention.

[0028] The mobile device connected to the sensor device receives data and provides the first responder with instructions for optimal resuscitation via application software installed on the device. The software running on the device can combine data from the electrodes and the sensor device to obtain valid results. For example, impedances (from the electrodes) combined with movement data from the position and / or motion sensor can enable a valid assessment of spontaneous breathing or ventilation by the responder. This provides the first responder with feedback on the quality of the measures performed, especially chest compressions, and an indication if defibrillation is necessary.

[0029] A defibrillation shock is prepared in the sensor device - either remotely controlled from the connected device or immediately after the sensor device is switched on - i.e. the high-voltage storage device, which can be designed as a capacitor, is charged. After automated activation by the mobile device and / or manual activation by the first aider using a trigger button on the sensor device and / or via an option in the software running on the mobile device, the current from the high-voltage storage device is delivered to the patient as a defibrillation shock. For example, the triggering of the shock is prepared automatically by the software running on the mobile device, whereby activation must first be confirmed by the first aider by pressing the trigger button on the sensor device.

[0030] Due to the size of the sensor device, the battery and high-voltage storage unit are dimensioned to generate a defibrillation shock. While the device does not meet the usual requirements for an (automated) external defibrillator, as the required external dimensions would prevent it from being carried around at all times (for example, in a handbag or jacket pocket), it can enable successful resuscitation by delivering at least one defibrillation shock, if delivered quickly enough.

[0031] The advantage of the invention is that, compared to prior art medical devices for assisting first aiders in resuscitation (particularly those with an additional defibrillator), the device is very small and therefore easily transportable. Furthermore, its smaller size makes it significantly more cost-effective, making it more widely applicable and accessible to everyone. Because the device's size means it can be carried in the glove compartment of a vehicle, for example, it is immediately available in emergency situations, and any necessary defibrillation shock can be delivered within less than two minutes. The device is designed to provide support in the first few minutes of emergency care. While it can deliver a defibrillation shock if necessary, it is by no means intended to replace a defibrillator.Occasionally, multiple or even many defibrillation shocks are necessary during resuscitation, so that an additional external defibrillator must be used if resuscitation with the device described here is not successful within a few minutes.

[0032] A further advantage is that the necessary processes—such as recording cardiac currents, analyzing and interpreting the measurement data, instructing the first responder on emergency measures, and (if necessary in combination with a switch activated on the device) triggering the defibrillation shock—are handled by the terminal device connected to the sensor device. This embodiment of the invention makes it possible to build the device, i.e., the hardware required in addition to the existing mobile device (e.g., a standard Android smartphone), extremely small. Ideally, the sensor device of the device can dispense with controls and a display unit.

[0033] Using software (application) running on the mobile device, the ECG acquired via the electrodes is evaluated, among other things, and a decision is made as to whether a shock should be delivered. If appropriate, the software integrates defibrillation into the first responder's instructions. The ECG and the data on the delivered defibrillation shock can be saved and transmitted to the medical facility that will provide further care for the patient.

[0034] The invention can be further configured to include an activation device by means of which the sensor device is switched on, ie, by means of which at least the microprocessor and the high-voltage storage device are connected to the battery. This activation device can be a manually operated toggle or push-button switch.

[0035] The sensor device can further comprise a positioning aid in the form of an extendable or foldable band of a predetermined length, so that after the extended / folded positioning aid is applied to the sternum, the sensor device lies in the optimal position on the chest for cardiac massages.

[0036] It can be provided that the positioning aid device is coupled to the activation device or represents the activation device itself, so that the sensor device can be activated at the same time by actuating the positioning aid device.

[0037] Alternatively, it can be provided that the activation device is a pressure- or movement-sensitive activation switch arranged within the housing of the sensor device, which activates the sensor device as soon as the first aider exerts pressure on it.

[0038] According to a preferred embodiment, the interface of the sensor device for communication with a mobile terminal is a wireless interface, which can be designed according to a Bluetooth standard.

[0039] Furthermore, the sensor device can have a pressure or force sensor, which, for example, detects a complete relief of the chest during cardiac massage and / or - as already explained - is used as an activation device for the sensor device.

[0040] According to one embodiment, the sensor device additionally comprises a temperature and / or multi-sensor for measuring medical parameters (e.g., body impedance). A sensor for monitoring respiration and the quality of ventilation may also be provided.

[0041] Alternatively, the adhesive is implemented as an adhesive coating on a surface area of ​​the sensor device, for example, as an adhesive patch (adhesive plaster). In this case, the adhesive surface of the patch is covered with a removable protective film.

[0042] It is intended that the battery and the high-voltage storage unit are designed in such a way that exactly one defibrillation shock can be delivered, whereby the residual energy remaining in the battery after the shock is only sufficient to operate the sensors, the microprocessor and the interface for approximately 30 minutes.

[0043] On the outside of its housing, the sensor device can have an adhesive surface in the form of an adhesive coating, at least on a surface area that – when used as intended during resuscitation – comes into contact with, for example, the resuscitator's hand pressing against the patient's chest using the sensor device. This means that, in addition to the adhesive applied to its "underside," the sensor device can have an additional, adhesive surface area (adhesive surface) on its "top side."

[0044] The storage device for electrical energy can be a disposable battery or a rechargeable battery cell, whereby the charging of the battery can be carried out inductively, i.e. in this case the sensor device additionally comprises an inductive charging interface for coupling to an inductive charging device.

[0045] According to one embodiment, the motion sensor of the sensor device is an acceleration sensor, for example, a three-axis acceleration sensor, whereby both the indentation depth and the compression frequency can be calculated from the acceleration values ​​detected by the sensor. It can also be provided that the sensor device comprises two, in particular redundant, motion sensors.

[0046] The positioning aid can be designed in the form of a measuring element, e.g., a tape, a cord, or a rod of a predetermined length, which can be folded out or pulled out of the housing. Preferably, the positioning aid is a pull-out, e.g., roll-out, flexible measuring element whose maximum length does not exceed 8 cm, preferably 5 cm.

[0047] The measuring scale can be provided with marking positions – e.g., designed as locking points, each of which defines a predetermined extension length of the measuring scale when withdrawn from the sensor device housing – for patients of different body sizes, e.g., in the form of a marking for children, adolescents, and adult men or women. Thus, by applying the measuring scale to the sternum, precise placement of the sensor device on the patient's chest is possible.

[0048] In particular, the invention can be designed such that the measuring embodiment consists of a flexible or rigid fiber-reinforced plastic, e.g., carbon fiber-reinforced plastic (CFRP) or aramid, wherein the temperature-dependent coefficient of linear expansion can be substantially zero.

[0049] Alternatively or additionally, it can be provided that the measuring embodiment has an adhesive layer applied at least partially on one side, so that when the positioning aid device is actuated, the measuring embodiment can be fixed to the patient's chest by means of the adhesive layer.

[0050] The device for assisting a first aider during cardiopulmonary resuscitation is explained in more detail below with reference to the figures, where identical or similar features are provided with the same reference numerals.

[0051] In a schematic representation, the Fig. 1 : a top view of the device; and Fig. 2 : an application of the device to the patient.

[0052] According to Fig. 1 The device comprises a two-part transport case 1, which is designed as a waterproof container. It contains the two adhesive electrodes 2 with the cables 8 and the sensor device 4. Fig. 1 The positioning aid 7 is shown already pulled out of the sensor device 4. The adhesive 5 is applied to the back of the sensor device 4, by means of which the sensor device 4 can be attached to the chest.

[0053] According to Fig. 2 When an emergency occurs, the sensor device 4 and the adhesive electrodes 2 are removed from the transport housing 1. The adhesive electrodes 2 are attached to the chest of the patient 3 and connected to the sensor device 4 via the cable 8. The sensor device 4 (here a version without a positioning aid) is switched on by pressing the switch 9, which also charges the high-voltage storage device (not shown), and is then attached to the chest of the patient 3.

[0054] The mobile device 6, in this case a smartphone, communicates with the sensor device 4 via a wireless interface (here according to the WLAN 802.11ax standard). Software started on the mobile device 6 instructs the first aider (not shown), and if the corresponding indication is present, it automatically triggers a single defibrillation shock after the first aider has been informed. List of reference symbols used

[0055] 1Transport case 2Adhesive electrode 3Patient 4Sensor device 5Adhesive 6Mobile device 7Positioning aid 8Cable 9Power switch

Claims

1. An apparatus for supporting a first aider in a cardiopulmonary resuscitation, comprising a sensor device (4) with - a top side that contacts a hand of the first aider when the sensor device (4) is used as intended, and a bottom side opposite the top side, which has an adhesive means (5) arranged on a surface area for fastening the sensor device (4) on the chest of a patient (3) or a training manikin, - a movement sensor and - an interface for sending and / or receiving data and / or commands, wherein the apparatus further has two adhesive electrodes (2) connectable or connected with the sensor device (4), wherein - the sensor device (4) has a storage for electrical energy, a microprocessor and a high-voltage storage with terminals for the adhesive electrodes (2), and - the sensor device (4) has an activation apparatus for connecting at least the microprocessor and the high-voltage storage to the storage for electrical energy, characterised in that - the apparatus furthermore has a largely flat, at least splash-proof transport housing (1) in which the sensor device (4) and the two adhesive electrodes (2) are storable, wherein the transport housing (1) has geometric external dimensions of at most 10 cm x 10 cm x 3 cm, - the adhesive electrodes (2) are foldable, having kinked folds for folding up during storage, and - the storage for electrical energy and the high-voltage storage are designed in such a way that exactly one defibrillation shock can be delivered.

2. The apparatus according to claim 1, characterised in that at least one surface area of the top side of the sensor device (4) has an adhesive coating or consists of an adhesive material.

3. The apparatus according to any one of the preceding claims, characterised in that the interface is wireless.

4. The apparatus according to any one of the preceding claims, characterised in that the storage for electrical energy is rechargeable, wherein the sensor device (4) has an inductive charging interface for an inductive charging device.

5. The apparatus according to any one of the preceding claims, characterised in that the motion sensor is an acceleration sensor.

6. The apparatus according to any one of the preceding claims, characterised in that the adhesive (5) is an adhesive bandage, the adhesive surface of which is covered with a removable protective film.

7. The apparatus according to any one of the preceding claims, characterised in that it has a positioning tool (7) connected to the sensor device (4) for the exact positioning of the sensor device (4) on the chest.

8. The apparatus according to claim 7, characterised in that the positioning tool (7) is a measuring standard that can be folded-out or pulled-out of the sensor device (1).