DEVICES TO ASSIST IN THE PERFORMANCE OF AN EMERGENCY CARE PROCEDURE, SYNCHRONIZED CARDIOPULMONARY RESUSCITATION SYSTEM AND ASSOCIATED METHOD

Abstract

The invention relates to a device for assisting in the performance of an emergency care procedure such as chest compressions on a patient's rib cage or pulmonary ventilations, a device comprising: - a measuring device, arranged to measure at least one variable representative of an expected effect of the care procedure and to produce at least one measurement signal, - a signal processing device arranged to extract from at least one measurement signal at least one quality parameter relating to a quality of the care procedure performed, - a communication device arranged to receive data from another device for assisting in the performance of another emergency care procedure, said data comprising at least one piece of information,a parameter or instruction for an assistance device characterized in that the signal processing device is arranged to process at least one measurement signal based on data received from the other assistance device. The invention also relates to a cardiopulmonary resuscitation assistance system comprising a compression assistance device and a ventilation assistance device intended for use by at least two separate persons. Finally, the invention relates to a display method associated with the assistance system. Abstract figure: Figure 1,

Description

Title of the invention: Devices for assisting in the performance of an emergency care procedure, synchronized cardiopulmonary resuscitation assistance system and associated method. Technical field

[0001] The invention relates to the field of assistance to persons in cardiopulmonary distress, and more specifically in this field, the invention relates to devices for assisting in the performance of an emergency care procedure and a system for assisting synchronized cardiopulmonary resuscitation.

[0002] Cardiac arrest is the leading cause of death worldwide, accounting for nearly 60,000 deaths per year in France and more than 15 million globally. These figures could even double by 2024 due to the aging population and the sharp increase in cardiopulmonary diseases. This serious public health problem is all the more worrying given that, for nearly 20 years, the survival rate following cardiac arrest has averaged 5% and has not improved despite considerable efforts to train and raise public awareness of life-saving techniques and to make automated external defibrillators (AEDs) available in public places.

[0003] For about ten years, international scientific societies in cardiac resuscitation, such as the AHA (American Heart Association) and the ERC (European Resuscitation Council), have conducted numerous studies to understand the reasons for this low survival rate and have demonstrated that in most cases, the quality of cardiac resuscitation is the cause. Studies show us that regardless of the level of training and experience of the emergency teams, cardiopulmonary resuscitation remains demanding and very difficult to perform, particularly under stressful conditions and in the sometimes hostile environments encountered in pre-hospital emergency situations.

[0004] Performing cardiac resuscitation is a complex process that requires at least 2 people working in perfect synchrony to optimize heart / lung interactions.

[0005] On the one hand, blood circulation must be maintained by performing chest compressions to a depth of 5 to 6 cm at a rate of 100 to 120 compressions per minute to ensure sufficient cerebral perfusion. At the same time, the patient must be ventilated at a rate of 8 to 12 ventilations per minute with a tidal volume of 6-7 ml / kg to generate intermittent positive pressure in the lungs and prevent lung collapse. bronchioles and the pulmonary vascular system, and thus ensure sufficient systemic oxygenation.

[0006] While ventilation is necessary for the patient's survival, it simultaneously generates intrathoracic pressures which, if too high, decrease venous return, preventing the heart from filling normally and impacting the effectiveness of cardiac massage. This affects cerebral perfusion and leads to a marked decrease in the patient's chances of survival. Conversely, insufficient ventilation does not allow for proper CO2 elimination and a sufficient oxygenation level to keep the brain alive. A proper balance of ventilatory parameters is therefore essential to maintain the patient's chances of survival and limit neurological sequelae. Several recent patents have described inventions that allow for better control of ventilatory parameters during cardiac resuscitation.Patent applications WO201478840 and WO2016198275 describe devices for measuring and providing feedback on ventilatory parameters such as ventilation rates, tidal volumes, and pulmonary pressures. However, in practice, some feedback is found to be inaccurate, particularly during chest compressions.

[0007] Regarding cardiac massage, studies show that the chances of a return to spontaneous circulation are affected by the quality of chest compressions, which, if performed too slowly or too quickly, do not generate adequate blood flow. Similarly, the depth of compressions influences the amount of blood ejected with each compression and must be controlled to ensure good cerebral perfusion. However, the most crucial factor in the patient's chances of survival remains the reduction of "no-flow" time, that is, the period during which chest compressions are interrupted for auscultation, intubation, and invasive ventilation, or, more often, to allow sufficient time for patient ventilation.

[0008] Ventilation is most often performed using a face mask, which must be perfectly positioned and held firmly against the patient's face to prevent leaks and ensure effective ventilation. This type of ventilation is the most widely used because it can be performed by all types of medical and paramedical personnel and does not require specific training, unlike tracheal intubation. However, it cannot be performed simultaneously with cardiac massage because in this case it is very difficult to control leaks, and air flows uncontrollably into the stomach, which generally leads to regurgitation and can result in aspiration of secretions into the patient's airways.

[0009] Controlling the quality of chest compressions and reducing no-flow time are critical aspects of resuscitation, and several patents have focused on chest compression monitoring. Patents EP1057451, WO2009037621, and WO2008015623 all describe systems based on motion sensors, accelerometers, and / or pressure sensors that determine, in particular, the frequency and depth of chest compressions and compare them to reference values, thus indicating to the rescuer whether the compressions are being performed correctly. However, in practice, some feedback is found to be inaccurate, especially during ventilation.

[0010] In recent years, assistive devices dedicated either to monitoring ventilatory parameters or chest compressions have been developed to guide rescuers in the practice of cardiopulmonary resuscitation. These devices, used separately or together, have not yet been proven to provide a real benefit in patient care, nor to have an impact on survival rates or the return of spontaneous circulation.

[0011] The effectiveness of cardiopulmonary resuscitation relies on a delicate balance based on a series of actions that require a high level of cooperation among the various responders. Instructions for chest compressions and ventilation, as well as decision-making, cannot be based solely on the observation of a single parameter but must therefore necessarily be grounded in a more complex interpretation of compression and ventilation parameters according to the situation encountered and the patient's characteristics. This allows for precise feedback to the rescue team and thus guarantees optimal resuscitation in all circumstances.

[0012] Several recent inventions therefore describe systems for receiving data from different sensors and for controlling both ventilation-related variables and cardiac massage variables. Patents WO2011127123 and WO201265167 show sensors communicating wirelessly with a monitoring device that displays and groups ventilation and cardiac massage information on a single screen.

[0013] However, in most cases, displaying a multitude of information on a single screen makes it difficult for the first responder to interpret the variables, especially for personnel who have received relatively short training and have little experience in managing life-threatening emergencies. Description of the invention

[0014] The invention proposes new devices for assisting in the performance of an emergency care procedure, in particular cardiopulmonary resuscitation, not presenting at least one of the disadvantages described above of known devices.

[0015] More particularly, the invention relates to a device for assisting in the performance of an emergency care procedure such as chest compressions on a patient's rib cage or pulmonary ventilations, a device comprising: - a measuring device (10), arranged to measure at least one variable representative of an expected effect of the care procedure and to produce at least one measurement signal, - a signal processing device (20) arranged to extract from at least one measurement signal at least one quality parameter relating to a quality of the care procedure performed, - a communication device (30) arranged to receive data from another device for assisting in the performance of another emergency care procedure, said data comprising at least one piece of information,a parameter or instruction of an assistance device characterized in that the signal processing device is arranged to process at least one measurement signal based on data received from the other assistance device.

[0016] Thus, in an assistance device according to the invention, the extraction of quality parameters is carried out by taking into account data provided by another assistance device, so that the quality parameters obtained are more precise and more relevant. This makes it possible to determine the quality of emergency care provided by considering, in real time, all the emergency care procedures administered to the patient simultaneously. This also allows the first responder using the assistance device to perform a more effective emergency care procedure.

[0017] Above, and more generally throughout the description and claims of this patent application, the term "variable" is used to refer to a physical quantity measured or measurable by the measuring device; the term "parameter" is used to refer to a parameter extracted (calculated) from a measured signal and relating to the quality of the associated care procedure.

[0018] An assistance device according to the invention may further include an alerting device (40) arranged to produce an alert signal if at least one quality parameter is outside said range, at least one of whose limits is determined based on data received from the other assistance device. The alerting device thus makes it possible to alert a first responder when they are performing a care procedure that is inappropriate or ineffective.

[0019] According to one embodiment, the alerting device can be arranged to set a lower bound of the setpoint range for a quality parameter to a first value if the communication device receives information of the type "another care procedure in progress" and to a second value otherwise. By adjusting, for a given quality parameter, a bound of the associated setpoint range in Taking into account data provided by another assistance device, the alerting device avoids generating alert signals that are not representative of the actual quality of the care procedure performed, as will be better seen later in examples.

[0020] In an assistive device according to the invention, the measuring device may include at least one sensor for measuring the variable representing an expected effect of the care procedure and a control circuit for said measuring sensor arranged to calibrate said measuring sensor if the communication device receives information such as "no other care procedure in progress". Thus, by taking into account data provided by another assistive device that could interfere with the measuring device, the calibration of the measuring sensor(s) is more precise and accurate, and subsequently allows for measurements to produce signals that more closely reflect the patient's actual condition.

[0021] An assistance device according to the invention may further include a display device (50) arranged to display at least one quality parameter. The display of one or more quality parameters relating to the quality of the care procedure performed allows the rescuer to best adjust their efforts and actions to carry out an optimal care procedure.

[0022] According to one embodiment, the display device can also be arranged to display an alert signal. The display of a possible alert signal associated with a quality parameter allows the first aider to react as quickly as possible to correct their efforts and actions for a more effective care procedure.

[0023] According to another embodiment, the display device can also be arranged to display instructions for performing the emergency care procedure based on data received from the other assistance device. Displaying precise instructions, taking into account data provided by another assistance device associated with another emergency care procedure being performed, allows the first aider to optimally coordinate their actions with those of the first aider performing the other emergency procedure.

[0024] In an assistive device, the communication device may be configured to receive from a user a choice of assistive protocol to be executed, and the display device may be configured to display appropriate instructions for executing the assistive protocol chosen by the user. These instructions are displayed based on data received from the other assistive device. This allows a third party (who may be one of the people working with one of the assistive devices) to choose the best overall assistive protocol to follow for optimally coordinated cardiopulmonary resuscitation, for example, based on the patient's general condition and environment. The display device then displays only the instructions. which relate to the assistance procedure associated with it, while taking into account the data received from the other assistance device, said data being for example instructions displayed by the display device of the other assistance device and / or quality parameters determined by the processing device of the other assistance device.

[0025] According to one embodiment, the assistance device is of the type used to assist in performing compressions on a patient's rib cage, a device called a compression assistance device, in which: * The variable representing compression is chosen from a set of compression variables including, in particular, pressure exerted on the patient's rib cage and acceleration relative to a movement of the patient's rib cage, and * at least one compression quality parameter is chosen from a set of compression parameters including in particular a number of compressions performed, a compression frequency and a compression amplitude.

[0026] According to another embodiment, the assistance device is of the type used to assist in the delivery of ventilation to a patient, a device called a ventilation assistance device, an assistance device arranged to cooperate with a ventilation mask coupled to a ventilation device to supply a respiratory gas, a ventilation assistance device in which: * The representative ventilation variable is a variable chosen from a set of ventilation variables including, in particular, an inspired gas flow rate, an expired gas flow rate, an inspired gas pressure and an expired gas pressure, and * at least one ventilation quality parameter is chosen from a set of ventilation parameters including, in particular, a ventilation rate, an inspired air volume, an expired air volume, a tidal volume or effective volume, a percentage of leaks, an insufflation pressure, an end-expiratory pressure, an insufflation time, an expiratory time.

[0027] The invention also relates to a cardiopulmonary resuscitation assistance system comprising a compression assistance device and a ventilation assistance device as described above, the compression assistance device and the ventilation assistance device being intended to be used by at least two separate persons, the system being characterized in that, in at least one of the assistance devices, the data processing device is arranged to process at least one measurement signal according to the data received from the other of the assistance devices.

[0028] Thus, in a system according to the invention, each assistance device retains its autonomy in that it processes the signal(s) it measures itself and can display itself quality parameters and / or warning signals that it produces, while taking into account data received from the other assistance device to improve the quality and efficiency of processing the measured signals.

[0029] The invention also relates to a method for displaying a combination of emergency care procedures in an assistance system as described above, a method comprising the following steps: * In at least one of the assistance devices, the communication device receives from a user an assistance protocol including at least the execution of a ventilation procedure and a compression procedure and transmits said assistance protocol to the communication device of the other assistance device; * In the compression assistance device, the display device shows instructions for performing the compression procedure of the assistance protocol, said instructions being displayed according to the assistance protocol and according to the data received from the ventilation assistance device and * in the ventilation assistance device, the display device shows instructions for carrying out the ventilation procedure of the assistance protocol, said instructions being displayed according to the assistance protocol and according to the data received from the compression assistance device.

[0030] Examples of implementation of the process are detailed further below.

[0031] The assistance system according to the invention and the associated method thus make it possible to provide first responders with the precise level of information necessary for the proper execution of actions and sound decision-making, without diverting their attention or impacting their concentration by disseminating information that is not directly addressed to them or that is irrelevant to the task at hand. The two assistance devices can therefore be used by two separate individuals or two separate teams of individuals without requiring direct contact to synchronize their respective activities.

[0032] In summary, the invention aims not only to collect information related to the quality of emergency care procedures such as chest compressions and ventilations, but also to be able to interpret the information to analyze the situation as a whole and thus give rescuers the right level of information necessary for the proper execution of actions and for good decision-making, without diverting the attention of the rescuers or impacting their concentration by disseminating information that is not directly addressed to them or that is of no real interest with regard to the task entrusted to them.

[0033] Additional features of the assistance devices and the assistance system according to the invention are mentioned in the dependent claims and in the detailed description that follows; these additional features can be taken alone or in any possible combination. Brief description of the figures

[0034] The invention will be better understood, and other features and advantages of the invention will become apparent from the following description of examples of implementations of the invention. These examples are given by way of non-limiting example. The description is to be read in conjunction with the accompanying drawings in which:

[0035] [Fig-1] is a diagram of an assistance system according to the invention, shown in context

[0036] [Fig.2] is a block diagram of an assistance device according to the invention

[0037] [Fig.3] is a graph showing the evolution of a respiratory flow rate as a function of the time

[0038] [Fig.4] is a graph showing the evolution of capnography as a function of time

[0039] Detailed description of embodiments of the invention

[0040] As stated previously, the invention relates to devices for assisting in the performance of an emergency care procedure such as performing chest compressions (a device hereafter referred to as a "compression assistance device") or performing pulmonary ventilation (a device hereafter referred to as a "ventilation assistance device"). The invention also relates to an assistance system using two assistance devices for performing optimal cardiopulmonary resuscitation, and an associated assistance method.

[0041] Each assistance device according to the invention comprises ([Fig. 2]) a measuring device 10, a signal processing device 20, and a communication device 30. The measuring device 10 is arranged to measure at least one variable representative of an expected effect of the care procedure and to produce at least one measurement signal. The signal processing device 20 is arranged to extract from at least one measurement signal at least one quality parameter relating to a quality of the care procedure performed. The communication device 30 is arranged to receive data from another assistance device for the performance of another emergency care procedure, said data comprising at least one piece of information, a parameter, or an instruction. According to the invention, the assistance device is characterized in that the signal processing device is arranged to process at least one measurement signal according to the data received from the other assistance device.

[0042] The word "data" should be understood here in a broad sense: the data received can be information, instructions, parameter values, etc.

[0043] An assistive device may take the physical form of a small box with dimensions on the order of a few centimeters so as to be easily transportable for The device should be positioned, during use, in a location easily visible to the first aider attending to the patient, but without hindering their movements. Preferably, the assistance device includes a power storage unit for energy autonomy and communicates with the other assistance device via a wireless connection such as Bluetooth.

[0044] According to embodiments of the compression assistance device, the unit can be coupled to a wristband for attachment to the rescuer's wrist, or to an adhesive patch for attachment to the patient's arm, shoulder, or chest (see [Fig. 1]), or more generally to any suitable support in the immediate vicinity of the rescuer. Alternatively, the compression assistance device unit can be attached in the immediate vicinity of the rescuer, and a measurement sensor for the measuring device is located outside the unit for attachment to the patient's chest. The ventilation assistance device is arranged to cooperate with a ventilation mask coupled to a ventilation device to deliver a breathing gas; the mask is arranged to allow the gas to be insufflated into the patient's lungs.According to a practical embodiment, the housing of the assistance device can be connected between the supply tube and the ventilation mask.

[0045] In each assistive device, the measuring device can be arranged to measure one or more variables representative of an expected effect of the care procedure performed and to produce one or more corresponding measurement signals. Similarly, in each assistive device, the signal processing device can be arranged to extract from the measurement signal(s) several quality parameters relating to a quality of the care procedure performed.

[0046] According to one embodiment, for the compression assistance device, * the variable representing the compressions is chosen from a set of compression variables including, in particular, a pressure exerted on the patient's rib cage and an acceleration relative to a movement of the patient's rib cage, and * At least one compression quality parameter is chosen from a set of compression parameters including, in particular, the number of compressions performed, the compression frequency, and the compression depth. In a practical example, the measurement device includes a pressure sensor or an accelerometer, and the processing device executes previously known algorithms to calculate the number of compressions performed, the frequency, and the depth of compressions performed based on the time evolution of the pressure exerted on the patient's chest or the acceleration causing rib cage displacement. Optionally, the set of compression variables may also include arterial pressure and venous pressure. and wherein the set of compression parameters also includes parameters relating to the patient's hemodynamic quality, in particular cerebral perfusion, coronary perfusion, blood flow, and blood pressure.

[0047] According to one embodiment, for the ventilation support device, * The representative ventilation variable is a variable chosen from a set of ventilation variables including, in particular, an inspired gas flow rate, an expired gas flow rate, an inspired gas pressure and an expired gas pressure, and * at least one ventilation quality parameter is chosen from a set of ventilation parameters including, in particular, a ventilation rate, an inspired air volume, an expired air volume, a tidal volume or effective volume, a percentage of leaks, an insufflation pressure, an end-expiratory pressure, an insufflation time, an expiratory time.In addition, optionally, the ventilation variable set also includes a variable representing patient oxygenation and in which the ventilation parameter set also includes parameters relating to the quality of patient oxygenation, including the amount of CO2 present in the exhaled gas (EtCO2) and the amount of oxygen in the blood (SaO2).

[0048] According to one embodiment, in an assistance device according to the invention, the signal processing device is arranged to extract at least one quality parameter according to a first extraction method if the communication device receives information of the type "other care procedure in progress" and according to a second extraction method otherwise.

[0049] The first extraction method and the second extraction method each comprise an algorithm and initial parameterization, and the second extraction method comprises: * an algorithm different from the algorithm of the first extraction process, or * an algorithm identical to the algorithm of the first extraction process and an initial parameterization different from the initial parameterization of the first process.

[0050] In one embodiment, the first extraction method and the second extraction method are distinguished by different signal processing algorithms (i.e., algorithms comprising at least one different step). In a practical embodiment, the measured variable is a time change in the amount of CO2 present in exhaled air (capnography). Capnography (or EtCO2) reflects CO2 elimination, providing an indication of the quality of gas exchange and thus the effectiveness of cardiopulmonary resuscitation. Figure 4a shows the change in the amount of CO2 present in exhaled air during ventilations, and Figure 4b shows the change in this same variable during chest compressions. As can be seen on In Figures 4a-4b, the variations in EtCO2 are strongly influenced by the presence of chest compressions, making their interpretation very complex. Using a specific algorithm to extract a representative capnography parameter from the measured signal when compressions are in progress, and a second algorithm otherwise, allows for a more representative and relevant quality parameter value, particularly when compressions are in progress. The second algorithm, in the absence of compressions, is based, for example, on the identification of an end-expiratory pressure plateau (Figure 4a, plateau A at the end of the patient's expiratory phase). The first algorithm, in the presence of compressions, is based, for example, on calculating an average value of the representative EtCO2 parameter over a sliding window of 2 to 5 seconds.

[0051] In another practical example, the variable measured as a function of time is the depth of the patient's chest; to extract a number of compressions from this variable, a first algorithm is used when ventilations are in progress, and a second algorithm otherwise.

[0052] In another variant, the first extraction method and the second extraction method use the same signal processing algorithm, but are distinguished from each other by different initial parameters, as is the case in the detailed example below.

[0053] During compressions, passive ventilation occurs in the patient, generating inspirations / expirations of gas with a volume smaller than the dead space in the airways, therefore inspirations / expirations without effect on the patient. The invention takes into account the volumes of these passive inspirations / expirations to determine more precisely the volume of gas actually inhaled or exhaled by the patient as follows.

[0054] As is known, determining ventilations and calculating inspired or expired volumes during active ventilation is based on measuring the time evolution of the gas flow rate through the ventilation device. An inspiratory phase is detected when the flow rate is positive and rises above a high threshold. An expiratory phase is detected when the flow rate is negative and falls below a low threshold. The inspired or expired gas volumes are then calculated by integrating the flow rate curve (curve shown in [Fig. 3]). To do this, flow rate measurements are taken at regular sampling intervals, and as soon as an inspiratory or expiratory phase is detected, the flow rate signal is integrated over the time period determined by exceeding the high and low thresholds.To take into account a calculation time and a latency time between the actual time of the start of an inspiration and the time of the detection of said inspiration, or between the actual time of the start of an expiration and the time of the detection of said expiration, we . A predetermined number of samples are stored in a buffer throughout the measurement. During compressions, it is preferable to set relatively high detection thresholds to avoid detecting gas flows generated by passive ventilation. Conversely, during active ventilation phases, it is preferable to have the lowest possible detection thresholds to detect the transition from inspiration to expiration, or vice versa, as quickly as possible. Typically, the choice of detection thresholds is a compromise between an ideal low threshold and an ideal high threshold. This results in inspired or expired gas volumes whose values ​​are sometimes inaccurate by a few tens of percent.

[0055] To overcome this difficulty, the invention proposes to use the same signal processing algorithm but different initial parameters: * if compression is in progress, an initial configuration including high detection thresholds and a large buffer size, and * otherwise, an initial setting including low detection thresholds (lower than the high detection thresholds) and a small buffer size (i.e. smaller than the size of the large buffer).

[0056] During compressions, high thresholds prevent the detection of passive ventilation, and a large buffer ensures that, during a transition to an active inspiration or expiration phase (the start of active ventilation), the samples measured between the actual start of the active inspiration (or expiration) phase and the detection of said active inspiration (or expiration) phase are properly recorded and can be included in the calculation of the inspired (or expired) gas volume. Conversely, outside of compressions, low detection thresholds allow for the earliest possible detection of the start or end of an active inspiration or expiration phase to determine the inspired or expired gas volume more accurately; and the use of a small buffer is sufficient to determine the inspired or expired gas volume.

[0057] Each assistance device may also include an alerting device (40) arranged to produce an alert signal if at least one quality parameter is outside the specified range, at least one of whose limits is determined based on data received from the other assistance device. The generation of an alert signal if one of these parameters is outside the setpoint range for that parameter allows the rescuer to adjust their chest compression techniques accordingly.

[0058] According to the invention, for a quality parameter of an emergency care procedure, at least one of the limits of the setpoint range is determined based on data received from the device assisting in the execution of the other emergency care procedure.

[0059] Experience shows that if active ventilations are performed concurrently with compressions, the pressure of the inspired gas in the lungs interferes with the performance of compressions, impacts compression measurement, and also affects the measurement and determination of hemodynamic parameters. Thus, performing ventilations may result in the ventilation assistance device displaying unwanted warning signals that could unnecessarily disturb the person performing the compressions. Similarly, experience shows that if compressions are performed concurrently with ventilations, the intrathoracic pressures are such that it is very difficult to insufflate the expected volume of gas.Performing compressions in parallel with ventilations can then result in the compression assistance device displaying unwanted warning signals that may unnecessarily disturb the person performing the ventilation.

[0060] Also, determining at least one of the limits of the setpoint range for a quality parameter relating to an emergency care procedure based on data received by the device assisting in the execution of the other emergency care procedure makes it possible to avoid the display of unwanted warning signals.

[0061] According to one embodiment, in an assistance device, the alerting device is arranged to set a limit, for example a lower limit, of the setpoint range for a quality parameter to a first value if the communication device receives information from the assistance device for performing the second emergency care procedure indicating "another care procedure in progress," and to a second value otherwise. For example, in a compression assistance device, the alerting device can be arranged to set a lower limit of the setpoint range for a parameter to a first value if the communication device receives information from the ventilation assistance device indicating "ventilation in progress," and to a second value otherwise.In a numerical example, for compression depth, the lower limit (5 cm) of the ideal setpoint range (5 cm–6 cm) can be lowered to 3 cm during ventilation. Similarly, in the ventilation assistance device, the alerting device can be configured to set a lower limit of the setpoint range for a parameter to a first value if the communication device receives a "compressions in progress" signal from the compression assistance device, and to a second value otherwise. In a numerical example, for inspired gas volume, the lower limit (400 ml) of the ideal setpoint range (400 ml–600 ml) can be lowered to 300 ml during compressions.

[0062] In an assistance device according to the invention, the measuring device may further include at least one sensor for measuring the variable representing an effect The expected outcome of the care procedure is a control circuit for the measurement sensor, configured to calibrate the sensor if the communication device receives a "no other care procedure in progress" signal from the device assisting with the other emergency care procedure. The control circuit also manages the overall operation of the measurement sensor(s) and, after calibration, provides a measurement signal representing the time evolution of the measured variable. Calibration allows for the determination of at least one sensor coefficient through a measurement of the variable (pressure, acceleration, etc.) in the absence of any other emergency care procedure in progress.

[0063] Practice shows that when manual ventilation is in progress, it generates positive pressure in the lungs, causing the chest to rise. Thus, if ventilation occurs during calibration of the measuring sensor of a compression-assisted device, the pressure of the inspired gas in the lungs and the resulting chest rise will distort the measurement of the initial value of the variable measured by the compression-assisted device's measuring device. Similarly, practice shows that when compressions are in progress, the resulting compression of the chest and decrease in lung volume will distort the measurement of the initial value of the variable measured by the ventilation-assisted device's measuring device.

[0064] Also, the fact that, in an assistance device according to the invention, the control circuit of the measuring device is arranged to calibrate the measuring sensor only if the communication device receives from the ventilation assistance device information of the type "no other procedure in progress" makes it possible to carry out a more precise, more accurate calibration.

[0065] Each assistance device according to the invention may also include a display device 50 arranged to display at least one quality parameter. Of course, the display device may simultaneously display several parameters, for example, for compression quality, the number of compressions already performed, the depth of compressions and the compression frequency, and for hemodynamic quality, the blood pressure, the rate of pulse recurrence, etc.

[0066] The display device can also be configured to display the warning signal(s) when a quality parameter is outside its setpoint range. Displaying at least one compression quality parameter and any associated warning message allows the person performing the compressions to quickly adjust their actions to improve compression quality.

[0067] The display device may, in a concrete implementation example, include a small display screen such as an LCD screen, and the parameters may These values ​​can be displayed using known graphical, visual, and / or audio representations. For example, for each parameter, the numerical value can be displayed, and the alert signal can be displayed as a light signal: green if the parameter value is within the setpoint range, red if the parameter value is outside the setpoint range, or orange if the parameter value is near the setpoint limits, or red if the parameter value is outside the setpoint range. In another example, the numerical value of the parameter can be displayed as a bar whose height depends on the numerical value to be displayed, and the alert signal is an audio signal whose volume is low when the parameter value is near a limit and increases as the parameter value approaches that limit.

[0068] Also, in an assistance device according to the invention, the display device can be arranged to display instructions for performing an emergency care procedure based on data received from the other assistance device. This makes it possible to synchronize the actions of the rescuer performing compressions with the actions of a rescuer performing ventilation in parallel or alternately, as will be explained in more detail later.

[0069] In an assistance device according to the invention also, the communication device is arranged to receive from a user a choice of assistance protocol to execute and the display device is arranged to display instructions appropriate for the execution of the assistance protocol chosen by the user, said instructions being displayed according to data received from the other assistance device.

[0070] As stated previously, a cardiopulmonary resuscitation assistance system according to the invention comprises a compression assistance device and a ventilation assistance device as described above and claimed; the compression assistance device and the ventilation assistance device are intended to be used by at least two separate persons; according to the invention, the assistance system is characterized in that, in at least one of the assistance devices, the data processing device is arranged to process at least one measurement signal according to the data received from the other of the assistance devices.

[0071] The assistance system can be used according to the procedure described below, and more specifically concerning the display of instructions for a coordinated emergency care assistance protocol including at least the performance of a ventilation procedure and a compression procedure. Of course, in addition and / or in parallel, each assistance device of the coordinated assistance system, i.e., The compression assistance device and the ventilation assistance device can perform the other functions for which it is designed (calibration of measuring sensors, extraction of quality parameters according to a first or second process, selection of setpoint range limits for quality parameters, production of warning signals, display of parameters and / or warning signals, etc.).

[0072] The method according to the invention for displaying instructions for a coordinated emergency care assistance protocol comprises the following steps: * in at least one of the assistive devices, the communication device receives from a user an assistive protocol including at least the execution of a ventilation procedure and a compression procedure and transmits said assistive protocol to the communication device of the other assistive device, * in the compression assistance device, the display device shows instructions for carrying out the compression procedure of the assistance protocol, said instructions being displayed according to the assistance protocol and according to the data received from the ventilation assistance device and * in the ventilation assistance device, the display device shows instructions for carrying out the ventilation procedure of the assistance protocol, said instructions being displayed according to the assistance protocol and according to the data received from the compression assistance device.

[0073] In addition to the ventilation and / or compression procedures to be performed, the support protocol may include at least one patient parameter chosen from a set of patient-related parameters, including, in particular, the patient's height, weight, age, or gender. These patient-related parameters allow for optimal adjustment of the setpoint ranges for quality parameters, in particular the setpoint range for the volume of air to be delivered or the setpoint range for the depth of compressions.

[0074] According to an embodiment suitable for the simultaneous performance of compressions and ventilations, the display method may comprise the following steps: * in at least one of the support devices, the communication device receives from a user a support protocol comprising the simultaneous execution of a ventilation procedure and a compression procedure and transmits said support protocol to the communication device of the other of the support devices, * in the compression support device, - the display device shows a compression instruction including a compression frequency setpoint range and a setpoint range of compression depths based on received data and, where applicable, patient-related parameters, and - the data processing device produces a number of compressions performed and - the display device transmits a ventilation instruction to the communication device of the ventilation assistance device when the number of compressions performed reaches a predefined number, and * in the ventilation assistance device: - The display device shows a ventilation instruction with a set range for ventilation rates and a set range for gas volumes to be insufflated, based on the data received and, where applicable, patient-related parameters. - the display device shows each synchronization instruction received from the compression assistance device.

[0075] These steps are of course repeated as long as the ventilation and compression operations need to be carried out.

[0076] According to another embodiment, suitable for the alternating performance of compressions and ventilations, the display method may comprise the following steps: * in at least one of the assistive devices, the communication device receives from a user an assistive protocol comprising the alternating execution of a compression procedure comprising X successive compressions and a ventilation procedure comprising Y successive ventilations, and transmits said assistive protocol to the communication device of the other assistive device, * in the compression assistance device, - the display device shows a compression instruction including the number X of compressions to be performed, a set range of compression frequencies and a set range of compression depths based on the data received and, where applicable, patient-related parameters, and - the data processing device produces a number of compressions performed and, - when the number of compressions performed reaches X, the display device shows an instruction to stop compressions and transmits a ventilation instruction to the communication device of the ventilation assistance device, and * in the ventilation assistance device: - When the communication device receives a ventilation instruction, the display device shows said ventilation instruction with the number Y of ventilations to be performed, a set range of ventilation frequencies and a set range of gas volumes to be insufflated, based on the received data and, where applicable, patient-related parameters - the data processing device produces a number of ventilations performed, and - when the number of ventilations performed reaches the number Y or when compressions have been stopped for more than N seconds, the display device displays an instruction to stop ventilations and transmits a compression instruction to the display device of the compression assistance device.

[0077] These steps are of course repeated as long as the ventilation and compression operations need to be carried out.

Claims

Demands

1. Device for assisting in the performance of a first emergency care procedure such as chest compressions on a patient's rib cage or pulmonary ventilations, device comprising: - a measuring device (10), arranged to measure at least one variable representative of an expected effect of the care procedure and to produce at least one measurement signal, - a signal processing device (20) arranged to extract from at least one measurement signal at least one quality parameter relating to a quality of the care procedure performed, - a communication device (30) arranged to receive data from another device for assisting in the performance of another emergency care procedure, said data comprising at least one piece of information,a parameter or instruction of an assistive device characterized in that the signal processing device is arranged to process at least one measurement signal according to the data received from the other assistive device, wherein the signal processing device is arranged to extract at least one quality parameter according to a first extraction method if the communication device receives information of the type "another care procedure in progress" and according to a second extraction method otherwise, and wherein the measurement device includes at least one sensor for measuring the variable representing an expected effect of the first care procedure and a control circuit for said measurement sensor arranged to calibrate said measurement sensor if the communication device receives information of the type "no other care procedure in progress".

2. An apparatus for assisting in the performance of a first emergency care procedure according to claim 1, wherein the signal processing device is arranged to extract at least one quality parameter according to the second extraction method comprising * an algorithm different from an algorithm of the first extraction method, or * an algorithm identical to the algorithm of the first extraction process and an initial parameterization different from an initial parameterization of the first extraction process.

3. Device for assisting in the performance of a first emergency care procedure according to any one of claims 1 to 2 also comprising a display device (50) arranged to display at least one quality parameter.

4. Device for assisting in the performance of a first emergency care procedure according to claim 3 wherein the display device is also arranged to display the alert signal.

5. Compression assistance device comprising a device for assisting in the performance of an emergency care procedure according to any one of claims 1 to 4 wherein * the measuring device is arranged to measure at least one representative compression variable from a set of compression variables including in particular pressure exerted on the patient's rib cage and acceleration relative to a movement of the patient's rib cage, and wherein * the signal processing device is arranged to extract from at least one measurement signal at least one compression quality parameter from a set of compression parameters including in particular the number of compressions performed, the frequency of compressions performed and the amplitude of compressions performed.

6. Compression assistance device comprising a device for assisting in the performance of an emergency care procedure according to any one of claims 1 to 4, wherein: * the measuring device is arranged to measure at least one representative compression variable from a set of compression variables including, in particular, pressure exerted on the patient's rib cage, acceleration relative to a movement of the patient's rib cage, arterial pressure, and venous pressure, and wherein * the signal processing device is arranged to extract from at least one measurement signal at least one compression quality parameter from a set of compression parameters including, in particular, the number of compressions performed, the compression frequency, the compression amplitude, and parameters relating to the quality of the patient's hemodynamics, including cerebral perfusion, coronary perfusion, blood flow, and blood pressure.

7. A ventilation assistance device arranged to cooperate with a ventilation mask coupled to a ventilation device to provide a breathing gas, a ventilation assistance device comprising a device for assisting in the performance of an emergency care procedure according to any one of claims 1 to 4 wherein: * the measuring device is arranged to measure at least one variable representative of ventilations from a set of ventilation variables including in particular an inspired gas flow rate, an expired gas flow rate, an inspired gas pressure and an expired gas pressure, and wherein * the signal processing device is arranged to extract from at least one measurement signal at least one ventilation quality parameter from a set of ventilation parameters including in particular a ventilation rate, an inspired air volume, an expired air volume, a tidal volume or effective volume,a percentage of leaks, an insufflation pressure, an end-expiratory pressure, an insufflation time, an expiratory time.

8. A ventilation assistance device arranged to cooperate with a ventilation mask coupled to a ventilation device to provide a breathing gas, a ventilation assistance device comprising a device for assisting in the performance of an emergency care procedure according to any one of claims 1 to 4 wherein * the measuring device is arranged to measure at least one variable representative of ventilations from among the set of ventilation variables including in particular an inspired gas flow rate, an expired gas flow rate, an inspired gas pressure and an expired gas pressure and a variable representative of patient oxygenation and wherein * the signal processing device is arranged to extract from at least one measurement signal at least one ventilation quality parameter from among a set of ventilation parameters including in particular a ventilation rate, an inspired air volume,exhaled air volume, tidal volume or effective volume, leakage percentage, insufflation pressure, an end-expiratory pressure, an insufflation time, an expiration time, and parameters relating to the quality of the patient's oxygenation, including the amount of CO2 present in the exhaled gas (EtCO2) and the amount of oxygen in the blood (SaO2).

9. A cardiopulmonary resuscitation assistance system comprising a compression assistance device according to any one of claims 5 to 6, and a ventilation assistance device according to any one of claims 7 to 8, the compression assistance device and the ventilation assistance device being intended to be used by at least two separate persons, the system being characterized in that, in at least one of the assistance devices, the data processing device is arranged to process at least one measurement signal according to the data received from the other of the assistance devices.

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