Automatic external defibrillator

Abstract

To provide an automatic external defibrillator capable of applying an electric shock by a double application method by a simple operation taking a short time.SOLUTION: The automatic external defibrillator comprises: an electrode part including a first electrode to be attached to the right / front chest of a patient, a second electrode to be attached to the left / front chest of the patient, a third electrode to be attached to the left flank of the patient, and a fourth electrode to be attached to the left back of the patient; and a voltage application part for applying a high voltage pulse between at least two electrodes selected out of the first to fourth electrodes.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to an automated external defibrillator. [Background technology]

[0002] By administering an electric shock to a patient in a state of cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia, the survival rate of the patient can be improved. Automated external defibrillators (AEDs) are widely used as a means for administering an electric shock (see, for example, Patent Document 1).

[0003] An automated external defibrillator has a main body and two electrodes connected to the main body. The automated external defibrillator defibrillates the heart by applying an electric shock to the heart through electrodes attached by the rescuer to the right anterior chest and left flank of the patient.

[0004] If this measure does not restore the patient's heart rate to normal, it is known that the survival rate can be improved by applying an electric shock to the heart through electrodes attached to the patient's left anterior chest and left back. This method of applying an electric shock between the patient's right anterior chest and left flank, and then between the left anterior chest and left back, is hereinafter referred to as the double application method. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Special Publication No. 2013-543781 Summary of the Invention [Problem to be solved by the invention]

[0006] To administer an electric shock using the dual-administration method using a conventional automated external defibrillator with two electrodes, the following steps are required: (1) attach electrodes to the patient's right anterior chest and left flank and administer the electric shock; (2) remove the electrodes from the patient, attach electrodes to the patient's left anterior chest and left back and administer the electric shock; and (3) repeat steps (1) and (2) until the heart rate returns to normal. The large number of steps required to administer an electric shock makes the process complicated and time-consuming. Given the importance of administering an electric shock as quickly as possible to a patient in cardiac arrest, a simpler procedure with a shorter administration time is desirable.

[0007] The present invention has been made in consideration of the above-mentioned circumstances, and has as its object to provide an automatic external defibrillator that can apply an electric shock using a dual application method with a simple and short operation. [Means for solving the problem]

[0008] In order to achieve the above object, the automated external defibrillator of the present invention comprises an electrode unit including a first electrode attached to the right anterior chest of a patient, a second electrode attached to the left anterior chest of the patient, a third electrode attached to the left flank of the patient, and a fourth electrode attached to the left back of the patient, and a voltage application unit that applies a high-voltage pulse between at least two electrodes selected from the first to fourth electrodes. [Effects of the Invention]

[0009] The electrode unit of the automatic external defibrillator according to the present invention includes four electrodes. When the electrode unit is attached to a patient, the four electrodes are positioned at the sites where an electric shock is to be administered. Therefore, according to the present invention, it is possible to administer an electric shock in a dual-application manner with a simple and quick operation. [Brief explanation of the drawings]

[0010] [Figure 1] 1 is a diagram showing the appearance of an automated external defibrillator according to a first embodiment. [Figure 2] FIG. 10A is a block diagram showing the physical configuration of an automated external defibrillator according to the first to sixth embodiments, and FIG. 10B is a block diagram showing the circuit configuration of a selection switch inside the automated external defibrillator. [Figure 3] 1A shows the waveform of a unipolar high-voltage pulse, and FIG. 1B shows the waveform of a bipolar high-voltage pulse output by the high-voltage generating unit of the automatic external defibrillator according to the first to sixth embodiments. [Figure 4] 3A and 3B are a front view and a side view, respectively, of a strip-shaped electrode portion according to the first embodiment. [Figure 5] 1A is a diagram showing the electrode parts according to the first to sixth embodiments in an expanded state, and FIG. 1B is a diagram showing the electrode parts in a twisted state. [Figure 6] 10A and 10B are diagrams showing the electrode parts according to the first to sixth embodiments in an unused state. [Figure 7] 3A, 3B, and 3C are front, rear, and side views showing a state in which the band-shaped electrode part according to the first embodiment is attached to a patient. [Figure 8] 10 is a flowchart of an electric shock application process in the automated external defibrillators according to the first to sixth embodiments. [Figure 9] 10A and 10B are side views of a strip-shaped electrode part according to a second embodiment. [Figure 10] 10A is a front view showing the state where the triangular sling-shaped electrode part of embodiment 3 is attached to a patient, (B) is a rear view showing the state where the triangular sling-shaped electrode part of embodiment 3 is attached to a patient, and (C) is a front view of the entire electrode part. [Figure 11] 10A and 10B are front and rear views of a garment-like electrode unit according to a fourth embodiment. [Figure 12] (A) A diagram showing an example of a band-shaped electrode part for children and adults, (B) A diagram showing an example of a triangular-scarf-shaped electrode part for children and adults, and (C) A diagram showing an example of a clothing-shaped electrode part for children and adults, relating to embodiment 5. [Figure 13] 13A and 13B are front and rear views showing a state in which the band-shaped electrode part according to the sixth embodiment is attached to a patient. DETAILED DESCRIPTION OF THE INVENTION

[0011] An automated external defibrillator (hereinafter referred to as AED) according to an embodiment of the present invention will be described below with reference to the drawings.

[0012] (Embodiment 1) 1, the AED 1 according to the first embodiment includes a main body 100, a band-shaped electrode section 200, and a cable 300. The AED 1 is an example of an automatic external defibrillator.

[0013] The main body 100 includes a display unit 110 that displays information, an operation unit 120 that accepts operations by the rescuer, and an audio output unit 130 that outputs information as sound.

[0014] The display unit 110 displays, for example, biological information such as an electrocardiogram and pulse rate of the patient P, a method for operating the AED 1, and a method for attaching the band electrode unit 200 to the patient P. The display unit 110 includes, for example, a liquid crystal display or an organic EL (Electro Luminescence) display.

[0015] The operation unit 120 includes a power switch, an operation button for receiving an instruction to apply an electric shock, and the like.

[0016] The audio output unit 130 includes, for example, a speaker.

[0017] As shown in FIG. 2(A), the main body 100 further includes a control unit 140 that calculates information and controls each device, a high voltage generation unit 150 that generates high voltage pulses, a selection switch 151, a biometric information acquisition unit 160 that acquires biometric information of the patient, a power supply unit 170 that supplies power to each device, and a memory unit 180 that stores information.

[0018] The control unit 140 includes, for example, a central processing unit (CPU), and executes a control program stored in the storage unit 180, and executes, for example, the electric shock application process described below.

[0019] The control unit 140 also analyzes the patient's biological information acquired by the biological information acquisition unit 160, and displays an electrocardiogram, heart rate, etc. on the display unit 110. The control unit 140 receives an instruction to apply an electric shock accepted by the operation unit 120 from the rescuer, and controls the high-voltage generation unit 150 to generate a high-voltage pulse. The control unit 140 controls the selection switch 151 to select an electrode to which the high-voltage pulse is to be applied.

[0020] The high voltage generating unit 150 generates a high voltage pulse between the positive output terminal + and the negative output terminal − under the control of the control unit 140. Any known circuit can be used as the circuit configuration of the high voltage generating unit 150. For example, the circuit configurations described in the specifications or drawings initially attached to the application of JP 2022-182010 A and International Application PCT / JP2023 / 030715 are effective.

[0021] The high voltage pulses generated by the high voltage generation unit 150 have, for example, a voltage value of 1000 to 3000 V, a current value of 15 to 30 A, a pulse width of 2 to 20 ms, and an energy value of 150 to 360 J. In this embodiment, the high voltage pulses generated by the high voltage generation unit 150 are two consecutive unipolar high voltage pulses PL1 and PL2 as shown in FIG.

[0022] The selection switch 151 shown in FIG. 2(A) includes switches SW1 and SW2 as shown in FIG. 2(B), and connects the positive output terminal + and the negative output terminal − of the high voltage generating unit 150 to different ones of the first electrode 201 to the fourth electrode 204 under the control of the control unit 140.

[0023] The switches SW1 and SW2 are interlocked, and when the switch SW1 connects the positive output terminal + and the first electrode 201, the switch SW2 connects the negative output terminal − and the third electrode 203. When the switch SW1 connects the positive output terminal + and the third electrode 203, the switch SW2 connects the negative output terminal − and the first electrode 201. When the switch SW1 connects the positive output terminal + and the second electrode 202, the switch SW2 connects the negative output terminal − and the fourth electrode 204, and when the switch SW1 connects the positive output terminal + and the fourth electrode 204, the switch SW2 connects the negative output terminal − and the second electrode 202.

[0024] By such a switching operation, the selection switch 151 converts the two consecutive unipolar high-voltage pulses PL1 and PL2 shown in Fig. 3(A) generated by the high-voltage generation unit 150 into the two consecutive bipolar high-voltage pulses PL1 and PL2 shown in Fig. 3(B), and applies them between the electrodes, i.e., between the first electrode 201 and the third electrode 203, or between the second electrode 202 and the fourth electrode 204. The control unit 140, the high-voltage generation unit 150, and the selection switch 151 are an example of a voltage application unit.

[0025] Returning to FIG. 2(A), the biological information acquiring unit 160 is electrically connected to the first electrode 201 to the fourth electrode 204 attached to the patient via a cable 300. The biological information acquiring unit 160 acquires biological information of the patient P from the first electrode 201 to the fourth electrode 204 under the control of the control unit 140. The biological information includes a biological voltage, a biological current, etc. The biological information acquiring unit 160 transmits the acquired biological information to the control unit 140.

[0026] The power supply unit 170 supplies power necessary for operation to the display unit 110, the operation unit 120, the audio output unit 130, the control unit 140, the high-voltage generation unit 150, the biological information acquisition unit 160, and the storage unit 180. The power supply unit 170 includes, for example, a primary battery, a secondary battery, an AC / DC converter, etc.

[0027] The storage unit 180 includes a nonvolatile auxiliary storage device and a volatile main storage device, and is connected to the control unit 140. The auxiliary storage device of the storage unit 180 stores programs and data. The programs are operation programs for the control unit 140, such as an operation program for executing the electric shock application process described below. The control unit 140 executes the programs to control the display unit 110, the operation unit 120, the audio output unit 130, the high-voltage generation unit 150, the selection switch 151, the biometric information acquisition unit 160, and the power supply unit 170. The data includes, for example, guidance on how to use the AED 1 to be displayed on the display unit 110 and audio guidance to be emitted from the audio output unit. The main storage device of the storage unit 180 temporarily stores programs and data in response to commands from the control unit 140. The storage unit 180 includes, for example, a static random access memory (SRAM), a flash memory, a hard disk drive (HDD), etc.

[0028] As shown in Figures 1, 4(A)(B), and 7(A)(B)(C), the strip-shaped electrode portion 200 is strip-shaped overall and includes a strip-shaped fabric 205 and, arranged thereon, a first electrode 201, a second electrode 202, a third electrode 203, a fourth electrode 204, and fasteners 601 to 604.

[0029] The strip-shaped fabric 205 is made of, for example, synthetic fiber. The strip-shaped fabric 205 has fasteners 601 and 602 at both longitudinal ends. The fasteners 601 and 602 are detachable from each other and include, for example, buttons or hook-and-loop fasteners. The strip-shaped electrode unit 200 can be made into a ring shape by engaging the fasteners 601 and 602 with each other. The lengths of the short and long sides of the strip-shaped fabric 205 are lengths that allow the strip-shaped electrode unit 200 to be worn on a human body when made into a ring, and take into account differences in patient physiques, for example, the short side = 10 to 20 cm and the long side = 140 to 180 cm.

[0030] The first to fourth electrodes 201 to 204 are arranged in a substantially straight line on one surface of the band-shaped fabric 205 and are fixed to the band-shaped fabric 205 by, for example, adhesive or the like. The first to fourth electrodes 201 to 204 and the cable 300 are electrically connected to each other via conductors extending inside the band-shaped fabric 205. The first to fourth electrodes 201 to 204 are made of flexible conductive layers such as copper foil or aluminum foil. This allows the first to fourth electrodes 201 to 204 to be flexibly attached to the body surface of the patient P. Furthermore, the first to fourth electrodes 201 to 204 can be folded when stored, or can be twisted into a string shape as described below.

[0031] 7(A), (B), and (C), when fasteners 601 and 602 are placed and attached on the right shoulder, first electrode 201 to fourth electrode 204 are positioned so that first electrode 201 is located approximately on the right front chest, second electrode 202 is located approximately on the left front chest over the heart, third electrode 203 is located approximately on the left flank, and fourth electrode 204 is located approximately on the left back over the heart. However, taking into consideration differences in the physique of patient P, the electrodes are positioned with some space between them.

[0032] In this specification, the terms "right anterior chest" where the first electrode 201 is attached, "left anterior chest" and "over the heart" where the second electrode 202 is located, "left flank" where the third electrode 203 is located, and "left back" and "over the heart" where the fourth electrode 204 is located do not refer to strict locations. Each term indicates an approximate location where a rescuer intends to attach the electrode. For example, "right anterior chest" broadly includes the area located to the right of the heart (which is usually located on the left chest), including the right shoulder and right chest. Furthermore, "left anterior chest" does not strictly mean "over the heart" but includes the area near the heart. "Left flank" broadly includes the area below the heart on the left side of the body, including the left abdomen, left flank, and lower left back. "Left back" does not strictly mean "over the heart" but includes the area near the heart. The first electrode 201 is an example of a first electrode, the second electrode 202 is an example of a second electrode, the third electrode 203 is an example of a third electrode, the fourth electrode 204 is an example of a fourth electrode, and the strip-shaped electrode portion 200 is an example of an electrode portion.

[0033] As shown in Fig. 4(B), a conductive adhesive layer 206 and a film 207 that covers the conductive adhesive layer 206 are arranged on the surfaces of the first electrode 201 to the fourth electrode 204 that are attached to the patient P. When using the AED 1, the film 207 is peeled off and the conductive adhesive layer 206 is attached to the patient P, thereby preventing the first electrode 201 to the fourth electrode 204 from shifting position or peeling off after attachment.

[0034] The band-shaped electrode unit 200 can be twisted when the AED 1 is not in use and unfolded when in use. As shown in Fig. 5(A), the band-shaped electrode unit 200 has fasteners 603 and 604 at both ends in the longitudinal direction. To twist the band-shaped electrode unit 200, the fasteners 603 and 604 are rotated in opposite directions around an axis S connecting the fasteners 603 and 604. This causes the band-shaped electrode unit 200 to twist into a twisted string as shown in Fig. 5(B).

[0035] 6(A), the band electrode unit 200 can be used as a strap for the main unit 100 by engaging the fasteners 603 and 604 of the band electrode unit 200 with the fasteners 605 and 606 provided on both sides of the main unit 100, respectively. When using the AED 1, the fasteners 603 and 604 of the band electrode unit 200 are detached from the fasteners 605 and 606 of the main unit 100, the band electrode unit 200 is unfolded, and the first electrode 201 to the fourth electrode 204 are attached to the patient P.

[0036] The cable 300 electrically connects the selection switch 151 and the biological information acquisition unit 160 of the main body 100 to the first electrode 201 to the fourth electrode 204 of the strip-shaped electrode unit 200. The cable 300 may be fixed to the main body 100 and the strip-shaped electrode unit 200, or may be detachable from the main body 100 and / or the strip-shaped electrode unit 200. If detachable, the end of the cable 300 is provided with a terminal provided on the main body 100 and a terminal that engages with a terminal provided on the strip-shaped electrode unit 200.

[0037] Next, we will explain the operation of the AED 1 having the above configuration. Here, it is assumed that the main body 100 is formed to a portable size and is carried around with the band-shaped electrode section 200 as a strap, as shown in Figure 6(A).

[0038] To use the AED 1 in this state, the rescuer disengages the fasteners 603 and 604 of the band electrode unit 200 from the fasteners 605 and 606 of the main body 100, and removes the band electrode unit 200. The rescuer unfolds the removed band electrode unit 200. Next, the rescuer attaches the band electrode unit 200 to the patient P. Specifically, first, as shown in FIGS. 7(A), (B), and (C), the band electrode unit 200 is wrapped around the patient P and roughly aligned so that the first electrode 201 is located on the right anterior chest, the second electrode 202 is located on the left anterior chest, the third electrode 203 is located on the left flank, and the fourth electrode 204 is located on the left back. Next, the film 207 on the first to fourth electrodes 201 to 204 is peeled off, and the conductive adhesive layer 206 is attached to the patient P. At this time, by engaging the fasteners 601 and 602 of the strip-shaped electrode portion 200 with each other, the wearing comfort can be improved.

[0039] Meanwhile, the user turns on the power of the main body 100. In response to the power-on, the control unit 140 displays operation guidance on the display unit 110, and also outputs operation guidance from the audio output unit .

[0040] When the power is turned on, the control unit 140 starts the electric shock application process shown in FIG.

[0041] First, the control unit 140 controls the biological information acquiring unit 160 to acquire the biovoltage, biocurrent, etc. of the patient P from the first electrode 201 to the fourth electrode 204 attached to the patient P. The control unit 140 analyzes the biovoltage, biocurrent, etc. acquired by the biological information acquiring unit 160 to obtain electrocardiogram information, heart rate, etc., and displays the electrocardiogram, heart rate, etc. on the display unit 110 (step S1). The control unit 140 may also display the standard waveform of the electrocardiogram, the heart rate, etc.

[0042] The rescuer determines whether defibrillation, i.e., the administration of an electric shock, is necessary based on the displayed information such as the electrocardiogram and heart rate. If the rescuer determines that defibrillation is necessary, the rescuer operates the operation unit 120 to instruct the control unit 140 to administer an electric shock.

[0043] In response to the instruction to apply an electric shock (step S2: application), the control unit 140 controls the high-voltage generation unit 150 to generate a high-voltage pulse. The control unit 140 also controls the selection switch 151 so that the switch SW1 of the selection switch 151 selects the first electrode 201 and the switch SW2 selects the third electrode 203. As a result, as shown in FIG. 3(B), when the high-voltage generation unit 150 outputs the first high-voltage pulse PL1, a positive high-voltage pulse (the voltage of the first electrode 201 > the voltage of the third electrode 203) is applied to the patient P between the first electrode 201 and the third electrode 203 (step S3). After the application of the first high-voltage pulse PL1 is completed, the control unit 140 controls the selection switch 151 so that the switch SW1 selects the third electrode 203 and the switch SW2 selects the first electrode 201. As a result, when the high voltage generating unit 150 outputs the second high voltage pulse PL2, a negative high voltage pulse (voltage of the third electrode 203 > voltage of the first electrode 201) is applied to the patient P between the first electrode 201 and the third electrode 203 (step S3).

[0044] This causes a pulsed current to flow from the right anterior chest to the left flank, and then from the left flank to the right anterior chest, applying a bipolar electric shock to the heart.

[0045] Returning to Fig. 8, after administering the electric shock in step S3, the control unit 140 controls the biological information acquisition unit 160 to acquire the biovoltage, biocurrent, etc. of the patient P from the band electrode unit 200. The control unit 140 analyzes the biovoltage, biocurrent, etc., and obtains electrocardiogram information, heart rate, etc., and displays them on the display unit 110 (step S4).

[0046] The rescuer determines whether further defibrillation is necessary, i.e., whether an additional electric shock is necessary (effective), based on the displayed information such as the electrocardiogram and heart rate. If the rescuer determines that an additional electric shock is necessary, the rescuer operates the operation unit 120 to instruct the administration of an electric shock.

[0047] In response to the instruction to apply an electric shock (step S5: Apply), the control unit 140 controls the high-voltage generation unit 150 to generate a high-voltage pulse. The control unit 140 also controls the selection switch 151 so that the switch SW1 of the selection switch 151 selects the second electrode 202 and the switch SW2 selects the fourth electrode 204. As a result, as shown in FIG. 3(B), when the high-voltage generation unit 150 outputs the first high-voltage pulse PL1, a positive high-voltage pulse (the voltage of the second electrode 202 > the voltage of the fourth electrode 204) is applied to the patient P between the second electrode 202 and the fourth electrode 204 (step S6). After the application of the first high-voltage pulse PL1 is completed, the control unit 140 controls the selection switch 151 so that the switch SW1 selects the fourth electrode 204 and the switch SW2 selects the second electrode 202. As a result, when the high voltage generating unit 150 outputs the second high voltage pulse PL2, a negative high voltage pulse (voltage of the fourth electrode 204 > voltage of the second electrode 202) is applied to the patient P between the second electrode 202 and the fourth electrode 204 (step S6).

[0048] This causes a pulsed current to flow from the left anterior chest to the left back, and then from the left back to the left anterior chest, applying a bipolar electric shock to the heart.

[0049] Returning to Fig. 8, after administering the electric shock in step S6, the control unit 140 controls the biological information acquisition unit 160 to acquire the biovoltage, biocurrent, etc. of the patient P from the band electrode unit 200. The control unit 140 analyzes the biovoltage, biocurrent, etc., and obtains electrocardiogram information, heart rate, etc., and displays them on the display unit 110 (step S7).

[0050] The rescuer determines whether further defibrillation is necessary, i.e., whether an additional electric shock is necessary, based on the displayed information such as the electrocardiogram and heart rate. If the rescuer determines that further defibrillation is necessary, the rescuer operates the operation unit 120 to instruct the control unit 140 to administer an electric shock.

[0051] In response to the instruction to apply an electric shock (step S8: apply), control unit 140 returns the process to step S3 and performs control so as to apply a high-voltage pulse between first electrode 201 and third electrode 203. Thereafter, the same operations as those described above are repeated.

[0052] On the other hand, if the rescuer determines that the application of an electric shock is not necessary, the rescuer operates the end button. This operation is detected in steps S2, S5, and S8, and the control unit 140 ends the electric shock application process.

[0053] Thereafter, the rescuer removes the first electrode 201 to the fourth electrode 204 from the patient P and moves on to the next treatment.

[0054] In this way, according to this embodiment, the first electrode 201 to the fourth electrode 204 can be attached to appropriate positions on the patient P with a relatively simple process. Furthermore, it is possible to apply an electric shock by repeatedly applying two successive bipolar high-voltage pulses between the right anterior chest and the left flank, and then applying two successive bipolar high-voltage pulses between the left anterior chest and the left back, that is, to apply an electric shock by a dual application method. Therefore, the survival rate of the patient P can be improved compared to conventional methods.

[0055] In particular, since the first electrode 201 to the fourth electrode 204 are arranged in advance in an appropriate order on the belt-shaped fabric 205, attaching the electrodes to the patient P is simple and does not require much time, and furthermore, the electrodes can be attached in appropriate positions.

[0056] Furthermore, since the conductive adhesive layer 206 is disposed on the first electrode 201 to the fourth electrode 204, the first electrode 201 to the fourth electrode 204 are brought into close contact with the body surface of the patient P, thereby reducing impedance. Furthermore, after the band-shaped electrode portion 200 is attached to the patient P, there is little risk that the first electrode 201 to the fourth electrode 204 will shift or peel off.

[0057] After using the AED 1, the strip-shaped electrode portion 200 can be restored by replacing or disinfecting the conductive adhesive layer 206 of the first electrode 201 to the fourth electrode 204 and attaching the film 207. Thereafter, the strip-shaped electrode portion 200 can be twisted around the axis S to form a twisted string, and by engaging the fasteners 603, 604 at both ends with the fasteners 605, 606 of the main body 100, the AED 1 can be used as a strap for carrying the AED 1.

[0058] By making the band-shaped electrode unit 200 into a twisted string, the overall size of the band-shaped electrode unit 200 can be made compact. At the same time, by making the band-shaped electrode unit 200 into a strap, the portability of the AED 1 is improved and it becomes easier to prevent the AED 1 from being lost. In particular, when engaging with an ultra-compact and lightweight AED 1, the twisted string-shaped band-shaped electrode unit 200 is suitable for a strap.

[0059] Furthermore, the first electrode 201 to the fourth electrode 204 are provided with a conductive adhesive layer 206. Therefore, even if the patient P's skin is intermittently wet due to rain, bleeding, or the like, the band-shaped electrode portion 200 can be attached to the patient P while preventing it from shifting out of position or peeling off. Furthermore, if there is a laceration, gunshot wound, or the like in the contact area between the patient P and the first electrode 201 to the fourth electrode 204, the first electrode 201 to the fourth electrode 204 can also function as a hemostatic device.

[0060] (Embodiment 2) In the first embodiment, the surfaces of the first to fourth electrodes 201 to 204 are flat as shown in FIG. 4(B). However, as shown in FIG. 9(A), a conductive needle-like body 208 may be disposed on the surface of all or any of the first to fourth electrodes 201 to 204. The material and shape of the conductive needle-like body 208 are not limited as long as it is conductive and has a hardness and shape that allows it to be punctured into the skin of the patient P. When attached to the patient P, all or a part of the conductive needle-like body 208 punctures the skin of the patient P, fixing the band-like electrode unit 200 to the patient P. This allows the band-like electrode unit 200 to be attached to the patient P without shifting from its attached position or peeling off, particularly even when the patient P's skin is intermittently wet due to rain, bleeding, or the like. Furthermore, if there is a laceration, gunshot wound, or the like in the area of contact between the patient P and the first to fourth electrodes 201 to 204, the first to fourth electrodes 201 to 204 can also function as a hemostatic tool.

[0061] Furthermore, bioimpedance is lower subcutaneously than on the skin. Therefore, by inserting all or part of the conductive needle-shaped member 208 into the subcutaneous tissue of the patient P and applying an electric shock to the subcutaneous tissue of the patient P via the conductive needle-shaped member 208, the bioimpedance can be reduced compared to when a pulse voltage is applied to the skin of the patient P.

[0062] Furthermore, if the patient P is fully clothed, and the first to fourth electrodes 201 to 204 are attached to the patient P over the patient's clothing, the impedance becomes too large. However, with the band-shaped electrode unit 200 including the conductive needle-shaped member 208, a sufficient electric shock can be applied to the patient P by inserting the tip of the conductive needle-shaped member 208 into the subcutaneous tissue of the patient P, even if the patient P is fully clothed.

[0063] Each of the first electrode 201 to the fourth electrode 204 may have only one conductive needle-like structure 208, or may have multiple conductive needle-like structures. Alternatively, only some of the electrodes may have needle-like structures. Alternatively, as shown in FIG. 9(B), each of the first electrode 201 to the fourth electrode 204 may have a conductive needle-like structure 208 and a conductive adhesive layer 206 on one surface thereof. The conductive needle-like structure 208 is an example of a needle-like structure.

[0064] (Embodiment 3) Although the band-shaped electrode section 200 in the first and second embodiments has an overall band-like shape, it is not limited to this shape. When the electrodes are attached to the patient P, the first electrode 201 to the fourth electrode 204 can be placed on the right anterior chest, the left anterior chest, the left flank, and the left back of the patient P, respectively, so long as the shape is arbitrary. For example, the band-shaped electrode section 200 may have an overall triangular band-like shape, as shown in Figs. 10(A), (B), and (C).

[0065] The triangular sling-shaped electrode unit 400 shown in Figures 10(A), (B), and (C) includes first to fourth electrodes 201 to 204 and a triangular sling-shaped fabric 401 on which they are arranged. As shown in an expanded view in Figure 10(C), the overall shape of the triangular sling-shaped electrode unit 400 is, for example, a shape in which one of the vertices of a triangle overlaps with one of the vertices of another triangle congruent with the triangle. Fasteners 607 may be provided around each vertex of one triangle of the triangular sling-shaped electrode unit 400, and fasteners 608 may be provided around each vertex of the other triangle, so that they can be attached and detached to each other. The triangular sling-shaped fabric 401 is made of, for example, synthetic fiber. However, the shape of the triangular sling-shaped electrode unit 400 is not limited as long as it forms a triangular sling shape when attached to the patient P.

[0066] 10(A) and 10(B), the first electrode 201, the second electrode 202, and the third electrode 203 are arranged on the lining of one triangle of the triangular sling-shaped fabric 401, and the fourth electrode 204 is arranged on the lining of the other triangle. Also, as shown in FIG. 10(A), the first electrode 201, the second electrode 202, and the third electrode 203 are fixed in positions that will be located above the right anterior chest, left anterior chest, and left abdomen of the patient P when the triangular sling-shaped electrode unit 400 is worn on the patient P. Also, as shown in FIG. 10(B), the fourth electrode 204 is fixed in a position that will be located above the left back of the patient P when the triangular sling-shaped electrode unit 400 is worn on the patient P. However, the attachment positions are set with some leeway in consideration of differences in physique.

[0067] By attaching the triangular sling-shaped electrode part 400 to the patient P, the rescuer can position the first electrode 201 to the fourth electrode 204 at approximately appropriate positions on the patient P. The electrodes can be easily positioned by fine-tuning the positions of the first electrode 201 to the fourth electrode 204 and attaching them to the patient P. The triangular sling-shaped electrode part 400 is an example of an electrode part.

[0068] (Fourth embodiment) Furthermore, the strip-shaped electrode portion 200 may be entirely in the form of a garment, as shown in FIGS. 11(A) and 11(B).

[0069] The garment-like electrode unit 500 shown in FIGS. 11(A) and (B) comprises first to fourth electrodes 201 to 204 and a garment-like fabric 501 on which these electrodes are arranged. The garment-like fabric 501 is, for example, vest- or poncho-shaped overall. It is desirable that the front or sides of the garment-like fabric 501 be open so that it can be easily worn by the patient P. When the front or sides are open, fasteners 609 and 610 that can be engaged and detached with each other may be provided around the front or sides. The garment-like fabric 501 is made of, for example, synthetic fiber. However, the shape is not limited thereto.

[0070] 11(A) and 11(B), the first electrode 201, the second electrode 202, and the third electrode 203 are arranged on the lining of the front bodice of the garment-like fabric 501, and the fourth electrode 204 is arranged on the lining of the back bodice of the garment-like fabric 501. Also, as shown in FIG. 11(A), the first electrode 201, the second electrode 202, and the third electrode 203 are fixed in positions that will be located above the right anterior chest, the left anterior chest, and the left abdominal region of the patient P when the garment-like electrode unit 500 is worn on the patient P. Also, as shown in FIG. 11(B), the fourth electrode 204 is fixed in a position that will be located above the left back of the patient P when the garment-like electrode unit 500 is worn on the patient P. However, the attachment positions are set with some leeway in consideration of differences in physique.

[0071] By attaching the clothing-like electrode unit 500 to the patient P, the rescuer can position the first electrode 201 to the fourth electrode 204 at approximately appropriate positions on the patient P. The electrodes can be easily positioned by fine-tuning the positions of the first electrode 201 to the fourth electrode 204 and attaching them to the patient P. The clothing-like electrode unit 500 is an example of an electrode unit.

[0072] (Embodiment 5) The attachment positions of the first electrode 201 to the fourth electrode 204 vary depending on the physical differences of the patient P. In particular, the physical differences are significant between the patient P who is a child and the patient P who is an adult.

[0073] 12(A), the AED 1 is provided with a child band-shaped electrode unit 220 and an adult band-shaped electrode unit 221, and a rescuer may switch between them. The child band-shaped electrode unit 220 and the adult band-shaped electrode unit 221 each include a first electrode 201 to a fourth electrode 204.

[0074] A rescuer can select either the child's band-like electrode unit 220 or the adult's band-like electrode unit 221 according to the physique of the patient P and attach it to the patient P. As shown in FIG. 12(B), the AED 1 may also be equipped with a child's triangular sling-like electrode unit 420 and an adult's triangular sling-like electrode unit 421. As shown in FIG. 12(C), the AED 1 may also be equipped with a child's clothing-like electrode unit 520 and an adult's clothing-like electrode unit 521. The child's band-like electrode unit 220, the child's triangular sling-like electrode unit 420, and the child's clothing-like electrode unit 520 are examples of child's electrodes, and the adult's band-like electrode unit 221, the adult's triangular sling-like electrode unit 421, and the adult's clothing-like electrode unit 521 are examples of adult electrodes.

[0075] (Sixth embodiment) The number of pulses, polarity, waveform (pulse width, pulse height), energy value, etc. of the high-voltage pulses generated by the high-voltage generation unit 150 can be changed as appropriate. For example, in step S3, bipolar high-voltage pulses may be applied n (n≧2) times between the first electrode 201 and the third electrode 203, and in step S6, bipolar high-voltage pulses may be applied m (m≧2) times between the second electrode 202 and the fourth electrode 204. When applying bipolar high-voltage pulses, the order in which positive and negative high-voltage pulses are applied does not matter. The high-voltage pulses applied in step S3 and the high-voltage pulses applied in step S6 may be different. For example, in step S3, bipolar pulses may be applied between the first electrode 201 and the third electrode 203, and a unipolar pulse may be applied in step S6.

[0076] Although the example in which the high-voltage generating unit 150 generates two consecutive unipolar pulses has been described, this is not limited thereto. For example, the high-voltage generating unit 150 may output bipolar high-voltage pulses such as known BTE waveforms, RLB waveforms, and ActiBiphasic waveforms. In this case, bipolar high-voltage pulses can be applied to the heart without switching the switches SW1 and SW2 in step S3 and without switching the switches SW1 and SW2 in step S6.

[0077] In the above explanation, step S5 instructs that a high voltage pulse be applied in step S6, but steps S3 and S6 may be combined as a set, and steps S3 and S6 may be automatically performed in sequence when application is instructed in step S2. Note that step S6 may be performed before step S3.

[0078] Furthermore, although high-voltage pulses are applied between the first electrode 201 and the third electrode 203 and between the second electrode 202 and the fourth electrode 204 in the above embodiment, the present invention is not limited to this. At least two of the four electrodes may be appropriately selected to apply high-voltage pulses so that a current flows through the heart, and the combination of electrodes may be appropriately changed to apply high-voltage pulses to the heart in different modes.

[0079] In the above embodiment, four electrodes are arranged on the band-shaped electrode unit 200, the triangular strap-like electrode unit 400, and the garment-like electrode unit 500. However, more than four electrodes may be arranged. For example, as illustrated in FIGS. 13(A) and 13(B), five electrodes may be arranged on the right anterior chest, left anterior chest, left flank, left back, and right back of the patient P. In this case, in addition to the first electrode 201 to the fourth electrode 204, a fifth electrode 209 is arranged on the band-shaped electrode unit 200, the triangular strap-like electrode unit 400, and / or the garment-like electrode unit 500. At least two of these five electrodes may be appropriately selected to apply a high-voltage pulse so that a current flows through the heart. By appropriately changing the combination of electrodes, high-voltage pulses may be applied to the heart in different modes.

[0080] Furthermore, the first to fourth electrodes 201 to 204 and the strip-shaped fabric 205 are bonded together, but this is not limiting. For example, the first to fourth electrodes 201 to 204 and the strip-shaped fabric 205 may be fixed together by sewing.

[0081] Furthermore, although the band-like electrode 200 is in the form of a twisted string, the triangular scarf-like electrode 400 and the garment-like electrode 500 may also be twisted strings. When the triangular scarf-like electrode 400 and the garment-like electrode 500 are twisted strings, a fastener is provided around one of the vertices of the triangular scarf-like electrode 400 and the garment-like electrode 500, and another fastener is provided around the vertex of the triangular scarf-like electrode 400 and the garment-like electrode 500 facing the fastener. The fasteners are rotated in opposite directions around the axis connecting them. This causes the triangular scarf-like electrode 400 and the garment-like electrode 500 to become twisted strings.

[0082] Furthermore, although the band-like electrode unit 200, the triangular scarf-like electrode unit 400, and the garment-like electrode unit 500 are shown in the form of twisted cords, the present invention is not limited to this. For example, as shown in Fig. 6(B), a space for storing the band-like electrode unit 200 may be provided in the main body 100, and the folded band-like electrode unit 200 may be stored in this space when not in use. Furthermore, the AED 1 and the folded band-like electrode unit 200 may be stored in the storage case 2.

[0083] In the first embodiment, the strip-shaped fabric 205 is strip-shaped as a whole and is provided with the fasteners 601 and 602 on both longitudinal end faces, respectively, but is not limited to this. For example, the strip-shaped fabric 205 may not be provided with the fasteners 601 and 602, and may be a seamless, continuous ring-shaped fabric as a whole.

[0084] In the above-mentioned first to fifth embodiments, the material of the belt-shaped fabric 205, the triangular scarf-like fabric 401, and the garment-like fabric 501 is synthetic fiber, but the material is not limited as long as it is flexible, strong enough not to tear when attached to a patient, and can insulate from applied voltage. Furthermore, the belt-shaped fabric 205, the triangular scarf-like fabric 401, and the garment-like fabric 501 may have an adhesive layer on the surface that comes into contact with the patient P. By providing an adhesive layer, the belt-shaped electrode unit 200, the triangular scarf-like electrode unit 400, or the garment-like electrode unit 500 can be attached to the patient P without shifting or peeling off, even if the patient P's skin is intermittently wet due to rain, bleeding, or the like. Furthermore, if there is a laceration, gunshot wound, or the like in the area of contact between the patient P and the band-like fabric 205, the triangular band-like fabric 401, or the clothing-like fabric 501, the band-like fabric 205, the triangular band-like fabric 401, and the clothing-like fabric 501 can also function as a hemostatic device.

[0085] Although the AED 1 waits for a command from the rescuer to administer an electric shock before administering an electric shock to the patient P, this is not a limitation. For example, the control unit 140 of the AED 1 may determine whether the biological information acquired by the biological information acquisition unit 160 satisfies a preset high-voltage pulse application criterion, and if it is determined that the biological information satisfies the criterion, automatically administer an electric shock to the patient P without receiving a command from the rescuer to administer an electric shock. The high-voltage pulse application criterion may be preset in, for example, the memory unit 180. Alternatively, any known criterion may be used as the high-voltage pulse application criterion. For example, if the control unit 140 determines that the heart rate of the patient P is similar to a heart rate that requires defibrillation, the control unit 140 may administer an electric shock to the patient P without receiving a command from the rescuer to administer an electric shock.

[0086] More specifically, the storage unit 180 pre-stores electrocardiogram information indicating a heartbeat requiring defibrillation and threshold information indicating the rate of match between the electrocardiogram information of patient P and the electrocardiogram information indicating the heartbeat requiring defibrillation. The control unit 140 analyzes the bioelectric voltage, bioelectric current, etc. of patient P acquired by the biological information acquisition unit 160 to obtain electrocardiogram information, heart rate, etc. The control unit 140 obtains the rate of match between the electrocardiogram information of patient P and the electrocardiogram information stored in the storage unit 180. The control unit 140 compares the obtained rate of match with the rate indicated by the threshold information. If the obtained rate of match exceeds the rate indicated by the threshold information, the control unit 140 determines that the heartbeat of patient P is similar to the heartbeat requiring defibrillation.

[0087] The first electrode 201 to the fourth electrode 204 provided on the triangular scarf-shaped electrode 400 in the third embodiment, the garment-like electrode 500 in the fourth embodiment, the child's band-like electrode 220, the adult's band-like electrode 221, the child's triangular scarf-shaped electrode 420, the adult's triangular scarf-shaped electrode 421, the child's garment-like electrode 520, and the adult's garment-like electrode 521 in the fifth embodiment may each have a conductive adhesive layer 206, or each have a conductive needle-like body 208, or each have a conductive adhesive layer 206 and a conductive needle-like body 208. [Explanation of symbols]

[0088] 1: AED (Automated External Defibrillator), 2: Storage Case, 100: Main Unit, 110: Display Unit, 120: Operation Unit, 130: Audio Output Unit, 140: Control Unit, 150: High Voltage Generator, 151: Selection Switch, 160: Biometric Information Acquisition Unit, 170: Power Supply Unit, 180: Memory Unit, 200: Strip Electrode Unit, 201: First Electrode, 202: Second Electrode, 203: Third Electrode, 204: Fourth Electrode, 205: Strip Fabric, 206: Conductive Adhesive Layer, 207: Film, 208: Conductive Needle Body, 209: Fifth Electrode, 220: Children's Strip Electrode Unit, 221: Adult Strip Electrode Unit, 30 0: Cable, 400: Scarf-shaped electrode part, 401: Scarf-shaped fabric, 420: Scarf-shaped electrode part for children, 421: Scarf-shaped electrode part for adults, 500: Clothing-like electrode part, 501: Clothing-like fabric, 520: Clothing-like electrode part for children, 521: Clothing-like electrode part for adults, 601: Fastener, 602: Fastener, 603: Fastener, 604: Fastener, 605: Fastener, 606: Fastener, 607: Fastener, 608: Fastener, 609: Fastener, 610: Fastener, P: Patient, S: Axis, SW1: Switch, SW2: Switch, PL1: High-voltage pulse, PL2: High-voltage pulse.

Claims

1. an electrode unit including a first electrode attached to the right anterior chest of the patient, a second electrode attached to the left anterior chest of the patient, a third electrode attached to the left flank of the patient, and a fourth electrode attached to the left back of the patient; a voltage application unit that applies a high voltage pulse between at least two electrodes selected from the first to fourth electrodes; An automated external defibrillator comprising:

2. the voltage application unit has a function of applying a high voltage pulse between the first electrode and the third electrode, and a function of applying a high voltage pulse between the second electrode and the fourth electrode; 10. The automated external defibrillator of claim 1.

3. The electrode portion is strip-shaped.

10. The automated external defibrillator of claim 1.

4. The electrode portion is provided with fasteners at both ends in the longitudinal direction that can be freely engaged with and detached from each other.

4. The automated external defibrillator of claim 3.

5. The electrode portion is triangular-strap shaped.

10. The automated external defibrillator of claim 1.

6. The electrode unit is in the form of clothing.

10. The automated external defibrillator of claim 1.

7. The electrode portion is twisted like a twisted cord.

7. An automatic external defibrillator according to any one of claims 3 to 6.

8. a child electrode portion used when the patient is a child; an adult electrode portion used when the patient is an adult; 10. The automatic external defibrillator of claim 1, comprising:

9. At least one of the first electrode, the second electrode, the third electrode, and the fourth electrode includes a needle-shaped member that is inserted subcutaneously into a patient.

10. The automated external defibrillator of claim 1.

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