System

Abstract

A system for assisting a user in performing chest compressions includes at least one input device providing information representative of a plurality of physical characteristics of a patient, at least one chest compression sensor, a feedback device providing chest compression feedback to a user, and at least one processor configured to receive and process the information representative of the plurality of physical characteristics of the patient to determine target chest compression criteria for the patient, receive and process signals indicative of chest compressions from the at least one chest compression sensor to calculate at least one chest compression parameter, determine whether the at least one chest compression parameter meets the target chest compression criteria, and cause the feedback device to provide an indication to the user as to whether the chest compression parameter meets the target criteria.

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims priority to U.S. Provisional Patent Application No. 62 / 692,004, filed Jun. 29, 2018, entitled "Systems and Methods for Providing Resuscitation Guidance Based on Physical Features of a Patient Measured During an Acute Care Event", the entire disclosure of which is incorporated herein by reference.

[0002] The present disclosure relates to an electronic device that assists emergency responders by providing guidance and feedback for performing resuscitation actions on a patient, and in some examples, to a system that determines criteria for performing resuscitation actions based at least in part on one or more physical characteristics of the patient measured during an acute care event.

Background Art

[0003] Cardiopulmonary resuscitation (CPR) is a process by which one or more emergency responders can attempt to resuscitate a patient who may have suffered a cardiac adverse event by taking one or more actions such as, for example, chest compressions and artificial respiration. Chest compressions contribute to maintaining blood circulation in the body and heart. Thus, chest compressions are an important element of CPR. Artificial respiration contributes to providing gas exchange (e.g., oxygen supply and carbon dioxide removal), which is essential for blood circulation. Thus, artificial respiration is also an essential element of CPR.

[0004] CPR can be performed by a team of one or more emergency responders, such as an emergency medical service (EMS) team composed of, for example, emergency medical technicians (EMTs), a hospital team including medical personnel (such as physicians, nurses, etc.), and / or a bystander responding to an emergency. In some cases, one emergency responder can provide chest compressions to the patient, and another emergency responder can provide rescue breaths to the patient. Here, chest compressions and rescue breaths can be performed in synchronization and / or in coordination according to an appropriate CPR pattern. In the case of assistance by an expert such as an EMT, rescue breaths can be provided not mouth-to-mouth but, for example, via a rescue breathing bag compressed by the emergency responder. CPR can be performed in conjunction with an electric shock provided to the patient by an automated external defibrillator (AED) or an external defibrillator such as a dedicated defibrillator / monitor. In many cases, such an AED provides guidance and instructions to the emergency responder, such as "Push harder" (if the emergency responder is not performing chest compressions to the desired depth, for example, in the form of auditory feedback), "Stop CPR," "Stand clear" (because a shock is about to be provided), etc. To determine the quality of the chest compressions being performed, certain defibrillators can obtain information from one or more accelerometers (such as the accelerometers provided with the CPRD PADZ (registered trademark), CPRSTAT PADZ (registered trademark), and ONE STEP (trademark) pads manufactured by ZOLL Medical Corporation of Chelmsford, Massachusetts). This can be used to provide data for determining information such as the depth of chest compressions (for example, to determine if the compressions are too shallow or too deep and to enable the defibrillator to give appropriate instructions). The AED can also provide feedback to prompt the emergency responder to perform resuscitation actions as recommended or according to a pattern. For example, such an AED can issue instructions or display an icon to inform the emergency responder when the chest compressions are too shallow or too deep.

[0005] On the one hand, an improved system that provides guidance, information, and feedback to first responders regarding the performance of resuscitation maneuvers would be useful in achieving better assistance and outcomes for patients. The devices, systems, and techniques described herein are aimed at providing such benefits.

SUMMARY OF THE INVENTION

[0006] According to aspects of the present disclosure, a system for assisting a user in performing chest compressions on a patient during an acute care treatment event includes at least one input device that provides information representing a plurality of physical characteristics of the patient measured during the acute care treatment event, at least one chest compression sensor configured to acquire a signal indicative of the chest compressions being performed on the patient during the acute care treatment event, a feedback device that provides chest compression feedback to the user, the at least one input device that provides information representing the plurality of physical characteristics, and at least one processor. The at least one processor may be communicatively coupled to the at least one input device that provides information representing the plurality of physical characteristics and the at least one chest compression sensor. The at least one processor receives and processes the information representing the plurality of physical characteristics of the patient to determine a target chest compression criterion for the patient, receives and processes the signal indicative of the chest compressions from the at least one chest compression sensor to calculate at least one chest compression parameter, determines whether the at least one chest compression parameter meets the target chest compression criterion, and is configured to cause the feedback device to provide an indication to the user as to whether the at least one chest compression parameter meets the target chest compression criterion.

[0007] According to another aspect of the present disclosure, in an acute treatment event, a system for assisting a user in performing chest compressions on a patient includes at least one input device that provides information representing at least one physical characteristic of the patient measured during the acute treatment event, a feedback device that provides guidance to the user on how the chest compressions should be performed on the patient, and at least one processor. The at least one processor can be communicatively connected to the at least one device that provides information representing the at least one physical characteristic. The at least one processor is configured to receive and process the information representing the at least one physical characteristic of the patient to determine a recommended chest compression technique for the patient, and cause the feedback device to provide an indication of the recommended chest compression technique to the user.

[0008] According to another aspect of the present disclosure, a method for providing chest compressions to a patient during an acute treatment event includes measuring a plurality of physical characteristics of the patient during the acute treatment event, determining a target chest compression criterion based on the measured plurality of physical characteristics, applying chest compressions to the patient, measuring at least one chest compression parameter during the applied chest compressions using at least one chest compression sensor, and providing feedback guidance to the user on how to adjust the chest compressions applied to the patient based on whether the at least one chest compression parameter meets the target chest compression criterion.

[0009] According to another aspect of the present disclosure, a method for providing chest compressions to a patient during an acute treatment event includes measuring a plurality of physical characteristics of the patient during the acute treatment event, determining a recommended chest compression technique based on the measured plurality of physical characteristics, providing feedback guidance to the user to provide an indication of the recommended chest compression technique, and applying chest compressions to the patient according to the recommended chest compression technique.

[0010] According to another aspect of the present disclosure, in performing artificial respiration on a patient during an acute treatment event, a system for assisting a user includes at least one input device that provides information representing a plurality of physical characteristics of the patient measured during the acute treatment event, at least one ventilation sensor configured to acquire a signal indicating the artificial respiration performed on the patient during the acute treatment event, a feedback device that provides guidance to the user regarding how to perform the artificial respiration on the patient, and at least one processor. The at least one processor can be communicatively connected to the at least one input device that provides information representing the plurality of physical characteristics and the at least one ventilation sensor. The at least one processor receives and processes the information representing the plurality of physical characteristics of the patient to determine a target artificial respiration standard for the patient, receives and processes the signal indicating the artificial respiration from the at least one ventilation sensor to calculate at least one ventilation parameter, determines whether the at least one ventilation parameter meets the target artificial respiration standard, and is configured to cause the feedback device to provide an indication to the user regarding whether the at least one ventilation parameter meets the target artificial respiration standard.

[0011] According to another aspect of the present disclosure, a method for providing artificial respiration to a patient during an acute treatment event includes measuring a plurality of physical characteristics of the patient during the acute treatment event, determining a target artificial respiration standard based on the at least one measurement, applying artificial respiration to the patient, using at least one ventilation sensor to measure at least one ventilation parameter during the application of the artificial respiration, and providing feedback guidance to the user regarding how to adjust the artificial respiration provided to the patient based on whether the at least one ventilation parameter meets the target artificial respiration standard.

[0012] According to another aspect of the present disclosure, in providing at least one cardiopulmonary resuscitation (CPR) action to a patient during an acute treatment event, a system for assisting a user includes at least one three-dimensional imaging system that acquires information representing at least one physical characteristic of the patient, at least one of a chest compression sensor or a ventilation sensor for acquiring a signal indicating the at least one resuscitation action applied to the patient, a feedback device that provides guidance to the user on how to apply the at least one resuscitation action to the patient, and at least one processor. The at least one processor can be communicatively connected to the at least one three-dimensional imaging system and the at least one chest compression or ventilation sensor. The at least one processor receives and processes the information representing the at least one physical characteristic from the three-dimensional imaging system to generate a three-dimensional representation of at least a part of the patient's body, determines a target resuscitation criterion based on the generated three-dimensional representation, receives and processes the signal indicating the at least one resuscitation action to calculate at least one resuscitation parameter, determines whether the at least one resuscitation parameter meets the target resuscitation criterion, and is configured to cause the feedback device to provide an indication as to whether the at least one resuscitation parameter conforms to the target resuscitation criterion.

[0013] According to another aspect of the present disclosure, a system for assisting a user in providing at least one cardiopulmonary resuscitation (CPR) action to a patient during an acute treatment event includes at least one input device that provides information representing at least one physical characteristic of the patient measured during the acute treatment event, a feedback device that provides information about the at least one resuscitation action, the patient, and the acute treatment event to the user, and at least one processor. The at least one processor is communicatively connected to the at least one device that provides information representing at least one physical characteristic of the patient. The at least one processor receives and processes the information representing the at least one physical characteristic measured during an initial period of the acute treatment event, determines an initial target resuscitation criterion based on the at least one physical characteristic during the initial period, causes the feedback device to provide an indication about the initial target resuscitation criterion to the user, receives and processes the information representing the at least one physical characteristic measured during a subsequent period of the acute treatment event, determines a modified target resuscitation criterion based on the at least one physical characteristic during the subsequent period, and is configured to cause the feedback device to provide an indication about the modified target resuscitation criterion to the user.

[0014] According to another aspect of the present disclosure, in providing at least one cardiopulmonary resuscitation (CPR) action to a patient during an acute treatment event, a computer-implemented method for assisting a user to cause a feedback device to provide feedback to the user includes receiving and processing information representing at least one physical characteristic of the patient measured during an initial period of the acute treatment event from at least one device providing the information representing the at least one physical characteristic; determining an initial target resuscitation criterion based on the at least one physical characteristic during the initial period; receiving and processing information representing the at least one physical characteristic of the patient measured during a subsequent period of the acute treatment event; determining a modified target resuscitation criterion based on the at least one physical characteristic during the subsequent period; and causing the feedback device to provide an indication of the modified target resuscitation criterion to the user.

[0015] According to another aspect of the present disclosure, a system for providing artificial respiration treatment to a patient includes at least one three-dimensional imaging system that acquires information representing at least one physical characteristic of the patient, an artificial respiration device that provides the artificial respiration treatment to the patient, and at least one processor. The at least one processor may be communicably connected to the at least one three-dimensional imaging system and the artificial respiration device. The at least one processor receives and processes the information representing the at least one physical characteristic of the patient to generate a three-dimensional representation of the patient, determines at least one artificial respiration criterion for the artificial respiration device based on the generated three-dimensional representation, and is configured to cause the artificial respiration device to provide artificial respiration based on the at least one artificial respiration criterion.

[0016] According to another aspect of the present disclosure, in an acute treatment event, a system for assisting a user in delivering a drug to a patient includes at least one input device that provides information representing a plurality of physical characteristics of the patient measured during the acute treatment event, a feedback device that provides dosage information for delivering the drug to the patient, and at least one processor. The at least one processor may be communicatively connected to the at least one input device that provides information representing the plurality of physical characteristics. The at least one processor receives and processes the information representing the plurality of physical characteristics of the patient to determine a target drug delivery dosage for the patient, and is configured to cause the feedback device to provide an indication of the target drug delivery dosage for the patient to the user.

[0017] According to another aspect of the present disclosure, in an acute treatment event, a system for assisting a user in providing a medical treatment to a patient includes at least one input device that provides information representing a plurality of physical characteristics of the patient measured during the acute treatment event, a user interface that provides acute treatment information for the patient, and at least one processor. The at least one processor is communicatively connected to the at least one input device that provides information representing the plurality of physical characteristics. The at least one processor receives and processes the information representing the plurality of physical characteristics of the patient to estimate the weight of the patient, determines at least one treatment parameter for the patient based at least in part on the estimated weight of the patient, and is configured to cause the user interface to provide an indication of the at least one treatment parameter for the patient.

[0018] Here, examples of the present invention will be described in the following numbered items.

[0019] Item 1: A system for assisting a user in performing chest compressions on a patient during an acute treatment event, comprising at least one input device that provides information representing a plurality of physical characteristics of the patient measured during the acute treatment event, at least one chest compression sensor configured to acquire a signal indicating the chest compressions performed on the patient during the acute treatment event, a feedback device that provides chest compression feedback to the user, and at least one processor communicatively connected to the at least one input device that provides information representing the plurality of physical characteristics and the at least one chest compression sensor, wherein the at least one processor receives and processes the information representing the plurality of physical characteristics of the patient to determine a target chest compression criterion for the patient, receives and processes the signal indicating the chest compressions from the at least one chest compression sensor to calculate at least one chest compression parameter, determines whether the at least one chest compression parameter meets the target chest compression criterion, and is configured to cause the feedback device to provide an indication to the user as to whether the at least one chest compression parameter meets the target chest compression criterion.

[0020] Item 2: The system according to Item 1, wherein the plurality of physical characteristics includes at least two of the anteroposterior (AP) distance of the sternum, the transverse width of the thorax, the chest circumference, the total volume of the patient, the thoracic volume, the abdominal circumference, the size of the neck, the shoulder width, the cranial volume, the interpupillary distance, the distance between the eyes and the nose, the finger length, the finger width, the hand width, the hand size, the toe length, the toe width, the foot width, the foot size, the thoracic shape, the height, the weight, and the body mass index (BMI).

[0021] Item 3: The system according to Item 1 or 2, wherein the at least one input device that provides information representing the plurality of physical characteristics of the patient comprises at least one of a user interface for manually inputting at least one measurement value of the physical characteristic, a two-dimensional camera, a stereoscopic camera, a three-dimensional sensor, a three-dimensional imaging system, a light field camera, and a position sensor or marker disposed on the patient.

[0022] Item 4: The at least one input device includes a three-dimensional imaging system for acquiring information representing the plurality of physical characteristics of the patient, and the processor is configured to generate a three-dimensional representation of at least a part of the patient's body based on the information acquired from the three-dimensional imaging system. The system according to item 3.

[0023] Item 5: The at least one input device that provides information representing the plurality of physical characteristics of the patient is attached to at least one of the patient, the feedback device, or the user. The system according to any one of items 1 to 4.

[0024] Item 6: Further comprising a smartphone or a computer tablet, the at least one input device that provides information representing the plurality of physical characteristics of the patient includes a camera of the smartphone or the computer tablet, and the at least one processor includes a processor of the smartphone or the computer tablet. The system according to any one of items 1 to 5.

[0025] Item 7: The feedback device includes a visual display of the smartphone or the computer tablet. The system according to item 6.

[0026] Item 8: The plurality of physical characteristics are measured during inhalation or exhalation. The system according to any one of items 1 to 7.

[0027] Item 9: At least one of the plurality of physical characteristics includes anthropometric features of the patient. The system according to any one of items 1 to 8.

[0028] Item 10: The anthropometric features of the patient include at least one of a thoracic shape, a ratio of an AP distance to a thoracic width, a thoracic volume, and a total volume of the patient. The system according to item 9.

[0029] Item 11: The chest compression sensor includes at least one of a single-axis accelerometer, a multi-axis accelerometer, and a gyroscope, and the system according to any one of Items 1 to 10.

[0030] Item 12: The feedback device includes at least one of a computer tablet, a smartphone, a personal digital assistant, a patient monitor device, a defibrillator, and a chest compression guidance device configured to be placed on the chest of the patient, and the system according to any one of Items 1 to 11.

[0031] Item 13: The feedback device is configured to provide at least one of auditory, visual, and tactile feedback, and the system according to any one of Items 1 to 12.

[0032] Item 14: The target chest compression criteria and the measured chest compression parameters include at least one of compression depth, compression rate, decompression speed, compression stop, and decompression, and the system according to any one of Items 1 to 13.

[0033] Item 15: The target chest compression criteria for compression depth include a depth of 0.2 inches (0.508 cm) to 3.5 inches (8.89 cm), and the system according to Item 14.

[0034] Item 16: The above-described target chest compression criteria for compression depth include at least one of the depths from 0.2 inches (0.508 cm) to 0.75 inches (1.905 cm) for patients with an AP distance of less than 3 inches (7.62 cm), from 0.75 inches (1.905 cm) to 1.25 inches (3.175 cm) for patients with an AP distance of 4.0 inches (10.16 cm) to 5.0 inches (12.7 cm), from 1.25 inches (3.175 cm) to 1.75 inches (4.445 cm) for patients with an AP distance of 6.0 inches (15.24 cm) to 8.0 inches (20.32 cm), from 1.75 inches (4.445 cm) to 2.25 inches (5.715 cm) for patients with an AP distance of 9.0 inches (22.86 cm) to 11.0 inches (27.94 cm), from 2.25 inches (5.715 cm) to 2.75 inches (6.985 cm) for patients with an AP distance of 10 inches (25.4 cm) to 12 inches (30.48 cm), and from 2.75 inches (6.985 cm) to 3.5 inches (8.89 cm) for patients with an AP distance of 13 inches (33.02 cm) or more, of the system described in Item 14 or 15.

[0035] Item 17: The above-described target chest compression criteria for chest compression rate include a rate from 100 cpm to 160 cpm, of the system described in any of Items 14 to 16.

[0036] Item 18: The above-described target chest compression criteria for compression rate include at least one of the rates from 140 cpm to 160 cpm for patients with an AP distance of less than 3.0 inches (7.62 cm), from 130 cpm to 150 cpm for patients with an AP distance of 4.0 inches (10.16 cm) to 5.0 inches (12.7 cm), from 120 cpm to 140 cpm for patients with an AP distance of 6.0 inches (15.24 cm) to 8.0 inches (20.32 cm), from 110 cpm to 130 cpm for patients with an AP distance of 9.0 inches (22.86 cm) to 11 inches (27.94 cm), or from 100 cpm to 120 cpm for patients with an AP distance of 12 inches (30.48 cm) or more, of the system described in any of Items 14 to 17.

[0037] Item 19: The above target chest compression criteria for the target chest compression release speed include a system as described in any of Items 14 to 18, including from 150 inches (381 cm) / minute to 600 inches (1524 cm) / minute.

[0038] Item 20: The above target chest compression criteria for the target chest compression release speed include at least one of the following: for patients with an AP distance of less than 3.0 inches (7.62 cm), from 150 inches (381 cm) to 250 inches (635 cm) / minute; for patients with an AP distance of 4.0 inches (10.16 cm) to 5.0 inches (12.7 cm), from 200 inches (508 cm) to 300 inches (762 cm) / minute; for patients with an AP distance of 6.0 inches (15.24 cm) to 8.0 inches (20.32 cm), from 250 inches (635 cm) to 400 inches (1016 cm) / minute; or for patients with an AP distance of 10 inches (25.4 cm) or more, from 250 inches (635 cm) to 600 inches (1524 cm) / minute, and is a system as described in Items 14 to 19.

[0039] Item 21: The above plurality of physical characteristics of the patient include at least one of the following: the anteroposterior distance of the patient's thoracic region, the transverse width of the thorax, the chest circumference, the total volume of the patient, the thoracic volume, the waist circumference, the size of the neck, the shoulder width, the intracranial volume, the interpupillary distance, the distance between the eyes and the nose, the finger length, the finger width, the hand width, the size of the hand, the length of the toe, the toe width, the foot width, the size of the foot, the thoracic shape, the height, the weight, and the body mass index (BMI), and the above target chest compression criteria include the target chest compression depth for the above patient, and is a system as described in any of Items 1 to 20.

[0040] Item 22: The indication to the user provided by the above feedback device includes an instruction to increase the chest compression depth, reduce the chest compression depth, or maintain the chest compression depth, which is determined based on the above determination of whether the above chest compression parameters meet the above target chest compression criteria, and is a system as described in Item 21.

[0041] Item 23: The at least one processor determines the target chest compression criterion for the patient based on the plurality of physical characteristics and a value determined from a look-up table and / or calculated by a linear regression equation, for the system according to any one of Items 1 to 22.

[0042] Item 24: The at least one processor is further configured to determine a type of patient based on the plurality of physical characteristics and cause the feedback device to provide an indication about the type of patient to the user, for the system according to any one of Items 1 to 23.

[0043] Item 25: The type of patient includes a pediatric patient or an adult patient, for the system according to Item 24.

[0044] Item 26: The type of patient includes at least one of a newborn, an infant, a small child, a large child, a small adult, an average-sized adult, or a large adult, for the system according to Item 24 or 25.

[0045] Item 27: After the chest compression has been performed for a predetermined period, the at least one processor receives and processes updated information representing the plurality of physical characteristics of the patient from the at least one device to determine a modified target chest compression criterion, determines whether the at least one chest compression parameter meets the modified target chest compression criterion, and causes the feedback device to provide an indication to the user as to whether the at least one chest compression parameter meets the modified target chest compression criterion, for the system according to any one of Items 1 to 26.

[0046] Item 28: The updated information representing the plurality of physical characteristics includes updated information about the anteroposterior distance of the patient's heart-thoracic region, and the modified target chest compression criterion includes a modified target chest compression depth that is at least partially based on the updated information about the anteroposterior distance of the patient's heart-thoracic region, for the system according to Item 27.

[0047] Item 29: The at least one processor is further configured to cause the feedback device to provide an indication to the user if the modified target chest compression criteria is different from the initial target chest compression criteria by comparing the initial target chest compression criteria with the modified target chest compression criteria, for the system according to item 27 or 28.

[0048] Item 30: The at least one processor is configured to maintain a record of past modified target chest compression criteria and the recorded chest compression parameters corresponding to each of the past modified target chest compression criteria, for the system according to any one of items 27 to 29.

[0049] Item 31: The predetermined period before receiving the updated information includes a period determined based on the initial information representing the plurality of physical characteristics and the target chest compression criteria, for the system according to any one of items 27 to 30.

[0050] Item 32: The at least one processor is further configured to cause the feedback device to provide an indication to the user to perform the recommended chest compression technique determined based on the plurality of physical characteristics of the patient, for the system according to any one of items 1 to 31.

[0051] Item 33: The recommended chest compression technique is based on a change in at least one of the plurality of physical characteristics of the patient during a predetermined period, for the system according to item 32.

[0052] Item 34: The recommended chest compression technique includes at least one of two - hand chest compression, one - hand chest compression, wrapped - thumb chest compression, and two - finger chest compression, for the system according to item 32 or 33.

[0053] Item 35: The recommended chest compression technique includes active chest decompression, for the system according to any one of items 32 to 34.

[0054] Item 36: The system according to item 35, wherein the plurality of physical characteristics include the anteroposterior sternal distance, and the active chest decompression as the recommended chest compression technique is based on a decrease in the anteroposterior sternal distance.

[0055] Item 37: The system according to item 35 or 36, wherein the indication for performing active chest decompression includes an indication for performing chest decompression using at least one of a suction cup device, an adhesive device, and a hook-and-loop fastener device, and an instruction to apply pressure to the side or abdomen of the patient.

[0056] Item 38: The system according to any one of items 1 to 37, wherein the at least one processor is further configured to determine, during a rescue operation, a ratio of a time period during which the measured chest compression parameter does not meet the target chest compression criterion, and when the ratio of the time period exceeds a predetermined value, cause the feedback device to provide an indication to the user.

[0057] Item 39: The system according to item 38, wherein the indication to the user when the ratio of the time period exceeds the predetermined value includes an instruction to start performing a second chest compression technique different from the initial chest compression technique performed during the predetermined period.

[0058] Item 40: The system according to item 39, wherein the initial chest compression technique includes two-handed chest compression, and the second chest compression technique includes performing chest compression together with active chest decompression.

[0059] Item 41: The system according to item 39 or 40, wherein the initial chest compression technique includes one-handed chest compression or two-handed chest compression, and the second chest compression technique includes two-finger chest compression.

[0060] Item 42: The system according to any one of items 39 to 41, wherein the at least one processor is configured to receive confirmation from the user when the user starts the second chest compression technique.

[0061] Item 43: The system according to any one of Items 1 to 42, further comprising at least one ventilation sensor configured to measure at least one of tidal volume, minute ventilation, end-inspiratory pressure, maximum ventilation pressure, and ventilation rate during the acute treatment event.

[0062] Item 44: The system according to Item 43, wherein the ventilation sensor includes an airflow sensor and / or a pressure sensor disposed within an air flow path of a breathing unit that is in fluid communication with the airway of the patient.

[0063] Item 45: The system according to Item 43, wherein the ventilation sensor includes at least a first absolute atmospheric pressure sensor and a second absolute atmospheric pressure sensor separated by a flow limiter for measuring the flow velocity and pressure of the airflow within the air flow path.

[0064] Item 46: The system according to any one of Items 1 to 45, wherein the target chest compression criterion includes an initial range of appropriate chest compressions, and the at least one processor is further configured to receive and process information representing a second physical characteristic of the patient that is different from the first physical characteristic of the plurality of physical characteristics after a predetermined period, and to determine an updated range of appropriate chest compressions based on the first physical characteristic and the second physical characteristic.

[0065] Item 47: The system according to Item 46, wherein the at least one processor determines whether the at least one chest compression parameter is within the updated range of appropriate chest compressions, and further configures the feedback device to provide the user with an indication of whether the at least one chest compression parameter is within the updated range of appropriate chest compressions.

[0066] Item 48: The at least one input device that provides information representing the plurality of physical characteristics of the patient further provides the age or gender of the patient, and the target chest compression criteria are determined based at least in part on the plurality of physical characteristics of the patient and the age or gender. The system according to any one of Items 1 to 47.

[0067] Item 49: The feedback device includes a defibrillator, and the at least one processor is configured to receive and process updated information representing the plurality of physical characteristics of the patient from the at least one device to determine a modified target chest compression criteria when a defibrillation shock is being provided to the patient by the defibrillator. The system according to any one of Items 1 to 48.

[0068] Item 50: The at least one processor causes the feedback device to provide an instruction to the user to resume chest compressions after the defibrillator shock, receives and processes a signal indicating the resumed chest compressions from the at least one chest compression sensor to calculate at least one chest compression parameter for the resumed chest compressions, determines whether the at least one chest compression parameter for the resumed chest compressions meets the modified chest compression criteria, and causes the feedback device to provide an indication to the user as to whether the at least one chest compression parameter for the resumed chest compressions meets the modified target chest compression criteria. The system according to Item 49.

[0069] Item 51: The plurality of physical characteristics of the patient include the anteroposterior distance of the patient's thoracic region and at least one of the lateral width of the thorax, chest circumference, thoracic volume, and thoracic shape, and the target chest compression criteria include a target chest compression depth for the patient. The system according to any one of Items 1 to 50.

[0070] Item 52: The plurality of physical characteristics of the patient include the anterior-posterior distance of the patient's thoracic region and at least one of the length, volume, or weight of the patient's body region. The target chest compression criterion includes a target chest compression depth for the patient. Optionally, the patient's body region includes at least one of the patient's thoracic region, hand, arm, foot, leg, face, or skull. The system according to any one of Items 1 to 51.

[0071] Item 53: The plurality of physical characteristics of the patient include the anterior-posterior distance of the patient's thoracic region and a characteristic or feature indicating the patient's overall size. Optionally, the characteristic or feature indicating the patient's overall size includes one or more of the patient's height, weight, outstretched arm length, body volume, or body mass index (BMI). The system according to any one of Items 1 to 51.

[0072] Item 54: The processor is configured to process the plurality of physical characteristics to estimate the weight of the patient. The system according to any one of Items 1 to 53.

[0073] Item 55: The processor is configured to determine a treatment parameter for the patient based at least in part on the estimated weight of the patient. The system according to Item 54.

[0074] Item 56: A system for assisting a user in performing chest compressions on a patient during an acute treatment event, comprising at least one input device that provides information representing at least one physical characteristic of the patient measured during the acute treatment event, a feedback device that provides guidance to the patient on how the chest compressions should be performed, and at least one processor communicatively connected to the at least one device that provides information representing the at least one physical characteristic, wherein the at least one processor receives and processes the information representing the at least one physical characteristic of the patient to determine a recommended chest compression technique for the patient, and is configured to cause the feedback device to provide an indication of the recommended chest compression technique to the user.

[0075] Item 57: The system according to item 56, wherein the at least one input device provides information representing a plurality of physical characteristics of the patient measured during the acute treatment event.

[0076] Item 58: The system according to item 56 or 57, wherein the plurality of physical characteristics includes at least two of anteroposterior (AP) sternal distance, chest width, chest circumference, total patient volume, chest volume, torso circumference, neck size, shoulder width, cranial volume, interpupillary distance, distance between the eyes and nose, finger length, finger width, hand width, hand size, toe length, toe width, foot width, foot size, chest shape, height, weight, and body mass index (BMI).

[0077] Item 59: The system according to any one of items 56 to 58, wherein the at least one input device that provides information representing the at least one physical characteristic of the patient comprises at least one of a user interface for manually entering at least one measurement of the physical characteristic, a two-dimensional camera, a stereo camera, a three-dimensional sensor, a three-dimensional imaging system, a light field camera, a position sensor or marker disposed on the patient.

[0078] Item 60: The system according to item 59, wherein the at least one device includes a three-dimensional imaging system for acquiring information representing the at least one physical characteristic of the patient, and the at least one processor is configured to generate a three-dimensional representation of at least a part of the patient's body based on the information obtained from the three-dimensional sensor.

[0079] Item 61: Further comprising a smartphone or a computer tablet, The at least one device for providing information representing the at least one physical characteristic of the patient includes a camera of the smartphone or the computer tablet, and the at least one processor includes a processor of the smartphone or the computer tablet, the system according to any one of items 56 to 60.

[0080] Item 62: The system according to item 61, wherein the feedback device includes a visual display of the smartphone or the computer tablet.

[0081] Item 63: The system according to any one of items 56 to 61, wherein the at least one physical characteristic is measured during inhalation or exhalation.

[0082] Item 64: The system according to any one of items 56 to 63, wherein the feedback device includes at least one of a computer tablet, a smartphone, a personal digital assistant, a patient monitor device, a defibrillator, and a chest compression guidance device configured to be placed on the patient's chest.

[0083] Item 65: The system according to any one of items 56 to 64, wherein the feedback device is configured to provide at least one of auditory, visual, and tactile feedback.

[0084] Item 66: The system according to any one of Items 56 to 65, further comprising at least one chest compression sensor configured to acquire a signal indicating the chest compression performed on the patient during the acute treatment event, wherein the at least one processor receives and processes the information representing the at least one physical characteristic of the patient to determine a target chest compression criterion for the patient, receives and processes the signal indicating the chest compression from the at least one chest compression sensor to calculate at least one chest compression parameter, determines whether the at least one chest compression parameter meets the target chest compression criterion, and is configured to cause the feedback device to provide an indication to the user as to whether the at least one chest compression parameter meets the target chest compression criterion.

[0085] Item 67: The system according to Item 66, wherein the target chest compression criterion and the measured chest compression parameter include at least one of compression depth, compression rate, decompression speed, compression stop, and decompression release.

[0086] Item 68: The system according to Item 67, wherein the at least one physical characteristic of the patient includes the anteroposterior sternal distance and at least one of the chest width or chest circumference, and the target chest compression criterion includes a target chest compression depth for the patient.

[0087] Item 69: The system according to Item 68, wherein the indication to the user provided by the feedback device is based on the determination as to whether the chest compression parameter meets the target chest compression criterion, and includes an instruction to increase the chest compression depth, reduce the chest compression depth, or maintain the chest compression depth.

[0088] Item 70: The at least one processor is configured to determine a modified recommended chest compression technique at least partially based on whether the at least one chest compression parameter meets the target chest compression criteria after the chest compression has been performed for a predetermined period, and to cause the feedback device to provide an indication of the modified recommended chest compression technique to the user, for the system according to any one of Items 66 to 69.

[0089] Item 71: The at least one processor is configured to determine, during a rescue operation, a percentage of time during which the measured chest compression parameter does not meet the target chest compression criteria, and if the percentage of time exceeds a predetermined value, to further cause the feedback device to provide an indication to the user, for the system according to any one of Items 66 to 70.

[0090] Item 72: The indication to the user when the percentage of time exceeds the predetermined value includes an instruction to start executing a second recommended chest compression technique that is different from the recommended chest compression technique executed during an initial period, for the system according to Item 71.

[0091] Item 73: The recommended chest compression technique executed during the initial period includes two - hand chest compression, and the second chest compression technique includes performing chest compression together with active chest decompression, for the system according to Item 72.

[0092] Item 74: The recommended chest compression technique executed during the initial period includes one - hand chest compression or two - hand chest compression, and the second recommended chest compression technique includes two - finger chest compression, for the system according to Item 72 or 73.

[0093] Item 75: The at least one processor is configured to receive confirmation from the user when the user starts the second chest compression technique, for the system according to any one of Items 72 to 74.

[0094] Item 76: The system according to any one of items 56 to 75, wherein after the chest compression is performed for a predetermined period, the processor is further configured to receive and process updated information representing at least one physical characteristic of the patient from the at least one device to determine a modified recommended chest compression technique, and cause the feedback device to provide an indication of the modified recommended chest compression technique to the user.

[0095] Item 77: The system according to any one of items 56 to 76, wherein the recommended chest compression technique is based on at least one change among the at least one physical characteristic of the patient during a predetermined period.

[0096] Item 78: The system according to any one of items 56 to 77, wherein the recommended chest compression technique includes at least one of two - hand chest compression, one - hand chest compression, wrapped - thumb chest compression, and two - finger chest compression.

[0097] Item 79: The system according to items 56 to 78, wherein the recommended chest compression technique includes active chest decompression.

[0098] Item 80: The system according to item 79, wherein the at least one physical characteristic includes the anteroposterior sternal distance, and the active chest decompression as the recommended chest compression technique is based on a decrease in the anteroposterior sternal distance.

[0099] Item 81: The indication for performing active chest decompression includes an indication for performing chest decompression using at least one of a suction cup device, an adhesive device, and a hook - and - loop fastener device, and / or an instruction to apply pressure to the side or abdomen of the patient.

[0100] Item 82: The feedback device includes a defibrillator, and the at least one processor is configured to receive and process updated information representing at least one physical characteristic of the patient from the at least one device to determine a modified recommended chest compression technique when a defibrillation shock is being provided to the patient by the defibrillator. The system according to any one of Items 56 to 81.

[0101] Item 83: The system according to any one of Items 56 to 82, further comprising at least one ventilation sensor configured to measure at least one of tidal volume, minute ventilation, end-inspiratory pressure, maximum ventilation pressure, and ventilation rate during the acute treatment event.

[0102] Item 84: The ventilation sensor includes an airflow sensor and / or a pressure sensor disposed within an air flow path of a breathing unit in fluid communication with the airway of the patient. The system according to Item 83.

[0103] Item 85: A method for providing chest compressions to a patient during an acute treatment event, the method comprising: measuring a plurality of physical characteristics of the patient during the acute treatment event; determining a target chest compression criterion based on the measured plurality of physical characteristics; applying chest compressions to the patient; measuring at least one chest compression parameter during the applied chest compressions using at least one chest compression sensor; and providing feedback guidance to the user on how to adjust the chest compressions applied to the patient based on whether the at least one chest compression parameter meets the target chest compression criterion.

[0104] Item 86: The method according to item 85, wherein the plurality of physical characteristics include at least two of the anteroposterior (AP) distance of the sternum, the transverse width of the chest, the chest circumference, the total volume of the patient, the chest volume, the abdominal circumference, the size of the neck, the shoulder width, the intracranial volume, the interpupillary distance, the distance between the eyes and the nose, the finger length, the finger width, the hand width, the size of the hand, the length of the toe, the toe width, the foot width, the size of the foot, the chest shape, the height, the weight, and the body mass index (BMI).

[0105] Item 87: The method according to item 85 or 86, wherein the step of measuring the plurality of physical characteristics of the patient during the acute treatment event includes obtaining at least one image of the patient by a handheld electronic device and processing the at least one captured image by at least one processor of the handheld electronic device to determine at least one measurement value of the physical characteristics.

[0106] Item 88: The method according to item 87, wherein the at least one processor of the handheld electronic device determines the target chest compression criterion based on the measurement values of the plurality of physical characteristics and the at least one chest compression parameter by processing the signal generated by the chest compression sensor.

[0107] Item 89: The method according to item 87 or 88, wherein the feedback guidance is provided on a display screen of the handheld electronic device.

[0108] Item 90: The method according to any one of items 85 to 89, wherein the step of measuring the plurality of physical characteristics of the patient during the acute treatment event includes obtaining information representing the plurality of physical characteristics using a three-dimensional sensor.

[0109] Item 91: The method according to any one of items 85 to 90, further including the step of manually inputting the measurement values of the plurality of physical characteristics of the patient on a user interface.

[0110] Item 92: The plurality of physical characteristics include the anterior-posterior distance of the patient's cardiac thoracic region and at least one of the width or the perimeter length of the patient's cardiac thoracic region. The method according to any one of Items 85 to 91, wherein the target chest compression criterion includes a target chest compression depth for the patient.

[0111] Item 93: After a predetermined period, recording at least one updated measurement of the plurality of physical characteristics of the patient; determining a modified target chest compression criterion based on the updated measurement; and providing feedback guidance to the user on how to adjust the chest compression applied to the patient based on whether the at least one chest compression parameter meets the modified target resuscitation criterion. The method according to any one of Items 85 to 92 further includes.

[0112] Item 94: The method according to Item 93, wherein the at least one updated measurement includes the anterior-posterior distance of the sternum.

[0113] Item 95: The method according to any one of Items 85 to 94, wherein the target chest compression criterion and the at least one measured chest compression parameter include at least one of compression depth, compression rate, decompression rate, compression stop, and decompression.

[0114] Item 96: The step of providing the feedback guidance includes providing an indication to increase the chest compression depth, decrease the chest compression depth, or maintain the chest compression depth based on whether the at least one chest compression parameter meets the target chest compression criterion. The method according to any one of Items 85 to 95 includes.

[0115] Item 97: The method according to any one of Items 85 to 96 further includes determining a recommended chest compression technique based on the measured plurality of physical characteristics and providing feedback guidance to the user to provide an indication of the recommended chest compression technique.

[0116] Item 98: The recommended chest compression technique is the method according to item 97, based on a change in at least one of the plurality of physical characteristics of the patient during a predetermined period.

[0117] Item 99: The recommended chest compression technique is the method according to item 97 or 98, including at least one of two - hand chest compression, one - hand chest compression, wrapped - thumb chest compression, and two - finger chest compression.

[0118] Item 100: The feedback guidance includes an indication to initiate the execution of a second chest compression technique different from the initial chest compression technique, based at least in part on whether the measured chest compression parameter meets the target chest compression criteria. The method is according to any one of items 85 to 99.

[0119] Item 101: The method according to item 100, wherein the initial chest compression technique includes two - hand chest compression, and the second chest compression technique includes performing chest compression together with active chest decompression.

[0120] Item 102: The method according to item 100 or 101, wherein the initial chest compression technique includes one - hand chest compression or two - hand chest compression, and the second chest compression technique includes two - finger chest compression.

[0121] Item 103: A method of providing chest compression to a patient during an acute - phase treatment event, including the steps of measuring a plurality of physical characteristics of the patient during the acute - phase treatment event; determining a recommended chest compression technique based on the measured plurality of physical characteristics; providing feedback guidance to provide an indication of the recommended chest compression technique to the user; and applying chest compression to the patient according to the recommended chest compression technique.

[0122] Item 104: The method according to item 103, wherein the plurality of physical characteristics include at least two of the anteroposterior (AP) sternal distance, the transverse diameter of the chest, the chest circumference, the total volume of the patient, the chest volume, the waist circumference, the neck size, the shoulder width, the cranial volume, the interpupillary distance, the distance between the eyes and the nose, the finger length, the finger width, the hand width, the hand size, the toe length, the toe width, the foot width, the foot size, the chest shape, the height, the weight, and the body mass index (BMI).

[0123] Item 105: The method according to item 103 or 104, wherein the step of measuring the plurality of physical characteristics of the patient during the acute treatment event includes the step of obtaining information representing the plurality of physical characteristics using a three-dimensional imaging system.

[0124] Item 106: The method according to items 103 to 105, wherein the recommended chest compression technique is based on a change in at least one of the plurality of physical characteristics of the patient during a predetermined period.

[0125] Item 107: The method according to items 103 to 106, further comprising the steps of determining a target chest compression criterion based on the measured plurality of physical characteristics, measuring at least one chest compression parameter during the applied chest compression using at least one chest compression sensor, and providing feedback guidance on how the user should adjust the chest compression applied to the patient based on whether the at least one chest compression parameter meets the target chest compression criterion.

[0126] Item 108: The method according to item 107, wherein the target chest compression criterion and the measured at least one chest compression parameter include at least one of compression depth, compression rate, decompression rate, compression stop, and decompression.

[0127] Item 109: The method according to item 108, wherein the plurality of physical characteristics include the anteroposterior sternal distance and at least one of the chest width or the chest circumference, and the target chest compression criterion includes the target chest compression depth for the patient.

[0128] Item 110: recording at least one updated measurement of the plurality of physical characteristics of the patient after a predetermined period; determining a modified target chest compression criterion based on the updated measurement; further comprising providing feedback guidance on how the user should adjust the chest compression applied to the patient based on whether the at least one chest compression parameter meets the modified target resuscitation criterion, the method according to any one of Items 107 to 109.

[0129] Item 111: the feedback guidance includes an indication to initiate execution of a second chest compression technique different from the initial chest compression technique, at least partially based on whether the measured chest compression parameter does not meet the target chest compression criterion, the method according to any one of Items 107 to 110.

[0130] Item 112: the method according to Item 111, wherein the initial chest compression technique includes two - hand chest compression and the second chest compression technique includes performing chest compression together with active chest decompression.

[0131] Item 113: A system for assisting a user in performing artificial respiration on a patient during an acute treatment event, the system comprising at least one input device that provides information representing a plurality of physical characteristics of the patient measured during the acute treatment event, at least one ventilation sensor configured to acquire a signal indicating the artificial respiration performed on the patient during the acute treatment event, a feedback device that provides guidance to the user on how to perform the artificial respiration, and at least one processor communicatively connected to the at least one input device that provides information representing the plurality of physical characteristics and the at least one ventilation sensor, the at least one processor receiving and processing the information representing the plurality of physical characteristics of the patient to determine a target artificial respiration standard for the patient, receiving and processing the signal indicating the artificial respiration from the at least one ventilation sensor to calculate at least one ventilation parameter, determining whether the at least one ventilation parameter meets the target artificial respiration standard, and configuring the feedback device to provide an indication to the user as to whether the at least one ventilation parameter meets the target artificial respiration standard.

[0132] Item 114: The system according to item 113, wherein the plurality of physical characteristics includes at least one of an anteroposterior (AP) distance of the sternum, a lateral width of the chest, a chest circumference, a total volume of the patient, a chest volume, a torso circumference, a neck size, a shoulder width, an intracranial volume, an interpupillary distance, an eye-to-nose distance, a finger length, a finger width, a hand width, a hand size, a toe length, a toe width, a foot width, a foot size, a chest shape, a height, a weight, and a body mass index (BMI).

[0133] Item 115: The system according to item 114, wherein the chest volume of the patient is determined based on at least one of an anteroposterior distance of the patient's chest region, a width of the patient's chest region, and a perimeter length of the patient's chest region.

[0134] Item 116: The at least one input device for providing information representing the plurality of physical characteristics of the patient includes a user interface for manually inputting at least one measurement value of the physical characteristics, a two-dimensional camera, a stereoscopic camera, a three-dimensional imaging system, a three-dimensional sensor, a light field camera, and at least one of a position sensor or a marker disposed on the patient, the system according to any one of Items 113 to 115.

[0135] Item 117: The camera, the three-dimensional sensor, and the three-dimensional imaging system are attached to at least one of the patient, the feedback device, or the user, the system according to Item 116.

[0136] Item 118: The at least one input device for providing information representing the plurality of physical characteristics of the patient further provides the age or gender of the patient, and the target ventilation criteria are determined based at least in part on the plurality of physical characteristics and the age or gender of the patient, the system according to any one of Items 113 to 117.

[0137] Item 119: At least one of the plurality of physical characteristics includes the shape of the patient's chest, the system according to any one of Items 113 to 118.

[0138] Item 120: The ventilation sensor includes an airflow sensor and / or a pressure sensor disposed in the air flow path of the ventilator unit in fluid communication with the patient's airway, the system according to any one of Items 113 to 119.

[0139] Item 121: The feedback device includes at least one of a computer tablet, a smartphone, a personal digital assistant, a patient monitor device, a ventilator, and a ventilation guidance device configured to be disposed in the air flow path between the ventilator and the patient, the system according to any one of Items 113 to 120.

[0140] Item 122: The system according to any one of Items 113 to 121, wherein the target ventilation standard and the measured ventilation parameter include at least one of tidal volume, minute ventilation volume, end-inspiratory pressure, maximum ventilation pressure, and ventilation rate during the acute treatment event.

[0141] Item 123: The system according to any one of Items 113 to 122, wherein the processor receives and processes updated information representing the physical characteristics of the patient from the at least one input device to determine a modified target ventilation standard after the ventilation has been performed for a predetermined period, determines whether the at least one ventilation parameter meets the modified target ventilation standard, and is further configured to cause the feedback device to provide an indication to the user as to whether the at least one ventilation parameter meets the modified target ventilation standard.

[0142] Item 124: The system according to any one of Items 113 to 123, wherein at least one of the plurality of physical characteristics of the patient includes the height of the patient.

[0143] Item 125: The system according to any one of Items 113 to 124, wherein the at least one input device providing information representing the plurality of physical characteristics of the patient further provides the age or gender of the patient, and the at least one processor is further configured to provide at least one of a recommended endotracheal tube placement depth and a recommended tidal volume based on the height and gender of the patient.

[0144] Item 126: The system according to Item 125, wherein the target ventilation standard is at least partially based on the height and gender of the patient.

[0145] Item 127: The system according to item 126, wherein at least one of the processors is configured to determine the recommended endotracheal tube placement depth or the recommended tidal volume based on the height and gender of the patient and the estimated tracheal length value from the look-up table.

[0146] Item 128: The system according to any one of items 113 to 127, wherein at least one of the processors is further configured to receive the age of the patient and determine the target mechanical ventilation criteria for the patient based on the plurality of physical characteristics and the age of the patient.

[0147] Item 129: The system according to any one of items 113 to 128, further comprising at least one chest compression sensor configured to acquire a signal indicating the chest compression performed on the patient during the acute treatment event, wherein at least one of the processors receives and processes the information representing the plurality of physical characteristics of the patient to determine a target chest compression criteria for the patient, receives and processes the signal indicating the chest compression from the at least one chest compression sensor to calculate at least one chest compression parameter, determines whether the at least one chest compression parameter meets the target chest compression criteria, and configures the feedback device to provide an indication to the user as to whether the at least one chest compression parameter meets the target chest compression criteria.

[0148] Item 130: The system according to any one of items 113 to 129, wherein at least one of the processors is further configured to determine a recommended chest compression technique for the patient based on the plurality of physical characteristics of the patient and provide an indication to the user via the feedback device to perform the recommended chest compression technique.

[0149] Item 131: A method of providing artificial respiration to a patient during an acute treatment event, the method comprising: measuring a plurality of physical characteristics of the patient during the acute treatment event; determining target artificial respiration criteria based on the at least one measurement; applying artificial respiration to the patient; using at least one ventilation sensor to measure at least one ventilation parameter during the application of the artificial respiration; and providing feedback guidance on how to adjust the artificial respiration provided to the patient based on whether the at least one ventilation parameter meets the target artificial respiration criteria.

[0150] Item 132: The method according to item 131, wherein at least one of the plurality of physical characteristics includes an anteroposterior (AP) distance of the sternum, a lateral chest diameter, a chest circumference, a total patient volume, a chest volume, a torso circumference, a neck size, a shoulder width, an intracranial volume, an interpupillary distance, an eye-to-nose distance, a finger length, a finger width, a hand width, a hand size, a toe length, a toe width, a foot width, a foot size, a chest shape, a body height, a body weight, and a body mass index (BMI).

[0151] Item 133: The method according to item 131 or 132, wherein the step of measuring the plurality of physical characteristics of the patient during the acute treatment event includes obtaining at least one image of the pediatric patient by a handheld electronic device and processing the at least one captured image by at least one processor of the handheld electronic device to determine at least one measurement value of the plurality of physical characteristics.

[0152] Item 134: The method according to item 133, wherein the at least one processor of the handheld electronic device determines the target artificial respiration criteria based on the at least one measurement value and determines the at least one ventilation parameter by processing a signal generated by the ventilation sensor.

[0153] Item 135: The method according to any one of Items 131 to 134, wherein the step of measuring the plurality of physical characteristics of the patient during the acute treatment event includes the step of obtaining information representing the plurality of physical characteristics using a three-dimensional imaging system.

[0154] Item 136: The method according to any one of Items 131 to 135, further including the step of manually inputting the measured values of the plurality of physical characteristics of the patient on a user interface.

[0155] Item 137: The method according to any one of Items 131 to 136, wherein the target ventilation standard and the measured ventilation parameter include at least one of tidal volume, minute ventilation volume, end-inspiratory pressure, maximum ventilation pressure, and ventilation rate during the acute treatment event.

[0156] Item 138: The method according to any one of Items 131 to 137, wherein at least one of the plurality of physical characteristics of the patient includes the height of the patient, and the method further includes the step of determining the recommended endotracheal tube placement depth based at least in part on the height of the patient.

[0157] Item 139: The method according to Item 138, further including the step of inserting the endotracheal tube to the recommended endotracheal tube placement depth, and the step of applying ventilation to the patient includes the step of applying ventilation to the patient through the inserted endotracheal tube.

[0158] Item 140: The method according to Item 138 or 139, further including the step of providing an input of at least one of the age and gender of the patient, and the recommended endotracheal tube placement depth is based on the height and gender of the patient.

[0159] Item 141: A method according to any one of Items 131 to 140, further comprising: determining a target chest compression criterion based on at least one of the plurality of physical characteristics; measuring at least one chest compression parameter during the applied chest compression using at least one chest compression sensor; and providing feedback guidance on how the user should adjust the chest compression applied to the patient based on whether the at least one chest compression parameter meets the target chest compression criterion.

[0160] Item 142: A method according to any one of Items 131 to 141, further comprising: determining a recommended chest compression technique based on the measured plurality of physical characteristics; and providing feedback guidance to the user to provide an indication of the recommended chest compression technique.

[0161] Item 143: A system for assisting a user in providing at least one cardiopulmonary resuscitation (CPR) action to a patient during an acute treatment event, comprising: at least one three-dimensional imaging system for acquiring information representing at least one physical characteristic of the patient; at least one of a chest compression sensor or a ventilation sensor for acquiring a signal indicating the at least one resuscitation action applied to the patient; a feedback device for providing guidance on how the user should apply the at least one resuscitation action to the patient; and at least one processor communicatively connected to the at least one three-dimensional imaging system, the at least one chest compression or ventilation sensor, wherein the at least one processor receives and processes the information representing the at least one physical characteristic from the three-dimensional imaging system to generate a three-dimensional representation of at least a part of the patient's body.

[0162] Based on the generated three-dimensional representation, determine a target resuscitation criterion, receive and process the signal indicating the at least one resuscitation action to calculate at least one resuscitation parameter, determine whether the at least one resuscitation parameter meets the target resuscitation criterion, and configure the feedback device to provide an indication as to whether the at least one resuscitation parameter complies with the target resuscitation criterion, a system.

[0163] Item 144: The system according to item 143, wherein the at least one physical characteristic includes at least one of an anteroposterior (AP) distance of the sternum, a lateral width of the chest, a chest circumference, a total volume of the patient, a chest volume, a torso circumference, a neck size, a shoulder width, an intracranial volume, an interpupillary distance, a distance between the eyes and the nose, a finger length, a finger width, a hand width, a hand size, a toe length, a toe width, a foot width, a foot size, a chest shape, a height, a weight, and a body mass index (BMI).

[0164] Item 145: The system according to item 143 or 144, wherein the information representing the at least one physical characteristic includes information representing the at least one physical characteristic recorded during inspiration and / or information representing the at least one physical characteristic recorded during expiration.

[0165] Item 146: The system according to any one of items 143 to 145, wherein the feedback device includes at least one of a computer tablet, a smartphone, a personal digital assistant, a patient monitor device, a defibrillator, a ventilator, a chest compression guidance device configured to be placed on the chest of the patient, or a ventilation guidance device configured to be placed in an air flow path between the ventilator and the patient.

[0166] Item 147: The system according to any one of items 143 to 146, wherein the at least one processor is configured to cause the feedback device to display at least a part of the three-dimensional representation of the patient to the user.

[0167] Item 148: The system according to any one of Items 143 to 147, wherein the processor is further configured to determine the type of the patient based on the generated three-dimensional representation of the patient and cause the feedback device to provide an indication to the user about the type of the patient.

[0168] Item 149: The system according to Item 148, wherein the type of the patient includes a neonate, an infant, a small child, a large child, a small adult, an adult of average build, or a large adult.

[0169] Item 150: The system according to any one of Items 143 to 149, wherein the processor is further configured to determine a recommended chest compression technique for the patient based on the generated three-dimensional representation of the patient and cause the feedback device to provide an indication to the user to perform the recommended chest compression technique.

[0170] Item 151: The system according to Item 150, wherein the resuscitation action is chest compression and the recommended chest compression technique includes at least one of two-handed chest compression, one-handed chest compression, wrapped thumb chest compression, or two-finger chest compression.

[0171] Item 152: The system according to Item 150 or 151, wherein the resuscitation action is chest compression and the recommended chest compression technique includes active chest decompression.

[0172] Item 153: The indication for performing active chest decompression includes a proposal for performing chest decompression using a suction cup device, an adhesive device, a hook-and-loop fastener device, and / or an instruction to apply pressure to the side or abdomen of the patient.

[0173] Item 154: A system for assisting a user in providing at least one cardiopulmonary resuscitation (CPR) action to a patient during an acute treatment event, comprising at least one input device that provides information representing at least one physical characteristic of the patient measured during the acute treatment event, a feedback device that provides information to the user about the at least one resuscitation action, the patient, and the acute treatment event, and at least one processor communicatively connected to the at least one device that provides information representing at least one physical characteristic of the patient. The at least one processor is configured to receive and process the information representing the at least one physical characteristic measured during an initial period of the acute treatment event, determine an initial target resuscitation criterion based on the at least one physical characteristic during the initial period, cause the feedback device to provide an indication of the initial target resuscitation criterion to the user, receive and process the information representing the at least one physical characteristic measured during a subsequent period of the acute treatment event, determine a modified target resuscitation criterion based on the at least one physical characteristic during the subsequent period, and cause the feedback device to provide an indication of the modified target resuscitation criterion to the user.

[0174] Item 155: The system according to Item 154, wherein the at least one physical characteristic includes at least one of an anteroposterior (AP) distance of the sternum, a lateral chest width, a chest circumference, a total patient volume, a chest volume, a torso circumference, a neck size, a shoulder width, an intracranial volume, an interpupillary distance, a distance between the eyes and the nose, a finger length, a finger width, a hand width, a hand size, a toe length, a toe width, a foot width, a foot size, a chest shape, a height, a weight, and a body mass index (BMI).

[0175] Item 156: The at least one device that provides information representing at least one physical characteristic of the patient comprises at least one of a user interface for manually entering the physical measurement values, a two-dimensional camera, a stereo camera, a light field camera, a three-dimensional sensor, a three-dimensional imaging system, or a position sensor or marker disposed on the patient, the system according to item 154 or 155.

[0176] Item 157: The feedback device includes at least one of a computer tablet, a smartphone, a personal digital assistant, a smartwatch, a patient monitoring device, a defibrillator, a ventilator, a chest compression guidance device configured to be disposed on the chest of the patient, or a ventilation guidance device configured to be disposed within an air flow path between the ventilator and the patient, the system according to any one of items 154 to 156.

[0177] Item 158: The length of the initial period is selected based on the at least one physical characteristic of the acute treatment event and the initial target resuscitation criteria, the system according to items 154 to 157.

[0178] Item 159: The at least one processor is further configured to determine a modified recommended technique for the resuscitation action based on the at least one physical characteristic measured during the subsequent period of the acute treatment event and cause the feedback device to provide an indication to the user to execute the modified recommended technique for the resuscitation action, the system according to any one of items 154 to 158.

[0179] Item 160: The resuscitation action includes chest compressions, and the modified recommended chest compression technique includes at least one of two-handed chest compressions, one-handed chest compressions, encircling thumb chest compressions, and two-finger chest compressions, the system according to item 159.

[0180] Item 161: The resuscitation action is chest compression, and the modified chest compression technique includes chest compression and active chest decompression, for the system described in Item 159.

[0181] Item 162: The instruction for performing active chest decompression includes an instruction for performing chest decompression using a suction cup device, an adhesion device, a hook-and-loop fastener device, and / or an instruction for applying pressure to the side or abdomen of the patient, for the system described in Item 161.

[0182] Item 163: Further includes at least one of a chest compression sensor and a ventilation sensor, communicatively connected to the at least one processor and configured to acquire a signal indicating the CPR applied to the patient. The at least one processor receives and processes the signal indicating the CPR applied to the patient during the initial period of the acute treatment event to calculate at least one resuscitation parameter, determines whether the at least one resuscitation parameter meets the initial target resuscitation criteria, and is further configured to cause the feedback device to provide an indication to the user as to whether the at least one resuscitation parameter meets the initial target resuscitation criteria, for the system described in Items 154 to 162.

[0183] Item 164: The at least one processor

[0184] receives and processes the signal indicating the CPR applied to the patient during the subsequent period of the acute treatment event to calculate at least one resuscitation parameter, determines whether the at least one resuscitation parameter meets the modified target resuscitation criteria, and is further configured to cause the feedback device to provide an indication to the user as to whether the at least one resuscitation parameter meets the modified target resuscitation criteria, for the system described in Item 163.

[0185] Item 165: The chest compression sensor includes at least one of a single-axis accelerometer, a multi-axis accelerometer, or a gyroscope, and the ventilation sensor includes at least one of an airflow sensor and a pressure sensor in an air flow path that is in fluid communication with the airway of the patient, the system according to Item 163 or 164.

[0186] Item 166: The at least one physical characteristic of the patient includes at least one of the anterior-posterior distance of the patient's cardiac thoracic region and the width or perimeter length of the patient's cardiac thoracic region, and the initial target resuscitation criteria and the modified target resuscitation criteria each include a target chest compression depth for the patient, the system according to any one of Items 163 to 165.

[0187] Item 167: The feedback includes an indication for the initial period of comparing the resuscitation parameter measured during the initial period with the initial target resuscitation criteria, and an indication for the subsequent period of comparing the resuscitation parameter measured during the subsequent period with the modified target resuscitation criteria, and includes a summary report on the rescue activity, the system according to any one of Items 163 to 166.

[0188] Item 168: The summary report includes a graph comparing the resuscitation parameter measured during the initial period with the initial target resuscitation criteria, and a graph for the subsequent period comparing the resuscitation parameter measured during the subsequent period with the modified target resuscitation criteria, the system according to any one of Items 163 to 167.

[0189] Item 169: A computer-implemented method for assisting a user in providing at least one cardiopulmonary resuscitation (CPR) action to a patient during an acute treatment event, the method causing a feedback device to provide feedback to the user, the method comprising: receiving and processing information representing at least one physical characteristic of the patient measured during an initial period of the acute treatment event from at least one device providing information representing the at least one physical characteristic; determining an initial target resuscitation criterion based on the at least one physical characteristic during the initial period; receiving and processing information representing the at least one physical characteristic of the patient measured during a subsequent period of the acute treatment event; determining a modified target resuscitation criterion based on the at least one physical characteristic during the subsequent period; and causing the feedback device to provide an indication of the modified target resuscitation criterion to the user.

[0190] Item 170: The method of item 169, wherein the at least one physical characteristic includes at least one of an anteroposterior (AP) sternal distance, a chest width, a chest circumference, a total patient volume, a chest volume, a torso circumference, a neck size, a shoulder width, an intracranial volume, an interpupillary distance, an eye-to-nose distance, a finger length, a finger width, a hand width, a hand size, a toe length, a toe width, a foot width, a foot size, a chest shape, a height, a weight, and a body mass index (BMI).

[0191] Item 171: The method of item 169 or 170, wherein the length of the initial period is selected based on the at least one physical characteristic of the patient and the initial target resuscitation criterion.

[0192] Item 172: The method according to any one of items 169 to 171, further comprising: determining a modified technique for the resuscitation action based on the at least one physical characteristic measured during the subsequent period of the acute treatment event; and causing the feedback device to provide an instruction to the user to perform the modified technique for the resuscitation action.

[0193] Item 173: The resuscitation action includes chest compression, and the modified chest compression technique includes at least one of two-handed chest compression, one-handed chest compression, wrapped thumb chest compression, and two-finger chest compression, the method according to item 172.

[0194] Item 174: The resuscitation action is chest compression, and the modified chest compression technique includes performing chest compression and active chest decompression, the method according to item 172.

[0195] Item 175: The instruction for performing active chest decompression includes an instruction for performing chest decompression using a suction cup device, an adhesive device, a hook-and-loop fastener device, and / or an instruction for applying pressure to the side or abdomen of the patient, the method according to any one of items 172 to 174.

[0196] Item 176: Receiving and processing a signal indicating CPR applied to the patient during the initial period of the acute treatment event from at least one resuscitation sensor including at least one of a chest compression sensor and a ventilation sensor; calculating at least one resuscitation parameter based on the signal indicating CPR from the at least one resuscitation sensor; determining whether the at least one resuscitation parameter meets the initial target resuscitation criteria; and causing the feedback device to provide an indication to the user as to whether the at least one resuscitation parameter meets the initial target resuscitation criteria, the method according to any one of items 169 to 175.

[0197] Item 177: Receiving and processing the signal indicating CPR applied to the patient during the subsequent period of the acute treatment event to calculate at least one resuscitation parameter; determining whether the at least one resuscitation parameter meets the modified target resuscitation criteria; and causing the feedback device to provide an indication to the user as to whether the at least one resuscitation parameter meets the modified target resuscitation criteria, the method according to item 176.

[0198] Item 178: The method according to Item 177, further comprising the step of causing the feedback device to provide the user with a summary report including an indication for the initial period comparing the resuscitation parameter measured during the initial period with the initial target resuscitation standard, and an indication for the subsequent period comparing the resuscitation parameter measured during the subsequent period with the corrected target resuscitation standard.

[0199] Item 179: The method according to Item 178, wherein the summary report includes a graph comparing the resuscitation parameter measured during the initial period with the initial target resuscitation standard, and a graph for the subsequent period comparing the resuscitation parameter measured during the subsequent period with the corrected target resuscitation standard.

[0200] Item 180: A system for providing mechanical ventilation treatment to a patient,

[0201] comprising at least one three-dimensional imaging system configured to acquire information representing at least one physical characteristic of the patient, a mechanical ventilation device configured to provide the mechanical ventilation treatment to the patient, and at least one processor communicatively connected to the at least one three-dimensional imaging system and the mechanical ventilation device, the at least one processor being configured to receive and process the information representing the at least one physical characteristic of the patient to generate a three-dimensional representation of the patient, determine at least one mechanical ventilation criterion for the mechanical ventilation device based on the generated three-dimensional representation, and cause the mechanical ventilation device to provide mechanical ventilation based on the at least one mechanical ventilation criterion.

[0202] Item 181: The system according to item 180, wherein the at least one physical characteristic includes at least one of the anteroposterior (AP) distance of the sternum, the transverse width of the chest, the chest circumference, the total volume of the patient, the chest volume, the waist circumference, the size of the neck, the shoulder width, the cranial volume, the interpupillary distance, the distance between the eyes and the nose, the finger length, the finger width, the hand width, the hand size, the toe length, the toe width, the foot width, the foot size, the chest shape, the height, the weight, and the body mass index (BMI).

[0203] Item 182: The system according to item 181, wherein the chest volume is calculated based on at least one of the anteroposterior distance of the chest region of the patient, the length of the chest region of the patient, and at least one of the width of the chest region and the perimeter length of the chest region.

[0204] Item 183: The system according to any one of items 180 to 182, wherein the information representing the at least one physical characteristic includes the information representing the at least one physical characteristic recorded during inspiration and / or the information representing the at least one physical characteristic recorded during expiration.

[0205] Item 184: The system according to any one of items 180 to 183, wherein the ventilation parameter includes at least one of the tidal volume, the minute ventilation volume, the end-inspiratory pressure, the maximum ventilation pressure, and the ventilation rate during the acute treatment event.

[0206] Item 185: The system according to any one of items 180 to 184, wherein the mechanical ventilation device includes an automatic ventilator configured to provide a plurality of mechanical ventilations to the patient according to at least one mechanical ventilation criterion.

[0207] Item 186: The system according to any one of items 180 to 185, wherein the mechanical ventilation device includes a mechanical ventilation unit, and the at least one processor causes the mechanical ventilation device to provide mechanical ventilation based on the at least one mechanical ventilation criterion by providing guidance for providing mechanical ventilation to the user according to the at least one mechanical ventilation criterion.

[0208] Item 187: The system according to item 186, wherein the artificial respiration unit includes an artificial respiration bag and an air flow path that are in fluid communication with the airway of the patient.

[0209] Item 188: The system according to any one of items 180 to 187, wherein the processor is further configured to receive and process updated information representing at least one physical characteristic of the patient from the three-dimensional imaging system to generate an updated three-dimensional representation of the patient after a predetermined period, determine at least one modified artificial respiration criterion based on the updated three-dimensional representation of the patient, and adjust the function of the artificial respiration device based on the at least one modified ventilation parameter.

[0210] Item 189: The system according to item 188, wherein the predetermined period is determined based on the three-dimensional representation of the patient generated initially.

[0211] Item 190: The system according to any one of items 180 to 189, wherein the at least one processor is further configured to receive the age of the patient and determine the at least one artificial respiration criterion based at least in part on the age of the patient.

[0212] Item 191: A system for assisting a user in providing medical treatment to a patient during an acute treatment event, the system comprising at least one input device that provides information representing a plurality of physical characteristics of the patient measured during the acute treatment event, a user interface that provides acute treatment information for the patient, and at least one processor communicatively connected to the at least one input device that provides the information representing the plurality of physical characteristics, the at least one processor receiving and processing the information representing the plurality of physical characteristics of the patient to estimate the patient's weight, determining at least one treatment parameter for the patient based at least in part on the estimated weight of the patient, and configured to cause the user interface to provide an indication of the at least one treatment parameter for the patient.

[0213] Item 192: The system according to Item 191, wherein the at least one input device that provides the information representing the plurality of physical characteristics of the patient comprises at least one of a two-dimensional camera, a stereo camera, a three-dimensional imaging system, a three-dimensional sensor, a light field camera, and a position sensor or marker disposed on the patient.

[0214] Item 193: The system according to Item 191 or 192, wherein the at least one input device includes the user interface, and the user interface is configured to enable the user to manually input at least one measurement value for each of the plurality of physical characteristics.

[0215] Item 194: The system according to any one of Items 191 to 193, wherein the plurality of physical characteristics includes at least one of an anteroposterior (AP) distance of the sternum, a lateral width of the patient's thorax, a chest circumference, a torso circumference, a hip circumference, a neck circumference, a shoulder width, a thorax shape, a height, a waist / hip ratio, or a waist / height ratio.

[0216] Item 195: A system described in any of Items 191 to 194, wherein the at least one processor is configured to process the information representing the plurality of physical characteristics to estimate a volume of at least a portion of the patient's body.

[0217] Item 196: The system described in Item 195, wherein the at least one processor is configured to estimate a weight of the patient based on the estimated volume and an estimated average density of the body.

[0218] Item 197: The estimated average density of the body is approximately 900 kg / m 3 to about 1050 kg / m 3 Item 197. The system of item 196,

[0219] Item 198: The system of items 196 or 197, wherein the estimated average density of the body comprises a predetermined value for a population of individuals.

[0220] Item 199: A system described in any of items 196 to 198, wherein the estimated average density of the body is a patient-specific value based on at least one of the plurality of physical characteristics of the patient.

[0221] Item 200: The system of any of items 195 to 199, wherein the estimated volume includes either the patient's thoracic volume or the patient's total volume.

[0222] Item 201: A system described in any of items 191 to 200, wherein the at least one therapeutic parameter includes at least one of defibrillator shock energy, artificial ventilation tidal volume, and drug delivery dosage.

[0223] Item 202: A system described in any of Items 191 to 201, wherein the at least one treatment parameter includes an artificial ventilation tidal volume, the artificial ventilation tidal volume being calculated based at least in part on the patient's ideal body weight.

[0224] Item 203: The at least one input device that provides information representing the plurality of physical characteristics of the patient provides at least one of the age or gender of the patient, and the at least one treatment parameter is determined based at least in part on the plurality of physical characteristics and at least one of the age or gender of the patient. The system according to any one of Items 191 to 202.

[0225] These and other features and characteristics of the present disclosure, as well as the methods of operation and functions of the related elements of the structure, and the combinations of manufacturing parts and costs, will become apparent by reference to the accompanying drawings and consideration of the following description and the appended claims. All of the accompanying drawings form a part of this specification, and like reference numerals indicate corresponding parts in the various drawings. However, it should be clearly understood that the drawings are for illustrative and explanatory purposes only and are not intended as a definition limiting the present disclosure.

Brief Description of the Drawings

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DETAILED DESCRIPTION OF THE INVENTION

[0249] As used herein, the singular forms "a", "an", and "the" include plural referents unless the context clearly dictates otherwise.

[0250] As used herein, the terms "right", "left", "upper" and their derivatives should relate to the aspects of the present disclosure as their orientation in the figures of the drawings. However, it should be understood that the embodiments of the present disclosure may assume various alternative orientations, and thus such terms should not be considered as limiting. It should also be understood that the embodiments of the present disclosure may assume various alternative variations and step sequences unless the contrary is explicitly specified. It should also be understood that the specific devices and processes shown in the accompanying drawings and described in the following specification are provided by way of example only. Accordingly, the specific dimensions and other physical characteristics related to the embodiments disclosed herein should not be considered as limiting.

[0251] As used herein, the terms "communicate" and "communicating" refer to receiving or transferring one or more signals, messages, commands, or other types of data. For a unit or component that is to communicate with another unit or component, it means that the one unit or component can receive data from, and / or transmit data to, the other unit or component, either directly or indirectly. This can refer to a direct or indirect connection that can be wired and / or wireless in nature. Further, even if the data being transmitted may be modified, processed, routed, etc. between the first and second units or components, the two units or components can communicate with each other. For example, even if the first unit passively receives data and does not actively transmit the data to the second unit, the first unit can communicate with the second unit. As another example, when a relay unit processes data from one unit and transmits the processed data to a second unit, the first unit can communicate with the second unit. It will be understood that numerous other configurations are possible.

[0252] The present disclosure generally relates to systems, methods, and techniques for providing guidance to medical professionals such as rescuers or emergency responders, used in the context of acute treatment or emergency medicine. "Acute treatment" can refer to situations where a patient receives active but short-term treatment for an injury, onset of illness, emergency or sudden medical condition, or the recovery period after a scheduled surgical procedure. "Emergency responder" can refer to any individual such as an emergency medical technician (EMT), physician, nurse, paramedic, etc., who provides short-term treatment to a patient in such "acute treatment" situations, states, or events.

[0253] The devices and systems described herein can be used in a variety of environments, such as, for example, emergency situations, ambulances, hospitals, emergency treatment rooms, and outpatient treatment facilities. The individual being treated by a (one or more) medical professional can be an individual in need of emergency treatment in a rescue situation, such as an individual suffering from a physical event or arrest (e.g., cardiac arrest, respiratory arrest / difficulty, and / or traumatic cardiac arrest). In another example, the individual can be a patient in a hospital, such as a patient receiving treatment in an emergency treatment room. In another example, the individual can be an inpatient (e.g., a patient during hospitalization) who receives treatment more regularly. For convenience, throughout this specification, any medical professional is referred to as a "rescuer", and the individual being treated is referred to as a "patient". However, a "patient" can be an individual in need of emergency treatment, an individual who has been injured but has not yet been treated by a medical professional, or any other individual who requires medical treatment or evaluation by a medical professional. A "rescuer" can refer to an individual who provides treatment to any patient who requires an emergency medical procedure, several examples of which are described herein.

[0254] Body shapes vary greatly from person to person. Therefore, during acute treatment activities where cardiopulmonary resuscitation (CPR) is provided, the preferred methods for applying appropriate CPR may vary depending on the body shape of the person being treated. The systems and methods described herein relate to measuring the physical characteristics of a patient for determining recommended target CPR criteria for treating the patient. For example, "physical characteristics" may refer to aspects of the patient that can be determined by visual inspection or analysis of a captured image of the patient, rather than by direct measurement of the patient. Such target CPR criteria can be, for example, target chest compression criteria and / or target artificial respiration criteria. In the embodiments described herein, one or more physical characteristics or a plurality of physical characteristics of the patient may be used as an input to one or more processors for determining how to provide chest compression and / or artificial respiration feedback to a rescuer performing CPR. Thus, the criteria for CPR feedback can be effectively adjusted according to various physical characteristics of the patient (e.g., size, shape, dimensions, height), and also according to how such physical characteristics change over time (e.g., during CPR). Weight can be, for example, a physical characteristic that can be manually input by a user.

[0255] Patient characteristics that may include physical aspects not verifiable by visual inspection can also be used in determining CPR criteria. For example, a patient's weight can be used as a physical characteristic for determining certain CPR criteria. In some examples, as described herein, a patient's weight can be estimated from patient physical characteristics that can be determined by visual inspection, such as, for example, height, waist circumference, chest circumference, and other physical characteristics (e.g., three-dimensional scanning techniques or other applicable (one or more) measurements). That is, the patient's weight can be estimated using a method in which the patient's volume is measured or determined using an appropriate (one or more) multiplicative factor for density (e.g., fat volume × approximate fat density, muscle volume × approximate muscle density, bone volume × approximate bone density, etc.). In some examples, non-physical patient characteristics, such as age and / or gender, can also be additionally used in determining the target CPR criteria in addition to physical characteristics. For example, whether the patient is a child or an adult, or male or female, can change how CPR should be applied to the patient (e.g., depending on the target CPR criteria). Alternatively, physical characteristics can be effectively used in the estimation of non-physical characteristics used in determining the target CPR criteria.

[0256] As an exemplary embodiment, the recommended target depth (or rate, or release rate, etc.) for applying chest compressions to a relatively large adult patient can be greater than, for example, that for a small child or infant. Such a target depth can lead to effective blood transport from the heart to the peripheral tissues of the body while suppressing the risk of traumatic injury to the patient's thorax. Similarly, a larger (or taller) adult patient is predicted to have a larger vital capacity than, for example, a smaller (or shorter) pediatric patient. The recommended target tidal volume for ventilating the patient can vary depending on the patient's estimated vital capacity. The recommended technique for applying chest compressions can also depend on one or more physical characteristics of the patient and, in some cases, how the (one or more) physical characteristics can change during a resuscitation event.

[0257] A patient's physical and / or non - physical characteristics can be manually input into a CPR feedback system (e.g., a patient monitor, a defibrillator, a CPR device, or other acute - care treatment device). Additionally or alternatively, one or more sensors or other devices (e.g., a 3 - D sensor or scanning device for generating a three - dimensional representation of various parts of the patient's body) can be used to automatically measure specific physical dimensions (e.g., the anterior - posterior distance of the chest, the left - right distance of the chest, the chest circumference, the aspect ratio of the chest / thorax, the patient's height, facial features, etc.). As described in more detail herein, such physical measurements can be used as inputs for determining recommended CPR criteria.

[0258] Some of the examples described herein relate to providing treatment to a person in cardiac arrest, but it should be noted that embodiments of the present disclosure relate to acute - care treatment provided to a person suffering from symptoms other than cardiac arrest, such as dyspnea or other symptoms. In various embodiments, depending on the medical problem, chest compressions, artificial respiration, drug delivery, or other forms of acute - care treatment therapies can be shown to the patient alone or in combination. System for guiding emergency responders during resuscitation

[0259] Figures 1A and 1B show a system 10 for guiding and providing feedback to an emergency responder performing resuscitation actions on a patient, including but not limited to chest compressions and artificial respiration. System 10 is configured to be used for recording information about a patient, including measuring the patient's physical characteristics in an emergency situation, processing patient information to determine criteria for performing resuscitation actions on the patient, and providing feedback and guidance to the emergency responder(s) to prompt them to perform resuscitation actions according to the determined criteria.

[0260] Figure 1A shows an exemplary rescue situation 100 in which emergency responders 104, 106 are present under circumstances 100 where resuscitation operations are being performed on an adult patient 102, including elements of a system 10 for providing resuscitation guidance and feedback. Emergency responder 104 is providing chest compressions to the torso of patient 102. Emergency responder 106 is providing artificial respiration to the patient using a manual artificial respiration unit equipped with an artificial respiration bag 112. For the sake of convenience of explanation, two emergency responders 104, 106 are shown here, but there may be only one emergency responder in the acute treatment situation, or the acute treatment team may include more than three emergency responders to assist in the treatment of patient 102. Additional emergency responders can perform tasks such as setting up medical devices or monitoring the patient's physiological state (e.g., checking the patient's vital signs). For example, one of the emergency responders can be in charge of setting up a medical device such as a patient monitor or a defibrillator 108 while one or more other emergency responders are performing other resuscitation operations on patient 102. For example, the emergency responder setting up the monitor and / or defibrillator 108 can be in charge of attaching the electrodes, which may be included within an electrode package 110, to patient 102. The defibrillator 108 can be a conventional automated external defibrillator (AED), a professional defibrillator such as the X SERIES, R SERIES, M SERIES, or E SERIES manufactured by ZOLL Medical Corporation of Chelmsford, Massachusetts, or an automated external defibrillator (AED) such as the AED PLUS or AED PRO manufactured by ZOLL Medical Corporation.

[0261] In FIG. 1A, an electrode package 110 is shown on a patient 102 in a normal posture. In this example, the electrode package 110 is an assembly that combines a treatment and / or ECG detection electrode disposed on the upper right side of the patient's torso, a separate treatment and / or ECG detection electrode placed on the lower left side of the patient's torso, and a sensor package disposed on the patient's sternum. In this example, the electrode package 110, which is covered in the figure by the hands of the first responder 104, may further include motion sensors such as an accelerometer, a laser interferometer, a magnetic induction velocity sensor, etc., or proximity sensors such as optical or capacitance sensors, configured to transmit data to a portable computer device or a defibrillator 108 for monitoring the performance of chest compressions.

[0262] In another example, movement information regarding the performance of chest compressions can be collected by a separate device placed on the patient's sternum. This device, which may be commonly referred to as a "CPR Puck", includes a plastic housing containing an electronic circuit and is often equipped with motion and / or proximity sensors in particular.

[0263] In some examples, when an electrode (e.g., the electrode package 110) is connected to a patient, the defibrillator 108 can monitor the patient's condition to identify the patient's physiological events and determine whether there is a shockable rhythm, and if there is a shockable rhythm, provide treatment to the patient. Non-limiting examples of the patient's cardiac events that can be detected by an external medical device such as the defibrillator 108 (e.g., via ECG electrodes and an appropriate analysis algorithm) include, for example, bradycardia, ventricular tachycardia (VT) or ventricular fibrillation (VF), atrial arrhythmias such as premature atrial contractions (PAC), multifocal atrial tachycardia, atrial flutter, atrial fibrillation, supraventricular tachycardia (SVT), junctional arrhythmias, tachycardia, junctional rhythm, junctional tachycardia, junctional premature contractions, and ventricular arrhythmias such as premature ventricular contractions (PVC), accelerated idioventricular rhythm, etc.

[0264] In some examples, mechanical ventilation is provided to a patient by a resuscitation bag 112 or a ventilator (not shown) connected to the patient through an air flow path 114. The path may include a ventilation sensor 22, such as a flow sensor, for measuring air flow to the patient and / or expiratory information. The information collected by the ventilation sensor 22 can be used to determine ventilation parameters, including, for example, tidal volume, minute ventilation, ventilation rate, airway pressure, flow rate within the patient's airway, inspiratory flow rate, and / or expiratory flow rate. Information about the ventilation operation performed by a first responder can be used to provide feedback to the first responder and, in some cases, to confirm whether the ventilation operation is properly synchronized and / or optimized with respect to another resuscitation operation being performed by another first responder. In some examples, an electromechanical ventilator can be used to provide mechanical ventilation to the patient 102. In another example, mechanical ventilation can be performed or initiated by a mechanical ventilation device, such as a belt wrapped around the patient's abdomen or torso. In another embodiment, mechanical ventilation can be performed using the RESQCPR (trademark) system, ResQGARD (registered trademark) or ResQPOD (registered trademark) manufactured by ZOLL Medical Corporation, and an impedance threshold device (ITD).

[0265] System 10 is configured to assist emergency responders 104, 106 during performance of resuscitation operations such as chest compressions, artificial respiration, and / or other CPR operations, such as for patient 102. System 10 includes at least one information input device 12, such as a manual data input accessory (e.g., keyboard, touch screen display, mouse, buttons, or other computer accessory). In FIG. 1A, a defibrillator 108 or a button or touch screen element of a mobile device can be used as a manual data input accessory 14 for manually inputting information and measurements to System 10. Input device 12 further includes a camera 16 and a three-dimensional imaging system 18 or sensors for providing information representative of at least one physical characteristic of patient 102 measured during an acute care event. System 10 further includes at least one resuscitation sensor, such as a chest compression sensor 20 or a ventilation sensor 22 configured to obtain a signal indicative of a resuscitation operation (e.g., chest compression or artificial respiration) performed on a patient during an acute care event. Chest compression sensor 20 can be, for example, an accelerometer-type sensor disposed on a patient's chest. In some examples, chest compression sensor 20 is housed within an electrode package 110 (shown in FIG. 1A). Ventilation sensor 22 can be a pressure sensor or an airflow sensor disposed within a patient's airway 114. System 10 further includes a feedback device 24 whose function can be performed by a defibrillator 108, such as shown in FIG. 1A. For example, a visual display 26 and a speaker 28 of defibrillator 108 can be used to provide resuscitation guidance and feedback to (one or more) emergency responders. Visual display 26 and speaker 28 can also be components of other treatment devices or patient monitoring devices, such as a ventilator or a heart monitor under rescue situation 100.

[0266] System 10 further includes at least one processor 30 (shown in FIG. 1B), such as a computer controller, microprocessor, or virtual processor of a computer device communicatively coupled to at least one input device 12 and one or more resuscitation sensors 20, 22. In some examples, at least one processor 30 is also a component of a medical device, such as a defibrillator 108 (shown in FIG. 1A). In another example, at least one processor 30 can be a component of a portable computing device 32, such as a computer tablet, smartphone, mobile phone, or laptop computer, present in the rescue situation 100. In another example, at least one processor 30 is located at a location remote from the rescue situation 10 and is a component of a computer terminal or server that communicates wired or wirelessly with sensors 20, 22, portable computing device 32, and medical devices (e.g., defibrillator 108) in the rescue situation 100.

[0267] As will be described in more detail below with reference to FIGS. 10 - 12 and 14, which provide flowcharts of computer processes executed by at least one processor 30, at least one processor 30 receives and processes information representing at least one physical characteristic of patient 102 from one or more input devices 12, such as a manual data input accessory 14, camera 16, and / or a three - dimensional imaging system 18 or sensor, to determine target resuscitation criteria for patient 102, receives and processes signals from resuscitation sensors (e.g., chest compression sensor 20 and ventilation sensor 22) indicating resuscitation actions being performed on patient 102 by first responders 104, 106 to calculate resuscitation parameters for the ongoing resuscitation action, determines whether the one or more resuscitation parameters meet the target resuscitation criteria, and is configured to cause feedback device 24 to provide an indication to first responders 104, 106 as to whether the one or more resuscitation parameters meet the target resuscitation criteria.

[0268] Although not bound by a particular theory, it is believed that patients with different physiques, particularly those with different shaped cardiac thoracic regions, may benefit from resuscitation actions performed according to different criteria, patterns, or techniques. Therefore, adjusting resuscitation criteria based on the patient's physical characteristic(s) is thought to improve the effectiveness of resuscitation and result in better patient outcomes such as survival rate and physical condition. The physical characteristic of the patient

[0269] The physical characteristics of patient 102 may refer to quantifiable measurements of the patient, such as the length, width, or height of the patient's external anatomical structure (e.g., patient's height, length of the patient's arm or leg, transverse width of the patient's thorax, patient's chest circumference or torso circumference, anteroposterior (AP) distance of the patient's thorax, patient's total volume, thoracic volume, torso circumference, neck size, shoulder width, cranial content volume, interpupillary distance, distance between the eyes and nose, finger length, finger width, hand width, hand size, toe length, toe width, foot width, foot size, thoracic shape, body mass index (BMI), etc.), or the distance between the patient's anatomical structures (e.g., distance between the scapulae). The physical characteristics described herein may include anthropometric characteristics. This may refer to the relationship between measurements between different physical characteristics of a person (e.g., the ratio of the sternal AP distance to the transverse width, the ratio of the sternal AP distance to the chest circumference, thoracic shape, thoracic volume, etc.). Body weight is a physical characteristic of patient 102. As described herein, body weight can be estimated based on physical characteristic measurements in combination with additional data such as density (described in more detail below). However, it is more difficult to determine body weight from information recorded by a camera or three-dimensional sensor in a rescue situation without relying on estimated density data. If a particular physical characteristic such as body weight cannot be immediately determined from the analysis of the recorded information, the physical characteristic can be manually entered into the input device 12. In some examples, the physical characteristics of patient 102 include overall measurements of the patient, such as height and other body dimensions. In another example, the (one or more) physical characteristics may include overall measurements (e.g., height, AP distance) combined with one or more measurements for a particular body region. The patient's age or gender or other non-physical characteristics can also be factors relevant to determining the patient's resuscitation criteria.

[0270] Other non-physical characteristics, such as age and gender, can be estimated based on the image analysis or three-dimensional scanning of the patient. For this (one or more) estimation, for example, specific physical characteristics (e.g., interpupillary distance, distance between eyes and nose for age) or approximate density (for weight) are used. In some embodiments, as additional inputs for a plurality of physical characteristics to determine target CPR criteria (e.g., chest compression depth / rate, tidal volume of artificial respiration, endotracheal tube depth, drug dosage, etc.), the emergency responders 104, 106 may manually input non-physical patient characteristic information such as age and gender.

[0271] In some examples, the patient's height, weight, and gender can be used to calculate the ideal weight of the patient 102 and / or the body mass index (BMI) of the patient 102. Here, the formula obtained for this calculation is used. The ideal weight (IBW) can be correlated with lung volume and thus can provide appropriate parameters for estimating specific recommendations or target artificial respiration criteria. As shown in Formula 1 below, BMI is based on weight and height. As shown in Formula 2 below, IBW is based on height and gender. Thus, if the patient's height, weight, and in certain cases gender are known, useful information about target ventilation parameters for patients with different body builds can be determined. It should be understood that physical characteristics other than height and weight can be used as inputs for determining target artificial respiration (or other resuscitation) criteria. For example, chest volume, chest circumference, AP distance, etc. can be indicators of the patient's torso and thus the volume of the patient's lungs. Therefore, a plurality of physical characteristics can be used to determine target ventilation parameters / criteria. Formula 1: Body Mass Index (BMI) = Weight (kg) / Height 2 (m 2 ). Formula 2: Ideal Weight (IBW) IBW male = 50 kg + 2.3 * [Height (inches) - 60] IBW female = 45.5 kg + 2.3 * [Height (inches) - 60]

[0272] From FIGS. 2A to 3B, diagrams of different types of patients 102, 302 are shown, who can be treated by the system 10 and whose physical characteristics can be recorded, detected, or measured by the system 10. In some examples, patient 102 is an adult patient (shown in FIGS. 2A and 2B). In another example, the patient is a pediatric patient 302 (shown in FIGS. 3A and 3B). In some examples, the physical characteristic is an overall physical measurement of the patient, such as height (H1 in FIGS. 2A and 3A).

[0273] In another example, the physical characteristic is a characteristic of the patient's cardiothoracic region 118. For example, the (one or more) physical characteristics may include the anteroposterior (AP) distance D1 of the patient's cardiothoracic region 118, which is the maximum distance between the front of the patient's chest and the back of the patient's back, the width W1 of the patient's cardiothoracic region 118, the length L1 of the patient's cardiothoracic region 118 (e.g., the length from the lowest part of the patient's neck to the base of the thorax), and the perimeter length C1 of the patient's cardiothoracic region 118. As described herein, the measurements can be obtained manually (e.g., determinable by the user using a tape measure or caliper). In another example, the measurements for the physical characteristics are determined by analyzing the rescue situation and the patient's image acquired by a camera and / or a three-dimensional imaging system. For example, as described herein, the images captured by a stereo camera and a light field camera can be analyzed to determine the distance information between objects in the captured image. Similarly, the measurements of the physical characteristics can be determined from the generated three-dimensional representation of the rescue situation. For example, the three-dimensional representation may include the position information of the objects in that situation, particularly the position information of various anatomical structures of the patient. Since the position information is known, the distance between anatomical structures can be determined by mathematical analysis. The information collected from a three-dimensional imaging system (e.g., a sensor, a camera, a scanning device) can be used to generate a three-dimensional representation of the patient, from which physical measurements can be obtained.

[0274] As will be understood by those skilled in the art, for example, a patient's build can vary significantly based on factors other than age or gender. Generally, the AP distance D1 can vary between about 2 inches (5.08 cm) and about 6 inches (15.24 cm) for neonates and infants, and between about 8 inches (20.32 cm) and about 18 inches (45.72 cm) for large adults. The cardiothoracic width W1 can vary between about 2 inches (5.08 cm) and about 10 inches (25.4 cm) for small patients (e.g., neonates and children), and between about 16 inches (40.64 cm) and about 24 inches (60.96 cm) for large adults. The perimeter length of the patient's cardiothoracic region can vary between about 4 inches (10.16 cm) and about 20 inches (50.8 cm) for the smallest patients (e.g., neonates and children), and between about 40 inches (101.6 cm) and about 60 inches (152.4 cm) for large adults. While general ranges have been described for these parameters, it should be understood that the AP distance, cardiothoracic width, perimeter length, and other dimensional attributes can vary considerably from person to person.

[0275] In another example, the (one or more) physical characteristics can be the thoracic volume or the maximum cross-sectional area of the patient's cardiothoracic region. Such physical characteristics can be used for approximating lung volume. Ideal body weight (IBW), expressed in height and gender, can be used as a relevant input parameter for determining recommended ventilation criteria (e.g., tidal volume), but in some cases (as implicitly indicated above), thoracic volume, cross-sectional area, chest circumference, AP distance, or (one or more) other measurements can also be used as relevant inputs for ventilation criteria such as tidal volume. Based on the AP distance and the cardiothoracic length and width, the cardiothoracic volume can be estimated. The perimeter length can also be used for estimating the thoracic volume. The maximum cross-sectional area of the thoracic region can be calculated based on the perimeter length. Resuscitation Criteria for Patients with Different Builds

[0276] Generally, when providing chest compressions, the recommended chest compression depth for adults is typically about 2.0 inches (5.08 cm), and the appropriate range of chest compression depth is between about 2.0 inches (5.08 cm) and 2.4 inches (6.096 cm). The target chest compression rate during chest compressions can be between about 100 compressions per minute (cpm) and 120 cpm, and preferably about 105 cpm for adult patients. For pediatric patients, the target compression rate can be from 100 cpm to 120 cpm. However, according to the embodiments presented herein, the target chest compression depth and rate can be different (for example, for infants and young children, the target chest compression depth can be lower and the target chest compression rate can be higher).

[0277] Current guidelines for resuscitation actions (e.g., the guidelines of the American Heart Association (AHA)) generally do not consider the patient's physical characteristics when determining resuscitation criteria. Instead, current guidelines generally determine resuscitation criteria based on patient age, such as pediatric patients (under 8 years old) and adult patients (over 8 years old). For example, the guidelines for chest compressions state that the target compression depth for adult patients should be from 2.0 inches (5.08 cm) to 2.4 inches (6.096 cm), the target compression rate for adult patients should be from 100 to 120 compressions per minute, and the compression depth for children (between 1 year old and 8 years old) is assumed to be one-third of the anteroposterior (AP) distance of the child's heart-thoracic region.

[0278] The target parameters for artificial respiration can include ventilation rate and volume. The target ventilation rate can be about 10 breaths per minute of artificial respiration for adults (e.g., about 30 compressions every 2 breaths of artificial respiration), and about 20 breaths per minute of artificial respiration for children and infants (e.g., about 15 compressions every 2 breaths of artificial respiration). The target parameters can also relate to the synchronization or sequence of chest compressions and artificial respiration. For example, a rescuer can be instructed to interrupt compressions while performing a certain number of compressions (e.g., about 15 compressions or about 30 compressions) and a predetermined number of breaths of artificial respiration (e.g., 2 breaths of artificial respiration).

[0279] As will be appreciated by those skilled in the art, a wide range of body sizes and shapes exist for both pediatric and adult patients. In some cases, particularly large children can have the same height and weight as small adults. The recommended target criteria provided by current guidelines do not take into account such differences in patient body size. System 10 is configured to take into account such differences in patient body size and shape when determining resuscitation criteria. Further, System 10 can be configured to update or adjust resuscitation criteria and provide instructions so as to improve CPR techniques during rescue operations.

[0280] Regarding chest compressions, the criteria and parameters can be at least one of compression depth, compression rate, decompression rate, compression cessation, or decompression. In some examples, depending on the patient's physical characteristics (e.g., height, AP distance, etc.), the recommended target compression depth can be from 0.2 inches (0.508 cm) to 3.5 inches (8.89 cm) for all individuals, from 0.5 inches (1.27 cm) to 3.0 inches (7.62 cm) for a smaller subset, or for adult patients, it can be from 2.0 inches (5.08 cm) to 2.4 inches (6.096 cm). This is in line with the current AHA guidelines. In some cases, depending on the patient's physical characteristics, the range of the recommended target compression depth can deviate. For example, for relatively large adults (e.g., with an AP distance between 12 inches (30.48 cm) and 18 inches (45.72 cm) and a perimeter length between 50 inches (127 cm) and 60 inches (152.4 cm)), the recommended target chest compression depth can deviate from 2.0 inches (5.08 cm) to 2.4 inches (6.096 cm) to ranges such as 3.0 inches (7.62 cm) to 3.5 inches (8.89 cm), 2.8 inches (7.112 cm) to 3.2 inches (8.128 cm), 2.5 inches (6.35 cm) to 3.0 inches (7.62 cm), or other appropriate compression ranges. For relatively small children (e.g., with an AP distance between 2 inches (5.08 cm) and 10 inches (25.4 cm) and a perimeter length between 10 inches (25.4 cm) and 20 inches (50.8 cm)), conversely, the recommended target chest compression depth can deviate to ranges such as 1.0 inch (2.54 cm) to 1.5 inches (3.81 cm), 0.5 inch (1.27 cm) to 1.0 inch (2.54 cm), 0.2 inch (0.508 cm) to 0.5 inch (1.27 cm), etc.

[0281] The target compression rate can also depend on the patient's measured physical characteristics. For example, the recommended target compression rate can vary between 100 and 160 compressions per minute (cpm) for pediatric patients, who may be characterized by relatively small physical characteristics as exemplified herein. For older patients, the recommended target compression rate can be between 100 and 120 cpm, which may be characterized by relatively larger physical characteristics. Generally, since the natural heart rate of younger patients is higher than that of older patients, the target compression rate for younger patients can be faster than that of older patients. However, it should be understood that the target compression rate can vary for different types of patients.

[0282] Similarly, the target CCRV (chest compression release velocity) can vary based on the patient's measured physical characteristics. For example, the recommended target CCRV can be between 100 inches (254 cm) and 650 inches (1651 cm) per minute. Achieving an appropriate CCRV can enable an appropriate natural recoil of the chest to improve venous return of blood to the heart. For example, the CCRV can be between 150 inches (381 cm) and 300 inches (762 cm) per minute for small children and between 250 inches (635 cm) and 600 inches (1524 cm) per minute (e.g., between 250 inches (635 cm) and 400 inches (1016 cm) per minute, between 350 inches (889 cm) and 500 inches (1270 cm) per minute, or between 400 inches (1016 cm) and 600 inches (1524 cm) per minute) for adults. Thus, the target CCRV varies according to the patient's physical attributes.

[0283] In a simplified example, the AP distance of the thorax can be a physical characteristic of patients 102, 302 for determining one or more initial target recommendations for various CPR criteria. For example, the target compression depth for a patient with a smaller AP distance can generally be smaller than that for a patient with a larger AP distance. However, as will be described in more detail below, a single physical measurement may not be able to determine what the target CPR criteria should be and may only provide an initial set of CPR criteria, thus requiring further improvement. Therefore, the patient's AP distance can be a quickly and easily measurable indication of whether the patient's build / thickness is large or small and can be used to set an initial range of recommended compression depths. However, if measurements of other physical characteristics of the patient are available, they can be used in combination with the initial measurement to narrow the range of recommended depths. As further described herein, the measurement of a single physical characteristic can be useful for providing an initial indication suggesting the target compression depth (or other CPR criteria), but the input of measurements of multiple physical characteristics can result in a significant improvement in the range(s) of target CPR criteria output as feedback to the rescuer.

[0284] For example, the AP distance of a patient can provide an initial recommendation for a target range of compression depth and / or compression rate or other CPR parameters. In an illustrative implementation for explanatory and non-limiting purposes, the system 10 can be configured to provide the following initial recommendations for target chest compression depth based on the AP distance of the patient. For patients with an AP distance of less than 3 inches (7.62 cm) (e.g., infants or neonates), the initial recommendation for target chest compression depth can be from 0.2 inches (0.508 cm) to 0.75 inches (1.905 cm). For patients with an AP distance of 4 inches (10.16 cm) to 5 inches (12.7 cm) (e.g., small children), the initial recommendation for target chest compression depth can be from 0.75 inches (1.905 cm) to 1.25 inches (3.175 cm). For patients with an AP distance of 6 inches (15.24 cm) to 8 inches (20.32 cm) (e.g., large children or small adult females), the initial recommendation for target chest compression depth can be from 1.25 inches (3.175 cm) to 1.75 inches (4.445 cm). For patients with an AP distance of 9 inches (22.86 cm) to 11 inches (27.94 cm) (e.g., average females or small males), the initial recommendation for target chest compression depth can be from 1.75 inches (4.445 cm) to 2.25 inches (5.715 cm). For patients with an AP distance of 12 inches (30.48 cm) to 14 inches (35.56 cm) (e.g., large females or average males), the initial recommendation for target chest compression depth can be from 2.25 inches (5.715 cm) to 2.75 inches (6.985 cm). For patients with an AP distance of 15 inches (38.1 cm) or more (e.g., large males), the initial recommendation for target chest compression depth can be from 2.75 inches (6.985 cm) to 3.5 inches (8.89 cm). The initial recommendations for the target range of (one or more) CPR parameters can be further refined or confirmed by providing additional information (physical or non-physical).

[0285] The patient's AP distance can further serve as a basis for the initial recommended target ranges of compression parameters for compression rate and release rate, which can be further improved or confirmed by additional information (physical or non - physical). For example, in an exemplary implementation, for patients with an AP distance of less than 3 inches (7.62 cm) (e.g., infants or neonates), the initial recommended target chest compression rate can be from 150 cpm to 160 cpm, and the initial recommended target chest compression release rate can be from 200 inches (508 cm) to 300 inches (762 cm) per minute. For patients with an AP distance of 4 inches (10.16 cm) to 5 inches (12.7 cm) (e.g., small children), the initial recommended target chest compression rate can be from 140 cpm to 150 cpm, and the initial recommended target chest compression release rate can be from 150 inches (381 cm) to 250 inches (635 cm) per minute. For patients with an AP distance of 6 inches (15.24 cm) to 8 inches (20.32 cm) (e.g., older children or small adult females), the initial recommended target chest compression rate can be from 120 cpm to 140 cpm, and the initial recommended target chest compression release rate can be from 250 inches (635 cm) to 400 inches (1016 cm) per minute. For patients with an AP distance of 9 inches (22.86 cm) to 11 inches (27.94 cm) (e.g., average females or small males), the initial recommended target chest compression rate can be from 110 cpm to 130 cpm, and the initial recommended target chest compression release rate can be from 250 inches (635 cm) to 400 inches (1016 cm) per minute. For patients with an AP distance of 12 inches (30.48 cm) to 14 inches (35.56 cm) (e.g., large females or average males), the initial recommended target chest compression rate can be from 100 cpm to 120 cpm, and the initial recommended target chest compression release rate can be from 250 inches (635 cm) to 600 inches (1524 cm) per minute. For patients with an AP distance of 15 inches (38.1 cm) or more (e.g., large males), the initial recommended target chest compression rate can be from 100 cpm to 120 cpm, and the initial recommended target chest compression release rate can be from 250 inches (635 cm) to 600 inches (1524 cm) per minute.

[0286] As described herein, other physical characteristics such as the measured values of the patient's chest circumference, height, and width can also be used alone or in combination with the AP distance to confirm or determine the recommended target range of compression depth. For example, when a single physical measurement is insufficient, other measured physical characteristics or non-physical characteristics of the patient (e.g., age, gender) may be useful for identifying the type of patient. As will be described in more detail later, the type of patient can vary widely for a given AP distance (or other physical characteristic). Therefore, it can be effective to provide measurements of multiple physical characteristics or non-physical characteristics as inputs to the feedback system, thereby resulting in the output of appropriate CPR criteria.

[0287] In some examples, the target chest compression depth can be based on a combination of the AP distance and one or more of the following physical characteristics: chest width, chest circumference, total patient volume, chest volume, torso circumference, neck circumference, shoulder width, cranial volume, interpupillary distance, distance between the eyes and nose, finger length, finger width, hand width, hand size, toe length, toe width, foot width, foot size, chest shape, and height.

[0288] In another example, the target chest compression depth can be based on the AP distance in combination with one or more physical characteristics of the patient's chest. The physical characteristics of the patient's chest can include one or more of chest width, chest circumference, chest volume, and chest shape.

[0289] In another example, the target chest compression depth can be based on the AP distance in combination with the length, volume, and / or weight of a patient's body region. The patient's body region can be any suitable body region that can be easily identified and measured using the manual or automated measurement techniques disclosed herein. For example, the body region can be the patient's hand, arm, foot, leg, face, or skull.

[0290] In another example, the target chest compression depth can be based on the AP distance, in combination with a physical characteristic or feature that represents or indicates the patient's overall build. For example, the physical characteristic or feature that represents the patient's overall build can be one or more of the patient's height, the patient's weight, the length of the patient's outstretched arms, body volume, waist / height ratio, or body mass index (BMI).

[0291] The patient's weight can also be used to provide a rough indication for distinguishing between smaller and larger patients. However, as described, multiple physical measurements can be used as inputs for determining target CPR criteria for providing feedback to the first responder. For example, the patient's weight can be used as a physical characteristic for providing an initial target chest compression depth. In an exemplary implementation, for patients weighing less than 20 lbs (9.07 kg) (e.g., infants or neonates), the initial target chest compression depth can be from 0.2 inches (0.508 cm) to 0.75 inches (1.905 cm). For patients weighing from 20 lbs (9.07 kg) to 50 lbs (22.7 kg) (e.g., small children), the initial target chest compression depth can be from 0.75 inches (0.905 cm) to 1.25 inches (3.175 cm). For patients weighing from 50 lbs (22.7 kg) to 100 lbs (45.4 kg) (e.g., large children or small adult women), the initial target chest compression depth can be from 1.25 inches (3.175 cm) to 1.75 inches (4.445 cm). For patients weighing from 100 lbs (45.4 kg) to 150 lbs (68.0 kg) (e.g., average adult women or small adult men), the initial target chest compression depth can be from 1.75 inches (4.445 cm) to 2.25 inches (5.715 cm). For patients weighing from 150 lbs (68.0 kg) to 200 lbs (90.7 kg) (e.g., large adult women or average adult men), the initial target chest compression depth can be from 2.25 inches (5.715 cm) to 2.75 inches (6.985 cm). For patients weighing 200 lbs (90.7 kg) or more (e.g., large men), the initial target chest compression depth can be from 2.75 inches (6.985 cm) to 3.5 inches (8.89 cm).

[0292] When artificial respiration is provided by a resuscitation action, the artificial respiration standard and ventilation parameters can be at least one of the tidal volume, minute ventilation volume, end-inspiratory pressure, maximum ventilation pressure, or ventilation rate during an acute treatment event. The target artificial respiration standard for a patient may be based in part on the patient's age. For example, ventilation parameters such as tidal volume or ventilation rate can be determined based on whether the patient is a pediatric patient (newborn, young child or adolescent) or an adult. According to the present disclosure, the target artificial respiration standard can also be based on one or more physical characteristics of the patient, such as the patient's height. Table 1 shows an exemplary table showing the correspondence between the height of an adult male patient and the tidal volume. The values for the table can be determined empirically, for example, considering patient outcome data from past rescue activities. In another example, the values in the table can be determined from anatomical modeling of the lungs and respiratory system. In some embodiments, the ventilation rate of an adult is generally about 8 to 12 breaths per minute, regardless of the patient's height / weight. However, in some cases, the target ventilation rate can be outside this range. Table 1

Table 1

[0293] The artificial respiration tidal volume may be calculated based on an equation based on the ideal body weight (IBW), which is determined by gender and height. For example, the ventilation parameter can be correlated with the patient's ideal body weight (IBW) (calculated by Equation 2 above) by Equation 3. Equation 3: Available tidal volume target = (6 to 8 mL / kg) × IBW

[0294] As described above, for various embodiments, by determining resuscitation criteria based on a plurality of physical characteristics of a patient, an improvement in the optimization of target resuscitation criteria can be achieved. For example, instead of simply considering height, weight, or physical characteristic dimensions (e.g., anteroposterior (AP) distance of the sternum, chest circumference, transverse width of the thorax, total volume of the patient, thoracic volume, abdominal circumference, neck size, shoulder width, cranial volume, distance between facial features, etc.) individually, resuscitation parameters can be determined based on combinations of two or more of these features. One reason why it can be useful to determine target resuscitation criteria based on a plurality of physical characteristics of a patient is the difference in the arrangement of organs such as the heart and lungs and other anatomical structures (e.g., soft tissue, sternum, or spine) between children and adults. For example, a child may have a smaller heart and lungs compared to an adult of similar build (e.g., similar height and weight). Therefore, optimal target resuscitation criteria such as compression depth can be different among patients with similar anteroposterior diameters. Thus, instead of combining with AP distance in place of age, using one or more physical characteristics such as height, cranial volume, distance between facial features such as the distance between the eyes or between the eyes and nose, characteristic measurements of the hands or feet (e.g., length / width of the fingers or toes, size / width of the hands or feet) can result in more accurate target resuscitation criteria (e.g., compression depth feedback). For various embodiments, the physical characteristics described in the reference "Standards in Pediatric Orthopaedics: Tables, Charts, and Graphs Illustrating Growth" by Robert N. Hensinger published by Raven Press in 1986, or the reference "Three-dimensional human facial morphologies as robust aging markers" by Weiyang Chen et al., Cell Research (2015) Vol 25, No 5, 25:574 to 587 may alternatively be used to estimate non-physical characteristics such as the age or gender of the patient.In some instances, when an imaging tool (e.g., a camera, a three-dimensional imaging system) is used to measure physical characteristics, a reference object or scale may be placed within the field of view so that measurements of specific characteristics (e.g., hand parts) can be accurately measured. As an example, it may be preferable to image a patient's hand or foot to measure the physical characteristics used as an input for determining a target resuscitation criterion. Optimal target resuscitation criteria may be based on non-physical characteristics of the patient such as age and gender. For example, as described above, regardless of the patient's build, younger patients may have a faster heart rate and may require a faster chest compression rate than older patients. Target ventilation parameters such as tidal volume may also at least partially depend on the patient's gender.

[0295] To illustrate these differences, drawings are shown comparing a cross-section 400a (FIG. 4A) of the cardiac thoracic region of an adult patient with a cross-section 400b (FIG. 4B) of the cardiac thoracic region of a pediatric patient. Cross-section 400a of the adult patient includes the heart 404a, lungs 406a, sternum 408a, and spine 410a. In the non-compressed state, the heart 404a is spaced apart from the spine 410a by a distance D2. During the downward stroke of chest compression, the heart 404a is moved downward toward the spine 410a, the thoracic cavity volume is decreased, the heart and great vessels are compressed, and blood moves in the forward direction.

[0296] For comparison, Figure 4B shows a cross-section 400b of a pediatric patient. The organs of a pediatric patient (heart 404b and lungs 406b) can be smaller than those of an adult. Thus, the distance D3 between the heart and the spine can be greater than that of an adult patient with a similarly shaped chest. In such a case, the compression depth can be increased to compensate for the relatively smaller size of the heart within the chest of a pediatric (0 to 7 years old) patient. If only one physical characteristic were considered, the difference between such pediatric and adult patients would not be examined. On the other hand, by considering multiple physical characteristics together, such as the patient's height, or other physical characteristics such as intracranial volume or perimeter or the separation distance and weight of facial features, a narrower appropriate target resuscitation criteria range can be determined for the patient. To further improve the range of appropriate target resuscitation criteria, additional patient characteristics such as estimated or actual patient age or gender may also be added to the multiple physical characteristics.

[0297] In some examples, more optimal target resuscitation criteria can be achieved by a more detailed examination of multiple physical characteristics regarding the size and shape of the patient's heart thoracic region. Such an examination of the size and shape of the heart thoracic region can be useful because the size, shape, and configuration of the heart thoracic region can vary greatly among patients with similar height and weight.

[0298] As described above, the AP distance is one physical characteristic of the patient's heart thoracic region that may be related to determining the target depth for chest compression. Generally, the chest compression depth corresponds to the AP distance. For patients with particularly large chest cavities, deeper chest compressions may be required. Therefore, by considering the AP distance in combination with physical characteristics, physical features (e.g., weight), gender, and / or other information, more accurate target criteria can be provided for chest compression and other resuscitation actions. However, the AP distance alone may be insufficient to fully characterize the shape across the entire circumference of the patient's heart thoracic region. For example, there are patients with flat chests as well as patients with more rounded or barrel-shaped chests. FIG. 5A is a diagram of a cross-section 500a of the heart thoracic region of a patient with a flat chest. The cross-section 500a includes the patient's heart 504a, lungs 506a, sternum 508a, and spine 510a. The distance D1 represents the AP distance for the patient's heart thoracic region. D2 is the distance between the heart 504a and the spine 510a. During chest compression, the heart 504a moves by the distance D2 and is pressed against the spine 510a.

[0299] FIG. 5B is a diagram of a cross-section 500b of the heart thoracic region of a patient with a barrel-shaped chest. For both the patient with a flat chest and the patient with a barrel-shaped chest, the AP distance is the same (denoted as D1 in FIGS. 5A and 5B). However, the distance D3 between the heart 504b and the spine 510b of the patient 502b with a barrel-shaped chest is greater than the distance D2 for the patient with a flat chest due to the curvature of the chest of the patient with a barrel shape. As a result, for the patient with a barrel-shaped chest, in order to ensure that the heart 504b completely moves the distance D3 and is pressed against the spine 510b during compression to push blood out of the heart, deeper chest compressions may be required.

[0300] To more fully characterize the shape of a patient's cardiothoracic region for the purpose of determining target resuscitation criteria, other physical characteristics may be considered in combination with the AP distance. For example, the width W1 or perimeter length of the cardiothoracic region can be used in combination with the AP distance to more fully characterize the shape of the patient's cardiothoracic region. The thoracic volume measured based on the patient's three-dimensional scan / image can also be used to determine and characterize the shape of the thoracic region. Table 2 shows exemplary target chest compression depths based on the AP distance D1 in combination with the thoracic width W1 for adult patients with similar height and weight. As shown in the exemplary example of Table 2, the target chest compression depth values can vary between 1.5 inches (3.81 cm) and 3.8 inches (9.652 cm). However, since both the AP distance (D1) and the thoracic width (W1) are considered, the system can provide a more accurate recommended chest compression depth, or at least a narrower range of recommended depths. Table 2

Table 2

[0301] In some examples, at least one processor 30 of system 10 may be further configured to determine the type of patient, at least in part based on the measured (one or more) physical characteristics of the patient. For example, at least one processor 30 may process information from input device 12 to determine the gender of the patient. In the simplest example, the gender can be manually input to system 10, for example, using manual data input accessory 14. Alternatively, information about the patient's physical characteristics (e.g., the patient's height, chest dimensions) may be considered to determine the predicted gender of the patient. In a more advanced example, image processing techniques may be applied to an image of rescue situation 100 captured by camera 16 associated with system 10 to estimate or predict the gender of the patient. For example, face image processing techniques may be applied to the captured image to estimate the gender of the patient. In another example, anthropometric relationships between parts of the patient's body may be used to predict the gender. For example, at least one processor 30 may be configured to determine the ratio of the patient's hip circumference to the waist circumference (waist / hip ratio). The at least one processor may further determine the ratio of the chest circumference to the height (waist / height ratio). To predict the gender of the patient, the determined (one or more) ratios may be compared to known ratios for males and females.

[0302] Similarly, at least one processor 30 may be configured to automatically distinguish between adult and pediatric patients based on measurements of physical characteristics provided by system 10. For example, at least one processor 30 may be configured to determine, based on the patient's height and weight, whether the patient is more likely to be a pediatric or an adult. In another example, at least one processor 30 may be configured to distinguish between a newborn, infant, small child, large child, small adult, average-sized adult, or large adult based on the measured height and / or weight of the patient. Recommended Technical Decisions for Resuscitation Actions

[0303] In some examples, at least one processor 30 may be configured to cause a feedback device to provide an indication regarding a recommended chest compression technique for a patient based on at least one physical characteristic of the patient. Further, in some cases, at least one processor 30 may propose a first chest compression technique based on the initially received physical characteristics of the patient, monitor changes in the patient's physical characteristics during the course of the rescue operation and / or during the rescue operation, or determine how well CPR guidelines are being adhered to, and after a predetermined period, be configured to provide an instruction to switch from the previously provided chest compression technique to a new technique. For example, an emergency rescuer may start chest compressions by performing a first or initial chest compression technique. For many adult patients, the first or initial technique is conventional two-handed chest compressions. After a predetermined period, if the system 10 determines that the applied chest compressions are not effective and / or not being performed properly, at least one processor 30 may cause the feedback device 24 to provide an instruction to the emergency rescuer to perform a different chest compression technique, such as active compression-decompression, one-handed chest compressions, or automated mechanical chest compressions. In some cases, if manual chest compressions are not effective, it may be preferable to switch to an automated mechanical chest compression system, such as the AutoPulse™ resuscitation system manufactured by ZOLL Medical Corporation, or the Lucas™ chest compression system manufactured by Physio-Control. These allow for a more consistent pattern of chest compressions compared to manually applied compressions.

[0304] Chest compression techniques may include, for example, two-handed chest compressions, one-handed chest compressions, two-finger chest compressions, and encircling thumb chest compressions. Generally, the determination of which chest compression technique to apply is based on the patient's build and / or age. For example, Table 3 shows the correlation between patient weight and chest compression technique that at least one processor 30 may use to provide an initial recommendation regarding chest compression technique. Table 3

Table 3

[0305] Determination of the recommended or preferred chest compression technique can also be based on the proficiency or experience of the rescuer or user. For example, for a passerby or other untrained individual, two - hand chest compressions may be easier to perform. This is because this two - hand technique is generally what is taught to inexperienced individuals in CPR training. On the other hand, if System 10 determines that a particular chest compression technique is not being properly executed and / or is not resulting in the desired improvement for the patient, System 10 may recommend to the rescuer or user that a different type of chest compression be initiated.

[0306] Two - hand chest compressions are typically performed on adults and older children. For example, current guidelines state that two - hand chest compressions can be performed on patients 8 years of age and older. In some instances, the patient's height and / or weight may be used to determine if two - hand chest compressions are appropriate for the patient. For example, the system may be configured to recommend providing two - hand chest compressions for patients over 50 lbs (22.7 kg).

[0307] Figure 6A shows a rescuer 604 performing two - hand chest compressions on a patient 602. As shown in Figure 6A, the rescuer 604 positions himself next to the patient's torso with his arms 606, 608 extended towards the patient 602 (e.g., on his knees). The base of the rescuer's lower hand 612 is placed on the patient 602's sternum several inches above the xiphoid process. The rescuer's upper hand 610 is placed on top of the lower hand 612. In some cases, the rescuer 604 may interlock his fingers to prevent displacement. The rescuer 604 leans forward to perform the compression, using his body weight to push the patient's chest downward. The rescuer 604 releases the compression by lifting his hands off the chest. This allows the chest to expand due to the natural recoil of the chest wall. The compressions are repeated at a compression rate of approximately 100 to 120 compressions per minute, depending on the patient's build and age.

[0308] One - hand chest compressions are generally performed on young children, especially when the rescuer is large in build, so as not to injure patient 602 with the compression force. For example, one - hand compressions can be performed on children from 1 to 8 years old. System 10 can be configured to recommend one - hand chest compressions for children weighing from 25 lbs to 50 lbs (11.3 kg to 22.7 kg). FIG. 6B shows a rescuer 604 performing one - hand chest compressions on patient 602. The rescuer 604 uses the first hand 610 to hold the patient's head. The rescuer's second hand 612 is placed in the same position on the sternum as the lower hand 612 in two - hand chest compressions. The target depth of one - hand chest compressions can be about 1 / 3 of the AP distance. Thus, for a child of normal build with an AP distance of 3 inches (7.62 cm), the target compression depth can be about 1 inch (2.54 cm). Since pediatric patients generally have a higher heart rate than adult patients, the target compression rate can be 120 to 160 compressions per minute. However, it should be understood that other target compression depths and rates may also be appropriate depending on the patient's physical characteristics or other features.

[0309] Two - finger chest compressions and encircling - thumb chest compressions are generally performed on infants and neonates (e.g., patients under 1 year old and / or weighing less than 25 lbs (22.3 kg)). FIG. 6C shows a rescuer 604 performing two - finger chest compressions on an infant patient 602. As shown in FIG. 6C, the rescuer 604 optionally places the first hand 610 on the patient's forehead, similar to the one - hand chest compressions described herein. Alternatively, the first hand 606 can be placed under the patient's back or at other locations other than the forehead. The second hand 612 is placed on the upper side of the patient's chest. The rescuer 604 presses two fingers (e.g., the middle finger and the ring finger) against the chest of the infant patient to perform the compression. In some embodiments, the target compression depth for an infant patient can be between about 0.25 inch (0.635 cm) and 0.75 inch (1.905 cm), depending on the patient's build and age. The target compression rate for pediatric patients can be about 120 to 160 compressions per minute.

[0310] Figure 6D shows emergency rescuer 604 performing wrapped thumb chest compressions on patient 602. To perform wrapped thumb chest compressions, rescuer 604 places thumbs 614 of hands 610, 612 on the patient's chest and fingers 616 along the patient's back, enclosing the heart thoracic region of the infant patient with his own hands. In some cases, rescuer 604 may perform wrapped thumb chest compressions while holding patient 602 in a substantially upright position. In another example, patient 602 may lie on a firm surface as shown in Figure 6D. To apply pressure, rescuer 604 moves his fingers 616 towards thumbs 614. This compresses the patient's chest and back towards each other. The target compression depth for wrapped thumb chest compressions should be similar to that for two-finger chest compressions (e.g., about 0.25 inches (0.635 cm) to 0.75 inches (1.905 cm)). The target compression rate for pediatric patients can be from about 120 compressions per minute to 160 compressions per minute. Active decompression and chest wall deformation

[0311] At least one processor 30 may be further configured to provide instructions to a rescuer to initiate timely application of active decompression to a patient. For example, at least one processor 30 may be configured to continuously or periodically monitor a patient's physical characteristics, such as the AP distance, during chest compression execution. A significant change in a physical characteristic, such as the AP distance, during an acute treatment event (e.g., due to repeated force applied to the chest resulting in chest deformation) (e.g., a reduction of about 20% or more) may indicate that the shape of the patient's chest and / or the elasticity of the thoracic cavity has changed and that active decompression is required to maintain blood flow. That is, as a result of the chest becoming substantially flatter, it may be preferable to adjust the target chest compression depth to a lower value and provide further active chest decompression to facilitate blood flow in and out of the heart.

[0312] Generally, active decompression is to pull the patient's chest or apply force in other ways during the intervals between compressions to return the chest to an inflated state. This has the advantage of reducing the intrathoracic pressure and promoting venous return of blood from the peripheral tissues to the heart. A situation where active decompression is particularly advantageous is after the chest has been deformed by chest compression. Applying chest compression to the patient's chest can displace the position of specific anatomical structures (e.g., ribs, soft tissues, etc.) and / or reduce the elasticity of such structures. For example, in the state where the chest is fully inflated as shown in FIG. 7A, the heart is separated from the sternum by a distance D2, and the mitral valve 712 is fully open. In this state, blood is pumped into the heart and can be recycled with each chest compression. Desirably, the chest returns to this inflated state (shown in FIG. 7A) by fully releasing the chest during the intervals between chest compressions. However, after being compressed for a long time, even if the rescuer releases the chest during the intervals between compressions, the chest may remain partially concave or compressed as shown in FIG. 7B. In the compressed state of FIG. 7B, the heart 704 is pressed against the sternum, and the mitral valve 712 may be closed or partially closed. That is, only a small amount of blood is pumped into the heart during the intervals between compressions. Since blood is not effectively pumped into the heart during the intervals between compressions, the amount of blood circulating with each chest compression is significantly reduced. Active decompression can be performed not only to create a negative intrathoracic pressure within the thoracic cavity, but also to provide an action against the reduction in the elasticity of the thoracic cavity and ensure that the chest returns to an inflated state during the intervals between compressions.

[0313] As shown in FIG. 7C, active decompression can be performed using a suction device, such as a plunger device 750, that is attached to the chest of patient 702. The suction device 750 includes a handle having hand grips 752, 754 for a first responder that are connected to a domed suction cup 756 disposed on the patient's chest. The device 750 may further include a depth indicator 758 disposed on the hand grips 752, 754 of the handle. In use, the first responder 744 grips the hand grips 752, 754 of the handle and, during the compression phase of the compression cycle, pushes the handle downward until the indicator 758 indicates that the target compression depth has been reached. When the target depth is reached, during the decompression phase of the compression cycle, the first responder 744 pulls the hand grips 752, 754 upward. As a result of the suction force between the suction cup 756 and the patient's chest, pulling the hand grips 752, 754 upward leads to moving the chest to an inflated state and drawing blood into the heart.

[0314] An exemplary plunger or suction cup device that can be used with the resuscitation feedback and guidance system 10 and provides active decompression to a patient is the ResQPUMP™ provided with the ResQCPR™ system manufactured by ZOLL Medical Corporation. The ResQPUMP™ system includes a suction system that forces the chest back to an inflated state during the intervals between compressions by applying a maximum lift force of 10 kg to the patient's chest during decompression. Exemplary devices that provide active decompression to a patient and include a suction cup configured to adhere to the patient's chest are also disclosed in Freeman U.S. Patent Application Publication No. 2017 / 0079876 (entitled “Chest Compliance Directed to Chest Compressions”) and may be implemented in embodiments of the present disclosure. Other devices that are attachable or adherable to the chest and are pullable upward to perform active chest decompression include, for example, devices that use a hook-and-loop fastener (e.g., Velcro®) to connect the device to the patient and devices that include an adhesive material for attaching the device to the patient's chest and coupling it there so that the device lifts the chest during decompression.

[0315] In another example, active decompression can be performed by applying pressure to other areas of the patient's body between chest compressions. For example, the feedback device 24 of the system 10 can instruct the rescuer to simultaneously compress both sides of the patient's cardiac thoracic region and force the chest back into an inflated state. Similarly, sufficient force can be applied to the chest cavity by the pressure applied to the patient's abdomen between chest compressions. This causes the chest cavity to return to its inflated state between chest compressions, promoting venous return of blood back to the heart. Alternatively, the feedback device can instruct or suggest applying automated mechanical chest compressions to the patient, particularly when manual compression is not appropriate.

[0316] In some examples, the system 10 can be configured to continuously or periodically obtain measurements representative of the patient's physical characteristics to determine if deformation has occurred. For example, the system 10 can be configured to monitor the patient's AP distance D1 (shown in FIGS. 7A and 7B) during an acute treatment event. If it is determined that the AP distance when the chest is fully released has decreased significantly (e.g., 10% to 20%) from the initial (e.g., before the start of chest compressions) AP distance, at least one processor 30 can cause the feedback device 24 to provide the user with an indication that deformation has occurred and / or cause the rescuer to be provided with a further indication that it may be preferable to apply active decompression.

[0317] For an emergency rescuer, when an active compression decompression (ACD) treatment is recommended as an adjustment of the technique (e.g., via a display screen, an audio speaker, or other suitable form of feedback device), if it is confirmed that the ACD treatment is being provided, the type of feedback can be modified according to the type of ACD feedback. The ACD treatment can be confirmed, for example, by waveform analysis, manual input, or detection via a suitable sensor(s) (e.g., a motion sensor, an accelerometer, a force sensor). Exemplary feedback techniques for ACD treatment are disclosed in U.S. Patent Application Publication No. 2018 / 0092803 (entitled "Active Compression Decompression Cardiopulmonary Resuscitation Chest Compression Feedback") and can be incorporated into embodiments of the present disclosure.

[0318] In some examples, at least one processor 30 may be further configured to modify or adjust the target chest compression criteria for compression depth and / or rate to account for changes or deformations in the AP distance due to prolonged chest compression application. For example, a decrease in the AP distance due to cardiothoracic deformation means that the chest does not move a sufficient distance between compressions. Similarly, the heart can be positioned closer to the spine. This means that the distance the heart moves before contacting the spine and before compression begins is shorter. Due to such changes, to account for the chest not moving a sufficient distance between compressions, the target compression depth and target release rate can be reduced. In some examples, at least one processor 30 may be configured to reduce the target criteria for compression depth and release rate based on a linear relationship between the compression depth and / or release rate and the AP distance. In another example, the relationship with depth and / or release rate is non-linear and can be determined, for example, based on experimental data regarding chest compression efficiency and / or patient outcome data. Exemplary electrical components of the resuscitation guidance system

[0319] When performing resuscitation operations on a patient, in order to provide guidance to the user, how the system 10 can be used in the rescue situation 100 was described. Here, the electrical components of the system will be described in detail. FIG. 1B shows a schematic diagram of the electrical components of an embodiment of the system. Physical characteristic measurement input device

[0320] As described herein, the system 10 includes at least one input device 12 that provides information representing at least one physical characteristic of the patient, such as a manual data input accessory 14, a camera 16, and / or a three-dimensional imaging system 18 or sensor, measured during an acute treatment event. Generally, the input device 12 is a computer device, a medical device, or an imaging device present in an acute treatment situation that records or receives information representing the physical characteristics of the patient. For example, as described above, the input device 12 can be a data input accessory such as a manual data input accessory 14. The input device 12 can further include a three-dimensional imaging system such as a camera 16 and / or a three-dimensional imaging system 18, such as a scanner, for recording information about the rescue situation 100 and the patient 102 (shown in FIG. 1A). The information from the input device 12 can be processed to determine measurement values for at least one physical characteristic of the patient. In some cases, one or more of the input devices 12 are placed or attached to a medical device in the rescue situation 100, such as a defibrillator 108 (shown in FIG. 1A). For example, the camera 16 can be connected to a defibrillator 108 placed near the patient or a patient monitor, and can be configured to periodically or continuously acquire images of the patient 102 during rescue activities. In another example, the input device 12 can be a handheld device such as a handheld digital camera or a smartphone carried by a first responder. In another example, the input device 12 can be worn by the user. For example, the input device 12 can be, for example, a digital camera clipped to a first responder's clothing or attached to the brim of a hat or visor.

[0321] The manual data input accessory 14 is electronically coupled to at least one processor 30 and may be configured to enable a user, such as an emergency rescuer, to manually input data about the patient 102 and the rescue operation. For example, the data may include measurements of the physical characteristics of the patient 102. The measurements can be manually obtained using conventional measuring devices such as a tape measure and / or calipers. Once the measurements are manually obtained, the emergency rescuer can use the manual data input accessory 14 to manually input the measurements into the system 10. In some cases, the data input accessory includes a user interface that guides the user or emergency rescuer during the process of obtaining the measurements of the patient 102. For example, the user interface may display instructions such as "Measure the chest circumference with a tape measure" or "Measure the AP distance with calipers". The user interface may further display a data input field that enables the emergency rescuer to manually input the measurements.

[0322] The camera 16 can be a conventional digital camera that acquires a two-dimensional image of the rescue situation 100. Although there are design differences among vendors, as is known in the art, cameras such as the camera 16 typically include a charge-coupled device (CCD) or complementary metal-oxide semiconductor (CMOS) imaging sensor, a lens, a multi-functional video control chip, and a set of individual components (e.g., capacitors, resistors, and connectors). The image can be recorded by the imaging sensor and processed by the video control chip. The captured image may further be processed by, for example, a three-dimensional information and / or image processing module configured to identify anatomical structures, distances, and physical objects within the captured image. The captured image can be stored on a computer memory associated with the input device 12 and / or at least one processor 30.

[0323] In some examples, the camera that images the rescue situation 100 and the patient 102 may include one or more of a digital camera, an RGB camera, a digital video camera, an RGB sensor, and / or a depth sensor for capturing visual information and still or moving images of the patient and the acute treatment situation. The camera 16 may further have multiple imaging functions to obtain a stereoscopic image of the acute treatment situation. The stereoscopic image may be processed to determine the depth information of the objects in the acute treatment situation.

[0324] In another example, the camera 16 can be a wide-angle or fisheye camera, a three-dimensional camera, a light field camera, or a similar image acquisition device. A light field or three-dimensional camera may refer to an imaging device with an extended depth of field of the subject. Advantageously, an extended depth of field of the subject means that during image processing after image recording, the user can change the focus, viewpoint, or perceived depth of field of the captured image. Therefore, it is recommended that the images captured using a light field or three-dimensional camera contain all the information necessary to calculate the three-dimensional form of the recorded situation. See "Single Lens 3D-Camera with Extended Depth-of-Field" by Christian Perwass et al., Raytrix GmbH, Schauenburgerstr. 116, 24116 Kiel, Germany (2012), which describes the implementation of a light field 3D camera that can be implemented in embodiments of the present disclosure.

[0325] The camera 16 is preferably arranged so that a large number of images of the patient can be obtained. In some cases, the images are automatically captured continuously or at predetermined intervals during the rescue operation. In another example, the emergency rescuers 104, 106 can hold an electronic device equipped with a camera, such as a smartphone or a similar handheld electronic device, near the patient, press an appropriate button, or touch a specific area of the touch screen of the handheld device to obtain digital images of the rescue situation 100 and the patient 102 before starting the resuscitation operation.

[0326] The three-dimensional imaging system 18 or sensor can further be used to obtain three-dimensional information regarding the placement of objects, the size of the objects, and the distances between objects in a rescue situation. The three-dimensional information can include distance or depth information regarding how far a physical object is from the three-dimensional imaging system 18, and the body size / dimension information of the objects and individuals present in the rescue situation. The three-dimensional information and / or images from the three-dimensional imaging system 18 or sensor can be processed to generate a three-dimensional representation of the acute care situation. The three-dimensional representation can include position information regarding different anatomical structures of the patient 102, including, for example, the patient's hands, feet, elbows, knees, shoulders, neck, head, eyes, mouth, chest, sternum, and other anatomical structures.

[0327] In some embodiments, the three-dimensional imaging system 18 can be configured to project a grid of markers so as to image the anatomical characteristics of the patient at high resolution. For example, a camera utilizing a technology such as the Kinect motion sensing input device provided by Microsoft Corporation may be used. The camera can include a depth sensor utilizing an infrared laser projector combined with a monochrome CMOS sensor. This enables the capture of 3D video data under ambient light conditions. It will be understood that any suitable three-dimensional imaging system can be used. The three-dimensional representation can be generated by a 3D surface imaging technology with anatomical integrity, such as, for example, the 3dMDthorax System (3dMD LLC, Atlanta, Georgia).

[0328] The three-dimensional imaging system 18 may include one or more of a digital camera, an RGB camera, a digital video camera, an RGB sensor, and / or a depth sensor for capturing visual information and still or moving images of the rescue situation. In some examples, the three-dimensional imaging system 18 may include, together with Microsoft's Kinect motion sensing input device or Apple's TrueDepth 3D sensing system, an infrared camera, a projection illuminator, a proximity sensor, an ambient light sensor, a speaker, a microphone, a 7-megapixel conventional camera, and a dot projector (projecting up to 30,000 points onto an object during scanning), and may include both optical and depth sensing components.

[0329] In some examples, the three-dimensional imaging system 18 is arranged to substantially correspond to the field of view of the emergency rescuer. In another example, the three-dimensional imaging system 18 may include a plurality of cameras. For example, the cameras may be arranged adjacent to each of the emergency rescuer's eyes such that a three-dimensional representation of the patient is generated while the rescuer is looking at the patient. Alternatively, the three-dimensional imaging system 18 may be held in the hand of the rescuer, such as by being attached to a tripod aimed at the patient, attached to or incorporated into a resuscitation device such as an AED or a defibrillator or a ventilator, or using an Apple iPhone X incorporating the three-dimensional imaging system 18.

[0330] Although there are design differences among vendors, a camera typically comprises a set of a charge-coupled device (CCD) or complementary metal-oxide semiconductor (CMOS) imaging sensor, a lens, a multi-functional video control chip, and individual components (e.g., capacitors, resistors, and connectors). An image can be recorded by the imaging sensor and processed by the video control chip. The processed image can be provided to the image processing module of the controller for further processing and object identification in the captured image. The image processing module may prepare a specific image or a three-dimensional representation for transmission from the device to other electronic devices via a communication interface. In some examples, the image or the three-dimensional representation can be transmitted to a remote electronic device in substantially real time. In another example, the acquired image or three-dimensional representation can be stored locally on the three-dimensional imaging system 18, such as in a computer-readable memory associated with the controller. The stored images can be transmitted to a remote electronic device to be downloaded in batches at predetermined intervals via the communication interface.

[0331] The three-dimensional representation of the patient is analyzed by the image processing module, and the volume of a specific region of the patient, such as the thoracic volume, or the total volume of the patient can be calculated.

[0332] Based on the calculated volume and average density of the human body (e.g., from about 900 kg / m 3 to about 1050 kg / m 3 , generally about 985 kg / m 3 ), the weight of the patient can be estimated as the product of the two. As an example, the average density of the human body after maximum inspiration can vary from about 985 kg / m 3 to about 945 kg / m 3 . On average, the density of fat can be estimated to be about 0.9 g / mL. The density of muscle can be estimated to be about 1.1 g / mL.

[0333] Based on the analysis of the patient's shape or other anthropometric characteristics and the relative density of various body components, a more accurate average density can be used in the calculation of the patient's estimated weight. This is described, for example, as a reference in Swainson MG, Batterham AM, Tsakirides, C, Rutherford ZH, Hind K (2017) "Prediction of whole-body fat percentage and visceral adipose tissue mass from five anthropometric variables" PLoS ONE 12(5): e0177175, https: / / doi.org / 10.1371 / journal.pone.0177175, and can be implemented in embodiments of the present disclosure (hereinafter referred to as "Swainson"). Swainson describes using the following anthropometric measurements to calculate or estimate the average density. The waist circumference ("WC") was measured at the midpoint between the iliac crest and the lowest rib, rounding off fractions less than 0.1 cm. The hip circumference ("HC") was measured at the widest part of the buttocks, rounding off fractions less than 0.1 cm. Thereby, the waist / hip ratio (WHR) is calculated by the simple division WC / HC. Next, the waist / height ratio (WHtR) was calculated by WC / height. WC / height 0.5 (the index "WHT.5R") was also calculated / estimated. The WHT.5R index has been proposed as an excellent cardiometabolic risk predictor compared to the WHR or WHtR ratios. Swainson further describes that the percent fat mass (%FM) can be calculated from these ratios as follows. Equation 4: %FM = 99.7 * WHtR - 24.7

[0334] Swainson describes that a relatively accurate estimate of the patient's weight can be determined based on the calculated %FM and the relative density of various body tissues. For example, measurements of specific body parts are highly correlated with the relative amounts of fat, muscle, and other body tissues of the body. Once the relative amounts of various body tissues are estimated, their weights can be calculated using the density as a multiplication factor.

[0335] For example, the estimated weight can be calculated using the following formula. Equation 5: Estimated weight = total body volume * (%FM * fat density + (1 - %FM) * average non-fat tissue, bone, and cartilage density)

[0336] As described above, generally, the fat density is about 0.9 g / mL and the average non-fat tissue density is about 1.1 g / mL. Therefore, by substituting these reasonable density values, the following formula for estimated weight can be used. Equation 6: Estimated weight = total body volume * (%FM * 0.9 g / mL + (1 - %FM) * 1.1 g / mL)

[0337] According to further embodiments, anthropometric measurements of a patient can be used to determine or propose therapeutic amounts such as defibrillation shock energy, tidal volume of artificial respiration, and drug dosage. That is, without directly knowing the weight of the patient, approximate treatment parameters are determined using measurable patient characteristics for estimating the patient's weight. For example, the estimated weight of the patient can be used to determine and set the treatment parameters of the patient and / or the operating parameters of treatment medical devices such as defibrillators, ventilators or other medical devices. In some examples, using the estimated weight of the patient, defibrillation shock energy (e.g., 3 joules per kilogram of the patient's weight), drug dosage (cc / kg), tidal volume of artificial respiration (mL), etc. can be determined. As will be understood by those skilled in the art, defibrillation shock energy, tidal volume of artificial respiration, and / or drug delivery dosage can be larger for patients with relatively larger volume and / or weight (overall or in the thorax). On the other hand, shock energy, tidal volume of artificial respiration, and / or drug dosage are often smaller for patients with relatively smaller volume and / or weight (overall or in the thorax). Thus, if the build and / or weight of the patient is estimated, for example, through three-dimensional representation and density analysis, the feedback device or user interface may provide the user with a proposal (e.g., visual or auditory indication) regarding the defibrillation energy and / or drug dosage to be applied corresponding to the build and / or weight of the patient. In some examples, the operating parameters for treatment medical devices such as defibrillators, ventilators or other medical devices can be automatically updated based on the calculated patient treatment parameters. As described above, the measured or provided physical characteristics and / or features of the patient can also be used to determine the patient treatment parameters for artificial respiration. For example, the tidal volume of artificial respiration (mL) can be calculated based on the ideal weight of the patient using Equation 3 above. As shown in Equation 2, the ideal weight is calculated from the patient's height and gender. In some examples, the tidal volume of artificial respiration can be further calculated or adjusted based on the estimated weight of the patient.

[0338] Furthermore, optimal target resuscitation criteria such as compression depth can vary among patients with similar anteroposterior distances. Thus, instead of age, one or more physical characteristics such as height, cranial volume, the distance between features of the face such as the interocular distance or the distance between the eye and the nose, or characteristic measurements of the hands or feet (e.g., the length / width of a finger or toe, the size / width of a hand or foot) can be utilized in combination with the AP distance to result in more accurate target resuscitation criteria (i.e., compression depth feedback).

[0339] At least one processor 30 may be configured to determine distance values for physical characteristics based on the generated three-dimensional representation. Regardless of where the three-dimensional imaging system / sensor is located, as long as the three-dimensional representation of the patient is appropriately imaged, it is possible to determine the relevant physical characteristics therefrom. For example, based on the three-dimensional representation of the patient, at least one processor may determine the AP distance of the thorax, the chest circumference, the lateral width of the chest, the height, and other relevant physical characteristics of the patient. As described herein, during CPR treatment of the patient, the three-dimensional representation of the patient may be updated substantially continuously or periodically. As a result, based on the change over time of the physical characteristics (e.g., due to deformation), the target CPR criteria, the recommended CPR techniques, and the relevant feedback to the rescuer may also change.

[0340] Furthermore, at least one processor 30 is capable of tracking the movement of anatomical structures over time in order to monitor changes in the physical characteristics of patient 102 that may occur during a rescue operation. Additionally, in some examples, information about the rescue situation 100 collected by the three-dimensional imaging system 18 or sensors may also be used to identify and track the position of objects in the rescue situation 18. For example, at least one processor 30 can analyze the generated three-dimensional representation to identify environmental objects such as patients, passersby, therapeutic medical devices, monitoring devices, medical supplies, and other objects present in the road or sidewalk, trees, buildings, power lines, cars, trucks, trains, or acute treatment situations that can affect where and how treatment is administered to the patient and provide feedback thereon. For example, U.S. Patent Application Publication No. 2014 / 0342331 (titled "Camera for Emergency Rescue"), which may be implemented in embodiments of the present disclosure, discloses an example of the use of a camera in an emergency acute treatment event.

[0341] In some examples, the input device 12, such as the camera 16 or the three-dimensional imaging system 18, has both imaging and depth sensing capabilities. For example, the input device 12 can be a Microsoft Kinect motion sensing input device, an Intel RealSense D415 camera, or an Apple TrueDepth 3D sensing system that utilizes a vertical cavity surface emitting laser (VCSEL) manufactured by Finisar (Sunnyvale, California). The Apple TrueDepth 3D sensing system may further include an infrared camera, a projector illuminator, a proximity sensor, an ambient light sensor, a speaker, a microphone, a 7-megapixel conventional camera, and / or a dot or grid projector (which projects up to 30,000 points onto the field of view during scanning or projects a fairly dense grid to effectively track the actual 3D objects detected within the field of view). Resuscitation sensor

[0342] Continuing to refer to FIG. 1B, the system 10 further includes resuscitation sensors such as a chest compression sensor 20 or a ventilation sensor 22. The resuscitation sensors 20, 22 are configured to obtain signals representing resuscitation actions performed by a first aider on a patient.

[0343] For example, the chest compression sensor 20 can be configured to measure chest compression parameters such as compression depth, compression rate, decompression speed, compression stop, or decompression. A variety of different types of chest compression sensors are known for recording information about the compressions performed on a patient. As described above, a common chest compression sensor is an accelerometer-based "CPR Puck" that includes a housing and a single-axis or multi-axis accelerometer. The "CPR Puck" is configured to be placed on the patient's sternum during compression. For example, the "CPR Puck" can be placed under the first aider's hand. In some examples, the "CPR Puck" includes a grip for the first aider to hold to maintain hand placement during compression. In another example, as shown in FIG. 1A, the CPR Puck is housed within the electrode pack 110. The acceleration waveform obtained by the (one or more) accelerometers during chest compression is processed to determine the compression parameters. The rate can be determined by identifying inflection points or changes in direction within the acceleration waveform that indicate when the first aider released the patient's chest between compressions. The compression speed or release speed can be determined by integrating the measured acceleration. The depth is determined by double integrating the measured acceleration. U.S. Patent No. 7,122,014 to Palazzolo et al., entitled "Method for Determining Depth of Chest Compressions During CPR", discloses an exemplary system and method for determining chest compression parameters from a measured accelerometer signal and can be implemented in embodiments of the present disclosure.

[0344] Generally, in order to ensure that the thoracic cavity expands during the intervals between compressions and blood flows into the heart, the rescuer should completely release the chest during the intervals between compressions. For compression release confirmation, the "CPR Puck" may include a release sensor, such as a capacitive touch sensor, an optical sensor, or a pressure sensor, for the rescuer to confirm that the chest has been released during the intervals between compressions. For example, the optical sensor can be any device used to detect light. Exemplary optical sensors include a photocell or a photoresistor whose resistance changes when light hits it, a charge-coupled device (CCD) that electrically transmits a charged signal, and a photomultiplier tube that detects and multiplies light. The optical sensor can be configured to detect when it is covered by the rescuer's hand and when the hand is removed from the sensor, indicating complete release of chest compressions. Capacitive sensing is a technique based on the capacitive coupling between something with conductivity or a different dielectric property than air and the sensor. When the rescuer's hand (one or both) approaches or touches the capacitive sensor, the touch is identified by a change in capacitance. The level of capacitance and / or the degree of change in capacitance can be used by a processor or device to determine that the rescuer's hand (one or both) has approached the capacitive sensor pad. An exemplary device for assisting a rescuer during CPR, including a proximity sensor for determining whether complete release of compression has occurred, is disclosed in U.S. Patent No. 9,387,147 to Elghazzawi et al. (inventive name "System for Assisting Rescuers in Performing Cardio-Pulmonary Resuscitation (CPR) on a Patient") and can be implemented in embodiments of the present disclosure.

[0345] Other resuscitation parameters that can be monitored to assess the quality of chest compressions provided to a patient are compression pause or compression ratio. During chest compressions, interruptions during or between chest compressions should be minimized so that blood flow is appropriately maintained through the rescue effort. Compression pause tracks the amount of time between compressions in the compression cycle. Similarly, compression ratio tracks the percentage of time that chest compressions are being provided to the patient during the rescue effort. During the rescue effort, compressions can be interrupted or delayed by tasks such as providing rescue breaths, checking for a pulse, and analyzing the heart rhythm. It has been confirmed that patient outcomes are significantly improved if any such interruptions are minimized. Information and feedback about compression pause and compression ratio can be determined from the acceleration waveforms obtained by the CPR Puck.

[0346] The ventilation sensor 22 is configured to measure ventilation parameters including tidal volume, minute ventilation volume, end-inspiratory pressure, maximum ventilation pressure, and ventilation rate during an acute treatment event. For example, the ventilation sensor 22 can be configured to monitor the artificial respiration provided to a patient using a manual artificial respiration unit equipped with an artificial respiration bag, such as the artificial respiration bag 112 shown in FIG. 1A. An example of the ventilation sensor 22 that can be disposed in the air flow path is an air flow sensor including a differential pressure sensor. Such a differential pressure sensor can be attached to a Venturi mechanism in the air flow path. The differential pressure sensor can further be provided in combination with a beam that substantially bisects the air flow path within the sensor. Taps from the differential pressure sensor can extend from different sides of the beam. Thereby, the presence and volume of the air flow can be determined by the difference in the measured pressure between the taps. The beam can be arranged and shaped in a known manner so as to provide more accurate measurements. In some embodiments, the differential pressure sensor can include an absolute atmospheric pressure sensor separated by a flow restrictor for measuring the flow velocity and pressure of the air flow within the air flow path. In another example, the ventilation sensor 22 can be a strain gauge or strain sensor provided on the artificial respiration bag 112 that is configured to determine how frequently the bag is compressed and further the rate of assisted ventilation provided to the patient. Exemplary ventilation sensors that can be used with the system 10 are described, for example, in U.S. Patent No. 9,364,625 to Silver et al. (entitled "Wireless Ventilator Reporting") and U.S. Patent Application Publication No. 2017 / 0266399 to Campana et al. (entitled "Flow Sensor for Ventilation") and can be implemented in embodiments of the present disclosure. Feedback device

[0347] System 10 further includes at least one feedback device 24 for providing information, instructions, and guidance to the user to perform resuscitation actions. In some cases, the feedback includes specific instructions for the user to perform actions. For example, auditory, visual, and / or tactile indicators can sound, light up, or vibrate as instructions for the first aider to perform an action. The actions can be, for example, starting chest compressions, releasing chest compressions, compressing the breathing bag, or releasing the breathing bag. In another example, the feedback includes quantitative information about the resuscitation actions being performed on or previously performed on the patient. For example, the feedback can include displaying measured numerical values for different resuscitation parameters. The feedback can further include graphs and other visual reports summarizing the changes in resuscitation parameters over time.

[0348] A number of different types of feedback devices can be used with System 10 to provide feedback to the first aider. In some examples, the feedback device 24 can be a portable electronic or computer device 32, such as a tablet, smartphone, smartwatch, or personal digital assistant, configured to provide guidance to the first aider to encourage the first aider to perform resuscitation actions according to target resuscitation criteria. The portable computer device 32 can include components for visual feedback (e.g., a display screen 34, LED indicators, etc.), auditory feedback (e.g., a speaker 28), and tactile feedback (e.g., a linear actuator 38). In some cases, the portable computer device 32 can also include other electronic components of System 10. For example, the input device 12 can be the touch screen display and user interface of the portable computer device 32. Similarly, at least one processor 30 of System 10 can be the processor of the portable computer device 32 that communicates wired or wirelessly with the sensors 20, 22 and other electrical components of System 10.

[0349] Information about the resuscitation actions performed on patient 102 can also be displayed on the visual display 34 of the portable computer device 32 or the defibrillator 108 to provide additional guidance for performing the resuscitation actions. Information about the patient, such as identification information (e.g., name, gender, known allergies) and physiological information (e.g., electrocardiogram, heart rate, ventilation parameters, etc.), can also be displayed on the visual display along with the resuscitation guidance. In some examples, the feedback device 24 can also submit a summary report after the resuscitation action has stopped and / or after the rescue activity, so that the first aider can review their performance during the rescue activity. In some embodiments, the summary review can include target compression and ventilation parameters based on the targets that were used and that could have been changed during resuscitation (e.g., based on the physical characteristics of the patient).

[0350] In some cases, visual feedback may be provided as a numerical value on the visual display 34. For example, the numerical value measured for a resuscitation parameter may be displayed on the visual display next to the target resuscitation reference value for the same parameter. Thereby, the emergency rescuer can confirm whether he or she meets the target reference value. In another example, the feedback may include an indication or instruction that prompts the emergency rescuer to adjust the way of performing the ongoing resuscitation action. For example, the feedback device 24 may be configured to provide an instruction to the emergency rescuer to increase, decrease, or maintain the rate and / or depth determined based on the measured resuscitation parameter and the target resuscitation criteria. As another example, the feedback device 24 may provide a display that shows the measured numerical value(s) of the relevant resuscitation parameter(s) (e.g., chest compression depth, chest compression rate, tidal volume of artificial respiration, ventilation rate, etc.). If the numerical value(s) deviate(s) from the target criteria, the display may provide an indication that the emergency rescuer is not performing in accordance with the current target CPR criteria (e.g., the target range of chest compression depth, chest compression rate, tidal volume of artificial respiration, and / or ventilation rate). Such an indication may be provided, for example, as a message on the display, a color change of the displayed numerical value, an emphasis on the displayed numerical value, or any other appropriate indication that the measured numerical value is out of range. The feedback device may further include auditory and / or tactile feedback, such as one or more auditory and / or vibration metronomes, which may be activated to assist the emergency rescuer in achieving an appropriate rate. By providing such indication(s), the emergency rescuer may recognize that he or she is not complying with the relevant CPR criteria, and thereby may change the way of applying the CPR treatment.

[0351] In another example, the feedback device 24 includes a treatment or monitoring medical device in an acute care situation, such as a defibrillator 108 (shown in FIG. 1A), a mechanical ventilator, or a patient monitor such as a heart rate or ECG monitor. Information and instructions to perform a resuscitation operation may be displayed on the screen of the medical device or emitted from the speaker of the medical device. For example, instructions or reminders such as "compression start" or "complete release" may be displayed on a screen that instructs the first aider to perform chest compressions at a target rate and depth.

[0352] In another example, the feedback device 24 can be a dedicated electronic device that provides feedback on specific resuscitation actions. For example, the "CPR Puck" device can include a feedback component such as a tactile feedback component (e.g., a linear actuator or a vibration motor configured to vibrate when activated), or a visual feedback component (e.g., an LED light that lights up to tell the first aider when to start and / or release compression). The ventilation sensor 22 connected to the patient's airway can also include a feedback component that guides the first aider to provide artificial respiration at a target volume and rate. For example, the ventilation sensor 22 can include an LED indicator light or a speaker attached to the housing of the ventilation sensor 22. The indicator light or the speaker can be configured to provide an indication to the first aider when the artificial respiration is too fast, or when the ventilation volume is in line with or not in line with the target criteria. In some examples, the indicator light or the speaker lights up or makes a sound when the target ventilation volume is reached, instructing the first aider to compress or release the bag. Resuscitation Feedback Display

[0353] In some examples, resuscitation feedback and guidance are provided to emergency responders in the form of a visual display that includes visual indicators. Such forms include gauges, numbers, and text that convey information about the patient, resuscitation actions, and rescue activities. The visual display can be provided on the screen of a medical device, such as a mobile computer device 32 (an example is shown in FIG. 1B), such as a smartphone, smartwatch, tablet, or the screen of a defibrillator 108 (shown in FIG. 1A). For example, the visual display can include information about the rescue activity (e.g., the length of the rescue activity, or the time until the resuscitation action ends), the rescue situation (e.g., location information, environmental hazards), and / or the patient (e.g., patient age / weight, downtime, known allergies, or medications being taken).

[0354] In some cases, the information is obtained from manual data entry or the keyboard 14 and resuscitation sensors 20, 22. The information can also be obtained from images acquired by input devices, such as a camera 16 and a three-dimensional imaging system 18 present in the rescue situation. For example, the captured images / videos can be processed and analyzed to determine resuscitation quality parameters, including chest compression depth, chest compression rate, and others. The visual display can also include information from other sources, such as a patient monitor connected to the patient, a therapeutic medical device, and physiological sensors.

[0355] FIG. 8A shows an exemplary visual display 800 of system 10 that can be used to provide resuscitation guidance and feedback to an emergency rescuer. The display 800 includes a patient information section 810, a physiological state section 812, and a resuscitation guidance section 814. The patient information section 810 includes information about the patient's physical characteristics. For example, information about the patient's height, weight, gender, AP distance, chest (e.g., thoracic cage) width, chest circumference, or other measurements can be displayed in the information section 810. The patient information can be manually input into the system 10 by one of the emergency rescuers in the rescue situation. In another example, as described herein, the patient's physical characteristics can be determined from information obtained by a three-dimensional imaging system such as a (one or more) camera and / or three-dimensional scanner. In some cases, the patient information section 810 can also include an image or graphical representation of the patient and / or a body part of the patient. For example, a portion of the generated three-dimensional representation of the patient can be displayed on the display 800. A message or notification can be displayed with the three-dimensional representation overlaid on or adjacent to the body part of the patient to which the message or notification relates.

[0356] In some examples, the physiological information section 812 of the display 800 includes visual indications representing the patient's physiological measurements. For example, the physiological information section 812 can include graphs or waveforms for different physiological parameters of the patient related to the rescue activities and / or resuscitation actions being performed by the emergency rescuer. For example, FIG. 8A shows an ECG waveform 816 and a carbon dioxide waveform 818. The physiological information section 812 can further include numerical values representing the patient's physiological measurements. For example, numerical values for blood pressure, pulse oxygen (SpO2), and other parameters of interest to the patient can be displayed in the physiological information section 812.

[0357] The resuscitation guidance or feedback section 814 of the display 800 may include measured resuscitation parameters and target resuscitation criteria for the resuscitation actions being performed on the patient. For example, as shown in FIG. 8A, the display 800 includes a compression depth icon 824 that includes an indicator 826 that displays the compression depth and a target range indicator 828 that represents the lower limit (e.g., 2.0 inches (5.08 cm)) and upper limit (e.g., 2.4 inches (6.096 cm)) of the target depth range. The emergency rescuer may be instructed to continue applying pressure to the chest until the indicator 826 is maintained within the area identified by the target range indicator 828. When the indicator 826 is located within the area of the indicator 828, the compression depth is maintained within the target depth range, and the emergency rescuer may be instructed to release the compression.

[0358] On the display, numerical values corresponding to each compression depth may be provided on the display at a resolution of at least 1 / 10, along with the numerical value for the chest compression rate (in the example shown in FIG. 8A, 1.8 inches (4.572 cm)). If the first responder is not performing to meet the current target CPR standards (e.g., the standards may be a depth of 2.0 inches (5.08 cm) to 2.4 inches (6.096 cm) and a rate of 100 to 120 cpm, which may be the default standards), the numerical values may change color on their own or be emphasized. This warns the person performing the chest compressions that the specific parameters are out of range. In FIGS. 8A and 8B, a depth of 1.8 inches (4.572 cm) is outside the target compression depth range of 2.0 inches (5.08 cm) to 2.4 inches (6.096 cm), and a rate of 154 cpm is outside the target compression rate range of 100 to 120 cpm. However, according to the embodiments disclosed herein, based on the measured physical characteristics of the patient, the CPR standards may differ from the default standards. For example, a relatively small pediatric patient may have physical characteristics corresponding to a target compression depth range of 1.5 inches (3.81 cm) to 2.0 inches (5.08 cm) and a target compression rate range of 140 to 160 cpm. In such a case, a depth of 1.8 inches (4.572 cm) and a rate of 154 cpm are within the target standards. Thus, the feedback device provides an indication (visual, auditory, tactile) that the (one or more) CPR parameters are within range. Or alternatively, the feedback device may simply provide the (one or more) CPR parameters on the display and not provide an indication that the (one or more) CPR parameters are out of range (e.g., no clear message, color change, or emphasis indicating that the rescuer should change the way CPR is applied).

[0359] The resuscitation guidance section 814 may further include text instructions for guiding the user in different modes of resuscitation operations. For example, a text instruction 830 to "fully release", or a reminder about releasing, may be displayed when the compression reaches the target depth. Text instructions to the user to "start compression" or "stop compression" may also be displayed to the on - scene rescuer in a timely manner. For example, at the start of a CPR interval, to start compression, or for a short period when an ECG shock analysis occurs, to stop compression. In some examples, the feedback section 814 may also include numerical values indicating the quality of chest compressions over time. For example, as shown in FIG. 8A, numerical values for the average compression depth and average compression rate (compressions per minute) may also be displayed. The target reference ranges for depth and rate may be displayed for comparison next to the average values. If the system 10 is configured to periodically update the measured values of the patient's physical characteristics, the display 800 may further include a countdown timer 836 indicating the remaining time until the target reference is updated.

[0360] FIG. 8B shows another exemplary visual display 850 that provides artificial respiration guidance and feedback to the rescuer. The display 850 may be configured to appear on the display screen of the feedback device when airflow through the patient's airway is detected, and may include, for example, patient information 852, artificial respiration history information 854, and (one or more) numerical ventilation volume indicators such as a ventilation rate indicator 856 and a ventilation volume indicator 862. The display 850 may further include numerical values 860 for the inhalation volume and / or exhalation volume for each positive - pressure artificial respiration. The display 850 may further include an artificial respiration performance indicator 858 based on target artificial respiration criteria (e.g., target tidal volume, target ventilation rate).

[0361] Similar to the exemplary display screen described above, the patient information 852 may include information about the patient's physical characteristics, such as, for example, information about the patient's height, AP distance, chest (e.g., rib cage) width, chest circumference, or other measurements. Other non-physical characteristics that cannot be measured, such as age or gender, may also be included. However, as described herein, (one or more) specific physical characteristic measurements may be used as (one or more) proxies to estimate non-physical characteristics such as age or gender. The patient information 852 may be manually entered into the system 10 by one of the emergency responders in the rescue situation. In another example, as described herein, the patient's physical characteristics may be determined from information obtained by a three-dimensional imaging system, such as (one or more) cameras and / or a three-dimensional scanner.

[0362] The ventilation volume indicator 962 includes the measured ventilation volume of 433 mL. Next to the measurement value, the target ventilation volume of 400 mL is also displayed. Since the measured value of 533 mL significantly exceeds the target value (e.g., by more than 10% from the target), the measured value of 533 is emphasized or enclosed in a colored box, thereby indicating to the emergency responder that the measured value is outside the target range. The ventilation rate indicator 8756 displays the measured ventilation rate of 7 breaths per minute. The target rate of 7 breaths per minute is also displayed next to the measured rate. Since the measured rate of 7 breaths per minute matches the target rate, the measured rate is displayed in normal text and is not emphasized or enclosed in a shaded box. When it is confirmed that the measured rate exceeds or is below the target rate, the rate indicator 856 may be emphasized, indicating to the emergency responder that the measured value does not match the target value.

[0363] The visual display 850 also includes a ventilation performance indicator 858 for providing feedback to the rescuer regarding the quality of the artificial respiration provided to the patient and / or any possible effects. In some examples, the ventilation performance indicator 858 may include a graph of a circular area that is filled as inspiration is detected by an airflow sensor in the patient's airway. As provided by the system 10 and processes disclosed herein, when the respiration ends, the circular area may change color depending on whether the detected ventilation rate and / or volume is within a target range for each ventilation parameter, such as a target range determined based on the patient's physical characteristics. In some cases, the circular area may display a green color, or another appropriate color, if both the measured ventilation rate and volume fall within the target range. If either the ventilation volume or ventilation rate is outside the target range, the circular area may display a different color, such as yellow, orange, red, or another color, indicating that one or more parameters are out of range. For example, if ventilation to the patient is too low (e.g., a volume below the lower limit of the target range is provided) or too high (e.g., a volume above the upper limit of the target range is provided), the circular area of the ventilation performance indicator 858 may display a warning color of yellow or another appropriate color, and the numerical ventilation volume indicator 860 may also change to a similar color (e.g., yellow). Similarly, if the measured ventilation rate does not fall within the generated target range, the circular area of the ventilation performance indicator 858 may emit a warning color of yellow or another appropriate color, and the numerical ventilation rate indicator 860 may also change color accordingly.

[0364] As shown in FIG. 8B, the cardiopulmonary resuscitation performance indicator 858 may include a numerical countdown timer 864 disposed within a circular area. When the numerical countdown timer counts down to 0 (e.g., counts down in seconds or other periods), the circular area becomes empty, and instead of the countdown timer 864, a prompt "Cardiopulmonary resuscitation" may appear. The prompt instructs the first aider to apply positive pressure ventilation to the patient (e.g., by squeezing the ventilation bag). If no respiration is detected after a certain period (e.g., 3 to 5 seconds), the prompt "Cardiopulmonary resuscitation" may start to blink. If no respiration is detected after a subsequent period (e.g., another 3 to 5 seconds), the circular area itself may blink and optionally change color to warn the user to perform cardiopulmonary resuscitation. An alarm (e.g., audible, visual, tactile) may also be triggered to issue an additional warning to the user to perform the cardiopulmonary resuscitation action. Resuscitation guidance system using a mobile computer device

[0365] FIG. 9 shows another exemplary system 910 that at least partially provides resuscitation guidance based on a patient's physical characteristics. As in the above example, the system 910 may be configured to obtain information about the patient's physical characteristics, process the information, and determine the patient's target resuscitation criteria based on the physical characteristics. The system 910 may also be configured to determine resuscitation parameters for the resuscitation actions to be performed on the patient and provide feedback on whether the measured resuscitation parameters meet the target resuscitation criteria. Advantageously, many of the electrical components of the system 910 can be housed within a single handheld electronic device 932 such as a smartphone, computer tablet, or personal digital assistant device that is easily portable by the first aider in a rescue situation.

[0366] System 910 includes at least one input component for providing information representing at least one physical characteristic of a patient measured during an acute treatment event. For example, the input component can be the touch screen 912 or button 914 of device 910 that enables a user to manually input information about the rescue operation and the patient, including measured values of the patient's physical characteristics. The input component 912 can further include the camera 916 of the portable electronic device 932. The camera 916 can be used to acquire images of the rescue situation and the patient. The captured images can be processed to determine information about the patient's physical characteristics. In some cases, the portable electronic device 932 is configured to provide instructions to the emergency rescuer on how and when to capture an image of the patient. For example, before starting a resuscitation operation, the emergency rescuer can be instructed or trained to hold the portable electronic device 932 at a specific distance above the patient's chest and acquire an image of the patient from that specific position. In another example, the emergency rescuer can be instructed or trained to move the camera 916 along the patient's body while maintaining a specific distance between the camera 916 and the patient to capture a video of the patient.

[0367] System 910 further includes at least one processor 930 communicatively coupled to the camera 916 and the touch screen 914. The at least one processor 930 can be the processor of the portable electronic device 932. In another example, the at least one processor 930 is remote from the portable electronic device 932 and is configured to transmit and receive data and / or signals with this remote electronic device 932. For example, the portable electronic device 932 can be configured to transmit data including information related to the determination of the patient's physical characteristics, as well as resuscitation parameter information and the patient's physiological information, to the remote processor. The remote processor can be configured to transmit resuscitation feedback and / or instructions for obtaining additional information to the portable electronic device 932.

[0368] To facilitate communication between at least one processor 930 and other components of the system 910, the portable electronic device 932 may include a communication interface 938 configured to transmit patient information, physical characteristic information, and other data between the portable electronic device 932 and other system components. The communication interface 938 may have short-range and / or long-range data communication functions, such as a wireless data transceiver, for wireless communication between the device 932 and other components. Exemplary short-range wireless data transmitters or transceivers that can be used with the system 910 include transceivers compatible with BLUETOOTH® or ZigBee®. The communication interface 938 may further include circuitry for long-range data transmission using a long-range data transmitter or transceiver, such as a WiFi transmitter or a cellular transmitter (e.g., a 3G or 4G compatible system). The data collected by the device 932 may be transmitted to an external source by the long-range data transmitter or transceiver. For example, the data may be transmitted to an external electronic device, a computer network, or a database using the long-range data transmission function of the portable electronic device 932.

[0369] The system 910 further includes at least one resuscitation sensor, such as a chest compression sensor 920 or a ventilation sensor 922, configured to acquire a signal indicating a resuscitation action performed on a patient during a rescue event. In some examples, the chest compression sensor 920 or the ventilation sensor 922 is a separate device that communicates wired or wirelessly with the portable electronic device 932 and the at least one processor 930 via a short-range data transmission protocol, such as BLUETOOTH®. For example, the sensors 920, 922 may be part of the defibrillator 108 or the artificial respiration unit 150. In that case, the chest compression sensor 920 and / or the ventilation sensor 922 functions in the same manner as the sensors described in connection with the foregoing embodiments.

[0370] In some examples, the resuscitation sensor can be a component of the portable electronic device 932. For example, the resuscitation sensor can be the accelerometer 940 or gyroscope 942 of the portable electronic device 932 housed within the housing of the device 932. The accelerometer 940 and gyroscope 942 can be configured to sense the movement of the portable electronic device 932, which can be used to determine information about the resuscitation actions being performed on the patient. For example, the portable electronic device 932 can be placed on the patient's chest and used to detect information representing chest compressions being performed on the patient. As described in the examples above, the acceleration and direction information recorded by the accelerometer 940 and gyroscope 942 can be used to determine parameters of the chest compressions, including compression depth and rate.

[0371] Referring further to FIG. 9, the system 910 further includes a feedback device that provides guidance on how to perform resuscitation actions on a patient. In some examples, the feedback device can be any of the feedback devices described in the examples above, namely, a computer tablet, smartphone, smartwatch, medical device, CPR Puck, or artificial respiration feedback device that communicates with the portable electronic device 932 either wired or wirelessly. In that case, the portable electronic device 932 can be configured to send an instruction to the feedback device to cause the feedback device to provide an indication to the rescuer as to whether at least one chest compression parameter matches the target chest compression criteria. The (one or more) feedback devices can be configured to receive the transmitted signal and provide feedback on the resuscitation actions performed in response to the instruction provided by the portable electronic device 932 and / or at least one processor 930.

[0372] In another example, feedback may be provided on the portable electronic device 932 itself. For example, at least one processor 930 may cause the portable electronic device 932 to provide visual feedback, for example, on the touch screen display 912 of the portable electronic device 932. The portable electronic device 932 may cause the touch screen 912 to display an indication as to whether the measured resuscitation parameter meets the target resuscitation criteria. The portable electronic device 932 may further display to the user instructions to improve the quality of the resuscitation operation being performed on the patient, such as instructions to increase the compression / ventilation rate, decrease the compression / ventilation rate, or maintain the current compression / ventilation rate. Feedback may be provided from another component of the portable electronic device 932. For example, audible feedback may be emitted from the speaker 928 of the portable electronic device 932. Tactile or vibration feedback may be provided from the linear actuator 944 of the portable electronic device 932. Process of determining target resuscitation criteria and providing feedback

[0373] At least one processor 30, 930 of the systems 10, 910 may be configured to receive data from system sensors and input devices, process the received data to determine target resuscitation criteria, and perform a number of different processes to provide feedback to a user, such as an emergency rescuer, regarding the resuscitation actions performed on the patient. In some cases, at least one processor 30, 930 may further be configured to periodically update the resuscitation criteria or provide recommendations for the type of chest compressions to be performed based on changes in the patient's physical characteristics.

[0374] Referring to FIG. 10, in an exemplary process executed by at least one processor, the at least one processor is configured at 1010 to receive and process information representing at least one physical characteristic of a patient from an input device. The type of physical characteristic received by the processor typically depends on the type of resuscitation action being performed on the patient. For example, the physical characteristics related to providing feedback for chest compressions may include the anteroposterior (AP) distance of the patient's cardiac thoracic region, the width of the patient's cardiac thoracic region, and the perimeter length of the patient's cardiac thoracic region. The related physical characteristics may further include the patient's height or other aspects of the patient. Physical characteristics such as the patient's weight, age, or gender may also be received by the at least one processor and used to determine target resuscitation criteria (e.g., age may provide an indication or confirmation as to whether the patient is an adult or a child, and gender may provide an indication or target ventilation volume). The physical characteristics related to providing feedback on the quality of artificial respiration provided to the patient may include the patient's height, weight, body mass index (BMI), and ideal body weight (IBW). The related artificial respiration parameters and target criteria may include tidal volume, minute ventilation, end-inspiratory pressure, maximum ventilation pressure, and ventilation rate during an acute care event. Some target criteria may be determined based on the physical characteristics of a single patient. In another example, the target resuscitation criterion value is determined based on multiple patient parameters. For example, the chest compression depth may be based on a combination of the AP distance and at least one of the cardiac thoracic width or perimeter length.

[0375] Depending on the type of collected physical characteristic data and the monitoring or recording devices present in the rescue situation, the input device that receives information representing at least one physical characteristic can be a manual data input accessory or a three-dimensional imaging system such as a camera or a three-dimensional scanner. As described in connection with various embodiments of systems 10, 910, the processor can be electrically connected to the (one or more) input devices by a wired or wireless connection. Depending on the processing capabilities of the system, information such as the position of the input device or camera and other elements can be continuously or periodically transmitted from the input device to at least one processor. This can enable updates to the (one or more) physical characteristics and thus the target CPR criteria and / or recommended CPR techniques. In some examples, the information transfer is initiated by the user. For example, each time the user acquires an image of the patient and / or the acute treatment situation, information can be transferred from the input device to at least one processor.

[0376] At 1012, the processor uses the received and processed information to determine target resuscitation criteria based on at least one physical characteristic of the patient. The target resuscitation criteria can include compression targets (e.g., compression depth, compression rate, or compression ratio) and / or ventilation targets (e.g., tidal volume and rate) as described above. In some cases, determining the target CPR criteria includes obtaining information from a lookup table such as a lookup table organized based on the AP distance and / or the patient's height and weight. Table 5 shows an exemplary lookup table in which the AP distance, cardiac thoracic width, and compression depth are associated.

[0377] In other cases, the resuscitation reference value is calculated using an equation that generates the resuscitation reference value based on the physiological characteristics of the patient as input. For example, an equation (e.g., a linear or non-linear regression equation) can be used to determine an optimal compression depth based on physical characteristics such as the AP distance, chest circumference, and / or chest wall width. For example, the following equation can be used to determine the target compression depth for patients with a height in the range of 20 inches (50.8 cm) to 48 inches (121.92 cm). Compression depth = 0.75AP - (H * AP) / 96 In the equation, "H" represents the height of the patient, and "AP" represents the AP distance. In some embodiments, additional non-physical characteristics, such as the gender of the patient (e.g., by assigning binary values, e.g., "0" for male and "1" for female), or the estimated or actual age, can also be used.

[0378] In some cases, the information received about the physical characteristics of the patient can also be used to make a determination about the type of patient being treated. For example, at least one processor can be configured to recognize whether the patient is a pediatric patient or an adult patient based on physical characteristics such as height, head circumference, hand or foot features, facial features, or other anthropometric characteristics, or the estimated or actual weight of the patient. In some cases, at least one processor can further distinguish between types of pediatric patients. For example, pediatric patients can be classified into at least one of neonates, infants, small children, or large children based on the physical characteristics of the patient determined by at least one processor.

[0379] At 1014, at least one processor is further configured to receive a signal from a resuscitation sensor such as a chest compression sensor and / or a ventilation sensor. At 1016, the processor processes the received signal to identify resuscitation parameters for a resuscitation operation being performed on a patient. The signal can include, for example, accelerometer data from a CPR Puck to provide additional information about the quality of chest compressions provided to the patient, and data from a sensor (e.g., proximity sensor), pressure sensor, or gyroscope to determine whether the chest has been released. Data from the ventilation sensor can include, for example, pressure measurements indicative of the pressure within the patient's airway. The pressure data can be used to calculate the flow or velocity of air passing through the airway. Data representing the air pressure within the airway can also be used to calculate parameters such as the ventilation rate (e.g., number of ventilations per minute) or maximum ventilation pressure (which can also be relevant to determining the quality of the artificial respiration provided to the patient).

[0380] If the target resuscitation criteria and resuscitation parameters are known, at 1018, at least one processor is configured to compare the measured resuscitation parameters with the target resuscitation criteria. The result of the comparison may represent the quality of the treatment being provided to the patient. The result of the comparison may also be used to provide feedback or guidance to the first responder to encourage the first responder to bring their performance closer to the target value. In some cases, the comparison of the measured resuscitation parameters with the target criteria is a determination of whether the parameters meet the target. In another case, at least one processor may be configured to record information such as the frequency with which the measured parameters meet the target, the percentage of time during the rescue operation that the first responder is compliant and / or non-compliant with the target, or the average difference between the measured parameters and the target. For example, at least one processor may determine, during the rescue operation, the percentage of time that the measured chest compression parameters meet or do not meet the target chest compression criteria, and configure a feedback device to provide an indication to the user if the percentage of time exceeds a predetermined value. In some cases, the measured resuscitation parameters and the target resuscitation criteria are considered to be substantially inconsistent if the difference between them exceeds 5%.

[0381] In some examples, at least one processor may be configured to provide recommendations to the user to improve chest compression quality, for example, if the rescuer does not regularly meet the target criteria. At least one processor may be configured to cause a feedback device to recommend to the rescuer to initiate the application of chest compressions using a different technique. For example, if a rescuer is providing one-handed chest compressions to a pediatric patient and is having difficulty reaching the target compression depth, at least one processor may cause the feedback device to provide an instruction to switch to two-handed chest compressions. Similarly, if a rescuer performing two-handed chest compressions on a patient repeatedly exceeds the target compression depth, at least one processor may cause the feedback device to instruct the rescuer to switch to one-handed compressions. To ensure that the rescuer sees and understands the instruction to switch techniques, the rescuer may be required to select a confirmation button on a portable computer device or medical device to indicate that the rescuer has seen and understood the instruction to switch compression techniques.

[0382] At least one processor is further configured to provide feedback to the rescuer based on a comparison of the resuscitation parameter(s) as shown in 1020 with the target resuscitation criteria. The feedback may include an immediate indication of whether the resuscitation action meets the target criteria. For example, the system may display an indicator such as a gauge, icon, or numerical value that indicates to the rescuer whether the ongoing resuscitation action meets the target value. In another example, the feedback may include a summary report provided after the rescue activity or resuscitation action has stopped, showing the result of the comparison of the measured resuscitation parameter(s) with the target value over a predetermined period or over the entire rescue activity.

[0383] Figure 11 shows another exemplary process that provides guidance and feedback on resuscitation actions based on patient characteristics. As shown at 1110, at least one processor receives information representing at least one physical characteristic or a plurality of physical characteristics of a patient. At 1112, the received information is processed to determine the type of patient being treated. For example, the type of patient determined based on the patient's height or weight can be a pediatric patient or an adult patient. In some examples, the patient can further be classified as a newborn, infant, small child, large child, small adult, average-sized adult, or large adult. At 1114, at least one processor can be configured to select a recommended chest compression type or chest compression technique for the patient based on the patient's physical characteristics. As described above, two-handed chest compressions are generally performed on patients 8 years of age and older. One-handed chest compressions are performed on patients from 1 to 8 years of age. Two-finger or encircling thumb chest compressions are generally performed on infants and newborns (less than 1 year old). Once the recommended chest compression type or technique is selected, at 1116, at least one processor causes the feedback device to provide an indication to the user about the recommended chest compression type. In some cases, the guidance can include displayed text that communicates or suggests to the rescuer the chest compression technique to be performed. In some cases, at least one processor can cause the feedback device to provide more detailed instructions on how the chest compression technique should be performed. In some cases, the rescuer can be asked to affirmatively confirm the instructions. For example, the rescuer can press a button on a mobile computer device or a medical device to indicate that they have viewed the instructions for the recommended chest compression technique and are starting to perform the recommended technique. In some examples, the rescuer can be able to reject the recommended technique or request that the system provide a new recommendation by pressing an appropriate button on a mobile computer device or a medical device.

[0384] Once the indication is confirmed, the emergency rescuer may begin providing chest compressions using the recommended technique and may continue to provide chest compressions for a predetermined or indefinite period. During the performance of chest compressions, at least one processor may be configured to monitor the quality of the chest compressions being provided to the patient based on signals received from resuscitation sensors associated with the patient and / or the emergency rescuer. After a predetermined period, at 1118, at least one processor may be configured to receive new information about at least one or more physical characteristics of the patient. The new information about the physical characteristics of the patient may indicate that deformation of the patient's chest has occurred as a result of the chest compressions. At 1120, at least one processor may determine whether different types of chest compressions would be more effective in providing treatment to the patient. Similarly, at 1122, at least one processor may determine whether active decompression should be applied to the patient based on the received updated information representing the physical characteristics of the patient. As described above, an instruction to initiate the performance of active decompression may include an instruction to initiate the use of a suction cup device, an adhesive device configured to be attached to the patient's chest, or a hook-and-loop (e.g., Velcro®) device. In some cases, an instruction to perform active decompression may include an instruction to apply pressure to the patient's side or abdomen.

[0385] Referring to FIG. 12A, a process for determining and updating a target chest compression criterion based on information about updated physical characteristics or based on information about one or more new physical characteristics of a patient is shown. At 1210, information representing the physical characteristics of the patient is received from the input device of the system as in the exemplary process described above. At least one processor is configured at 1212 to process the received information to determine a target resuscitation criterion for the patient. As in the example above, the target resuscitation criterion can be extracted from a look-up table into which target resuscitation criterion values have been entered based on the physical characteristics of the patient. In another example, the target resuscitation criterion is calculated based on an equation obtained from experimental data. At 1214, at least one processor receives a signal from at least one resuscitation sensor, such as a chest compression sensor, configured to measure a signal representing chest compressions being performed on the patient. At 1216, the processor determines resuscitation parameters for the chest compressions being performed on the patient based on the signal received from the chest compression sensor.

[0386] When chest compressions are being performed, at 1218, at least one processor may be configured to cause a feedback device to provide resuscitation guidance. In some cases, as described herein, the guidance tells the rescuer whether the chest compressions being performed are in line with the target criterion for chest compressions determined based on the physical characteristics of the patient. In another example, the feedback may include instructions (e.g., "start compression", "fully release compression", "increase compression speed", "decrease compression speed") that prompt the rescuer to better adhere to the target criterion value.

[0387] After a predetermined period, at least one processor may be configured to receive updated physical characteristic information about the patient, as shown at 1220. In some cases, the information representing the updated physical characteristics is automatically received by the processor. For example, a three-dimensional imaging system, such as a camera or a three-dimensional scanner in an emergency situation, may be configured to automatically acquire an image of the patient according to a predetermined schedule. In another case, the emergency rescuer may be instructed to manually acquire an image of the patient after performing chest compressions for a predetermined period. This period may be a preselected value based on, for example, an estimated time until deformation in the cardiac thoracic region occurs, or simply the typical length of the chest compression time interval. In another example, the predetermined period may be a period selected by at least one processor. In some cases, the length of the predetermined period may be based on the physical characteristics of the patient or the type of resuscitation action being performed on the patient. For example, physical characteristics related to the determination of ventilation parameters, such as tidal volume and rate (e.g., the patient's height and weight), do not change during the rescue operation. Therefore, if artificial respiration is being performed on the patient, it may not be necessary to regularly acquire new physical characteristic information and recalculate the target values. On the other hand, when chest compressions are performed, deformation of the thoracic cavity may occur. As a result of this deformation, it may be necessary to regularly recalculate the target resuscitation criteria for chest compressions. The length of the predetermined period between receiving updated physical characteristic information may also be based on the physical characteristics of the patient. For example, for patients who are shorter or lighter (e.g., patients with a low weight relative to height, a short AP distance, and / or a small chest circumference), the impact of deformation due to chest compressions may be more significant. Patients who are taller, heavier, or more robust may be less likely to experience deformation. Therefore, the frequency of updating the physical characteristic information may be lower (e.g., the predetermined period between updates may be longer).

[0388] At 1222, when updated information representing a patient's physical characteristics is received, at least one processor may be configured to calculate a modified target chest compression criterion based on the received updated physical characteristic information for the patient. At 1224, at least one processor is configured to determine whether the chest compression parameters of the compressions performed by the first responder match the modified target chest compression criterion. At 1226, at least one processor may be configured to cause the feedback device to provide the user with an indication as to whether at least one chest compression parameter matches the modified target chest compression criterion. The feedback device may also be configured to provide feedback to the first responder regarding changes to the target chest compression parameters. For example, if the modified target chest compression criterion is different from the initial target chest compression criterion, the processor may cause the feedback device to provide an indication to the first responder.

[0389] In another example, at least one processor may be configured to receive information about a patient's new or different physical characteristics and use the new information to determine a modified chest compression target criterion. For example, at the initial setup of the system, at least one processor may receive a patient's physical characteristics such as height and / or weight. At least one processor may determine a broad range of reasonable target chest compression criteria. During a rescue event, at least one processor may receive from an input device information representing other physical characteristics of the patient (e.g., AP distance, chest circumference, chest width). When additional information is received or an existing measurement of a physical characteristic is updated, at least one processor may determine a modified target resuscitation criterion that includes a narrower range of reasonable target values, based on, for example, a combination of the initially received physical characteristics and the other physical characteristic information received during the acute care event.

[0390] In some examples, at least one processor may be configured to generate and maintain, during a rescue event, a record of past modified target chest compression criteria and the recorded chest compression parameters corresponding to each of the past modified target chest compression criteria. For example, the modified target chest compression criteria and the recorded chest compression parameter information may be stored in a computer-readable memory associated with the at least one processor. The recorded information may be transmitted to a remote computer device or server continuously or periodically for further processing and / or long-term storage. Information regarding past target chest compression criteria and / or comparisons of target criteria to measured parameters may be utilized to generate a visual summary of the performance of emergency rescuers during a rescue operation. For example, the summary may include a graph showing target criteria for different periods during the rescue operation and whether the emergency rescuers complied with the target for different periods. The graph may facilitate an emergency rescuer's identification of which targets were complied with most frequently and which targets were difficult to comply with. The graph may further show, for example, the impact of a rescuer's fatigue during a rescue operation on the quality of treatment provided to a patient.

[0391] FIG. 12B shows a flowchart depicting a process for determining, improving, or narrowing appropriate target parameters for a patient. The process shown in FIG. 12B is executable by at least one processor of a system that performs chest compressions as described herein to assist a user. The results of the process, including target parameter values, confidence levels of the target parameter values, an estimate of the type of patient (e.g., pediatric or adult), and measurements of physical characteristics about the patient, can be displayed to the user using an appropriate user interface display or feedback device as described herein. The displayed information can be updated during a rescue event if additional information about the patient becomes available. The user interface or feedback device can further be configured to provide an alert or warning to the emergency rescuer if the value of the chest compressions performed by the emergency rescuer is outside the target range or substantially outside the target range (e.g., more than 5% or more than 10% different from the target range). However, it should be understood that the values shown in the flowchart of FIG. 12B are exemplary values of exemplary target chest compression parameters for an exemplary patient. There is no intention to limit the types of feedback or chest compression guidance that can be provided by the guidance system described herein to the values shown in FIG. 12B.

[0392] As shown in FIG. 12B, in the initial state, as shown at 1230, at least one processor is not provided with sufficient information to distinguish between a pediatric patient and an adult patient. Further, as shown at 1232, the target parameter values for depth and rate are not known. Information about the patient's AP distance is provided to determine or estimate parameter values for chest compressions or other resuscitation actions. For example, as shown at 1234, information from sensors and / or a generated three-dimensional representation of the patient can be processed to determine that the patient's AP distance is 12 cm. At 1236, based on the 12 cm AP distance, the processor may determine that the patient is a pediatric patient and may be an infant, toddler, or child. Further, at 1238, the processor estimates that the target compression depth is 3 cm to 5 cm, preferably about 4 cm, with a 75% confidence level. The processor estimates that the target compression rate is 90 cpm to 110 cpm, preferably about 100 cpm. Information about the AP distance and target compression parameters can be displayed on the display screen of the feedback device or on the user interface. At 1240, to further improve the target parameter values, the patient's height (e.g., 80 cm) can be received by the processor. At 1242, based on the received patient height, the processor determines whether the pediatric patient is an infant or a toddler, since children are generally over 80 cm. At 1244, based on the received patient height, the processor determines that the target depth is 2 cm to 4 cm, preferably about 3 cm, and the target rate is 100 cpm to 120 cpm, preferably about 110 cpm, with a 95% confidence level. The display screen or user interface can be updated to include the received patient characteristics and the newly calculated parameter values. For example, the display screen or user interface can be updated to display the patient type (e.g., pediatric or infant), the patient's physical characteristics (e.g., AP distance and height), and the target compression parameters. At 1246, a measurement of the patient's chest width (shown as the LL distance in FIG. 12B) (15 cm) is received. At 1248, based on the received LL distance, the processor determines that the patient is an infant.Further, in box 1250, the processor determines, at a 99% confidence level, that the target compression depth is between 2 cm and 4 cm, preferably about 3 cm, and the target compression rate is between 110 cpm and 130 cpm, preferably about 120 cpm. The display screen or user interface can be updated to display the newly calculated values and the patient's LL distance as described above. System for providing artificial respiration to a patient

[0393] According to another aspect of the present disclosure, the systems and methods described herein can be applied to provide guidance for performing manual ventilation (e.g., artificial respiration) on a patient or to provide settings for operating an electromechanical patient ventilator device.

[0394] Referring to FIG. 13, a patient ventilation system 1310 is shown that is configured to determine target patient ventilation criteria based on the patient's physical characteristics measured in a rescue situation. The system 1310 includes at least one input device 1312, such as a three-dimensional imaging system 1318 or a sensor, for obtaining information representing at least one physical characteristic of the patient. For example, the physical characteristic can be the patient's height, the patient's chest volume, or other physical characteristics as described above. The chest volume can represent the lung volume and, thus, can be relevant for determining target criteria for parameters such as tidal volume. The chest volume can be calculated based on at least one of the AP distance of the patient's chest region, the length of the patient's chest region, and the width of the chest region and the perimeter length of the chest region. As described herein, other non-physical characteristics, such as age and gender, may also be input to determine the target criteria, or the physical characteristics may be input as their estimated or determined values. In another example, using Equation 3 described above, a target criteria for tidal volume can be calculated based on the patient's ideal body weight (IBW). As described above, Equation 3 estimates the available tidal volume of the patient based on the IBW. The IBW for a male or female is calculated from Equation 2 based on the patient's height. The target ventilation tidal volume can vary depending on whether ventilation is being performed in a cardiac arrest or non-cardiac arrest state. For example, in the case of cardiopulmonary resuscitation (CPR) performed in a cardiac arrest state, the target ventilation tidal volume can be in the range of 6 to 10 mL / kg. On the other hand, in a non-cardiac arrest state, the target ventilation tidal volume can be in the range of 6 to 8 mL / kg). The feedback system can include an input for determining whether the patient is in cardiac arrest, and the target ventilation tidal volume can be adjusted in response to the input.

[0395] System 1310 may further include a ventilation device 1350 for providing ventilation treatment to a patient. As shown in FIG. 13, the ventilation device 1350 is a manual ventilation unit including a ventilation bag 1352 connected to a patient ventilation mask 1354 through an air flow path 1356. To provide manual ventilation to the patient, in some examples, the first aider places one or both of his thumbs near the top of the bag 1352 and his fingers under the bag 1352, and grasps the ventilation bag 1352 with one or both of his hands. The first aider compresses the bag 1352 by moving both one or both of his thumbs and one or more fingers together.

[0396] In another example, the ventilation device 1350 includes an electromechanical and / or automatic ventilator (not shown) configured to deliver a plurality of ventilations to the patient according to at least one ventilation criterion. The electromechanical and / or automatic mechanical ventilation device is a mechanical device that delivers positive pressure forced air ventilation to the patient through an air flow path, such as the airway 1356 described above, that is in fluid communication with the patient's airway, as is known in the art. Since it may take time to set up the mechanical ventilation device, a first aider arriving at the rescue situation may provide manual ventilation to the patient during the setup of the ventilator. When the ventilator becomes available, the first aider may attach the ventilator to the patient's airway 1356 so that automatic ventilation can be provided to the patient.

[0397] Referring further to FIG. 13, system 1310 further comprises at least one processor 1330 communicatively coupled to at least one three-dimensional sensor 1318 and a breathing device 1350. Optionally, at least one processor 1330 is an electronic component of a medical device in a rescue situation, such as a mechanical ventilator. In another example, at least one processor 1330 can be a component of a portable computer device in a rescue situation, as in the case of the system described above. In another example, at least one processor 1330 can be located at a location remote from the rescue situation and communicate with the device in the rescue situation, either wired or wirelessly. At least one processor 1330 can be configured to receive and process information representing at least one physical characteristic of a patient to generate a three-dimensional representation of the patient. As in the example above, the three-dimensional representation of the patient can be processed to determine measurements of the patient's physical characteristics. At least one processor 1330 can be further configured to determine at least one breathing criterion for the breathing device 1350 based on the generated three-dimensional representation.

[0398] At least one processor is further configured to cause the breathing device 1350 to provide breathing to the patient based on at least one breathing criterion. In the case of an automatic mechanical ventilator, causing the breathing device to provide breathing according to the calculated target breathing criterion can include automatically adjusting the ventilator settings so that the desired breathing is provided to the patient.

[0399] For a system in which the manual resuscitation device 1350 is a manual resuscitation unit, as shown in FIG. 13, causing the resuscitation device 1350 to provide resuscitation to a patient according to a target criterion may include providing feedback to a rescuer (one or more) to instruct the rescuer to provide resuscitation according to the target value to a feedback device associated with the resuscitation device 1350 in a rescue situation. For example, the feedback may be provided by a visual display 1334, a speaker 1336, or a linear actuator 1338 of the feedback device 1332 such as a portable computer device or a medical device, as described in connection with the above examples. Alternatively, or additionally, the feedback may be provided by a resuscitation feedback device attached to the resuscitation bag 1352 or the air flow path 1356. For example, the resuscitation feedback device may include a linear actuator or a vibration motor that tells the user when to start compressing the resuscitation bag and when to release the resuscitation bag. Alternatively, or additionally, the feedback provided by the resuscitation feedback device may be auditory feedback (e.g., an instruction to compress, squeeze, or release from the speaker of the feedback device) or visual feedback (e.g., an LED indicator on the feedback device may blink or light up to tell the rescuer to compress or release the bag 1352).

[0400] In some examples, the system 1310 further includes a sensor, such as a ventilation sensor 1322, for measuring the airflow provided to the patient to confirm that resuscitation is being provided according to the determined resuscitation criteria. For a system 1310 using a mechanical ventilator, the normal sensor 1322 is not required because the ventilation parameters can be determined from the ventilator settings. However, depending on the situation, a ventilation sensor 1322 may be placed within the patient's airway 1356 to confirm that the resuscitation provided to the patient by the ventilator matches the ventilator settings.

[0401] For a system 1310 that includes a manual patient ventilation unit, measurements from a ventilation sensor 1322 can be used to confirm that the ventilation provided to a patient using the manual ventilation unit meets the determined ventilation criteria. If at least one processor 1330 determines that the ventilation parameters of the ventilation provided to the patient do not meet the ventilation criteria, the at least one processor 1330 may cause the feedback to provide the emergency rescuer with feedback about the difference between the measured parameter and the target reference value. Further, in some examples, if at least one processor 1330 determines that the flow rate and pressure are significantly higher than the target ventilation criteria due to the provided ventilation, the at least one processor 1330 may cause the feedback device 1332 of the system 1310 to provide an indication to the emergency rescuer to warn the emergency rescuer of the potential danger that the ventilation for the patient is excessive. Specifically, for smaller or younger patients, ventilation provided at high flow rates and / or pressures may be inappropriate.

[0402] As another use of the mechanical ventilation system 1310 disclosed herein, assisting the user in placing an endotracheal tube or a breathing tube may be mentioned. When inserting an endotracheal tube or a breathing tube into a patient, the problem is to determine the appropriate insertion depth. The tip of the endotracheal tube or the breathing tube is desirably inserted below the vocal cords to avoid the risk of pharyngeal trauma. However, the tip of the endotracheal tube should be separated from the tracheal keel by at least a distance of 2.0 cm to avoid the risk of endobronchial intubation. The physical characteristics of the patient determined by the system 1310 may be used to determine the appropriate insertion distance of the endotracheal tube. For example, the insertion depth may be based on the physical characteristics of the patient such as the patient's height or the length of the chest. At least one processor 1330 may be configured to receive information about the patient's height and determine an estimated insertion tube distance. The at least one processor may further cause a feedback device such as a display screen of a mechanical ventilator to display the determined estimated endotracheal tube insertion depth. In an exemplary implementation, the system 1310 may provide the following initial recommendations for endotracheal tube depth based on the patient's height. As used herein, the endotracheal tube depth may refer to the insertion depth of the endotracheal tube measured between the patient's mouth and the tip of the endotracheal tube. For patients with a height of less than 20 inches (50.8 cm) (e.g., infants / newborns), the recommended tube insertion depth may be from 4.0 inches (10.16 cm) to 5.0 inches (12.7 cm). For patients with a height of 20 inches (50.8 cm) to 40 inches (101.6 cm) (e.g., small children), the recommended tube insertion depth may be from 5.0 inches (12.7 cm) to 6.0 inches (15.24 cm). For patients with a height of 40 inches (101.6 cm) to 60 inches (152.4 cm) (e.g., large children or small adult females), the recommended tube insertion depth may be from 6.0 inches (15.24 cm) to 7.5 inches (19.05 cm). For patients with a height of 60 inches (152.4 cm) to 68 inches (172.72 cm) (e.g., average adult females or small adult males), the recommended tube insertion depth may be from 7.5 inches (19.05 cm) to 8.25 inches (20.955 cm).For patients with a height from 68 inches (172.72 cm) to 75 inches (190.5 cm) (e.g., large adult females or average adult males), the recommended tube insertion depth can be from 8.25 inches (20.955 cm) to 9.0 inches (22.86 cm). For patients with a height of 75 inches (190.5 cm) or more (e.g., large adult males), the recommended tube insertion depth can be from 9.0 inches (22.86 cm) to 10.0 inches (25.4 cm).

[0403] Figure 14 shows a flowchart depicting the processing performed by at least one processor to provide artificial respiration to a patient using system 1310. At 1410, the processor is configured to receive information representative of at least one physical characteristic of the patient from an input device such as a three-dimensional imaging system. In box 1412, at least one processor is configured to generate a three-dimensional representation of the patient from a three-dimensional scan of the patient recorded by the three-dimensional imaging system. As described herein, the three-dimensional representation can be of a body part of the patient, such as a generated three-dimensional representation of the patient's heart thoracic region. In this case, the three-dimensional representation can be processed to identify heart thoracic measurements such as an AP distance or a heart thoracic width. In another example, the three-dimensional representation is of the entire patient's body. In this case, the three-dimensional representation can be processed to determine both heart thoracic measurements and overall physical characteristic information such as the patient's height and thoracic volume.

[0404] At 1414, optionally, at least one processor may provide a recommendation regarding the placement of an endotracheal tube (or other feedback instructions such as target CPR criteria and CPR techniques) based on the patient's physical characteristics determined or extracted from the generated three-dimensional representation of the patient. For example, at least one processor may be configured to provide a recommended endotracheal tube placement depth based on the patient's physical characteristics such as the patient's height. It is known from research that there is a correlation between the patient's height and the tube insertion depth. The tube is desirably inserted into the patient such that the tip of the tube comes to at least 2 cm above the sternum and at least 2 cm below the vocal cords. In some cases, at least one processor may be configured to obtain an optimal endotracheal tube depth from a look-up table organized based on the patient's height and gender.

[0405] At 1416, at least one processor may be configured to provide an indication regarding the recommended tube placement depth to the first responder on a feedback device. For example, the recommended depth may be displayed on the screen of the feedback device. In some cases, the first responder may be asked to press a button or take other action to confirm that they have seen the estimated tube depth value. Thereafter, the first responder can insert the tube into the patient at the recommended depth. Conventionally, the first responder can monitor the tube depth based on the graduations or markings on the tube itself. In another example, the endotracheal tube may include a sensor or monitor that provides information regarding the tube insertion depth to the first responder. In that case, the first responder can monitor the sensed information regarding the insertion of the tube to determine when the desired depth has been reached.

[0406] At 1418, at least one processor is further configured to determine at least one ventilation criterion for a breathing device based on the generated three-dimensional representation and / or the patient's physical characteristics extracted from the generated three-dimensional representation. As described herein, ventilation parameters computable from the physical characteristics and / or the generated three-dimensional representation include, for example, tidal volume, minute ventilation volume, end-inspiratory pressure, maximum ventilation pressure, and ventilation rate during an acute care event. For example, as described above, using Equation 3, a tidal volume available based on the patient's ideal body weight (IBW) can be calculated.

[0407] At 1420, at least one processor is configured to cause the breathing device to provide ventilation based on at least one ventilation criterion. As described herein, with respect to an electromechanical ventilator, causing the breathing device to provide ventilation according to the determined criterion may include automatically adjusting the settings of the mechanical ventilator to provide appropriate ventilation. With respect to a manual ventilation unit, causing the breathing device to provide ventilation according to the determined criterion may include providing feedback and guidance to the rescuer for performing manual ventilation according to the determined ventilation criterion. The feedback may further include an indication or guidance as to whether the ventilation being performed on the patient meets or substantially meets the determined criterion.

[0408] As in the example above, ventilation may continue to be provided to the patient during the rescue operation according to the determined ventilation criterion. When the patient's physiological assessment indicates that ventilation is no longer necessary, ventilation may be stopped. Further, at least one processor may be configured to periodically receive updated information about the patient's physical characteristics during the rescue operation and generate an updated three-dimensional representation of the patient. The modified ventilation criterion may be determined from the updated three-dimensional representation and used to adjust the settings of the mechanical ventilator or to change the feedback provided to the rescuer. Thereby, the patient receives ventilation according to the modified ventilation criterion.

[0409] Based on the currently most effective examples, a system, method, and technique for providing resuscitation guidance based on a patient's physical characteristics have been described in detail for illustrative purposes. However, these details are for that purpose only, and it should be understood that the present disclosure is not limited to the disclosed examples, but rather is intended to cover variations and equivalent configurations. For example, it will be understood that the present disclosure is intended, to the extent possible, that one or more features of any example can be combined with one or more features of any other example. Other possible items (Item 1) A system for assisting a user in performing chest compressions on a patient during an acute treatment event, at least one input device that provides information representing a plurality of physical characteristics of the patient measured during the acute treatment event, at least one chest compression sensor configured to acquire a signal indicating the chest compressions performed on the patient during the acute treatment event, a feedback device that provides chest compression feedback to the user, and at least one processor communicatively connected to the at least one input device that provides information representing the plurality of physical characteristics and the at least one chest compression sensor, wherein the at least one processor receives and processes the information representing the plurality of physical characteristics of the patient to determine a target chest compression criterion for the patient, receives and processes the signal indicating the chest compressions from the at least one chest compression sensor to calculate at least one chest compression parameter, determines whether the at least one chest compression parameter meets the target chest compression criterion, and is configured to cause the feedback device to provide an indication to the user as to whether the at least one chest compression parameter meets the target chest compression criterion. A system (Item 2) The above-mentioned plurality of physical characteristics include at least two of the anteroposterior (AP) distance of the sternum, the transverse width of the chest, the chest circumference, the total volume of the patient, the chest volume, the abdominal circumference, the size of the neck, the shoulder width, the intracranial volume, the interpupillary distance, the distance between the eyes and the nose, the finger length, the finger width, the hand width, the size of the hand, the length of the toe, the toe width, the foot width, the size of the foot, the chest shape, the height, the weight, and the body mass index (BMI), for the system according to Item 1. (Item 3) The at least one input device for providing information representing the above-mentioned plurality of physical characteristics of the patient includes at least one of a user interface for manually inputting at least one measurement value of the physical characteristics, a two-dimensional camera, a stereoscopic camera, a three-dimensional sensor, a three-dimensional imaging system, a light field camera, and a position sensor or marker disposed on the patient, for the system according to Item 1. (Item 4) The at least one input device includes a three-dimensional imaging system for acquiring information representing the above-mentioned plurality of physical characteristics of the patient, and the processor is configured to generate a three-dimensional representation of at least a part of the patient's body based on the information acquired from the three-dimensional imaging system, for the system according to Item 3. (Item 5) The at least one input device for providing information representing the above-mentioned plurality of physical characteristics of the patient is attached to at least one of the patient, the feedback device, or the user, for the system according to Item 1. (Item 6) Further comprising a smartphone or a computer tablet, The at least one input device for providing information representing the above-mentioned plurality of physical characteristics of the patient includes the camera of the smartphone or the computer tablet, and the at least one processor includes the processor of the smartphone or the computer tablet, for the system according to Item 1. (Item 7) The feedback device is the system according to item 6, including the visual display of the smartphone or the computer tablet. (Item 8) The plurality of physical characteristics are measured during inhalation or exhalation, and the system is as described in item 1. (Item 9) At least one of the plurality of physical characteristics includes anthropometric characteristics of the patient, and the system is as described in item 1. (Item 10) The anthropometric characteristics of the patient include at least one of the rib cage shape, the ratio of the AP distance to the width of the rib cage, the rib cage volume, and the total volume of the patient, and the system is as described in item 9. (Item 11) The chest compression sensor includes at least one of a single-axis accelerometer, a multi-axis accelerometer, and a gyroscope, and the system is as described in item 1. (Item 12) The feedback device includes at least one of a computer tablet, a smartphone, a personal digital assistant, a patient monitor device, a defibrillator, and a chest compression guidance device configured to be placed on the chest of the patient, and the system is as described in item 1. (Item 13) The feedback device is configured to provide at least one of auditory, visual, and tactile feedback, and the system is as described in item 1. (Item 14) The target chest compression criteria and the measured chest compression parameters include at least one of compression depth, compression rate, decompression rate, compression stop, and decompression, and the system is as described in item 1. (Item 15) The target chest compression criteria for compression depth include a depth of 0.2 inches (0.508 cm) to 3.5 inches (8.89 cm), and the system is as described in item 14. (Item 16) The above-mentioned target chest compression criteria for compression depth include at least one of the depths from 0.2 inches (0.508 cm) to 0.75 inches (1.905 cm) for patients with an AP distance of less than 3 inches (7.62 cm), from 0.75 inches (1.905 cm) to 1.25 inches (3.175 cm) for patients with an AP distance of 4.0 inches (10.16 cm) to 5.0 inches (12.7 cm), from 1.25 inches (3.175 cm) to 1.75 inches (4.445 cm) for patients with an AP distance of 6.0 inches (15.24 cm) to 8.0 inches (20.32 cm), from 1.75 inches (4.445 cm) to 2.25 inches (5.715 cm) for patients with an AP distance of 9.0 inches (22.86 cm) to 11.0 inches (27.94 cm), from 2.25 inches (5.715 cm) to 2.75 inches (6.985 cm) for patients with an AP distance of 10 inches (25.4 cm) to 12 inches (30.48 cm), and from 2.75 inches (6.985 cm) to 3.5 inches (8.89 cm) for patients with an AP distance of 13 inches (33.02 cm) or more, of the system described in item 14. (Item 17) The above-mentioned target chest compression criteria for chest compression rate include a rate from 100 cpm to 160 cpm, of the system described in item 14. (Item 18) The above-mentioned target chest compression criteria for compression rate include at least one of the rates from 140 cpm to 160 cpm for patients with an AP distance of less than 3.0 inches (7.62 cm), from 130 cpm to 150 cpm for patients with an AP distance of 4.0 inches (10.16 cm) to 5.0 inches (12.7 cm), from 120 cpm to 140 cpm for patients with an AP distance of 6.0 inches (15.24 cm) to 8.0 inches (20.32 cm), from 110 cpm to 130 cpm for patients with an AP distance of 9.0 inches (22.86 cm) to 11 inches (27.94 cm), or from 100 cpm to 120 cpm for patients with an AP distance of 12 inches (30.48 cm) or more, of the system described in item 14. (Item 19) The above target chest compression criteria for the target chest compression release speed include from 150 inches (381 cm) / minute to 600 inches (1524 cm) / minute, and the system described in item 14. (Item 20) The above target chest compression criteria for the target chest compression release speed include at least one of from 150 inches (381 cm) to 250 inches (635 cm) / minute for patients with an AP distance of less than 3.0 inches (7.62 cm), from 200 inches (508 cm) to 300 inches (762 cm) / minute for patients with an AP distance of 4.0 inches (10.16 cm) to 5.0 inches (12.7 cm), from 250 inches (635 cm) to 400 inches (1016 cm) / minute for patients with an AP distance of 6.0 inches (15.24 cm) to 8.0 inches (20.32 cm), or from 250 inches (635 cm) to 600 inches (1524 cm) / minute for patients with an AP distance of 10 inches (25.4 cm) or more, and the system described in item 14. (Item 21) The above plurality of physical characteristics of the above patient include at least one of the anteroposterior distance of the patient's thoracic region, the lateral width of the thorax, the chest circumference, the total volume of the patient, the thoracic volume, the waist circumference, the size of the neck, the shoulder width, the cranial content volume, the interpupillary distance, the distance between the eyes and the nose, the finger length, the finger width, the hand width, the size of the hand, the length of the toe, the toe width, the foot width, the size of the foot, the thoracic shape, the height, the weight, and the body mass index (BMI). The above target chest compression criteria include the target chest compression depth for the above patient, and the system described in item 1. (Item 22) The above indication to the above user provided by the above feedback device includes an instruction to increase the chest compression depth, reduce the chest compression depth, or maintain the chest compression depth, which is determined based on the above determination of whether the above chest compression parameters meet the above target chest compression criteria, and the system described in item 21. (Item 23) The above at least one processor determines the above target chest compression criteria for the above patient based on the above plurality of physical characteristics and values determined from a look-up table and / or calculated by a linear regression equation, and the system described in item 1. (Item 24) The at least one processor is further configured to determine a patient type based on the plurality of physical characteristics and cause the feedback device to provide an indication about the patient type to the user, for the system according to item 1. (Item 25) The patient type includes a pediatric patient or an adult patient, for the system according to item 24. (Item 26) The patient type includes at least one of a neonate, an infant, a small child, a large child, a small adult, an average-sized adult, or a large adult, for the system according to item 24. (Item 27) The at least one processor after the chest compression has been performed for a predetermined period, receives and processes updated information representing the plurality of physical characteristics of the patient from the at least one device to determine a modified target chest compression criterion, determines whether the at least one chest compression parameter meets the modified target chest compression criterion, and is further configured to cause the feedback device to provide an indication to the user as to whether the at least one chest compression parameter meets the modified target chest compression criterion, for the system according to item 1. (Item 28) The updated information representing the plurality of physical characteristics includes updated information about the anteroposterior distance of the patient's heart-thoracic region, and the modified target chest compression criterion includes a modified target chest compression depth that is at least partially based on the updated information about the anteroposterior distance of the patient's heart-thoracic region, for the system according to item 27. (Item 29) The at least one processor is further configured to cause the feedback device to provide an indication to the user if the modified target chest compression criterion is different from the initial target chest compression criterion by comparing the initial target chest compression criterion with the modified target chest compression criterion, the system according to item 27. (Item 30) The at least one processor is configured to maintain a record of past modified target chest compression criteria and recorded chest compression parameters corresponding to each of the past modified target chest compression criteria, the system according to item 27. (Item 31) The predetermined period before receiving the updated information includes a period determined based on the initial information representing the plurality of physical characteristics and the target chest compression criterion, the system according to item 27. (Item 32) The at least one processor is further configured to cause the feedback device to provide an indication to the user to perform the recommended chest compression technique by determining a recommended chest compression technique for the patient based on the plurality of physical characteristics of the patient, the system according to item 1. (Item 33) The recommended chest compression technique is based on at least one change of the plurality of physical characteristics of the patient during a predetermined period, the system according to item 32. (Item 34) The recommended chest compression technique includes at least one of two-handed chest compression, one-handed chest compression, wrapped thumb chest compression, and two-finger chest compression, the system according to item 32. (Item 35) The recommended chest compression technique includes active chest decompression, the system according to item 32. (Item 36) The plurality of physical characteristics includes the anteroposterior sternal distance, and the active chest decompression as the recommended chest compression technique is based on a decrease in the anteroposterior sternal distance, the system according to item 35. (Item 37) The indication for performing active chest decompression is the indication for performing chest decompression using at least one of a suction cup device, an adhesion device, and a hook-and-loop fastener device, and / or an instruction to apply pressure to the side or abdomen of the patient, for the system according to item 35. (Item 38) The at least one processor is further configured to determine, during a rescue operation, a ratio of a time during which the measured chest compression parameter does not meet the target chest compression criterion, and if the ratio of the time exceeds a predetermined value, cause the feedback device to provide an indication to the user, for the system according to item 1. (Item 39) The indication to the user when the ratio of the time exceeds the predetermined value includes an instruction to start executing a second chest compression technique different from the initial chest compression technique executed during the predetermined period, for the system according to item 38. (Item 40) The initial chest compression technique includes two-handed chest compression, and the second chest compression technique includes performing chest compression together with active chest decompression, for the system according to item 39. (Item 41) The initial chest compression technique includes one-handed chest compression or two-handed chest compression, and the second chest compression technique includes two-finger chest compression, for the system according to item 39. (Item 42) The at least one processor is configured to receive confirmation from the user when the user starts the second chest compression technique, for the system according to item 39. (Item 43) The system according to item 1, further comprising at least one ventilation sensor configured to measure at least one of tidal volume, minute ventilation volume, end-inspiratory pressure, maximum ventilation pressure, and ventilation rate during the acute treatment event. (Item 44) The ventilation sensor includes an airflow sensor and / or a pressure sensor disposed within an air flow path of a ventilator unit that is in fluid communication with the airway of the patient, for the system according to item 43. (Item 45) The ventilation sensor includes at least a first absolute atmospheric pressure sensor and a second absolute atmospheric pressure sensor separated by a flow limiter for measuring the flow velocity and pressure of the airflow in the airflow path, and the system according to Item 43. (Item 46) The target chest compressio...

Claims

1. A system for assisting a user in performing chest compressions on a patient during a series of procedures for resuscitating the patient, comprising: at least one input device configured to provide, during the series of procedures, information representing a plurality of physical characteristics of the patient related to providing feedback on the chest compressions; at least one chest compression sensor configured to acquire a signal indicative of the chest compressions performed on the patient during the series of procedures; a feedback device configured to provide chest compression feedback to the user; at least one processor communicatively connected to the at least one input device configured to provide information representing the plurality of physical characteristics and the at least one chest compression sensor, wherein the at least one processor is configured to: receive the information representing the plurality of physical characteristics of the patient, and determine a target chest compression criterion, which is a criterion to be targeted by the user in performing the chest compressions on the patient, for at least one of compression depth, compression rate, decompression rate, time between compressions in a compression cycle, and timing of complete decompression of the compression, based on the plurality of physical characteristics and values determined from a look-up table and / or calculated by a linear regression formula; receive the signal indicative of the chest compressions from the at least one chest compression sensor, and calculate at least one chest compression parameter based on the signal; determine whether the at least one chest compression parameter meets the target chest compression criterion; configure the feedback device to provide an indication to the user as to whether the at least one chest compression parameter meets the target chest compression criterion; the at least one processor is further configured to: after the chest compressions have been performed for a predetermined period, receive new information representing the plurality of physical characteristics of the patient from the at least one device, and determine a modified target chest compression criterion based on the new information; determine whether the at least one chest compression parameter meets the modified target chest compression criterion; further configure the feedback device to provide an indication to the user as to whether the at least one chest compression parameter meets the modified target chest compression criterion; The new information representing the plurality of physical characteristics includes new information about the anteroposterior (AP) sternal distance, and the modified target chest compression criterion includes a modified target chest compression depth that is at least partially based on the new information about the anteroposterior (AP) sternal distance. System. **Claim 2** The plurality of physical characteristics includes at least two of anteroposterior (AP) sternal distance, chest width, chest circumference, total patient volume, torso circumference, neck size, shoulder width, interpupillary distance, distance between the eyes and nose, finger length, finger width, hand width, hand size, toe length, toe width, foot width, foot size, height, weight, and body mass index (BMI). The system according to claim 1. **Claim 3** The at least one input device for providing information representing the plurality of physical characteristics of the patient includes at least one of a user interface for manually entering at least one measurement of the plurality of physical characteristics, a two-dimensional camera, a stereoscopic camera, a three-dimensional sensor, a three-dimensional imaging system, a light field camera, and a position sensor disposed on the patient. The system according to claim 1. **Claim 4** The at least one input device includes a three-dimensional imaging system for acquiring information representing the plurality of physical characteristics of the patient, and the processor is configured to generate a three-dimensional representation of at least a part of the patient's body based on the information acquired from the three-dimensional imaging system. The system according to claim 3. **Claim 5** The at least one input device for providing information representing the plurality of physical characteristics of the patient is at least one of a device disposed near the patient, a device attached to the feedback device, or a device attached to the user performing the chest compression on the patient. The system according to claim 1. **Claim 6** Further comprising a smartphone or a computer tablet, The at least one input device for providing information representing the plurality of physical characteristics of the patient includes the camera of the smartphone or the computer tablet, and the at least one processor includes the processor of the smartphone or the computer tablet. The system according to claim 1. **Claim 7** The system of claim 6, wherein the feedback device includes a visual display of the smartphone or the computer tablet.

8. The system of any one of claims 1 to 7, wherein the input device provides the information representing the plurality of physical characteristics measured during the series of processes.

9. The system of any one of claims 1 to 8, wherein at least one of the plurality of physical characteristics includes a ratio of an AP distance to a transverse width of the chest.

10. The system of any one of claims 1 to 9, wherein the chest compression sensor includes at least one of a single-axis accelerometer, a multi-axis accelerometer, and a gyroscope.

11. The system of any one of claims 1 to 10, wherein the feedback device includes at least one of a computer tablet, a smartphone, a personal digital assistant, a patient monitoring device, a defibrillator, and a chest compression guidance device that can be placed on the chest of the patient.

12. The system of any one of claims 1 to 11, wherein the feedback device is configured to provide at least one of auditory, visual, and tactile feedback.

13. The system of any one of claims 1 to 12, wherein the target chest compression criterion for compression depth is within a depth range of 0.2 inches (0.508 cm) to 3.5 inches (8.89 cm).

14. The target chest compression criteria for compression depth are within a depth range of 0.2 inches (0.508 cm) to 0.75 inches (1.905 cm) for patients with an AP distance of less than 3 inches (7.62 cm), within a depth range of 0.75 inches (1.905 cm) to 1.25 inches (3.175 cm) for patients with an AP distance of 4.0 inches (10.16 cm) to 5.0 inches (12.7 cm), within a depth range of 1.25 inches (3.175 cm) to 1.75 inches (4.445 cm) for patients with an AP distance of 6.0 inches (15.24 cm) to 8.0 inches (20.32 cm), within a depth range of 1.75 inches (4.445 cm) to 2.25 inches (5.715 cm) for patients with an AP distance of 9.0 inches (22.86 cm) to 11.0 inches (27.94 cm), within a depth range of 2.25 inches (5.715 cm) to 2.75 inches (6.985 cm) for patients with an AP distance of 10 inches (25.4 cm) to 12 inches (30.48 cm), and within a depth range of 2.75 inches (6.985 cm) to 3.5 inches (8.89 cm) for patients with an AP distance of 13 inches (33.02 cm) or more, at least one of which is the system according to claim 12.

15. The target chest compression criteria for chest compression rate are within a rate range of 100 cpm to 160 cpm, the system according to any one of claims 1 to 14.

16. The target chest compression criteria for compression rate are within a rate range of 140 cpm to 160 cpm for patients with an AP distance of less than 3.0 inches (7.62 cm), within a rate range of 130 cpm to 150 cpm for patients with an AP distance of 4.0 inches (10.16 cm) to 5.0 inches (12.7 cm), within a rate range of 120 cpm to 140 cpm for patients with an AP distance of 6.0 inches (15.24 cm) to 8.0 inches (20.32 cm), within a rate range of 110 cpm to 130 cpm for patients with an AP distance of 9.0 inches (22.86 cm) to 11 inches (27.94 cm), or within a rate range of 100 cpm to 120 cpm for patients with an AP distance of 12 inches (30.48 cm) or more, at least one of which is the system according to any one of claims 1 to 14.

17. The target chest compression reference for the target chest compression release speed is within a compression release speed range of 150 inches (381 cm) / minute to 600 inches (1524 cm) / minute, for the system according to any one of claims 1 to 16.

18. The target chest compression reference for the target chest compression release speed is within a compression release speed range of 150 inches (381 cm) to 250 inches (635 cm) / minute for patients with an AP distance of less than 3.0 inches (7.62 cm), within a compression release speed range of 200 inches (508 cm) to 300 inches (762 cm) / minute for patients with an AP distance of 4.0 inches (10.16 cm) to 5.0 inches (12.7 cm), within a compression release speed range of 250 inches (635 cm) to 400 inches (1016 cm) / minute for patients with an AP distance of 6.0 inches (15.24 cm) to 8.0 inches (20.32 cm), or within a compression release speed range of 250 inches (635 cm) to 600 inches (1524 cm) / minute for patients with an AP distance of 10 inches (25.4 cm) or more, and is at least one of these, for the system according to any one of claims 1 to 16.

19. The plurality of physical characteristics of the patient include at least one of the anteroposterior (AP) distance of the sternum, the transverse width of the chest, the chest circumference, the total volume of the patient, the waist circumference, the size of the neck, the shoulder width, the interpupillary distance, the distance between the eyes and the nose, the finger length, the finger width, the hand width, the size of the hand, the length of the toe, the toe width, the foot width, the size of the foot, the height, the weight, and the body mass index (BMI). The target chest compression reference includes the target chest compression depth for the patient, for the system according to any one of claims 1 to 18.

20. The indication to the user provided by the feedback device is determined based on the determination of whether the at least one chest compression parameter meets the target chest compression reference, and includes an instruction to increase the chest compression depth, reduce the chest compression depth, or maintain the chest compression depth, for the system according to claim 19.

21. The at least one processor is further configured to determine the type of patient based on the plurality of physical characteristics and cause the feedback device to provide an indication about the type of patient to the user, for the system according to any one of claims 1 to 20.

22. The system according to claim 21, wherein the type of the patient includes a pediatric patient or an adult patient.

23. The system according to claim 21, wherein the type of the patient includes at least one of a neonate, an infant, a small child, a large child, a small adult, an average-sized adult, or a large adult.

24. The at least one processor determines, for a predetermined period during which the chest compression is performed, a ratio of a time during which the at least one chest compression parameter does not meet the target chest compression criteria, and if the ratio of the time exceeds a predetermined value, the at least one processor is further configured to cause the feedback device to provide an indication to the user. The system according to any one of claims 1 to 23.

25. The indication to the user when the ratio of the time exceeds the predetermined value includes an instruction to start performing a second chest compression technique different from an initial chest compression technique proposed by the at least one processor to perform during the predetermined period. The system according to claim 24.

26. The initial chest compression technique includes two-handed chest compression, and the second chest compression technique includes performing chest compression together with active chest decompression. The system according to claim 25.

27. The initial chest compression technique includes one-handed chest compression or two-handed chest compression, and the second chest compression technique includes two-finger chest compression. The system according to claim 25.

28. The at least one processor is configured to require the user to affirmatively confirm the instruction to start performing the second chest compression technique. The system according to any one of claims 25 to 27.

29. The system according to any one of claims 1 to 28, further comprising at least one ventilation sensor configured to measure at least one of tidal volume, minute ventilation, end-inspiratory pressure, maximum ventilation pressure, and ventilation rate during the series of processes.

30. The ventilation sensor includes an airflow sensor and / or a pressure sensor disposed within an air flow path of a breathing unit in fluid communication with the airway of the patient. The system according to claim 29.

31. The ventilation sensor includes at least a first absolute atmospheric pressure sensor and a second absolute atmospheric pressure sensor separated by a flow restrictor for measuring the flow velocity and pressure of the airflow within the air flow path. The system according to claim 29.

32. The at least one input device that provides information representing the plurality of physical characteristics of the patient further provides the age or gender of the patient, and the target chest compression criterion is determined based at least in part on the plurality of physical characteristics of the patient and the age or gender, the system according to any one of claims 1 to 31.

33. The plurality of physical characteristics of the patient includes at least one of the anteroposterior (AP) distance of the sternum, the transverse width of the chest, and the chest circumference, and the target chest compression criterion includes a target chest compression depth for the patient, the system according to any one of claims 1 to 32.

34. The plurality of physical characteristics of the patient includes at least one of the anteroposterior (AP) distance of the sternum and the length, volume, or weight of any distinguishable and measurable part of the patient's body, and the target chest compression criterion includes a target chest compression depth for the patient, the system according to any one of claims 1 to 32.

35. The plurality of physical characteristics of the patient includes the anteroposterior (AP) distance of the sternum and a characteristic or feature indicating the build of the patient, the system according to any one of claims 1 to 32.

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