Cardiopulmonary Resuscitation Decision Support

Abstract

According to one aspect, there is provided a system for providing cardiopulmonary resuscitation (CPR) decision support, the system comprising: a photoplethysmography (PPG) detection unit configured to determine one or more PPG signals at measurement sites on a subject; a core unit having a user interface; a motion detection unit configured to detect movement on the subject correlating with chest compressions during compression therapy; and a processing unit configured to perform: determining the presence or absence of a spontaneous pulse based on the detected movement correlating with chest compressions during compression therapy on the subject and the one or more PPG signals; determining a recommendation to be provided based on the determination of the presence or absence of the spontaneous pulse, the recommendation being associated with CPR decision support; and controlling the user interface to output the determined recommendation.

Description

Technical Field

[0001] The present disclosure relates to a system for providing cardiopulmonary resuscitation (CPR) decision support and a method of operating the same.

Background Art

[0002] During cardiopulmonary resuscitation (CPR), pulse checking is mainly performed by palpation. Palpation requires interruption of chest compressions, is subjective, difficult, and time-consuming. As a result, palpation can interrupt chest compressions for longer than 10 seconds, as recommended by medical guidelines. Palpation tends to be time-consuming, especially when potentially perfusing the electrocardiogram (ECG) rhythm. These long interruptions can have an adverse effect on the outcome of CPR.

Summary of the Invention

Problems to be Solved by the Invention

[0003] There are several currently available objective methods for checking the state of circulation during CPR. For example, invasive arterial blood pressure (iABP) measurement can directly observe when the heart resumes beating, and during compression, a quantified measurement of the state of circulation can also be obtained. However, iABP measurement is invasive and thus not a common practice during CPR. As an alternative, waveform capnography is a less invasive objective method that provides information regarding the state of circulation. Nevertheless, capnography still requires intubation, and the interpretation of end-tidal CO2 levels requires well-controlled ventilation, and it does not provide any measurement of spontaneous pulse rate (PR).

[0004] As mentioned above, there are many drawbacks associated with currently available methods for checking circulatory status during compression therapy. Furthermore, the pulse oximetry sockets of some currently available systems do not support the intended application scenarios of CPR, and such applications require internal signal fusion along with significant modifications to the firmware within the monitor. In addition, the measurement sockets of currently available monitors do not facilitate access to additional sensor signals (e.g., accelerometer, ambient light conditions, etc.) that have the necessary synchronization in signal acquisition. To date, there is no method to assist in pulse detection during CPR that is objective, non-invasive, easy to use, and provides flexibility in the use of reference signals corresponding to compression. [Means for solving the problem]

[0005] This disclosure describes the use of motion-robust photoplethysmography (PPG) for the purpose of determining pulses during compression therapy. Pre-clinical and clinical data demonstrate the good potential of using PPG to detect spontaneous pulses during pauses and progressive compressions in CPR. Furthermore, algorithms for the automated detection of spontaneous pulses in PPG signals during CPR have been developed. For example, International Patent Application No. 2017 / 211814 describes a technique that can use PPG signals to detect the recovery (or continued presence) of spontaneous pulses during the application of CPR. These algorithms rely on frequency analysis and require a reference signal to process artifacts caused by compression in order to reveal the presence of potentially present spontaneous pulse signals. Today, transthoracic impedance signals from defibrillators or monitors are used as reference signals for chest compressions. However, the applicability of this approach is limited because it requires the full integration of such algorithms into the monitor (or defibrillator).

[0006] Nevertheless, one way to implement PPG as a method for detecting spontaneous heartbeats during compression therapy is to implement essential system components outside the monitor or defibrillator to facilitate basic functionality. This concept is sometimes called "smart cabling" or "smart measurement." In some currently available systems, the measurement hardware is integrated into a cable connected by a standardized interface. In these systems, the monitor can be the user interface, but can also be the processing unit.

[0007] Therefore, it is beneficial to provide an improved system that enables motion-robust, low-perfusion pulse oximetry-based CPR decision support as a standalone monitoring tool to assist both manual and automated CPR.

[0008] According to a first particular embodiment, a system is provided for providing cardiopulmonary resuscitation (CPR) decision support, comprising: a photoplethysmography (PPG) detection unit configured to determine one or more PPG signals at measurement sites on a subject; a core unit having a user interface; a motion detection unit configured to detect movements correlated with chest compressions during compression therapy to a subject; a processing unit configured to perform the steps of: determining the presence or absence of a spontaneous heartbeat based on the detected movements correlated with chest compressions during compression therapy to a subject; determining a recommendation to be provided based on the determination of the presence or absence of a spontaneous heartbeat, wherein the recommendation is associated with CPR decision support; and controlling the user interface to output the determined recommendation.

[0009] In some embodiments, the motion detection unit may be part of the core unit.

[0010] In some embodiments, if it is determined that a spontaneous heartbeat is present, the recommendation determined may be to perform further checks for the presence of the heartbeat and / or to discontinue administration of vasopressors.

[0011] In some embodiments, if it is determined that no spontaneous pulse is present, the determined recommendation may be to continue compression therapy on the subject.

[0012] In some embodiments, the PPG detection unit may have at least one of the alae PPG sensors, columella PPG sensors, conchae PPG sensors, and forehead PPG sensors. In these embodiments, the PPG detection unit may have two or more of the alae PPG sensors, columella PPG sensors, conchae PPG sensors, and forehead PPG sensors, and the user interface may be configured to receive user input indicating at least one sensor to be activated to determine one or more PPG signals. Alternatively or additionally, the processing unit may receive signal quality indicators corresponding to one or more of the PPG sensors, and one or more PPG sensors may be activated based on the received signal quality indicators. Alternatively or additionally, one or more PPG sensors may be activated based on the received user input and the received signal quality indicators.

[0013] In some embodiments, the processing unit can be further configured to acquire the core body temperature value of the subject and control the user interface to output at least one of the following: the detected core body temperature, an indication that the detected core body temperature is within a predetermined target range or at a predetermined target value, and an indication that the detected core body temperature is within a predetermined target range or approaching a predetermined target value.

[0014] In some embodiments, the processing unit may be further configured to acquire at least one of the electrocardiogram (ECG) signal associated with the subject and a signal indicating the subject's nasal airflow. In these embodiments, determining the recommendation to be provided may further be based on at least one of the acquired ECG signal and nasal airflow signal of the subject.

[0015] In some embodiments, the processing unit may be further configured to perform the steps of: determining whether the amplitude and / or signal quality corresponding to detected motion correlated with chest compressions during compression therapy on a subject is within a predetermined target range; and controlling the user interface to output at least one of the following: a display of the result of the determination of whether the amplitude and / or signal quality is within the predetermined target range; and a command to adjust the position of the built-in motion detection unit or a core unit having a motion detection unit.

[0016] In some embodiments, the processing unit can be implemented in a mobile device and can be configured to wirelessly connect to at least one of the core unit, motion detection unit, and PPG detection unit.

[0017] In some embodiments, the processing unit may be part of a core unit, which may be configured to be positioned on or adjacent to the upper part of the chest region of the subject.

[0018] In some embodiments, the core unit can be implemented in a mobile device.

[0019] In some embodiments, the mobile device may be a smartphone.

[0020] According to a second specific embodiment, a method is provided for operating a system that provides cardiopulmonary resuscitation (CPR) decision support, the system comprising a photoplethysmography (PPG) detection unit, a core unit having a user interface, a motion detection unit, and a processing unit, the method comprising: a step of determining one or more PPG signals at a measurement site of a subject in the PPG detection unit; a step of detecting movements of the subject that correlate with chest compressions during compression therapy in the motion detection unit; a step of determining the presence or absence of a spontaneous heartbeat based on the movements of the subject that correlate with chest compressions during compression therapy in the processing unit; a step of determining a recommendation to be provided based on the determination of the presence or absence of a spontaneous heartbeat in the processing unit; and a step of controlling the user interface in the processing unit to output the determined recommendation.

[0021] The limitations of existing technologies are addressed by the embodiments and models described above. In particular, at least some of the embodiments and models described above provide a cost-effective standalone “smart cable” solution compared to fully integrated PPG measurement approaches in monitors or defibrillators. Some embodiments and models further offer easy compatibility with third-party systems (for example, when used with a CPR robot, compressions are not interrupted if no pulse is present, and compressions can be stopped according to a determined recommendation if the presence of a pulse is detected). Furthermore, some embodiments and models allow the measurements required for CPR-proof pulse oximetry to be used as a criterion for detecting spontaneous pulses, while providing flexibility in the use of various different signals corresponding to compressions. Moreover, at least some of the embodiments and models employ both wired and wireless transmission technologies and modes, which can reduce or avoid clutter problems, particularly during cardiopulmonary resuscitation.

[0022] These and other embodiments will be evident from the embodiments described below and will be explained with reference thereto. Brief Description of the Drawings

[0023] Exemplary embodiments are described by way of example only, with reference to the following drawings. **Brief Description of the Drawings**

[0024] [Figure 1] FIG. 1 is a block diagram of a system for providing cardiopulmonary resuscitation (CPR) decision-making support. [Figure 2] FIG. 2 is a flowchart for operating a system for providing cardiopulmonary resuscitation (CPR) decision-making support according to an embodiment. **Modes for Carrying Out the Invention**

[0025] As described above, an object of the present invention is to provide an improved system and an operating method thereof that address conventional problems.

[0026] FIG. 1 is a block diagram of a system 100 for providing cardiopulmonary resuscitation (CPR) decision-making support. The system 100 does not require incorporation into a patient monitor or defibrillator and can be used in scenarios such as out-of-hospital CPR to perform functions as described below.

[0027] As shown in Figure 1, system 100 includes a photoplethysmography (PPG) detection unit 110, a core unit 120, a motion detection unit 130, and a processing unit 140. The connections between the components of system 100, particularly between the core unit 120 and the other components, and between the processing unit 140 and the other components, can be implemented wirelessly, for example, by GSM (Global System for Mobile Communications), Bluetooth, Bluetooth Low Energy, and / or near-field communication (NFC). In some embodiments, the connection between the PPG detection unit 110 and the core unit 120 can be implemented via a digital signal interface, for example. Furthermore, in some embodiments, at least some of the connections between the components of system 100 may be switchable between wired and wireless.

[0028] The PPG detection unit 110 is configured to determine one or more PPG signals at measurement sites on the subject. The PPG detection unit 110 may have a low-perfusion oximetry sensor, and more specifically, the PPG detection unit 110 may have at least one of alar PPG sensors, columella PPG sensors, concha PPG sensors, and forehead PPG sensors.

[0029] The core unit 120 further includes a user interface 122. The user interface 122 can be used to provide information resulting from the techniques described herein to a user of system 100. Alternatively or additionally, the user interface 122 can be configured to receive user input. For example, the user interface 122 can allow a user of system 100 to manually input commands, data, or information.

[0030] User interface 122 may be any user interface that enables the rendering (or output or display) of information to the user of system 100. Alternatively or additionally, user interface 122 may be any user interface that enables the user of system 100 to provide user input, interact with system 100, and / or control it. For example, user interface 122 may have one or more switches, one or more buttons, a keypad, a keyboard, a touchscreen or application (e.g., on a tablet or smartphone), a display screen, a graphical user interface (GUI) or other visual rendering component, one or more speakers, one or more microphones or any other audio component, one or more lights, a component for providing haptic feedback (e.g., a vibration function), any other user interface, or a combination of user interfaces.

[0031] As described above, in some embodiments, the PPG detection unit 110 may have at least one of the alae PPG sensors, columella PPG sensors, conchae PPG sensors, and forehead PPG sensors. In these embodiments, the PPG detection unit 110 may have two or more of the alae PPG sensors, columella PPG sensors, conchae PPG sensors, and forehead PPG sensors, and the user interface 122 may also be configured to receive user input indicating at least one sensor to act to determine one or more PPG signals. Alternatively or additionally, the processing unit 140 may receive signal quality indicators corresponding to one or more of the PPG sensors, and one or more PPG sensors may be activated under the control of the processing unit 140 based on the received signal quality indicators (i.e., the processing unit 140 may determine at least one of the one or more PPG sensors to be activated based on the received signal quality indicators). Alternatively or additionally, one or more PPG sensors may be activated based on the received user input and the received signal quality indicators. Therefore, users can decide which sensor to use based, for example, on the best compatibility with their workflow. For instance, this decision might be based on whether the subject's ventilation is performed using a mask or via intubation.

[0032] The motion detection unit 130 is configured to detect movements correlated with chest compressions during compression therapy on a subject. In some embodiments, the motion detection unit 130 may be part of the core unit 120. The motion detection unit 130 may have one or more accelerometers.

[0033] The processing unit 140 is configured to determine the presence or absence of a spontaneous heartbeat based on detected motion (from the motion detection unit 130) that correlates with chest compressions during compression therapy of the subject, and one or more PPG signals (from the PPG detection unit 110). For example, an accelerometer trace of the detected motion can be used as a criterion for chest compressions, and as a result, the effect of compression therapy can be taken into consideration in determining the presence or absence of a spontaneous heartbeat. In some embodiments, this determination can be performed according to one or more algorithms developed for the purpose of detecting the recovery (or continued presence) of a spontaneous heartbeat during the application of CPR, such as the technique described in International Application Brochure No. 2017 / 211814, which includes a method that yields a result output of classified heartbeat states ("no heartbeat", "heartbeat", and "uncertain"), the detection based on the compression criterion signal and the PPG signal.

[0034] The processing unit 140 is further configured to determine recommendations to be provided based on the determination of the presence or absence of a spontaneous heartbeat, and such recommendations are associated with CPR decision support. For example, if the processing unit 140 determines that a spontaneous heartbeat is present, the recommendation may be to perform further checks for the presence of a heartbeat and / or to discontinue administration of vasopressors, and / or if the processing unit 140 determines that a spontaneous heartbeat is absent, the recommendation may be to continue compression therapy to the subject.

[0035] Since the recommendations are determined based on the presence or absence of a spontaneous heartbeat, these recommendations can improve patient safety, especially when using automated CPR techniques (e.g., CPR robots), as they can provide recommendations such as "further check for the presence of a heartbeat," which encourages the user to check for the presence of a heartbeat before discontinuing or continuing CPR treatment. Furthermore, the determined recommendations can improve patient care outcomes by avoiding unnecessary heartbeat checks and associated interruptions to compression therapy.

[0036] The processing unit 140 is further configured to control the user interface 122 to output the determined recommendation, for example, via the display screen of the user interface 122. As a more specific example, the output may include text information that indicates, "Perform further checks for the presence of a pulse," "Discontinue administration of vasopressors," or "Continue CPR," via the display screen of the user interface 122.

[0037] In some embodiments, one or more other important basic vital signs (e.g., SpO2, pulse rate, core temperature, and respiratory rate) may be monitored by the system 100 to provide further information about the patient's condition or to provide further advice during CPR treatment or after recovery of spontaneous circulation (ROSC). For example, in some embodiments, the processing unit 140 may be configured to acquire the subject's core body temperature (CBT) value and control the user interface 122 to output at least one of the following: the detected core body temperature, an indication that the detected core body temperature is within a predetermined target range or at a predetermined target value, and an indication that the detected core body temperature is within a predetermined target range or approaching a predetermined target value. During CPR, the controlled reduction and / or maintenance of appropriate CBT is important for the outcome of CPR (e.g., to preserve brain function). Therefore, by indicating the CBT (and / or whether the CBT is within the target range or at the target value) via the user interface 122, the user can be provided with useful information during CPR that may help them achieve the desired outcome more efficiently and effectively.

[0038] For this purpose, the system 100 may further include a deep body temperature (CBT) detection unit, which is configured to detect the deep body temperature of the subject. Thus, in these embodiments, the subject's CBT value can be obtained from the CBT detection unit by the processing unit 140. Furthermore, in some embodiments, the CBT detection unit may be part of the core unit 120. Alternatively, the subject's CBT value may also be provided by a CBT detection unit located outside the system 100.

[0039] In some embodiments, the processing unit 140 may be further configured to acquire at least one of an electrocardiogram (ECG) signal associated with the subject and a signal indicating the subject's nasal airflow. In these embodiments, the processing unit 140 may be further configured to determine recommendations to be provided based on at least one of the acquired ECG signal and the signal indicating the subject's nasal airflow. For example, recommendations (e.g., whether to start or resume compression therapy, or when to start or resume compression therapy, or follow-up actions after recovery of spontaneous circulation (ROSC)) may be provided based on the subject's respiratory rate, which is derived in the processing unit 140 or otherwise from the signal indicating the subject's nasal airflow. In another example, the ECG signal may be used by the processing unit 140 to confirm controlled electrical activity of the subject's heart, which is a prerequisite for the presence of a pulsation.

[0040] In some embodiments, the processing unit 140 may be further configured to determine the presence or absence of spontaneous heartbeat based on at least one of the acquired ECG signal and a signal indicating the subject's nasal airflow, thereby allowing recommendations to be provided based on the presence or absence of spontaneous heartbeat.

[0041] In some embodiments, the system 100 may further include an ECG detection unit configured to detect an ECG signal associated with a subject. In these embodiments, the ECG signal can be acquired from the ECG detection unit by the processing unit 140. The ECG detection unit may have, for example, an ECG electrode placed at a skin contact measurement site on the subject (e.g., the nose or core unit 120). Alternatively, the ECG signal may be acquired from an external ECG detection unit outside of the system 100.

[0042] In some embodiments, the system 100 may further include a nasal flow detection unit configured to detect a signal indicating the subject's nasal flow. In these embodiments, the signal indicating the subject's nasal flow can be acquired by the processing unit 140 from the nasal flow detection unit. Alternatively, the signal indicating the subject's nasal flow may be acquired from a nasal flow detection unit outside of the system 100.

[0043] In some embodiments, the processing unit 140 may further be configured to perform the following: determine whether the amplitude and / or signal quality corresponding to detected movements correlated with chest compressions during compression therapy of a subject is within a predetermined target range; provide an indicator of the result of the determination of whether the amplitude and / or signal quality is within the predetermined target range (e.g., a warning that the signal quality is not sufficient to allow compression-induced vibrations in the detected movements to be identified, or is not sufficient for the respective algorithms for the purpose of detecting the presence of spontaneous pulsation); and provide a command to adjust the position of the core unit 120 having the incorporated motion detection unit or the motion detection unit 130 itself. The command to adjust the position of the incorporated motion detection unit or the core unit 120 having the motion detection unit 130 itself may provide information that can guide or assist the user in adjusting the position of the incorporated motion detection unit or the core unit 120 having the motion detection unit 130 so that sufficient and / or accurate motion detection corresponding to compression-induced movements can be achieved.

[0044] In some embodiments, the processing unit 140 can be implemented in a mobile device, and the processing unit is configured to wirelessly connect to at least one of the core unit 120, the motion detection unit 130, and the PPG detection unit 110. In these embodiments, the raw or filtered PPG signal can be transmitted to the processing unit 140 via a wired or wireless connection, for example, directly from the PPG detection unit 110 or via the core unit 120. As described above, in some embodiments, the determination of the presence or absence of spontaneous heartbeat can be performed in the processing unit 140 according to one or more algorithms developed for the purpose of detecting the recovery (or continued presence) of spontaneous heartbeat during the application of CPR. In these embodiments, the relevant algorithms can be executed on the mobile device, for example, using a mobile application installed on the mobile device. By executing the decision algorithm using a mobile application installed on the mobile device, algorithm updates can be deployed more conveniently and effectively.

[0045] In some embodiments, the processing unit 140 may be part of the core unit 120, which can be configured to be positioned above or adjacent to the chest region of the subject. Positioning the core unit 120 above or adjacent to the chest region of the subject ensures that it does not interfere with ongoing compression therapy for the subject. Furthermore, in some embodiments, the motion detection unit 130 may be part of the core unit 120, in which case positioning the core unit 120 above or adjacent to the chest region of the subject ensures proper measurement of movements correlated with chest compressions during compression therapy for the subject. Furthermore, in these embodiments, the core unit can be implemented in a mobile device (e.g., a smartphone or tablet). Specifically, in some implementations, the motion detection unit 130 may be part of the core unit 120, which may be an embedded component of the mobile device (e.g., an accelerometer).

[0046] Although not shown, in some embodiments, system 100 may further have a communication interface (or circuit) for enabling system 100 to communicate with any interface, memory, and / or device located inside or outside system 100. The communication interface may communicate with any interface, memory, and / or device wirelessly or via a wired connection. For example, the communication interface may communicate with one or more user interfaces wirelessly or via a wired connection. Similarly, the communication interface may communicate with one or more memories wirelessly or via a wired connection.

[0047] Figure 1 shows only the components necessary to illustrate one aspect of system 100, and it will be understood that in actual implementations, system 100 may have alternative or additional components to those shown. For example, in some embodiments, system 100 may have a power supply (for example, implemented in core unit 120).

[0048] Figure 2 is a flowchart illustrating how to operate a system that provides cardiopulmonary resuscitation (CPR) decision support, such as System 100 shown in Figure 1. The system comprises a photoplethysmography (PPG) detection unit, a core unit with a user interface, a motion detection unit, and a processing unit. For ease of understanding, some of the following descriptions refer to the various components of System 100 as shown in Figure 1.

[0049] Referring to Figure 2, in block 202, one or more PPG signals at the measurement site of the subject are determined by a PPG detection unit 110 which may have at least one of the following: alar PPG sensor, columella PPG sensor, concha PPG sensor, and forehead PPG sensor.

[0050] In some embodiments, prior to block 202, the method may further include a step of receiving user input at the user interface 122 of system 100 indicating at least one sensor to be activated to determine one or more PPG signals. Alternatively or additionally, the method may include a step of receiving signal quality indicators corresponding to one or more of the sensors in processing unit 140, and one or more sensors may be activated based on the received signal quality indicators. Alternatively or additionally, the method may include a step of activating one or more PPG sensors based on the received user input and the received signal quality indicators. Thus, the user can decide which sensors to use, for example, based on best compatibility with the user's workflow. For example, this decision may be based on whether the subject's ventilation is performed using a mask or via intubation.

[0051] Returning to Figure 2, in block 204, movements correlated with chest compression during compression therapy on the subject are detected by the motion detection unit 130.

[0052] Next, in block 206, the processing unit 140 determines the presence or absence of spontaneous heartbeat based on detected movements correlated with chest compressions during the subject's compression therapy and one or more PPG signals. This determination can be performed according to one or more algorithms developed for the purpose of detecting the recovery (or continued presence) of spontaneous heartbeat during the application of CPR, such as the technique described in International Application Brochure No. 2017 / 211814, which includes a method that yields the output of classified heartbeat states ("no heartbeat", "heartbeat", and "uncertain"), the detection based on compression reference signals and PPG signals. Furthermore, in some embodiments, one or more algorithms can be implemented by a mobile application installed on a mobile device.

[0053] Next, in block 208, the processing unit 140 determines the recommendation to be provided based on the determination of whether or not a spontaneous heartbeat is present. For example, if block 206 determines that a spontaneous heartbeat is present, the recommendation in block 208 may be to perform further checks for the presence of a heartbeat and / or to discontinue the administration of vasopressors. As another example, if block 206 determines that a spontaneous heartbeat is not present, the recommendation in block 208 may be to continue compression therapy for the subject. As a more specific example, the output may include outputting text information via the display screen of the user interface 122 that indicates "Perform further checks for the presence of a heartbeat" and / or "Discontinue administration of vasopressors" or "Continue CPR."

[0054] In some embodiments, the method may further include the step of acquiring at least one of an electrocardiogram (ECG) signal related to the subject and a signal indicating the subject's nasal airflow in the processing unit 140. The ECG signal may be acquired from the system's ECG detection unit or an external ECG detection unit. The signal indicating the subject's nasal airflow may be acquired from the system's nasal airflow detection unit or an external nasal airflow detection unit. In these embodiments, determining the recommendations to be provided in block 208 may further be based on at least one of the acquired ECG signal and the signal indicating the subject's nasal airflow. For example, recommendations (e.g., whether to start or resume compression therapy, or when to start or resume it, or follow-up actions after recovery of spontaneous circulation (ROSC)) may be provided in the processing unit 140 or otherwise based on the subject's respiratory rate derived from the signal indicating the subject's nasal airflow. In another example, the ECG signal may be used by the processing unit 140 to confirm controlled electrical activity of the subject's heart, which is a prerequisite for the presence of a pulsation.

[0055] In some embodiments, determining the presence or absence of spontaneous heartbeat in block 206 can further be based on at least one of the acquired ECG signal and / or a signal indicating the subject's nasal airflow, thereby allowing a recommendation to be determined in block 208 based on the presence or absence of spontaneous heartbeat.

[0056] Returning to Figure 2, in block 210, the user interface 122 of the core unit 120 is controlled to output the recommendation determined in block 208.

[0057] In some embodiments, the method may further include obtaining the subject's core body temperature (CBT) value in the processing unit 140. The CBT value may be obtained from a CBT detection unit in the system 100 and / or from a CBT detection unit outside the system 100. In these embodiments, the method may further include controlling the user interface 122 in the processing unit 140 to output at least one of the following: the detected core body temperature, an indication that the detected core body temperature is within a predetermined target range or at a predetermined target value, and an indication that the detected core body temperature is approaching a predetermined target range or a predetermined target value. Since controlled reduction and / or maintenance of appropriate CBT is important for the outcome of CPR (e.g., to preserve brain function), the user interface 122 can provide the user with useful information during CPR, such information can help achieve the desired outcome more efficiently and effectively.

[0058] In some embodiments, the method may further include the steps of: determining in the processing unit 140 whether the amplitude and / or signal quality corresponding to detected movement correlated with chest compressions during compression therapy of a subject is within a predetermined target range; and controlling the user interface 122 to output at least one of the following in the processing unit 140: an instruction of the result of the determination of whether the amplitude and / or signal quality is within a predetermined target range (e.g., a warning that the signal quality is not sufficient to allow compression-induced vibrations in the detected movement to be identified); and a command to adjust the position of the core unit 120 having an incorporated motion detection unit or the motion detection unit 130 itself. The command to adjust the position of the incorporated motion detection unit or the core unit 120 having the motion detection unit 130 itself may provide the user with information to adjust the position of the incorporated motion detection unit or the core unit 120 having the motion detection unit 130 itself so that sufficient and / or accurate motion detection corresponding to compression-induced movement can be achieved.

[0059] Therefore, an improved system that overcomes existing problems and a method for operating such a system are provided.

[0060] Also provided is a computer program product including a computer-readable medium, wherein the computer-readable medium has computer-readable code embodied therein, and the computer-readable code is configured to cause a computer or processor to perform one or more of the methods described herein when executed by a suitable computer or processor. Therefore, it will be understood that this disclosure also applies to computer programs adapted to carry out embodiments, in particular computer programs on or within a carrier. The program may be source code, object code, code intermediate source, or object code in a partially compiled form, or any other form suitable for use in implementing the methods described herein by implementation.

[0061] Furthermore, it will be understood that such programs can have many different architectural designs. For example, program code that implements the functionality of a method or system can be subdivided into one or more subroutines. Many different ways of distributing functionality among these subroutines will be apparent to those skilled in the art. Subroutines can be stored together in a single executable file to form a self-contained program. Such an executable file may contain computer executable instructions, e.g., processor instructions and / or interpreter instructions (e.g., Java interpreter instructions). Alternatively, one, more, or all of the subroutines may be stored in at least one external library file and linked to the main program statically or dynamically, e.g., at runtime. The main program contains at least one call to at least one of the subroutines. Subroutines may also have function calls to each other.

[0062] Embodiments relating to a computer program product include computer executable instructions corresponding to at least one processing stage of the methods described herein. These instructions can be subdivided into subroutines and / or stored in one or more files that can be statically or dynamically linked. Another embodiment relating to a computer program product includes computer executable instructions corresponding to at least one means of the systems and / or products described herein. These instructions can be subdivided into subroutines and / or stored in one or more files that can be statically or dynamically linked.

[0063] The carrier of a computer program can be any entity or device capable of carrying the program. For example, the carrier may include ROM, such as a CD-ROM or semiconductor ROM, or a data storage device such as a magnetic recording medium, such as a hard disk drive. Furthermore, the carrier may be a transmittable carrier, such as an electrical signal or an optical signal, which can be carried via an electrical or optical cable, or by wireless or other means. When the program is embodied in such a signal, the carrier may consist of such a cable or other device or means. Alternatively, the carrier may be an integrated circuit in which the program is embedded, which is adapted to perform the relevant method or is used to perform the relevant method.

[0064] Variations of the disclosed embodiments can be understood and implemented by those skilled in the art in carrying out the principles and techniques described herein, based on a review of the drawings, disclosures, and appended claims. In the claims, the word “comprising” does not preclude other components or steps, and the indefinite article “a” or “an” does not preclude plurality. A single processor or other unit can perform the functions of several items enumerated in the claims. The mere fact that certain means are described in mutually different dependent claims does not imply that combinations of these means cannot be used advantageously. Computer programs can be stored or distributed on suitable media such as optical storage media or solid-state media supplied together with or as part of other hardware, but they can also be distributed in other forms, such as via the Internet or other wired or wireless telecommunications systems. No reference numeral in a claim should be construed as limiting the scope of that claim.

Claims

1. A system that provides support for cardiopulmonary resuscitation (CPR) decision-making, A PPG detection unit configured to determine one or more photoplethysmography (PPG) signals at measurement sites on a subject, A core unit with a user interface, A motion detection unit configured to detect movements correlated with chest compressions during compression therapy for the subject, A processing unit, A step of determining whether or not there is a spontaneous heartbeat based on the detected movement and the one or more PPG signals that correlate with chest compressions during compression therapy of the subject, A step of determining, based on the aforementioned determination of the presence or absence of spontaneous heartbeat, a recommendation to be provided, wherein the recommendation relates to CPR decision support, and The steps include controlling the user interface to output the determined recommendation, A step of determining whether the amplitude and / or signal quality corresponding to the detected movement, which correlates with chest compressions during compression therapy for the subject, is within a predetermined target range. If it is determined that the amplitude and / or signal quality corresponding to the detected movement, which correlates with chest compressions during compression therapy for the subject, is not within a predetermined target range, the user interface is controlled to output a command to adjust the position of the motion detection unit, or, if the motion detection unit is incorporated into the core unit, the position of the core unit. The steps include guiding the user when adjusting the position of the core unit and / or the motion detection unit by using data including readings from the motion detection unit, A processing unit configured to perform the following: A system that has

2. The system according to claim 1, wherein the motion detection unit is part of the core unit.

3. The system according to claim 1 or 2, wherein if spontaneous pulsation is determined to be present, the recommendation determined is to perform further checks for the presence of pulsation and / or discontinue administration of a vasopressor.

4. The system according to any one of claims 1 to 3, wherein if it is determined that no spontaneous heartbeat is present, the recommendation to be made is to continue compression therapy on the subject.

5. The system according to any one of claims 1 to 4, wherein the PPG detection unit comprises at least one of a nasal ala PPG sensor, a columella PPG sensor, a concha PPG sensor, and a forehead PPG sensor.

6. The system according to claim 5, wherein the PPG detection unit comprises two or more of the alae PPG sensors, columella PPG sensors, concha PPG sensors, and forehead PPG sensors, and the user interface is configured to receive user input indicating at least one sensor to be activated to determine the one or more PPG signals.

7. The PPG detection unit comprises two or more of the following: alar PPG sensors, columella PPG sensors, concha PPG sensors, and forehead PPG sensors. The aforementioned processing unit The steps include receiving one or more signal quality indicators corresponding to one or more of the PPG sensors, The steps include determining at least one of the one or more PPG sensors to activate based on the received signal quality indicators, The system according to claim 5 or 6, configured to perform the following.

8. The aforementioned processing unit further, The steps include obtaining the core body temperature value of the subject, The steps include controlling the user interface to output at least one of the following: the detected core body temperature; an indication that the detected core body temperature is within a predetermined target range or at a predetermined target value; and an indication that the detected core body temperature is approaching a predetermined target range or a predetermined target value. A system according to any one of claims 1 to 7, configured to perform the following:

9. The processing unit is further configured to acquire at least one of the following: an electrocardiogram, an ECG, a signal associated with the subject, and a signal indicating the subject's nasal airflow. The step of determining the recommendation to be provided further includes the acquisition of the ECG signal and the signal indicating the nasal airflow of the subject, The system according to any one of claims 1 to 8.

10. The system according to any one of claims 1 to 9, wherein the processing unit is further configured to control the user interface to output a display of the result of the determination of whether the amplitude and / or the signal quality are within a predetermined target range.

11. The system according to any one of claims 1 to 10, wherein the processing unit is implemented in a mobile device and is configured to wirelessly connect to at least one of the core unit, the motion detection unit, and the PPG detection unit.

12. The processing unit is part of the core unit, The system according to any one of claims 1 to 10, wherein the core unit is configured to be positioned on or adjacent to the upper part of the chest region of the subject.

13. The system according to claim 12, wherein the core unit is implemented in a mobile device.

14. The system according to claim 11 or 13, wherein the mobile device is a smartphone.

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