Expedient pre-shock charging for manual defibrillation

Abstract

Various embodiments of a monitor / defibrillator (20) of the present disclosure employ a monitor (30) and defibrillator (40). In operation, upon a monitoring activation of the monitor (30), the monitor (30) generates an electrocardiogram (ECG) of a heart of a patient. Further in operation, upon a manual defibrillation mode activation of the defibrillator (40) and prior to a charge activation of the defibrillator (40), the defibrillator (40) analyzes and classifies a cardiac rhythm of the ECG generated by the monitor (30) and the defibrillator (40) further executes a pre-shock charge of the defibrillator (40) in response to a determinate classification by the defibrillator (40) of the ECG as a shockable cardiac rhythm.

Description

[0001] EXPEDIENT PRE-SHOCK CHARGING FOR MANUAL DEFIBRILLATION

[0002] FIELD OF THE INVENTION

[0003] The present disclosure generally relates to manual defibrillation of a patient experiencing cardiac arrest. The present disclosure particularly relates to a manner of pre-shock charging a monitor / defibrillator for effectuating an expedient manual defibrillation of a patient experiencing cardiac arrest.

[0004] BACKGROUND OF THE INVENTION

[0005] A responder utilizing a monitor / defibrillator when attempting to rescue a patient experiencing cardiac arrest will manually deliver defibrillation shock(s) to the patient when the responder has ascertained a shockable cardiac rhythm of a patient. To this end, when the responder has decided to manually deliver a defibrillation shock to the patient, the responder will sequentially press a “Charge” button of the monitor / defibrillator to activate a charging of the monitor / defibrillator, wait until the charging of the monitor / defibrillator is complete as symbolized by an actuation of a "Shock” button by the monitor / defibrillator, and then press the “Shock” button of the monitor / defibrillator to deliver a defibrillating shock to the patient (hereinafter “basic manual defibrillation mode”). Depending on the energy level of the defibrillation shock to be delivered to the patient in a basic manual defibrillation mode, a preshock charging time of the monitor / defibrillator between the responder pressing the “Charge” button and the monitor / defibrillator actuating the “Shock” button ranges from a few seconds to around ten (10) seconds.

[0006] If the responder is also performing cardiopulmonary resuscitation (CPR) when attempting to rescue the patient, then responder will need to pause CPR when the responder has decided to manually deliver a defibrillation shock to the patient. Thereafter the CPR pause, the responder will sequentially press the “Charge” button of the monitor / defibrillator, wait until the charging of the monitor / defibrillator is complete, and then press the “Shock” button of the monitor / defibrillator (hereinafter “CPR based manual defibrillation mode”). Depending on the energy level of the defibrillation shock to be delivered to the patient in the CPR based manual defibrillation mode, a pre-shock charging time of the monitor / defibrillator between the responderpausing the CPR and the monitor / defibrillator actuating the “Shock” button is typically longer than the pre-shock charging time of the basic manual defibrillation mode.

[0007] The present disclosure is directed to reducing the pre-shock charging time of a monitor / defibrillator, particularly in a basic manual defibrillation mode and in a CPR based manual defibrillation mode.

[0008] SUMMARY OF THE INVENTION

[0009] The present disclosure provides a pre-shock charging of a monitor / defibrillator for effectuating an expedient manual defibrillation of a patient experiencing cardiac arrest based on commencing the pre-shock charging of the monitor / defibrillator in response to detecting a shockable cardiac rhythm of the patient (e.g., a ventricular fibrillation (VF) rhythm or a ventricular tachycardia (VT) rhythm).

[0010] The present disclosure can be embodied as (1) a monitor / defibrillator, (2) a manual defibrillation controller, and (3) a manual defibrillation method.

[0011] Various embodiments of a monitor / defibrillator of the present disclosure encompass, upon a monitoring activation of the monitor, the monitor is configured to generate an electrocardiogram (ECG) of a heart of a patient.

[0012] Various embodiments of a monitor / defibrillator of the present disclosure further encompasses, upon a manual defibrillation mode activation of the defibrillator and prior to a charge activation of the defibrillator, the defibrillator is configured to (1) analyze and classify a cardiac rhythm of the ECG generated by the monitor and (2) execute a pre-shock charge of the defibrillator in response to a determinate classification by the defibrillator of the ECG as a shockable cardiac rhythm.

[0013] Various embodiments of a manual defibrillation controller of the present disclosure employ a non-transitory machine-readable storage medium encoded with instructions executable by one or more processor(s) to, upon a manual defibrillation mode activation of a defibrillator and prior to a charge activation of the defibrillator, (1) analyze and classify a cardiac rhythm of an electrocardiogram (ECG) of a heart of patient, and (2) execute a pre-shock charge of the defibrillator in response to a determinate classification of the ECG as a shockable cardiac rhythm.Various embodiments of a manual defibrillation method of the present disclosure involve (1) upon a monitoring activation of a monitor, the monitor generating an electrocardiogram (ECG) of a heart of a patient, and (2) upon a manual defibrillation mode activation of a defibrillator and prior to a charge activation of the defibrillator, the defibrillator analyzing and classifying a cardiac rhythm of an electrocardiogram (ECG) of a heart of patient, and (2) the defibrillator executing a pre-shock charge of the defibrillator in response to a determinate classification of the ECG as a shockable cardiac rhythm.

[0014] The foregoing exemplary embodiments and other embodiments of the present disclosure as well as various structures and advantages of the present disclosure will become further apparent to those having ordinary skill in the art from the following detailed description of various embodiments of the present disclosure read in conjunction with the accompanying drawings. The detailed description and drawings are merely illustrative of the present disclosure rather than limiting, the scope of the present disclosure being defined by the appended claims and equivalents thereof.

[0015] BRIEF DESCRIPTION OF THE DRAWINGS

[0016] The present disclosure will present in detail the following description of exemplary embodiments with reference to the following figures wherein:

[0017] FIG. 1 illustrates an exemplary embodiment of a monitor / defibrillator in accordance with the present disclosure;

[0018] FIG. 2 illustrates a flowchart illustrative of an exemplary embodiment of an ECG generation method as known in the art of the present disclosure;

[0019] FIG. 3 illustrates a flowchart illustrative of an exemplary embodiment of a manual defibrillation activation method as known in the art of the present disclosure;

[0020] FIG. 4 illustrates a flowchart illustrative of an exemplary embodiment of a manual defibrillation control method in accordance with the present disclosure;

[0021] FIG. 5 illustrates a flowchart illustrative of an exemplary embodiment of a manual defibrillation activation method as known in the art of the present disclosure;

[0022] FIG. 6 illustrates an exemplary embodiment of the monitor / defibrillator shown in the FIG. 1 in accordance with the present disclosure;FIG. 7 illustrates an exemplary embodiment of the monitor / defibrillator shown in FIG. 5 in accordance with the present disclosure; and

[0023] FIG. 8 illustrates an exemplary embodiment of the defibrillation controller shown in FIG.

[0024] 6 in accordance with the present disclosure.

[0025] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0026] The present disclosure provides a pre-shock charging of a monitor / defibrillator for effectuating an expedient manual defibrillation of a patient experiencing cardiac arrest based on commencing the pre-shock charging of the monitor / defibrillator in response to detecting a shockable cardiac rhythm of the patient (e.g., a ventricular fibrillation (VF) rhythm or a ventricular tachycardia (VT) rhythm).

[0027] For purposes of describing and claiming the present disclosure,

[0028] (1) terms of the art of the present disclosure, but not limited to, “defibrillating shock”, “electrocardiogram (ECG)”, “cardiac rhythm”, “cardiopulmonary resuscitation (CPR)”, and “manual defibrillation” are to be interpreted as known in the art of the present disclosure and as exemplary described in the present disclosure;

[0029] (2) the term “C-Shock Advisory” broadly encompasses all methods, as known in the art of the present disclosure or hereinafter conceived, for analyzing and classifying a cardiac rhythm of an ECG of a heart of a patient including artifacts as known in the art of the present disclosure resulting from an administration of chest compressions to the heart of the patient (i.e., a corrupt ECG) to thereby derive

[0030] (a) a shock decision based upon a determinate classification of the corrupt ECG as having a shockable cardiac rhythm (e.g., a ventricular fibrillation (VF) rhythm or a ventricular tachycardia (VT) rhythm),

[0031] (b) a non-shock decision based upon a determinate classification of the corrupt ECG as having a non-shockable cardiac rhythm (e.g., a pulseless electrical activity rhythm or an asystole rhythm), or

[0032] (c) an undecided shock decision based upon an indeterminate classification of the corrupt ECG as having a shockable cardiac rhythm (e.g., a ventricular fibrillation (VF) rhythm or a ventricular tachycardia (VT) rhythm) or a non-shockable cardiac rhythm (e.g., a pulseless electrical activity rhythm or an asystole rhythm);(3) the term “C-Shock Delivery” broadly encompasses all methods, as known in the art of the present disclosure or hereinafter conceived, for delivering a defibrillating shock to a heart of a patient corresponding to a shock decision derived by the C-Shock Advisory in accordance with rule(s) / guideline(s) associated with a rescue protocol (e.g., rule(s) / guideline(s) established by the American Heart Association);

[0033] (4) the term “F-Shock Advisory” broadly encompasses all methods, as known in the art of the present disclosure or hereinafter conceived, for analyzing and classifying a cardiac rhythm of an ECG of a heart of a patient excluding artifacts as known in the art of the present disclosure resulting from a termination / suspension of an administration of chest compressions to the heart of the patient (i.e., a clean ECG) to thereby derive

[0034] (a) a shock decision based upon a determinate classification of the clean ECG as having a shockable cardiac rhythm (e.g., a ventricular fibrillation (VF) rhythm or a ventricular tachycardia (VT) rhythm),

[0035] (b) a non-shock decision based upon a determinate classification of the clean ECG as having a non-shockable cardiac rhythm (e.g., a pulseless electrical activity rhythm or an asystole rhythm, or

[0036] (c) an undecided shock decision based upon an indeterminate classification of the clean ECG as having a shockable cardiac rhythm (e.g., a ventricular fibrillation (VF) rhythm or a ventricular tachycardia (VT) rhythm) or a non-shockable cardiac rhythm (e.g., a pulseless electrical activity rhythm or an asystole rhythm); and

[0037] (5) the term “F-Shock Delivery” broadly encompasses all methods, as known in the art of the present disclosure or hereinafter conceived, for delivering a defibrillating shock to a heart of a patient corresponding to a shock decision derived by the F-Shock Advisory in accordance with rule(s) / guideline(s) associated with a rescue protocol (e.g., rule(s) / guideline(s) established by the American Heart Association).

[0038] A non-limiting example of a C-Shock Advisory is an Arrythmia Recognition Technology (ART) as known in the art of the present disclosure.

[0039] A non-limiting example a F-Shock Advisory is a Patient Analysis System (PAS) as known in the art of the present disclosure.In practice, for the C-Shock Advisory and the F-Shock Advisory, one or more of the described shock decisions can be omitted and / or additional shock decision(s) can be derived from an analysis and rhythm classification of ECG.

[0040] To facilitate an understanding of the present disclosure, the following description of FIGS. 1-5 describes and teaches exemplary embodiments of various devices, systems and methods in accordance with the present disclosure. From the description of FIGS. 1-5, those having ordinary skill in the art of the present disclosure will appreciate how to apply the present disclosure to make and use additional embodiments of devices, systems and methods in accordance with the present disclosure.

[0041] Referring to FIG. 1, a monitor / defibrillator 20 of the present disclosure employs a monitor 30 and a defibrillator 40. In practice, monitor 30 and defibrillator 40 can be segregated devices having a signal connection between the devices as known in the art or hereinafter conceived, or can be components integrated within a single device as known in the art or hereinafter conceived.

[0042] Still referring to FIG. 1, monitor 30 employs an ECG module 31 embodied as

[0043] an electronic circuit (e.g., electronic components and / or hardware) and / or as a controller having an executable program (e.g., executable software stored on non-transitory computer readable medium(s) and / or firmware) for generating an electrocardiogram (ECG) 32 representative of cardiac rhythm(s) of a heart 11 of patient 12 via electrodes 40a and 40b adhered to the patient 12.

[0044] In one exemplary embodiment, ECG module 31 includes amplifier(s), filter(s), buffer(s) and analog-to-digital converter(s) as known in the art of the present disclosure for amplifying, filtering, buffering and digitizing electrode signals 41 from electrodes 40a and 40b to thereby generate ECG signal 32.

[0045] FIG. 2 illustrates a flowchart 50 representative of an ECG generation method as known in the art of the present disclosure. Referring to FIG. 2, upon a monitor activation 51 of monitor 30 (e.g., a powering-on of monitor 30 or a user activation of a powered-on monitor 30), a stage 52 of flowchart 50 encompasses ECG module 31 receiving electrode signals 41 from electrodes 40a and 40b to thereby generate ECG signal 32 as known in the art of the present disclosure or hereinafter conceived.In practice, ECG signal 32 generated by the ECG module 31 can include artifacts as known in the art of the present disclosure resulting from an administration of chest compressions to the heart of the patient (i.e., a corrupt ECG) or exclude artifacts as known in the art of the present disclosure resulting from a termination / suspension of an administration of chest compressions to the heart of the patient (i.e., a clean ECG).

[0046] Further in practice, ECG module 31 can implement techniques for transforming, partially or entirely, a corrupt form of ECG signal 32 into a clean form of ECG signal 32 as known in the art of the present disclosure or hereinafter conceived.

[0047] Still referring to FIG. 2, a stage S54 of flowchart 50 encompasses ECG module 31 controlling a display of an ECG waveform representative of the generated ECG signal 32 whereby a responder to the cardiac arrest of patient 10 is enabled to ascertain whether or not to manually administer a defibrillating hock to patient 10.

[0048] Referring back to FIG. 1, defibrillator 40 employs a shock module 41 embodied as an electronic circuit (e.g., e.g., electronic components and / or hardware) for delivering a defibrillation shock to the heart 11 of the patient 10 as known in the art of the present disclosure or hereinafter conceived.

[0049] In one exemplary embodiment, shock module 41 includes a microcontroller, high voltage (HV) energy storage source (e.g., a capacitor or capacitor bank) and a shock delivery circuit as known in the art of the present disclosure or hereinafter conceived.

[0050] FIG. 3 illustrates a flowchart 60 representative of a manual defibrillation activation method as known in the art of the present disclosure. Referring to FIG. 3, a stage S62 of flowchart 60 encompasses the microcontroller awaiting receipt of a charge activation by the responder (e.g., a pressing of “Charge” button of the defibrillator by the responder). Upon receiving the charge activation, a stage S64 of flowchart 60 encompasses the microcontroller controlling a charging of the the HV energy storage source in preparation for delivering a defibrillating shock.

[0051] Upon the HV energy source being fully charged, a stage S66 of flowchart 60 encompasses the microcontroller awaiting receipt of a shock activation by the responder (e.g., a pressing of an actuated “Shock” button of the defibrillator by the responder). Upon receiving the shock activation, a stage S68 of flowchart 60 encompasses the microcontroller activating theshock delivery circuit to discharge HV energy storage source as a defibrillating shock to the heart 11 of patient 10 via electrodes 40a and 40b.

[0052] As known in the art of the present disclosure, the time between receipt of a charge activation and a receipt of a shock activation typically ranges between a few seconds and ten (10) seconds. As will now be further described in detail herein, the present disclosure is directed to a manual defibrillation activation method in accordance with the present disclosure that involves a pre-shock charging of the HV energy source prior to receiving a charge activation to thereby reduce the time between receipt of the charge activation and receipt of the shock activation. In effect, the manual defibrillation activation method in accordance with the present disclosure eliminates stage S64 of flowchart 60.

[0053] Referring back to FIG. 1, a control module 42 of defibrillator 40 is embodied

[0054] an electronic circuit (e.g., a controller having an executable stored on non-transitory computer readable medium(s) and / or firmware, an application specific integrated circuit or a field programmable gate array) for executing a flowchart 70 as shown in FIG. 4 that is representative of a manual defibrillation control method in accordance with the present disclosure.

[0055] Referring to FIG. 4, upon a manual defibrillation mode activation 71 of defibrillator 40 (e.g., a powering-on of defibrillator 40 or a responder selection of a manual defibrillation mode for a powered-on defibrillator 40), a stage S72 of flowchart 70 encompasses control module 42 initiating a continual execution of a C-Shock Advisory or a F-Shock Advisory for analyzing and classifying a cardiac rhythm of an ECG signal 32 to thereby derive:

[0056] (a) a shock decision based upon a determinate classification of ECG signal 32 as having a shockable cardiac rhythm (e.g., a ventricular fibrillation (VF) rhythm or a ventricular tachycardia (VT) rhythm),

[0057] (b) a non-shock decision based upon a determinate classification of ECG signal 32 as having a non-shockable cardiac rhythm (e.g., a pulseless electrical activity rhythm or an asystole rhythm), or

[0058] (c) an undecided shock decision based upon an indeterminate classification of ECG signal 32 as having a shockable cardiac rhythm (e.g., a ventricular fibrillation (VF) rhythm or a ventricular tachycardia (VT) rhythm) or a non-shockable cardiac rhythm (e.g., a pulseless electrical activity rhythm or an asystole rhythm).Upon a deriving a shock decision during a stage S74 of flowchart 70, control module 42 proceeds to a stage S76 of flowchart 70 to pre-shock charging shock module 41 as known in the art of the present disclosure or hereinafter conceived. Stage S76 occurs before any receipt of a charge activation and therefore will reduce time between a charge activation and a shock activation.

[0059] Still referring to FIG. 4, flowchart 70 simultaneously proceeds along three (3) flow branches while pre-shock charging shock module 41.

[0060] The first flow branch includes a stage S78 and a stage 80 of flowchart 70 whereby control module 42 will execute a C-Shock delivery or a F-Shock Delivery in response to a charge activation and a shock activation during stage S78.

[0061] Specifically, FIG. 5 illustrates a flowchart 90 representative of a manual defibrillation activation method of the present disclosure performed during stage S78 (FIG. 4). Referring to FIG. 5, a stage S92 of flowchart 90 encompasses control module 42 awaiting receipt of a charge activation by the responder (e.g., a pressing of “Charge” button of the defibrillator by the responder). Upon receiving the charge activation and the HV energy source being fully charged, a stage S94 of flowchart 90 encompasses the microcontroller awaiting receipt of a shock activation by the responder (e.g., a pressing of actuated “Shock” button of the defibrillator by the responder). Upon receiving the shock activation, control module 42 proceeds to stage S80 of flowchart 70 (FIG. 4). Flowchart 90 as incorporated in flowchart 70 (FIG. 4) facilitates a reduction in the time between a charge activation by the responder and a shock activation by the responder due to the pre-charging of the shock module in stage S76 of flowchart 70.

[0062] Referring back to FIG. 4, the second flow branch includes a stage S82 and a stage S84 of flowchart 70 whereby control module 42 will discharge the shock module 41 during stage S84 in response to stage S84 deriving a no-shock decision or an undecided shock decision subsequent to the pre-shock charging of stage S76.

[0063] Still referring to FIG. 5, the third flow branch includes a stage S86 and a stage S88 of flowchart 70 whereby control module 42 will discharge the shock module 41 during stage S88 in response to an expiration of a time period during stage S86 (e.g., two (2) minute time period based on a CPR protocol).Control module 42 will return to stage S74 upon completion of any of the three flow branches. Flowchart will terminate at any time upon a manual defibrillation deactivation of defibrillator (40) (e.g., a powering down of defibrillator 40 or a non-selection of a manual defibrillation mode of a powered-on defibrillator 40).

[0064] To facilitate a further understanding of the present disclosure, the following description of FIGS. 6-8 describes and teaches additional exemplary embodiments of various devices, systems and methods in accordance with the present disclosure. From the description of FIGS.

[0065] 6-8, those having ordinary skill in the art of the present disclosure will appreciate how to apply the present disclosure to make and use additional embodiments of devices, systems and methods in accordance with the present disclosure.

[0066] Referring to FIG. 6, an exemplary monitor / defibrillator 120 of the present disclosure incorporating embodiments of monitor 30 and defibrillator 40 of FIG. 1. As shown in FIG. 6, monitor / defibrillator 120 incorporates a settings dial 121 for enabling a clinician to set various parameters of the shock (e.g., an energy level of the shock), a charge activation control 122, a shock activation control 123 and a display 124.

[0067] FIG. 7 is a functional block diagram 200 of monitor / defibrillator 120 (FIG. 6) according to the one embodiment of the present disclosure.

[0068] Monitor / defibrillator 120 receives an input of an ECG signal from, for example, two or more electrodes 202 that are connected to a patient. An ECG front end circuit 203 is in electrical communication with the input via a connector plug and socket or the like. The ECG front end circuit 203 operates to amplify, buffer, filter and optionally digitize an electrical ECG signal generated by the patient's heart to produce a stream of digitized ECG samples. The digitized ECG samples are provided to a manual defibrillation controller 204, which may be a processor that combines a DSP and ARM processor. One exemplary controller is the family of Applications Processors manufactured by Texas Instruments Incorporated Inc. In one embodiment of the apparatus, the DSP conducts all of the previously described filtering under the ART protocol, and then passes the multiple streams of filtered ECG data to the ARM processor. The ARM buffers the stream of digitized ECG signal data into segments (buffers) corresponding to a predetermined time. The ARM performs an outcomes analysis on the filtered ECG data to detect VF, shockable VT or other shockable cardiac rhythms. In accordance withthe present disclosure, the ARM uses the outcomes analysis to determine a treatment regimen which is most beneficial to the patient. These controller 204 portions of the DSP and ARM thus operate together as an ECG analyzer. Of course, the scope of the present disclosure is not limited to a particular DSP / ARM configuration. The foregoing and following functions may be equivalently implemented in a single processor or distributed among multiple processors.

[0069] The ECG analyzer incorporates an analysis algorithm that can determine a shockable cardiac rhythm in the presence of CPR-related signal noise artifact with a defined sensitivity and specificity. The accuracy of the ECG analyzer is sufficient to safely and effectively assess the cardiac state of the input signal in the presence of CPR compressions noise. One such analysis algorithm is ART as described previously.

[0070] If the ECG analyzer determines a shockable cardiac rhythm in combination with the determination of a treatment regimen that indicates the need for a defibrillation shock, then controller 204, responsive to the output of the ECG analyzer, sends a signal to a HV (high voltage) charging circuit 205 to charge a HV energy storage source 206 in preparation for delivering a shock. When the HV energy storage source 206 is fully charged and a charge button 210 has been actuated by a responder, controller 204 directs a shock button 211 to begin flashing to re-direct the attention of the user from the task of providing CPR compressions to the task of delivering electrotherapy.

[0071] As previously described herein, controller 204 can initiate a pre-shock charging of HV energy storage source 206 immediately upon detection of a shockable cardiac rhythm.

[0072] When the user presses the shock button 210, a defibrillation shock is delivered from HV energy storage source 206 through a shock delivery module 207. In a preferred embodiment, shock delivery module 207 is electrically connected via an output of the monitor / defibrillator 120 to the same electrodes 202 which receive the raw ECG signal.

[0073] Controller 204 may also provide control of the user interface (UI) output functions in the device. The user interface 213 is the primary means for guiding the user through the progress of the cardiac rescue protocol, and so includes at least one of an aural instruction output and a visual display. In particular, user interface 213 may comprise an audio speaker 214 to issue an aural verbal or signal prompt to the user regarding a state of the rescue, an instruction as to a next step to be taken in the rescue, or regarding instructions responsive to the determined shockablecardiac rhythm. User interface 213 may also convey audible information via a beeper 209. User interface 213 may also provide visual text or graphical indications on a display 215. User interface 213 may also convey visual information via flashing light LED 212, which may illuminate adjacent graphics or buttons to be pressed. Preferably, controller 204 controls the user interface such that each of these cues is provided in a manner that optimizes the desired response of the user.

[0074] Audible and visual cues pertaining to the same information need not be issued simultaneously if one or the other cue may detract from the desired response. For example, controller 204 may control the charging circuit to fully charge the HV storage source to the armed state preceding issuing any instructions at all. Alternatively, controller 204 may drive the user interface to indicate a determination of a shockable cardiac rhythm on visual display 215 preceding issuing related aural instructions on speaker 214. And again, controller 204 may drive the user interface to indicate the state of the HV charging circuit preceding issuing related aural instructions on speaker 214.

[0075] Software instructions for operating controller 204 are disposed in an onboard memory. Instructions in non-volatile memory may include the algorithm for the ART algorithm, the algorithm for PAS, instructions for a CPR rescue protocol that includes a period for providing CPR compressions, UI configurations for multiple user types, and the like. Volatile memory may include software-embodied records of device self-tests, device operating data, and rescue event audio and visual recordings.

[0076] Other features of the defibrillator shown in FIG. 7 include a system monitor controller 208 which receives signals from various Buttons (e.g. Power On, Shock) and provides signals for the beeper and LED lights. State changes of the buttons and sensors are transmitted back to the controller 204 through a communications interface. This feature enables very low-power standby operations with wake-up sensing by means of the button actuation and readiness status outputs.

[0077] Furthermore, additional optional features include communication links with a CPR monitor 340 or a CPR mechanical device 350 as known in the art of the present disclosure.

[0078] Referring to FIG. 8, shown is an exemplary embodiment 300 of controller 204 (FIG. 7) that includes one or more processor(s) 301, memory 302, a user interface 303, a network interface 304, and a storage 305 interconnected via one or more system bus(es) 306.Each processor 301 can be any hardware device, as known in the art of the present disclosure or hereinafter conceived, capable of executing instructions stored in memory 302 or storage or otherwise processing data. In a non-limiting example, the processor(s) 301 can include a microprocessor, field programmable gate array (FPGA), application-specific integrated circuit (ASIC), or other similar devices.

[0079] The memory 302 can include various memories, as known in the art of the present disclosure or hereinafter conceived, including, but not limited to, LI, L2, or L3 cache or system memory. In a non-limiting example, the memory 302 can include static random access memory (SRAM), dynamic RAM (DRAM), flash memory, read only memory (ROM), or other similar memory devices.

[0080] In practice, controller 300 also provides control of the user interface (UI) output functions. Specifically, user interface 303 is the primary means for guiding the responder through the protocols of the present disclosure, and so includes at least one of an aural instruction output and a visual display. In particular, user interface 303 may comprise an audio speaker to issue an aural verbal or signal prompt to the responder regarding a state of the rescue, an instruction as to a next step to be taken in the rescue, or regarding instructions responsive to an execution of a particular protocol (e.g., administering CPR and / or delivering a drug). User interface 303 can also convey audible information via a beeper. User interface 303 can also provide visual text or graphical indications on a display. User interface 303 can also convey visual information via a flashing light LED, which may illuminate adjacent graphics or buttons to be pressed. Preferably, controller 300 controls the user interface 301 such that each of these cues is provided in a manner that optimizes the desired response of the responder in the execution of protocols of the present disclosure.

[0081] Still referring to FIG. 8, network interface 304 can include one or more devices, as known in the art of the present disclosure or hereinafter conceived, for enabling communication with other components of defibrillator (defibrillator 200 of FIG. 6) or another device, particularly a mechanical CPR device or a CPR coaching device, as known in the art of the present disclosure or hereinafter conceived, in the administration of CPR / chest compression to a patient in accordance with the protocols of the present disclosure and / or in the acquisition of CPR data indicative of the quality of CPR being administered to the patient.In a non-limiting example, the network interface 304 can include a network interface card (NIC) configured to communicate according to the Ethernet protocol. Additionally, the network interface 414 may implement a TCP / IP stack for communication according to the TCP / IP protocols. Various alternative or additional hardware or configurations for the network interface 304 will be apparent.

[0082] The storage 305 can include one or more machine-readable storage media, as known in the art of the present disclosure or hereinafter conceived, including, but not limited to, read-only memory (ROM), random-access memory (RAM), magnetic disk storage media, optical storage media, flash-memory devices, or similar storage media. In various non-limiting embodiments, the storage 305 can store instructions for execution by the processor(s) 301 or data upon with the processor(s) 301 may operate. For example, the storage 305 may store a base operating system for controlling various basic operations of the hardware.

[0083] The storage 305 can also store an application modules 307 in the form of executable software / firmware for implementing the methods of the present disclosure as previously described in the present disclosure. As shown in FIG. 7, application modules 307 include a ECG signal / waveform generator for implementing flowchart 50 of FIG. 2, and a manual defibrillation manager for implementing flowchart 70 of FIG. 4 and flowchart 90 of FIG. 5.

[0084] From the description of FIGS. 1-8 herein, those having ordinary skill in the art will appreciate the numerous benefits of the present disclosure including, but not limited to, a reduction in time between a charge activation and a shock activation of a defibrillator.

[0085] The present disclosure has been described with reference to the preferred embodiments. Modifications and alterations may occur to others upon reading and understanding the preceding detailed description. It is intended that the invention be construed as including all such modifications and alterations insofar as they come within the scope of the appended claims or the equivalents thereof.

[0086] Further, as one having ordinary skill in the art shall appreciate in view of the teachings provided herein, features, elements, components, etc. disclosed and described in the present disclosure / specification and / or depicted in the appended Figures and / or recited in the Claims can be implemented in various combinations of hardware and software, and provide functions which can be combined in a single element or multiple elements. For example, the functions of thevarious features, elements, components, etc. shown / illustrated / depicted in the Figures and / or recited in the Claims can be provided through the use of dedicated hardware as well as hardware capable of executing software in association with appropriate software. When provided by a processor, the functions can be provided by a single dedicated processor, by a single shared processor, or by a plurality of individual processors, some of which can be shared and / or multiplexed. Moreover, explicit use of the term “processor” or “controller” should not be construed to refer exclusively to hardware capable of executing software, and can implicitly include, without limitation, digital signal processor (“DSP”) hardware, memory (e.g., read only memory (“ROM”) for storing software, random access memory (“RAM”), non-volatile storage, etc.) and virtually any means and / or machine (including hardware, software, firmware, combinations thereof, etc.) which is capable of (and / or configurable) to perform and / or control a process.

[0087] Moreover, all statements herein reciting principles, aspects, and exemplary embodiments of the present disclosure, as well as specific examples thereof, are intended to encompass both structural and functional equivalents thereof. Additionally, it is intended that such equivalents include both currently known equivalents as well as equivalents developed in the future (e.g., any elements developed that can perform the same or substantially similar functionality, regardless of structure). Thus, for example, it will be appreciated by one having ordinary skill in the art in view of the teachings provided herein that any block diagrams presented herein can represent conceptual views of illustrative system components and / or circuitry embodying the principles of the invention. Similarly, one having ordinary skill in the art should appreciate in view of the teachings provided herein that any flow charts, flow diagrams and the like can represent various processes which can be substantially represented in computer readable storage media and so executed by a computer, processor or other device with processing capabilities, whether or not such computer or processor is explicitly shown.

[0088] Having described preferred and exemplary embodiments of the present disclosure, which embodiments are intended to be illustrative and not limiting, it is noted that modifications and variations can be made by persons having ordinary skill in the art in view of the teachings provided herein, including the appended Figures and claims. It is therefore to be understood that changes can be made in / to the preferred and exemplary embodiments of the present disclosurewhich are within the scope of the present disclosure and exemplary embodiments disclosed, described and taught herein.

[0089] Moreover, it is contemplated that corresponding and / or related systems incorporating and / or implementing the device or such as can be used / implemented in a device in accordance with the present disclosure are also contemplated and considered to be within the scope of the present disclosure. Further, corresponding and / or related method for manufacturing and / or using a device and / or system in accordance with the present disclosure are also contemplated and considered to be within the scope of the present disclosure.

Claims

Claims1. A monitor / defibrillator (20), comprising:a monitor (30) and a defibrillator (40);wherein, upon a monitoring activation of the monitor (30), the monitor (30) is configured to generate an electrocardiogram (ECG) of a heart of a patient; andwherein, upon a manual defibrillation mode activation of the defibrillator (40) and prior to a charge activation of the defibrillator (40), the defibrillator (40) is configured to analyze and classify a cardiac rhythm of the ECG generated by the monitor (30) and the defibrillator (40) is further configured to execute a pre-shock charge of the defibrillator (40) in response to a determinate classification by the defibrillator (40) of the ECG as a shockable cardiac rhythm.

2. The monitor / defibrillator (20) of claim 1,wherein, upon the charge activation of the defibrillator (40), the defibrillator (40) is further configured to terminate the pre-shock charge of the defibrillator (40) based on the charge activation of the defibrillator (40); andwherein, subsequent to a termination of the pre-shock charge of the defibrillator (40), the defibrillator (40) is further configured to execute a defibrillation shock delivery to the heart of the patient in response to a shock activation of the defibrillator (40).

3. The monitor / defibrillator (20) of claim 1,wherein, in response to a determinate classification by the defibrillator (40) of the ECG as a non-shockable cardiac rhythm subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm, the defibrillator (40) is further configured to terminate the pre-shock charge of the defibrillator (40) and to execute a discharge of the pre-shock charge of the defibrillator (40).

4. The monitor / defibrillator (20) of claim 1,wherein, in response to an indeterminate classification by the defibrillator (40) of the ECG as a shockable cardiac rhythm or a non-shockable cardiac rhythm subsequent to thedeterminate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm, the defibrillator (40) is further configured to terminate the pre-shock charge of the defibrillator (40) and to execute a discharge of the pre-shock charge of the defibrillator (40).

5. The monitor / defibrillator (20) of claim 1, wherein, in response to an expiration of a preshock charging time period subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm, the defibrillator (40) is further configured to terminate the pre-shock charge of the defibrillator (40) and to execute a discharge of the preshock charge of the defibrillator (40).

6. A manual defibrillation controller, comprising:a non-transitory machine-readable storage medium encoded with instructions for execution by at least one processor,wherein, upon a manual defibrillation mode activation of a defibrillator (40) and prior to a charge activation of the defibrillator (40), the non-transitory machine-readable storage medium includes the instructions to:analyze and classify a cardiac rhythm of the ECG generated by a monitor (30); andexecute a pre-shock charge of the defibrillator (40) in response to a determinate classification by the defibrillator (40) of the ECG as a shockable cardiac rhythm.

7. The manual defibrillation controller of claim 6,wherein, upon the charge activation of the defibrillator (40), the non-transitory machine-readable storage medium further includes the instructions to terminate the pre-shock charge of the defibrillator (40) based on the charge activation of the defibrillator (40); andwherein, subsequent to a termination of the pre-shock charge of the defibrillator (40), the non-transitory machine-readable storage medium further includes the instructions to execute a defibrillation shock delivery to the heart of the patient in response to a shock activation of the defibrillator (40).

8. The manual defibrillation controller of claim 6, wherein, in response to a determinate classification by the defibrillator (40) of the ECG as a non-shockable cardiac rhythm subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm, the non-transitory machine-readable storage medium further includes the instructions to:terminate the pre-shock charge of the defibrillator (40); andexecute a discharge of the pre-shock charge of the defibrillator (40).

9. The manual defibrillation controller of claim 6, wherein, in response to an indeterminate classification by the defibrillator (40) of the ECG as a shockable cardiac rhythm or a non-shockable cardiac rhythm subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm, the non-transitory machine-readable storage medium further includes the instructions to:terminate the pre-shock charge of the defibrillator (40); andexecute a discharge of the pre-shock charge of the defibrillator (40).

10. The manual defibrillation controller of claim 6, wherein, in response to an expiration of a pre-shock charging time period subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm, the non-transitory machine-readable storage medium further includes the instructions to”terminate the pre-shock charge of the defibrillator (40); andexecute a discharge of the pre-shock charge of the defibrillator (40).

11. A manual defibrillation method, comprising:generating, by a monitor (30) upon a monitoring activation of the monitor (30), an electrocardiogram (ECG) of a heart of a patient;analyzing and classifying, by a defibrillator (40) upon a manual defibrillation mode activation of the defibrillator (40) and prior to a charge activation of the defibrillator (40), a cardiac rhythm of the ECG generated by the monitor (30); and19executing, by the defibrillator (40), a pre-shock charge of the defibrillator (40) in response to a determinate classification by the defibrillator (40) of the ECG as a shockable cardiac rhythm prior to the charge activation of the defibrillator (40).

12. The manual defibrillation method of claim 11 ,terminating, by the defibrillator (40) upon the charge activation of the defibrillator (40), the pre-shock charge of the defibrillator (40) based on the charge activation of the defibrillator (40); andexecuting, by the defibrillator (40) subsequent to the terminating of the pre-shock charge of the defibrillator (40), a defibrillation shock delivery to the heart of the patient in response to a shock activation of the defibrillator (40).

13. The manual defibrillation method of claim 11,terminating, by the defibrillator (40), the pre-shock charge of the defibrillator (40) in response to a determinate classification by the defibrillator (40) of the ECG as a non-shockable cardiac rhythm subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm; andexecuting, by the defibrillator (40), a discharge of the pre-shock charge of the defibrillator (40) in response to the determinate classification by the defibrillator (40) of the ECG as the non-shockable cardiac rhythm subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm.

14. The manual defibrillation method of claim 11 ,terminating, by the defibrillator (40), the pre-shock charge of the defibrillator (40) in response to an indeterminate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm or the non-shockable cardiac rhythm subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm; andexecuting, by the defibrillator (40), a discharge of the pre-shock charge of the defibrillator (40) in response to the indeterminate classification by the defibrillator (40) of the20ECG as the shockable cardiac rhythm or the non-shockable cardiac rhythm subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm.

15. The manual defibrillation method of claim 11,terminating, by the defibrillator (40), the pre-shock charge of the defibrillator (40) in response to an expiration of a pre-shock charging time period subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm; and executing, by the defibrillator (40), a discharge of the pre-shock charge of the defibrillator (40) in response to an expiration of a pre-shock charging time period subsequent to the determinate classification by the defibrillator (40) of the ECG as the shockable cardiac rhythm.21

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