AED CPR Source Detection and Synchronized Shock Delivery

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Solution Overview

Problem

Current AEDs require cessation of CPR chest compressions to obtain clean ECG data, leading to undesirable interruption of blood flow, and struggle to synchronize defibrillation with manual CPR compressions due to safety concerns for the rescuer.

Innovation Solution

A chest compression monitor generates signals for chest wall motion, allowing an AED control system to determine optimal shock points and differentiate between manual and automated CPR, ensuring synchronized shocks only occur with automated systems, thus preventing shocks during manual compressions.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If CPR chest compressions are halted to obtain clean ECG data for defibrillation, then ECG signal quality is improved, but blood flow induced by CPR compression ceases which is highly undesirable

Engineering Contradiction:
ImproveECG signal qualityVSAvoidblood flow maintenance
Core Design Contradiction:
Measurement precisionVSProductivity

Solution Approach 1:

A motion artifact reduction technique acts as an intermediary between the ECG electrodes and the AED processor. This intermediary component filters and processes the ECG signal to remove motion artifacts caused by CPR compressions, allowing the AED to obtain clean ECG data without requiring cessation of compressions. The technique enables simultaneous maintenance of both ECG signal quality and continuous blood flow.

Inventive Principle:
Principle #24Intermediary (Mediator)

2Reliability

If synchronized cardioverting shock is applied during CPR compression cycle, then defibrillation effectiveness is improved, but there is risk of shocking the CPR provider if compressions are performed manually

Engineering Contradiction:
Improvedefibrillation effectivenessVSAvoidrisk of shocking CPR provider
Core Design Contradiction:
ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The system employs feedback by continuously monitoring compression waveform characteristics and using this information to control shock delivery. The AED analyzes the waveform to determine whether compressions are manual or automated, and automatically adjusts shock delivery accordingly - permitting synchronized shock only when automated compression is detected, thereby eliminating the risk of shocking manual CPR providers while maintaining defibrillation effectiveness.

Inventive Principle:
Principle #23Feedback

3Duration of action of moving object

If AED provides electrotherapy during manual CPR compressions, then treatment continuity is improved, but CPR provider may be shocked which can cause cardiac arrest in the rescuer

Engineering Contradiction:
Improvetreatment continuityVSAvoidcardiac arrest risk to rescuer
Core Design Contradiction:
Duration of action of moving objectVSObject-affected harmful factors

Solution Approach 1:

The AED uses feedback from compression waveform analysis to automatically determine the source of compressions. By continuously monitoring waveform characteristics and comparing them against known patterns, the system identifies whether compressions are manual or automated. This feedback mechanism enables the AED to maintain treatment continuity by providing electrotherapy during automated CPR while preventing harmful shock delivery during manual CPR.

Inventive Principle:
Principle #23Feedback

Solution Approach 2:

The system performs self-service by autonomously analyzing compression waveforms and making intelligent decisions about shock delivery without requiring manual input from the CPR provider. The AED automatically distinguishes between manual and automated compression sources and independently controls electrotherapy delivery, eliminating the need for the provider to manually activate or deactivate shock functions.

Inventive Principle:
Principle #25Self-service

4Reliability

If compression waveform analysis is used to distinguish manual from automated CPR, then safety is improved, but device complexity increases due to additional signal processing requirements

Engineering Contradiction:
Improvesafety of shock deliveryVSAvoidsignal processing complexity
Core Design Contradiction:
ReliabilityVSDevice complexity

Solution Approach 1:

The existing chest compression monitor, already present in the system for measuring compression depth, is made multi-functional by adding waveform analysis capability. The same hardware infrastructure is utilized to perform both compression depth measurement and waveform-based source identification, eliminating the need for separate dedicated sensors or complex additional hardware, thereby reducing overall device complexity while maintaining high safety standards.

Inventive Principle:
Principle #6Universality (Multi-functionality)

Data Source

PatentEP3988073B1System and method for distinguishing manual from automated cpr
Publication Date: 2023.04.12 ZOLL MEDICAL CORPORATION
  • EP3988073B1 patent drawingFigure 1
  • EP3988073B1 patent drawingFigure 2
  • EP3988073B1 patent drawingFigure 3

AI summary

A system and method for use during the administration of CPR chest compressions and defibrillating shock on a cardiac arrest victim. The system analyzes compression waveforms from a compression depth monitor to determine the source of chest compressions, and enables the delivery of defibrillating shock during a compression cycle if the compression waveforms are characteristic of an automated CPR chest compression device.