JP4563392B2 - Lightweight electromechanical automatic chest compression device and its temperature control system - Google Patents

Description

  The invention described below relates to the field of cardiopulmonary resuscitation, and more particularly to an automatic chest compression device.

Cardiopulmonary resuscitation (CPR). Is a well-known and valuable first aid used to revive people who have had cardiac arrest. CPR tightens the heart and chest cavity and requires repeated chest compressions to pump blood into the body. In order to supply air to the lungs, artificial respiration such as mouse-to-mouse artificial respiration or a bag mask device is used. When first aiders perform manual and effective chest compressions, the blood flow in the body is reduced from 25% to 30% of normal blood flow. However, even an experienced paramedic cannot continue with sufficient chest compression for several minutes. Hightower, et al., Decay in Quality of Chest Compressions Over Time , 26 Ann. Emerg. Med. 300 (Sep. 1995) (High Tower et al., “Attenuation of chest compression characteristics over time”, 26 Ann. Emerg. Med. 300 (Sep. 1995)). Thus, patient maintenance or resuscitation with CPR is often unsuccessful. However, if chest compressions are continued sufficiently, victims of cardiac arrest can be maintained for a long time. Long-term CPR (45 to 90 minutes). Later, reports of victims being saved by coronary artery bypass surgery have occasionally been reported. See Tovar, et al., Successful Myocardial Revascularization and Neurologic Recovery, 22 Texas Heart J. 271 (1995) (Tovar et al. I want.

Various mechanical devices have been proposed for CPR in order to more effectively provide blood flow and enhance the effectiveness of resuscitation efforts by those present. In one form of such a device, a belt is placed around the patient's chest, and an automatic chest compression device tightens the belt to provide chest compression. Our own patent, Mollenauer et al. Resuscitation device having a motor driven belt to constrict / compress the chest , US Pat. No. 6,142,962 (November 2000) 7), Bystrom et al. Resuscitation and alert system , US Pat. No. 6,090,056 (July 18, 2000), Sherman et al. Modular CPR assist device , US Pat. No. 6,066,106 (September 23, 2000), and Sherman et al. Modular CPR assist device , US Pat. No. 6,398,745, (June 4, 2002), and May 21, 2001 Our application No. 09 / 866,377 and Application No. 10 / 192,771 filed on July 10, 2002 disclose chest compression devices that use a belt to compress a patient's chest. Each of these patents or applications is incorporated herein by reference in its entirety.
U.S. Patent No. 6,142,962 U.S. Patent No. 6,090,056 U.S. Patent No. 6,066,106 U.S. Patent No. 6,398,745 U.S. Patent Application No. 09 / 866,377 U.S. Patent Application No. 10 / 192,771

  In case of an emergency, all CPR devices need to be easy to use and quickly attached to the patient to compete for 1 second. Our own device is quick and easy to install and can greatly increase the chances of patient survival. However, a new chest compression device has been designed to further improve ease of use, allow for quicker attachment, and increase the life and convenience of the device.

  A problem encountered in making a light and small electromechanical chest compression device was that the device could overheat. (Motors, brakes, and electrical systems all generate heat). Overheating can damage the device and cause injury to the patient.

  The devices and methods described below provide an electromechanical chest compression device that is less than 30 pounds when fully assembled. The device was equipped with a channel beam to strengthen the device in that most of the compression force was applied, thereby making it possible to create a hollow device and use a lighter material. The channel beam also has a role of a table on which a compression belt cartridge can be mounted, so that the belt can be easily replaced with each use. A slotted drive spool is mounted on the channel beam. The drive spool is attached to a motor that can rotate the drive spool. Spindles are placed at both ends of the channel beam to guide the belt during compression and contribute to energy saving.

  In use, a compression belt cartridge is provided, the belt is attached to a slot in the drive spool, and the belt is stretched and applied to both spindles. Next, the cover plate of the cartridge is attached to the channel beam. The patient is then placed on the device and the belt is secured around the patient's chest. As the motor rotates, the belt wraps around the drive spool, thereby tightening the belt. Sufficient torque is generated so that the belt compresses the patient's chest.

  FIG. 1 shows a state in which a chest compression belt is attached to a patient 1. The chest compression device 2 performs compression with the belt 3 having the right part 3R and the left part 3L of the belt. The chest compression device 2 has a belt drive platform 4 and a compression belt cartridge 5 (including a belt). The belt drive platform includes a housing 6 on which a patient lies, and means for tightening the belt, a processor, and a user interface are disposed on the housing. The belt includes fastening straps 18 and 19 and wide load distribution portions 16 and 17 at both ends of the belt. The means for tightening the belt includes a motor connected to the drive spool, and the belt is wound and tightened around the drive spool during use. The chest compression device design shown herein allows for a lightweight electromechanical chest compression device. A fully assembled chest compression device weighs only 29 pounds and can therefore be carried long distances by hand. (The device itself weighs 22.0 to 23.0 pounds, the battery weighs about 5.0 pounds, the belt cartridge weighs about 0.8 pounds, and the strap that secures the patient weighs about 1.6 pounds). To date, the chest compression device described below is the only self-contained electromechanical or belt-based automatic chest compression device that weighs less than 30 pounds, to the best of the inventors' knowledge.

  FIG. 2 shows the front side of the electromechanical chest compression device 2. The chest compression device includes a belt drive platform 4 and a belt cartridge 5. The belt drive platform includes a headrest plate 20 that supports the patient's head and a backrest plate 21 that supports the patient's back. The headrest plate and backrest plate are preferably part of an integral plate of material. The chest compression device 2 is described in relation to the patient when the patient's back is on the backrest plate and the patient's head rests on the headrest plate. Thus, in normal use, the upper part of the device is the front side 22 (the side on which the patient lies during use), the lower part of the device is the rear side 23 (the side facing the ground in use as shown in FIGS. 3 and 4), The front is the upper side 24 and the rear of the device is the lower side 25. The left side 26 and right side 27 of the device are on the left side and right side of the patient, respectively, during use.

  The device is lightweight and compact. Of the device (along arrow 28). The vertical height is about 32 inches, along the device (along arrow 29). The width is about 19 inches. The longitudinal thickness of the device is about 3 inches. The left belt spindle 30 and the right belt spindle 31 are in the range of about 12 inches to about 22 inches. The distance between the spindles is preferably about 15 inches to accommodate the majority of patients. Specifically, the distance is from the outer edge of one spindle side to the outer edge of the other spindle side. (It is possible to make the device larger to accommodate larger patients).

  In use, a belt cartridge is provided and secured to the back side of the chest compression device as described with respect to FIGS. The patient is then placed on the device. The belt is wrapped around the left and right spindles, under the patient's axilla (armpit), and around the chest around the patient. The load distribution is then secured on the patient's chest. The chest compression device then repeatedly tightens the belt to perform chest compressions.

  3 and 4 show the posterior side 23 of the chest compression device as viewed from the lower and upper directions, respectively. (In the perspective views of FIGS. 3 and 4, the average sized patient's buttocks and the back of the patient's legs will extend beyond the lower bumper 40). The device is built around a sturdy channel beam 41 transverse to the housing. The channel beam supports the device against forces generated during compression. The channel beam further provides a structure for attaching the belt cartridge. The channel beam 41 is formed of a piece of cast aluminum alloy that forms two walls perpendicular to the flat bottom. (The channel beam can be formed of separate components, or can be formed of other reasonably strong and hard materials such as steel, magnesium, or reinforced polymer composites). To fit the belt, the channel beam is about 2.5 inches high (up and down), about 12 to 16 inches long (left and right), and about 2 deep (from the bottom to the top of the wall) Inches.

  The channel beam 41 forms a groove extending across the lateral width of the device. During compression, the belt moves in the groove. The belt is attached to a drive spool 42 installed in the groove. The drive spool serves as a means for connecting to the motor that operates the compression belt. The drive spool (shown in phantom in FIG. 3 to indicate that the drive spool is located near the bottom of the channel beam) is less than 3 inches in length and less than 1 inch in diameter. The drive spool can be located anywhere in the channel beam. The drive spool preferably extends across the channel beam at a point slightly offset from the vertical centerline of the device.

  For example, the drive spool is conical and used with a cable (or cable replaced with a belt) connected to a fastening strap. During the initial wrapping, the cable is wound around the bottom of the cone, which is a great mechanical advantage when it begins to compress. The cable is then wound in the length of the cone and wound toward the apex. As the cable is wound around the smaller diameter portion of the cone, the drive spool will further torque the cable, thereby applying more force to the patient near the end of the compression where chest resistance to compression is highest. (The shape of the drive spool becomes the wrapping profile of the device. The wrapping profile can be specially made to take advantage of speed-torque trade-off due to power transmission or the viscoelastic effect of the patient's chest) .

  The drive spool is provided with a slot 43 arranged along the length of the spool shaft. The splines attached to the belt are matched to the slot shape of the drive spool. Thus, when the spline is inserted into the slot of the drive spool, the belt is securely fixed to the drive spool. A groove 44 in the channel beam wall helps to align and secure the spline with respect to the slot of the drive spool. Similarly, one or more disks or guide plates mounted on one or both walls of the channel beam also assist in aligning and securing the spline to the drive spool slot. (The guide plate can be operated even if attached to the drive spool or both the drive spool and the channel beam). The guide plate is attached to a spring that allows the guide plate to move easily in and out of the channel, thereby simplifying spline removal. When the guide plate returns with spring spring after the clip is inserted, the guide plate helps to fix the spline in place. The guide plate can also have a slot sized and dimensioned to receive the spline, which further secures the spline within the slot of the drive spool.

  The left spindle 30 and the right spindle 31 are arranged at both ends of the channel beam 41 and are attached to the wall of the channel beam via seal bearings. The spindle is a hollow aluminum cylinder to minimize weight and moment of inertia and has a length of about 2.5 inches and a diameter of about 0.75 inches. The left and right spindles save energy by allowing the compression belt to easily move on the left and right sides of the device with minimal friction. The left and right spindles are positioned in the vertical direction of the device so that the belt can easily wrap around the patient when the patient is placed on the device. The spindle is fitted on the side of the housing to protect the patient, rescuer, and device components. As shown in FIG. 5, the belt guard disposed on the belt cartridge also covers the spindle. The belt guard further protects patients, rescuers, and device components.

  A means for fixing the compression belt cartridge to the channel beam is further disposed on or near the channel beam. For example, several blind holes or slots 45 are disposed within the housing and along the ends of the channel beam. A corresponding alignment tab located on the compression belt cartridge fits into the slot. The slot further extends outwardly and has a boss or detent 46 that partially enters the channel. A snap latch located on the compression belt cartridge fits securely into the boss or detent, although it is removable. Similarly, several openings 47 are arranged in the housing and along the end of the channel beam 41. The compression belt cartridge includes a tab or hook that fits into the opening and further secures the cartridge to the channel beam. The slots and openings are arranged symmetrically around the inner axis of the device. However, asymmetric placement of the slots and openings around the inner axis of the device can ensure that the cartridge is attached to the channel beam in only one direction.

  In addition, the housing is provided with a label, such as a triangle 48, to help the user correctly install the compression belt cartridge. When the compression belt cartridge is correctly aligned with the device, the label on the housing is aligned with the corresponding label located on the cartridge. To further assist the user in aligning the cartridge, contrast colors are used in the triangular area. An additional label 49 can be added to assist in patient and device alignment or to provide warnings, instructions, or promotional information. For example, a recess 50 (shown in FIG. 2) located across the width of the device provides a visual alignment marker. This recess 50 helps the fluid flow down from the surface of the device.

  Although the channel beam 41 provides the central support structure for the device, the device housing further reinforces the device. Referring again to FIGS. 3 and 4, the housing of the frame consists of a front cover plate 60, an upper cover plate 61 and a lower cover plate 62 attached to two rear cover plates. The front cover plate is attached to the upper cover plate and the lower cover plate by a plurality of screw parts arranged in the holes 63 or a fitting mechanism that fits together.

  The upper cover plate 61 is disposed above the channel beam 41, and the lower cover plate 62 is disposed below the channel beam. (Using three cover plates is the preferred design of the device shown in FIGS. 2-7, but the housing can be formed with more or fewer cover plates). The three part framework minimizes the shear forces applied to the fasteners connecting the cover plates and increases the durability of the device. (The channel beam absorbs most shear forces). In addition, the rear edge of the channel connects with the raised portions of the upper and lower cover plates to protect the fasteners connecting the cover plate to the channels. Alignment pins and bumpers mesh with the overlapping cover plates to provide further protection against shear forces.

  The housing is constructed with rounded edges to minimize impact damage to humans or devices. The housing is made of a hard, liquid-resistant material that is easy to clean, has low thermal conductivity, and is resistant to fire, electricity, chemicals, sun exposure, and extreme weather conditions. (Such materials include acrylonitrile butadiene styrene, high molecular weight polyethylene, other polymer plastics, and lightweight metals such as aluminum and titanium. However, in the case of metals, coatings or other materials can be used to make the housing non-conductive. Need to have features).

  FIG. 5 shows a compression belt cartridge used in a chest compression device. The cartridge includes a belt 3, a spline 65 for attaching the belt to the chest compression device, a belt cover plate 66 for protecting the belt, and a belt guard 67 rotatably attached to the belt cover plate by a hinge 68. (The belt guard is placed around the spindle in use). The belt cartridge may further comprise a compression bladder 69 placed between the compression belt and the patient's sternum. An example of a compression bladder is shown in our patent application 10 / 192,771, filed July 10, 2002.

  To attach the belt cartridge to the chest compression device, the belt spline 65 is inserted into the drive spool slot 43. Next, the hook 70 on the belt cover plate is inserted into the corresponding opening 47 on the device, and the tab and snap latch 71 is inserted into the slot 45 and boss on the device, so that the belt cover plate 66 and the channel beam 41 and Fixed to the housing 6. (Slots, openings, tabs and hooks are aligned so they slide and engage before the snap latch engages in the boss). Further, the label 72 disposed on the belt cover plate assists the user in aligning the belt cover plate with the channel beam.

  6 and 7 show the internal components of the chest compression device. The motor 79 is operated to apply torque to the drive spool 42 by the clutch 80 and the gear box 81. A brake 82 attached to the upper side of the motor operates to brake the operation of the drive spool. The brake hub is directly connected to the rotor shaft of the motor.

  A drive spool extending across the channel is rotatably mounted on the wall of the channel beam by a bearing. The drive spool, clutch, gear box, and brake together constitute a power transmission mechanism of the device. The power transmission mechanism is preferably not connected to any of the other components of the device or to the housing of the device except that the drive spool is connected to the channel beam. Therefore, the power transmission mechanism protrudes from the channel beam in a cantilever manner. When cantilevered from the channel beam, the power transmission mechanism minimizes rotational resistance and inertia, reduces unwanted bending or shear forces on the power transmission components, and reduces the overall weight of the device And improving the air flow around the components of the power transmission mechanism (and thereby improving the cooling of these components).

  The gearbox includes a gear system having a gear ratio that reduces the speed of the drive spool relative to the clutch or motor drive shaft. The gear ratio is preferably about 10 to 1. Gear systems that can be used include planetary gear systems that act directly from the motor shaft to the output shaft (which becomes the shaft of the drive spool). Since other gear systems do not act linearly, the motor and output shaft need not be on the same line. In the apparatus shown in FIGS. 6 and 7, the drive spool is the output shaft of the gearbox.

  The clutch disconnects the motor from the gearbox when excessive torque is applied to the drive spool. Based on other detection parameters, the control system can also disengage the clutch. For example, the controller can control the clutch to disengage if an excessive load preset by the manufacturer is detected at the load plate, if a software error occurs, or due to other conditions. Thus, the clutch serves as a safety mechanism for the chest compression device. It is also an option to actively use a clutch during compression to assist in timing of compression and save energy. Such use of the clutch is found in our US Pat. No. 6,142,962. The brake, motor, gear box, clutch, and drive spool are preferably perpendicular to the channel beam 41 and aligned.

  The motor 79 and the brake 82 are controlled by the processor unit 83, the motor control device 84, and the output control device 85, all of which are mounted inside the front cover plate 60. (To clearly show the battery compartment, the output control device is not shown in FIG. 6). The processor unit includes a computer processor, a non-volatile memory device, and a display. The user can see the display through the opening 86 in the housing. Further, feedback is given to the user by a speaker 87 attached to the bracket 88.

  The processor unit includes software for controlling the output control device and the motor control device. The processor unit, the output control device, and the motor control device together constitute a control system capable of precisely controlling the operation of the motor. Thus, the timing and force of compression is automatically and precisely controlled for patients of various sizes. Examples of compression belt timing methods can be found in our US Pat. No. 6,066,106 and patent application 09 / 866,377.

The motor controller can further be operably connected to a torque sensor that senses the torque that the motor applies to the drive spool. In this case, the motor control device has a function of automatically stopping the device when the torque exceeds a predetermined threshold. The motor controller or processor can further be connected to a biosensor that senses a biological parameter such as end-tidal carbon dioxide, pulse, or blood pressure. Thereby, the processor and the motor control device can control the operation of the device based on the sensed biological parameter. Examples of motor control and biofeedback control include our patent, Mollenauer et al. Resuscitation Device Having a Motor Driven Belt to Constrict / Compress the Chest, and a resuscitation device with a motor-driven belt to tighten / compress the chest See US Pat. No. 6,142,962 (November 7, 2000). A motor controller or processor can be connected to the current sensor to sense the current in the motor. A sudden spike in motor current indicates that the motor has been suddenly loaded, thereby indicating how much torque is being applied to the patient. Thus, based on the measured current in the motor, the control system can control the operation of the device.

The processor unit is further connected to a rotary encoder 100 arranged in the lower part of the housing and mounted on the channel beam 41. (The rotary encoder can also be replaced by a linear encoder operably arranged with respect to the belt). The rotary encoder measures the rotation of the drive spool 42 and outputs spool data corresponding to the rotation of the drive spool. The processor, in combination with the encoder controller 101 mounted on the lower portion of the housing, converts the spool data into the total amount of belt winding and total compression achieved by the system. The encoder controller converts the pulses from the encoder into count and direction signals that the processor uses to control the device. (The encoder controller and encoder may be located elsewhere in the device. For example, the encoder may be located in a gear box and operably connected to one of the gear shafts). Examples of encoders used with chest compression devices include our patent, Sherman et al. Modular CPR assist device , US Pat. No. 6,066,106 (May 23, 2000) and May 25, 2001 See in our patent application 09 / 866,377 filed on

  In addition, referring again to FIGS. 6 and 7, several additional features are provided to improve the convenience and safety of the device. Ribs 102, 103, and 104 are provided to further reinforce the device. The ribs are metal plates that support the housing during use and protect the device and the components of the device. All ribs are placed in the same plane as the motor to save space. In addition, more ribs can be added to reinforce the device. The rib edges are sealed with foam to prevent contact with the controller board, power distribution board, motor controller, and other electronic devices and associated cables when liquid enters the device.

  Further reinforcement is provided by hollow struts 105 formed integrally with the cover plate of the housing. The hollow strut is open at one end into which the screwed fastener is inserted to connect the cover plates together. (The column opening corresponds to hole 63 in FIGS. 3 and 4). In addition, an internal mounting post 106 is provided for mounting the electronic system and floating it from the floor of the device. In this way, the internal mounting posts help prevent liquid entering the device from accumulating in the electronic device. Further, reinforcement is provided by a corner plate 107 that is mounted throughout the housing of the device. Multiple additional reinforcements in the device and tightly-fitting and partitioned design provide a high degree of protection against forces, shocks and vibrations. The device shown in FIGS. 2-7 can withstand distributed forces in excess of 1,200 pounds.

  Means are provided to sense the presence of the belt to protect the patient and user from accidental actuation or actuation when the belt is not secured to the device. The drive spool slot 43 is provided with a pin 108 that is movable in the vertical direction through the drive spool and the rotary encoder. The pin is connected to a spring that pushes the pin into the drive spool slot. When the belt spline is inserted into the drive spool slot, the pin is pushed toward the contact switch 109 through the drive spool and rotary encoder. The contact switch is mounted on the brace 110, and the brace itself is mounted on the channel beam 41. The contact switch is operatively connected to the encoder controller (and thereby to the processor). When the belt is inserted, the pin is pushed by the contact switch, and the device thereby records the presence and correct insertion of the belt spline. To provide further safety, the spline is matched to the slot shape of the drive spool, thus preventing the pin from moving toward the contact switch unless the spline is inserted into the slot. Other means of sensing the presence of the belt can also be used. For example, the slot of the drive spool can include an electrical contact that senses the presence of the belt.

  In addition, the spool shaft includes a detent that secures the shaft in place when the spline is removed. The detent holds the spool shaft in a particular position to aid in spline insertion. Holding the spool shaft in a particular position also maintains the relationship between the actual physical position of the spool and the spool position as measured by the control system. Thus, the starting position of the spool shaft does not change when the device is in the off state. This helps maintain the measurement accuracy of the actual belt travel during compression.

  The chest compression device includes a control system that controls how the belt is wrapped around the drive spool. For example, the drive spool is controlled so that the belt remains somewhat wrapped around the drive spool between compressions (ie, when the device loosens the belt around the patient just before starting the next compression). During the compression, it is preferable that a belt having a length corresponding to one rotation of the drive spool is always wound around the drive spool. This maintains the belt in its wound shape, reduces the possibility of wrinkling of the belt during compression, and increases the efficiency of winding the belt around the drive spool.

  6 and 7 also show the position of the battery compartment in the vicinity of the patient's head. The location and design of the battery pack and battery compartment allows for quick battery replacement. Unless the battery pack is completely and correctly inserted into the storage section, a spring at the back of the storage section forcibly pushes out the battery pack. The recess 120 indicates the position of the spring in the battery housing part 121. A plastic grid 122 at the end of the battery compartment reinforces the recess.

  A blower 123 is provided to cool the device and the electronics of the device and circulates air within the device. Outside air is drawn in from the left louvered vent 124 or the upper louvered vent 125 and exhausted from the other vent to help cool the components of the device. (In the apparatus illustrated in FIGS. 2-7, air is drawn through the left vent and exhausted through the upper vent). The vent hole is located in a concave portion arranged in the housing and inclined inward. The recess prevents liquid from entering the vent.

  The temperature in the housing is measured by a temperature sensor 127 such as a thermometer or a thermistor mounted inside the front cover plate. When the temperature exceeds a predetermined temperature, the processor is programmed to control the system of the device to cool the device. For example, the processor can increase the speed of the blower, reduce the motor speed, or allow the user to clean a blocked vent or move the patient and device to a cooler location. Can be alerted to.

  A force measuring means is operatively connected to the device. The force measuring means is operative to measure the force applied by the patient to the device and the force of the compression. The force measuring means is a load plate attached to two load cells 129. Other means of sensing force or weight can also be used, such as one or more strain gauges operatively attached to the channel beam. A load plate cover 130 made of high density polyethylene polymer, santoprene rubber, or similar material is also provided to seal the interior of the device against liquids and other contaminants.

  A backup battery may be provided in the system to provide power when the main battery is not installed. The backup battery is mounted on the mounting plate 131 of the channel beam 41. The mounting plate is the portion of the channel beam itself that is thickened, but it may be a separate component attached to the channel beam.

  FIG. 8 shows an exploded view of a part of the automatic chest compression device 2 as seen from the front side 22 of the device. The device is shown in the corresponding direction when placed on the ground and in use. The patient's head is placed on the headrest plate 20 portion of the front cover plate 60, the patient's torso is placed on the load plate 128, and the patient's back is placed on the back plate 21 portion of the front cover plate 60. The legs and buttocks extend beyond the handle 140 on the underside of the device.

  FIG. 8 further shows a load cell 129 for the channel beam 41. The load cell is attached to the channel beam by being installed in the slot 141 of the load cell. The load cell rests on a step 142 provided in the slot. The boss 143 disposed in the load cell contacts the load plate, and the force applied to the load plate 128 by the load cell can be measured. In this way, the load cell can measure the force applied by the patient's thorax and device to the load cell, which corresponds to the total compression force applied to the patient.

  The load cell converts the applied load into an electrical signal in a strain based manner. (Other load measuring devices such as resistors, capacitors, pneumatic actuators, piezoelectric actuators, and other force or pressure measuring means may be used). The processor and software control the operation of the device based on the load signal generated by the load cell. For example, the device determines how much force to apply based in part on the patient's weight relative to the load plate. The device further monitors the force of compression and prevents excessive force on the patient. Excessive compression force ranges from about 600 pounds to about 1000 pounds (over the load distribution portion), depending on the patient and the use embodiment.

  FIG. 9 illustrates a method of performing chest compressions on the patient 1. The patient's head 156 rests on the headrest plate 20 between the rings 176, the patient's chest 157 rests on the load plate 128, the patient's back 158 waist rests on the housing backplate 21, and the patient's hips and legs Extends beyond the lower handle 140 (while using the device, the buttocks and legs rest on the ground, trolley with a carriage, or other surface). Belt 3 extends from drive spool 42 to spindles 30 and 31 and rests on the patient's chest. As the motor is rotated on the drive spool during use, the drive spool tightens the belt, thereby compressing the patient's chest.

  As shown in FIG. 9, the backrest portion 21 of the device has an ergonomic shape for both the patient and the device operator. The patient's head can be easily tilted as recommended by current American Heart Association (AHA) guidelines. The design further facilitates endotracheal intubation and visualization during endotracheal intubation. The backrest design further allows the patient's head, torso and buttocks to be secured safely and easily. Specifically, the back plate portion of the housing is inclined toward the ground toward the lower end of the belt drive platform. Thereby, the device corresponds to the lumbar curve of the patient's back when the patient is resting on the backrest plate.

  Referring again to FIG. 2, the device has been devised to make it easier to use and last longer. Multiple ergonomic handles 140 allow the user to carry the device in several different orientations, or multiple people can carry the device when the patient is lying on the housing it can. The sides of the device are shaped to be gently inclined from the top to the bottom of the device. (In other words, the front portions of the left and right sides of the device are gently curved toward the rear portions of the left and right sides of the device). Thus, when the device is placed on the ground, the handle 140 and the vents 124 and 125 are slightly lifted from the ground. This shape helps to prevent liquid from entering the louvered vent. The shape further facilitates the user to place the device on the ground without rubbing his finger and lift or move the device. In addition, the shape makes it easier to lower the patient from the side of the device.

  A user interface 159 is placed on the left side of the device near the patient's head so that the rescuer can easily interact with the device during use of the device and to reduce interference from the patient's clothing or body parts. The user interface includes switches or buttons 160 that are color-coded for ease of use. (In a preferred embodiment, a thin membrane switch or touch panel is used). The user interface is placed in a recess in the housing to reduce inadvertent actuation of buttons and other interfaces. The user interface is further covered with a plastic cover 161 to prevent liquid from damaging the interface. One or more slots 162 are disposed in the recesses of the user interface to allow liquid to drain from the recesses.

  Further, the ear 163 and the bumper 40 attached to the side of the device are shown in FIG. The bumper provides additional protection against shock and vibration. The bumper also prevents the device from slipping when leaning against a wall or other object. The bumper attached to the ear is thicker than the bumper in other parts of the device. All bumpers are made of any thermoplastic elastomer compound manufactured by GLS Corporation, such as Dynaflex ™, but rubber and other elastomer materials can also be used. The bumper preferably has a shape, size, and dimensions that fit between the cover plates of the housing to serve as a gasket. Additional gaskets are provided to further seal the device. The entire periphery of the device, including the spindle and channel beam edges, is sealed with a combination of gasket, adhesive, and compressed rubber seal.

  A left gap 173 and a right gap 174 are provided between the ear and the handle on the left side 26 and right side 27 of the housing, respectively. An additional strap can be secured to the device by the gap. Further, the data port 175 is disposed on the edge of the housing in a form that is pushed into one or both of the gaps. The data port allows the device to communicate with other devices or processors. The data port may be an infrared port, Bluetooth port, Ethernet cable, telephone jack, USB port, wireless transmitter, or any other means suitable for data transmission. (Data ports may be located elsewhere in the device).

  2 and 9 further show several flexible rings 176 that are attached to the headrest plate portion of the housing. The flexible ring is a plastic-coated metal cable. A head restraint strap, or other head restraint means, can be threaded or worn around the patient and placed around the patient's head or shoulder. The head restraint means secures the patient's head to the device during treatment and delivery. (The flexible ring can be replaced by other means of securing the patient's head to the device, such as a head restraint frame provided).

  A plurality of securing tools 177 are further provided so that straps or other restraining means can be placed around. (This allows the device to be easily fixed to a cart or bed, or the device can be easily fixed to the patient for transport). The fixing tool is attached to the handle 140 in the gaps 173 and 174. The anchoring device can be rotatable within the housing to act as a strap spindle disposed around it. The fixing device further serves to reinforce the handle.

  The fasteners used to secure each component of the device are located in the device or on the rear side of the housing (the bottom of the device in use). Fasteners are also placed in holes in the housing to prevent them from getting caught in clothing or other objects. All fasteners are made of plastic to prevent current from flowing into and out of the device. In addition, fluid spilled on the front side of the device does not collect in the fastener holes, increasing the resistance of the device to fluid. (Screw fasteners may be replaced with latches or snap latches so that the device can be opened easily).

  Referring again to FIGS. 3 and 4, the device is further devised to enhance its convenience. A battery compartment 121 located at the upper end of the device holds one or more batteries designed to fit within the compartment. A pin-type electrical connector in the battery compartment electrically connects the battery to the device. The electrical connector comprises a foam seal or gasket that is compressed when the battery is connected to the device. The foam seal seals the electrical connection against the liquid.

  The bottom of the storage part (inside the upper cover plate) is provided with a notch, boss or detent for receiving the corresponding spring latch of the rectangular battery. Thereby, when the battery pack is fixed to the battery housing portion, a sound is generated.

  The battery storage section or the opening of the storage section has a shape that fits a specific battery pack. Therefore, a battery that is not designed for use in the device cannot be inserted into the storage section and cannot be used in the device. Similarly, the shape of the storage part ensures that the battery pack is correctly inserted. An alignment ridge 183 disposed in the storage further serves for alignment and battery insertion. In addition, a flexible metal strip can be placed between the rails 184 attached to the ceiling of the storage (inside the front cover plate). The metal strip is bent slightly away from the rail. The metal strip applies a force that pushes the battery pack toward the bottom of the storage unit. In this way, the rail serves to fix the battery pack in the housing and to align the battery and the electrical connector when the battery slides.

  The battery storage unit 121 is sealed against liquid and other contaminants by a battery storage unit cover plate 185. A gasket or a seal can be provided between the storage unit cover plate and the housing to further prevent liquid from entering.

  To indicate the battery status, the device or battery pack (or both) can comprise means for indicating the battery status operatively connected to the means for determining the battery status. For example, an LED may be added to the battery pack to indicate battery status, or the processor may be programmed to display battery status on the display.

  A power switch 186 is located on the top side of the device and is housed in a recess in the housing to prevent inadvertent operation. The power switch is a button protected by a flexible waterproof cover, but a toggle switch or other means for device activation or device deactivation can be used. The power switch may be arranged at another position of the housing.

  Protection against electric shocks or surges is provided by a channel beam that acts as a grounding element. Further, a thin metal film applied to the inside of the outer frame is connected to the channel beam. The metal coating conducts stray current to the channel beam and grounds it. The coating further limits electromagnetic radiation by the device and protects patients with pacemakers or other electro-medical devices. The housing is also made of a non-conductive material and further improves electrical insulation. The device can also be provided with other forms of electrical insulation or protection.

  Additional safety features can be added to the device. For example, the device can be designed so that it does not operate without a key. Similarly, multiple actions may be required to activate a particular function. For example, twisting and pushing operations may be required to activate and deactivate the device. Alternatively, it may require that two or more buttons be pressed in a particular order to activate the device. Furthermore, the device can provide different levels of operation of the device function for different users based on the user's degree of training. An example of a step-by-step emergency device can be found in our US Pat. No. 6,398,744.

  The processor can also monitor the status of the device and take appropriate action in response to a particular event. For example, when the device is activated, the device can contact an emergency telephone number or a central operating center. The device can further notify the customer or manufacturer when the battery is about to run out or the battery has expired. An example of device monitoring can be found in our US Pat. No. 6,142,962.

  FIG. 10 shows an exploded view of some internal components of the device (also shown in FIG. 7). The display and processor unit 83, ribs 102, 103, 104, blower 123, drive spool 42, motor 79, clutch 80, gear box 81 and brake 82, and channel beam 41 are shown to show the air passage around the power transmission mechanism. In part, the left spindle 30 and the right spindle 31, and the central rib 102 and the motor controller 84 are separated. Motors, brakes, and electronic devices all generate excessive heat that can cause device failure or permanent damage. Excessive heat can further harm the patient or rescuer if the device heats up. Therefore, a cooling mechanism is required to remove heat from the device.

  One means of removing heat is to circulate outside air throughout the device and to remove the heated air out of the device. As described with reference to FIGS. 6 and 7, the blower sucks outside air from one vent and passes over the blower. Next, the blower exhales air into the apparatus through the opening 187 of the rib 104. Air circulates in the apparatus and is finally discharged from the other vent hole. (The air flow may be reversed so that the blower blows air from inside the device to outside the device). The blower itself is a 12 volt blower of ComAir / Rotron Model WT12B3-E2. Any suitable blower, fan, or other similar airflow cooling device can be used, but the blower is preferred because it is smaller than the fan and has less electromagnetic noise than the fan.

  In order to enhance the effect of air cooling, the device is configured such that airflow is guided along the power transmission mechanism (drive spool 42, motor 79, clutch 80, gear box 81, and brake 82). Specifically, the ribs 102, 103, and 104 serve as an airflow guide around the power transmission mechanism. The ribs are closely spaced from the power transmission mechanism to provide higher air velocity and thus stronger convective cooling. The air flow path along the power transmission mechanism of the illustrated apparatus is represented by an arrow. In general, air flows between the power transmission mechanism and the rib, but air flows both above and below the gear box, the clutch, and the motor. In addition, the ribs form compartments that allow air to flow over or under all of the heat generating or heat sensitive internal components of the device, such as the processor, power control device, and other components.

  Further cooling is provided by attaching a metal foil to the inner surface of the front cover plate (copper, steel, or any other number of metals can be used). The metal foil extends from the channel beam to the upper edge of the device and across the width of the device. The metal foil absorbs heat generated from the motor and increases heat dissipation by distributing the heat over a large area. (The metal foil further reflects infrared radiation into the device, preventing the outside of the device from overheating the patient). Further, in the vicinity of the brake and the motor, a heat insulating layer is added between the front cover plate and the metal foil. The insulation layer reduces the thermal conductivity to the front cover plate and thus to the patient. In addition, motors, brakes, electronic devices, and other heat generating components of the device are isolated from the metal sheet and the external surface of the device by an air filled space. This space prevents direct heat transfer and further reduces the thermal conductivity to the external surface of the device and the patient.

  Further cooling is provided by a heat sink 189 located on the motor, ribs, and other components of the system. Heat sinks increase the surface area of these components and allow more heat to be dissipated into the surrounding air stream. In addition, the motor, brake, gearbox, and clutch are physically thermally connected. The physical thermal connection serves as an additional heat sink for these heat generating devices. An additional heat sink is provided in the form of a brace 190 with a central rib 102. The brace holds the motor controller 84 and provides a physical thermal connection between the motor controller and the central rib. The central rib thereby acts as a heat sink for the motor controller. Other connections throughout the device also provide additional heat sinks that further increase the ability to remove excessive heat.

  The temperature is measured by a temperature sensor (such as a thermometer or thermistor) mounted inside the front cover plate (near the patient in use). Thus, the temperature sensor monitors the temperature at a slightly higher temperature than the surface in direct contact with the patient, which means that the possibility of patient overheating is detected early. (The patient's temperature can also be measured and tracked by the system with a separate sensor). As described for FIG. 7, the processor is programmed to cool the device or patient when the temperature exceeds a predetermined temperature, or to alert the user to take measures to cool the device or patient. .

  Since the device housing is made of a material with low thermal conductivity, the patient is less likely to overheat and the effects of exposing the device to a heat source or in the sun are reduced. Other heat dissipation mechanisms such as radiators, thermoelectric cooling devices, or spray / drip devices can be added to further cool the device during use. Thus, although preferred embodiments of the apparatus and method have been described in relation to their development environment, they are merely illustrative of the principles of the invention. Other embodiments and configurations may also be devised without departing from the spirit of the invention and the scope of the appended claims.

  The device can be sized to allow the patient to rest completely on the device, or the housing can be provided with a removable plate that can be pulled out of the device. The removable plate allows the patient's legs to be placed on the device during transport, making it easier to carry when not using the device. (The plate does not necessarily have to be removable, but may be connected to the housing by a hinge or other suitable means of connecting the plate to the housing). Similarly, the device may include a storage for storing supplemental devices such as gloves, respirators, ECG monitors, sphygmomanometers, pulse oximeters, defibrillators, or other emergency devices.

  In addition, one or more stands or braces can be added to the device. When the device is used on a rough surface, a stand or brace stabilizes the device during use. Thus, although preferred embodiments of the apparatus and method have been described in relation to their development environment, they are merely illustrative of the principles of the invention. Other embodiments and configurations may also be devised without departing from the spirit of the invention and the scope of the appended claims.

A method of performing chest compression on a patient using an automatic chest compression device is shown. Fig. 3 shows the front side of an electromechanical chest compression device. The lower and rear sides of the automatic chest compression device are shown. The upper and rear sides of the automatic chest compression device are shown. 1 shows a compression belt cartridge for use in a chest compression device. The lower and rear sides of the automatic chest compression device with the upper and lower cover plates removed are shown. An exploded view of the automatic chest compression device as seen from the rear is shown. FIG. 5 shows an exploded view of a portion of the automatic chest compression device as seen from the front, omitting some of the rear components. A method of chest compression on a patient is illustrated from the side. Figure 2 shows some exploded views of the internal components of the device.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Patient 2 ... Chest compression apparatus 3 ... Belt 4 ... Belt drive platform 5 ... Compression belt cartridge 16, 17 ... Load distribution part 18, 19 ... Pull strap 22 ... Front side 23 ... Rear side 24 ... Upper side 25 ... Lower side 30 ... Left belt spindle 31 ... right belt spindle 40 ... bumper 41 ... channel beam 43 ... slot

Claims (7)

A housing that supports the patient's back;
When the patient is supported by the housing, a motor below said patient Ru disposed in said housing,
A channel beam attached to the housing and oriented transversely to the patient and defining a channel extending transversely across the housing;
A drive spool that spans the channel beam, is operably attached to the motor, is rotatably attached to the channel beam, and can be rotated by the motor;
A belt attached to the drive spool and disposed laterally within the channel, extending at least partially around a patient's chest, and tightened by rotation of the drive spool to compress the patient's chest;
A spline attached to the belt;
Wherein arranged in the longitudinal direction of the drive spool, and a slot having a size such as to approximate the size of the spline,
The chest compression device, wherein the belt is attached to the drive spool when the spline is disposed in the slot. A guide plate,
Said guide plate, said drive spool, said channel beams, before SL is attach to a component of the chest compression device selected from the group that consists of with both the drive spool and the channel beam,
When the spline is inserted before kissing lot, the guide plate is chest compression device of claim 1, wherein the benzalkonium is fixed to the spline in the slot. A housing that supports the patient's back;
A motor disposed in the housing below the patient when the patient is supported by the housing;
A channel beam attached to the housing and oriented transversely to the patient and defining a channel extending transversely across the housing;
A drive spool that spans the channel beam, is operably attached to the motor, is rotatably attached to the channel beam, and can be rotated by the motor;
A belt attached to the drive spool and disposed laterally within the channel, extending at least partially around a patient's chest, and tightened by rotation of the drive spool to compress the patient's chest;
A first spindle rotatably attached to the first end of the channel beam ; and a second spindle rotatably attached to the second end of the channel beam ;
The chest compression device, wherein the second spindle is disposed to face the first spindle.   4. The chest compression device of claim 3, wherein the distance between the first spindle and the second spindle ranges from about 12 inches (about 30 centimeters) to about 22 inches (56 centimeters).   The chest compression device according to claim 3, wherein the first spindle and the second spindle are inserted at a distance from an edge of the housing. A housing that supports the patient's back;
A motor disposed in the housing below the patient when the patient is supported by the housing;
A channel beam attached to the housing and oriented transversely to the patient and defining a channel extending transversely across the housing;
A drive spool that spans the channel beam, is operably attached to the motor, is rotatably attached to the channel beam, and can be rotated by the motor;
A belt attached to the drive spool and disposed laterally within the channel, extending at least partially around a patient's chest, and tightened by rotation of the drive spool to compress the patient's chest;
A detent operably attached to a component of a chest compression device selected from the group consisting of the drive spool and the channel beam;
The chest compression device, wherein the detent is arranged so that the spool shaft cannot rotate when the belt is not attached to the drive spool . A spline attached to the belt;
Wherein along the length of the drive spool further includes a placement slot in the drive spool, said slot having a size such as to approximate the size of the spline, the spline in the slot When placed, the belt is attached to the drive spool;
The chest compression device according to claim 6, wherein the detent is arranged so that the spool shaft can rotate when the spline is inserted into the drive spool slot.

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