Automatic external defibrillator

FIELD: medicine.

SUBSTANCE: group of inventions refers to medical engineering and is designed to restore normal rhythm and contractile function of heart. Automatic external defibrillator includes a pair of electrode plates; a controller connected to the electrode plates through the front-end circuit of ECG and running for analysis of ECG signals to determine whether ECT is recommended, high-voltage circuit connected to the electrode plates for carrying out biphasic defibrillation electric shock when ECT/treatment protocol storage device is recommended, which retains one or more of treatment protocols that include the protocol of single electroshock controlled by AED for carrying out a single biphasic electric defibrillation, followed by a period of cardio-pulmonary resuscitation (CPR); while the controller is connected to the treatment protocol storage device working to implement the protocol of single electric shock where the single electric shock protocol is the default protocol for AED. The second version of defibrillator also contains a battery connected to AED power circuit; user interface control elements the administrator works with to select either a single electric shock protocol, or protocol of repeated electric shocks through the resident piece of software in AED, without removal of battery or linking-up external hardware or software to the AED.

EFFECT: providing opportunities of time management of cardio-pulmonary resuscitation.

14 cl, 10 dwg

 

The invention, in General, refers to a collection of operations that are performed when electrotherapy, and, more specifically, to automatic external defibrillators, which provide increased proportion of time for carrying out cardio-pulmonary resuscitation (CPR) in relation to the time spent on defibrillation.

Automatic external defibrillators ("AWD") serves high-voltage pulse to the heart to restore normal rhythm and contractile function of the heart in patients who have arrhythmias, such as ventricular fibrillation ("Fi") or ventricular tachycardia ("VT"), which is not accompanied apparently by the pulse. There are several classes of defibrillators, including manual defibrillators, implantable defibrillators and automated external defibrillators. RTH differ from manual defibrillators fact that the AWD pre-programmed for automatic analysis of rhythm electrocardiogram ("ECG"), to determine whether defibrillation and to provide measures of assistance, such as the sequence of shocks and periods of CPR. While the rescuer is not necessary and in most cases there is no possibility to do the installation Protocol salvation. This differs from manual defibrillators, which are used by highly skilled honey the medical professionals, with experience in setting defibrillation required for a particular operation rescue.

In Fig. 1 shows an illustration of the last 10 used by the user 12 to reinvigorate the patient 14, suffering from cardiac arrest. When sudden cardiac arrest patient is dangerous to life the cessation of normal heart rhythm, usually in the form of FE or adipose tissue, which is apparently not accompanied by a pulse (i.e. adipose tissue, which requires stimulation by electric shock). When Fi instead of the normal rhythmic contractions of the ventricles happen fast, irregular, spasmodic contraction, resulting in inefficient and extremely reduced pumping of blood by the heart. If normal rhythm is not restored within a period of time, which are usually considered to be around 8-10 minutes, the patient will die. Conversely, the faster will be applied defibrillation after the start Fi, the better the chances that the patient 14 will survive after a heart attack.

When using the RTH user 12 provides a pair of electrodes 16 on the chest of the patient 14 for receiving the ECG signal from the patient's heart. The defibrillator 10 then analyzes the ECG signal for signs of arrhythmia. If detected to be treated fibrillation, defibrillator 10 transmits to the user 12 is ignal about recommended electroshock. After detecting Fi or other rhythm that requires stimulation by the electric shock, the user 12 clicks on the button of the shock on the defibrillator 10 for supplying the pulse defibrillation to reinvigorate the patient 14.

Recent studies have shown that different patients can be resuscitated more effectively using different treatment regimens depending on various factors. One of the factors that affect the likelihood of successful defibrillation, represents the time that has passed after the patient has happened arrhythmia. This study showed that, depending on the duration of cardiac arrest, the patient has a better chance at recovery when using one Protocol over another. If the AWD will be installed on less efficient Protocol resuscitation of the patient, the likelihood of recovery of a patient can be reduced. These studies have shown that some of these patients have the best chance of recovery if it is first performed CPR to start some circulation, which can lead the patient into a state in which the shocks will be successful. Also, there is information that the Protocol salvation RTH, which provides CPR before saving during genial, OEM is x attacks, improves survival in the long term. The protocols of salvation, which provide a continuous period of CPR, as described in application for U.S. patent No. 60/737,187, filed November 16, 2005, entitled "AED HAVING MANDATORY PAUSE FOR ADMINISTERING CPR". In addition, there is evidence that the Protocol of salvation, which makes the maximum proportion of time CPR to perform actions related to defibrillation improves survival. Accordingly, it is desirable to provide the AWD, which would provide early CPR at the time of salvation, and which would have increased the proportion of time allocated to conduct CPR on the time of application of electric shock.

In accordance with the principles of the present invention described RTH, which provides the possibility of increasing the proportion of time for CPR in relation to the time spent on the use of electroshock. RTH pre-installed before you perform rescue operations on the Protocol of salvation, which, when the shock recommended is to apply a single bi-phase electric shocks, at least 150 joules and preferably 175 joules or more. Preferably, the Protocol is a single shock was pre-programmed as the default Protocol for the AWD. After conducting a one-time shock to the AWD goes into p is the period of pause to perform CPR during which the rescuer performs CPR.

In accordance with an additional aspect of the present invention RTH can be easily installed on the Protocol single shock, if it is in the current time set on the Protocol of multiple shocks. The Protocol setup a single shock can be performed using the user interface RTH without removing the battery.

In accordance with another another aspect of the present invention after a period of pause for CPR should the analysis of the ECG waveform and, if recommended electroshock, and served either a single shock, or a sequence of multiple shocks.

In the drawings:

In Fig. 1 shows an illustration of a defibrillator is applied to the patient suffering from cardiac arrest.

In Fig. 2 shows a block diagram of a defibrillator constructed in accordance with the principles of the present invention.

In Fig. 3 illustrates the AWD with audio user interface.

In Fig. 4 shows the AWD with a visual user interface.

In Fig. 5 illustrates the Protocol defibrillation with three tazers prior art.

In Fig. 6 illustrates the Protocol rescue defibrillation single shock in accordance with the present invention.

In Fig. 7 illustrates the second proto the ol defibrillation single shock in accordance with the present invention.

In Fig. 8 illustrates the Protocol defibrillation single shock and multiple electroshock in accordance with the present invention.

In Fig. 9 illustrates a third defibrillation Protocol with a single shock in accordance with the present invention.

In Fig. 10 shows a detailed block diagram of a prediction device resuscitation, suitable for use with the Protocol of resuscitation in accordance with the present invention.

In Fig. 2 illustrates RTH 110, constructed in accordance with the principles of the present invention. RTH 110 is designed so that it has a small physical size, light weight and relatively simple user interface, with which you can work with people with a high level of training, or otherwise, which uses the defibrillator 110 only in rare cases. In contrast (manual) defibrillator for rescue or clinical defibrillator of this type, which is usually included in the equipment ambulance (SMEs), typically made larger, heavier and has a more complex user interface, which allows you to maintain a large number of manual monitoring and analysis systems and Protocol.

Circuit 202 in the input stage of the ECG is connected to the pair of electrodes 116, which are connected with the breast klecko the patient 14. Circuit 202 in the input stage of the ECG during operation increases, buffers, filters and converts the digital electric ECG signal generated by the patient's heart, for receiving the stream of digitized samples of the ECG. Converted into digital form by sampling the ECG enter the controller 206, which performs analysis to detect FG requiring stimulation of electroshock in adipose tissue or other requiring stimulation electroshock rhythm, and in accordance with the present invention, in which the mode of treatment, providing a relatively large proportion of CPR to the patient. If the detected rhythm requiring electroconvulsive stimulation, the controller 206 transmits a signal to the circuit 208 supply HV (high voltage) to charge the high voltage capacitor circuit 208 in preparation for submission to shock and activated button electroshock interface 214 of the user so that it starts to flash. The rescuer then receives audio instructions, to be at a distance from the patient (manual clean hands"). When the rescuer presses the shock on the interface 214 user defibrillations the shock comes from the schema 208 filing NR to the body 14 of the patient through electrodes 116.

The controller 206 is connected so that it optionally accepts an input signal from the microphone 212 for receipt of the voice track. The analog audio signal from microphone 212 is preferably converted into digital form to receive the stream of digitized samples of the sound, which can be saved as part of the conclusion 130 about the event in the storage device 218. The interface 214 may comprise a display, a loudspeaker and control buttons, such as push-button on/off button electric shock, ensure the control of the user, as well as visual and audio cues. The user interface in accordance with the present invention may also include one or more control buttons to select the Protocol of salvation, stored in a storage device 218, which is performed during rescue operations. Watch 216 provide data on a real time or elapsed time to the controller 206 for setting the timestamp information contained in the conclusion 130 about the event. The storage device 218, or embodied as an embedded random access memory, or a removable memory card, or as a combination of different technologies storage devices during operation saves the conclusion 130 about the event in digital form, in that form, as it is compiled during treatment of the patient 14. Conclusion 130 about the event can include streams of digitized ECG, audiovisual and other data is abitia, as explained above.

RTH in Fig. 2 has several treatment protocols used during rescue operations, or saved regimens that can be selected during installation AWD when it is initially taken in the ambulance service. One type of Protocol is a Protocol "first shock". When the AWD set this Protocol, RTH, when it is connected to the patient and activate immediately analyzes the heart rhythm on the ECG of the patient in order to perform a classification of the cardiac rhythm. If the analysis determines that there is an arrhythmia that requires the application of electrical defibrillation, usually either ventricular fibrillation (FG)or ventricular tachycardia (VT)at which no palpable pulse, the rescuer is notified and receives supply of electric shock. If it is determined that such arrhythmias may not be applied impact defibrillation electroshock, AWD goes into "pause"during which it can be performed CPR.

The second type of Protocol is a Protocol "CPR first". When the AWD set this Protocol, AWD starts to work by providing instructions to the rescuer to conduct CPR for the patient. After carrying out CPR for a specified period of time AWD start parsing the encoded ECG data with the to verify the presence of arrhythmia that requires electrical defibrillation.

In accordance with the principles of the present invention RTH 110 has the ability to perform either a Protocol of repeated electric shock, or Protocol of a single shock, the latter provides one or more periods of CPR, which constitute a large proportion of the time of salvation in relation to the time spent RTH when exposed relating to defibrillation shock, as described in detail below. Preferably, the Protocol single shock is a Protocol, default, i.e. the AWD was pre-installed to use either a single shock at the time when it was received by the ambulance service. RTH can be installed on the default setting at the factory or by service personnel before the device will be available for use in the ambulance service. Thus, when the AWD take in the ambulance service, he is ready to work immediately with the application of the Protocol single shock after installing the battery and the automatic execution of the self so that it does not require any additional installation. If the ambulance service prefers Protocol mnogokrat is on electroshock, installation of the Protocol can be changed by staff or administrator RTH, or other authorized individual of the ambulance service for use of the requested Protocol, as described below. Preferably the setting of the Protocol can be changed using the controls interface 214 of the user and without unnecessarily complex manipulations, such as the use of special hardware or software. Preferably, the installation of the Protocol could be changed without having to disconnect the AWD.

In accordance with an additional aspect of the present invention the Protocol single shock RTH in Fig. 2 delivers biphasic waveform single shock instead of a single pulse. The level of energy supplied to a single bi-phase electric shocks, at least, is at the same energy level as the shock RTH sequence of multiple shocks. The energy level in excess of 150 joules, is desirable, and energy levels in excess of 175 joules, is preferred, and the energy level in excess of 200 joules, is preferable. (The actual supplied energy may differ from the intended dose depending on the internal electrical resistance of the patient). the usual single bi-phase electric shock, as a rule, has the same or greater energy level than the highest energy level of the shock when a sequence of multiple shocks.

Consider now Fig. 3, which shows sold at retail (ISD) RTH 310, in top view in perspective. PTS AWD 310 is installed in a rigid polymer enclosure 312, which protects the electronic circuit inside the housing, and also protects low-skilled user from electric shock. To the housing 312 is attached electric wires, the pair of electrode plates. In the variant embodiment shown in Fig. 3, the electrode plates are in the cartridge 314, which is located in the recess on the upper side of ISD RTH 310. Electrode plate out for use by pulling the handle 316 that allows you to remove the plastic cover installed over the top of the electrode plates. The user interface is located on the right side AWD 310. A small indicator light 318 readiness informs the user about the readiness ISD RTH. In this variant embodiment the light the ready light blinks after proper installation PTS AWD and ready for use. Light the ready light on constantly when the PTS RTH is used, and light the ready light turns off or blinks with the color of the alarm when the PTS AWD requires attention to the expression.

Light ready indicator button 320 on/off. Button on/off press to turn on the PTS AWD for use. To turn off the PVR RTH the user holds the button on/off pressed for one second or more. Button 322 information flashes when there is information to the user. The user clicks the button information to access available information. The light signal 324 warning light flashes when the PTS AWD receives information of cardiac contractions of a patient, and is on continuously when recommended electroshock, which prevents the rescuer and others that no one should touch the patient at this time. Interaction with the patient, while the receive signal of the heart, may introduce unwanted artificial interference in the detected ECG signal. Click 326 electroshock click for supplying electric shock after ISD RTH informs the rescuer that recommended electroshock. Infrared port 328 on the side of the ISD RTH is used to transfer data between PTS AWD and the computer. This data port is used after the rescue works with the patient and when the doctor you want to receive event data from ISD RTH after loading them into his or her computer for detailed analysis. Gro is logowriter 313 provides voice instructions to the rescuer, passing the lifeguard instructions when using PTS AWD for treatment of the patient. Provides audible warning device 330, which "beeps"when the PTS AWD requires attention, for example when replacing the electrode plate or the installation of a new battery.

When using the configuration in accordance with the prior art ISD RTH 310 has been configured at the factory and shipped to customers with a default Protocol with three tazers. The user is not provided with instructions for changing the Protocol; if the owner or potential rescuer will need a Protocol single electric shock or other Protocol may be modified only by authorized personnel using special software installation. However, when the PTS AWD is developed in accordance with the present invention, it is configured at the factory for delivery to the customer with the Protocol of the single shock Protocol installed by default. In accordance with an additional aspect of the present invention, the Protocol can be changed via the user interface RTH without removing the battery or other specialized hardware or software. Authorized person three times clicks 322 information or uses another special is th sequence. This action causes the speaker 313 reports that the AWD is in install mode, and the listener is provided with one or more choices, including the choice of Protocol. Following the audio instructions, an authorized person can change the default Protocol is a one-time shock to another installation Protocol or may modify the Protocol with a single shock, as presented below.

It should be understood that, when it is supposed to use the AWD 310 unskilled person without the assistance of trained personnel ambulance, still it is desirable to provide the ability to adjust the Protocol is installed by authorized personnel only, and not by an unskilled user RTH.

In Fig. 4 illustrates a defibrillator in accordance with another example of the present invention. This AWD 410 has a pair of electrodes 416 connector 426, which is developed with the possibility of inserting into the slot 428 on the AWD 410. On the upper surface of the RTH 410 is a user interface that includes a switch 418 power that activates the AWD 410 and begins the process of sound prompts the user to secure the electrodes 416 on the patient 14. The indicator 420 provides a continuous visual indication of the status of the defibrillator and the available charge of baht the unit. The display 422 displays text, such as prompts to the user, and a graphic image, such as the ECG waveform. Button 424 shock supply shock to the patient 14, if the analysis of the electrocardiogram shows that there is a rhythm that require the use of electro-stimulation. Holding defibrillating shock is performed by prompting the user for 12 manually click on the button 424 shock.

When using the configuration in accordance with the prior art RTH 410 deliver to the customer with the established Protocol of three tazers as the default Protocol. Authorized persons can change or adjust the treatment Protocol to other protocols such as the Protocol single shock, using several different procedures. One procedure is to remove the battery RTH and insert a specially configured card installed in the unit. When the battery is re-installed, RTH 410 is enabled and is set-up menu on the display 422. The required changes to the Protocol can be executed from the setup menu or by reading data from the card installation. During installation RTH cannot be used for defibrillation. After the installation, the AWD off, and the battery is again removed. Map setup, then remove from AB is, and reinstall the battery. RTH can now enable the new configuration.

Another procedure consists in removing the battery and installing a specialized battery pack for administration. When installed in the battery pack for administration, the user presses and holds two buttons 430 and 432 selection on the user interface. When RTH 410 is enabled when the battery pack administration, software installation works, displaying the setup menu on the display 422. After the end of the installation process RTH is turned off, the battery pack administration removed, install a working battery, and RTH can then be used with the new Protocol configuration.

Another procedure consists in the reception of new data using the infrared port RTH 328 (not shown in Fig. 4). These settings may be accepted by transfer from another RTH 410 or when transferring from the computer that runs special software installation.

In accordance with the principles of the present invention RTH 410 is configured at the factory for delivery with the established Protocol of a single shock as the default Protocol. The customer can thus use the AWD 410 immediately after installing the battery and somatesthesia the Oia, as RTH a single shock. Any of the above procedures can be used to replace the Protocol to the Protocol of repeated electric shock, or to adjust the Protocol single shock, as described below. Alternatively, the Protocol single shock can be modified to change the period of CPR, as described below, and/or Protocol may be modified by the Protocol of repeated electric shocks through the user interface without removing the battery or connections with other AWD or computer. Special buttons of the user interface, such as holding pressed both buttons 430 and 432 of choice, by clicking on the button 424 electric shock, or when using another special sequence of buttons allows authorized personnel to call up the setup menu on the display 422 for modifications and/or changes of the Protocol electroshock.

Consider now Fig. 5 and 6, which presents an illustration of the increased proportion of time spent on CPR, the Protocol of salvation in accordance with the present invention, when comparing two block diagrams of the sequence of operations. In Fig. 5 illustrates a block diagram of a typical sequence of operations of the Protocol 500 of the impact of the three shocks. At step 502 the AWD starts by analyzing the fo is we wave ECG of the patient. If recommended electroshock (the only outcome in these illustrations), RTH charges its high-voltage electrical circuit and supplies the first electric shock on stage 504. After the artificial interference signals resulting from supply shocks, sufficiently dissipated, again analyzed ECG at step 506 in order to ensure that returned normal heart rhythm or require another shock. If it is determined that it is recommended to use another electric shock, AWD again charges the high-voltage electrical circuit and supplies a second electric shock on stage 508. After the filing of the second shock again analyze the ECG waveform at step 510 to check back if normal heart rhythm or need additional shock. If recommended electroshock, RTH charges and delivers a third shock at step 512. After the third shock in this example, the AWD starts the period 514 pause for CPR, and during this time the rescuer can receive audio instructions when performing CPR. After the end of the pause for CPR analyzed ECG to determine, it is recommended that if another sequence of shocks. You can see that the sequence of three shocks during the execution of the operations takes considerable time for analysis and preparation for electr therapy, compared to the time allocated for CPR.

For comparison in Fig. 6 illustrates a typical sequence 600 one-time shock in accordance with the present invention. As in the sequence shown in Fig. 5, the Protocol begins at step 602 where the AWD performs the analysis of the ECG waveform to determine, it is recommended that if the shock. When the shock is recommended RTH charges the high-voltage electric circuit at step 604 and delivers a single bi-phase electric shock. As mentioned above, once the shock takes the energy level is the highest level served by an electric shock while performing a sequence of three tazers, preferably at the level of 175 joules or more, and more preferably at 200 joules or more. After filing a single shock RTH in this example enters the period 606 pause for CPR within which produce CPR. At the end of the period of CPR RTH analyzes the ECG waveform at step 608 to determine, returned if a normal heart rhythm or require another shock. Analysis of the electrocardiogram may begin during the pause for CPR, if artificial interference associated with compression of the chest, sufficiently filtered from the data processing. You can see that a significantly large proportion lying is neither spent on CPR within the sequence 600 single shock, compared to sequence 500 with three tazers in Fig. 5.

In Fig. 7 illustrates a second Protocol 700 one-time shock in accordance with the present invention. The Protocol 700 begins with an analysis of the electrocardiogram at step 702 charge and the filing of a single shock at step 704, when the shock is recommended, and after a period of pause for CPR at step 706 is performed another analysis of ECG waveforms at step 708 the same as described above with reference to Fig. 6. If normal heart rhythm is not returned, and it is recommended that another shock, RTH charges and takes another single bi-phase electric shock on stage 710. After this second filing shock RTH enters another period of pause for CPR. In this example you can see that after each feed defibrillation shock should the period of the CPR to ensure a significant amount of CPR to the patient. Since the circulation caused by the CPR may increase the chances of successful defibrillation, the Protocol often allows the successful rescue, in particular, patients with significant time his heart stopped before performing rescue operations.

In Fig. 8 illustrates the Protocol 800 salvation in accordance with the present invention, which is used as a single shock, and the sequence of Mogok Atego shock. This sequence begins with the same four steps 802-808, as described above. When recommended electroshock after analysis of the ECG waveform at step 808, the Protocol begins a sequence of three electric shocks by charging high-voltage electric circuit and submission of the first shock in the sequence of the three shocks at step 810. After the filing of this first of three tazers, RTH analyzes the ECG waveform to determine, returned if a normal heart rhythm or need additional shock. If shock advised, the sequence proceeds to the steps 508-512, as described above, pausing for another period of pause for CPR. The patient thus receives the advantage of the use of a single shock, and a sequence of multiple electric shocks when using this Protocol.

In Fig. 8 illustrates another Protocol 900 of the present invention, which starts at step 902, with the CPR. During or at the end of the period of the pause for CPR RTH analyzes the ECG waveform at step 904. If recommended electroshock, RTH charges and delivers a single bi-phase electric shock on stage 906, followed by another period of pause for CPR at step 908. Treatment continues at steps 708 or 808 and the following stages odnokratnogo the electric shock or a mixed sequence of shocks, respectively. You can see that the Protocol 900 provides the greatest percentage of time for CPR in the illustrated exemplary protocols.

RTH 110 in Fig. 2 has an additional option, which is to recommend a Protocol such as the Protocol first the shock (see, for example, Fig. 6) CPR or first (see, for example, Fig. 9), as more fully described in concurrently filed patent application number [attorney docket 001633]. This is done with the AWD, which begins to analyze the ECG waveform of the patient and to calculate and evaluate the indicator of return of spontaneous circulation (VSC), as described below. The evaluation metric VSC recommended treatment Protocol. The recommended Protocol can be immediately executed RTH or recommendation may be submitted for the rescue so that he could make their own final decision in relation to the performed treatment Protocol.

Figure 10 illustrates the circuit portion 202 in the input stage of the ECG and the controller 206 of figure 2, which during operation of the recommended treatment Protocol, which will likely be effective for the patient. As mentioned above, the electrodes 116 provide the ECG signals from the patient, for which the sample is converted to digital form using an A/d Converter 120. Converted to the number form the ECG signals fed into the processor analyzing the electrocardiogram in the controller, which performs the analysis of the ECG waveform to determine, it is recommended to apply an electric shock. Sample ECG serves to block 122 of subdirectly, which performs subsampling flow of ECG samples to a lower data rate. For example, the stream data at a rate of 200 samples/second can be converted into a rate of 100 samples/second. ECG data after lowering speed is served in the transmitter 124 VSC, which determines the sequence of indices of the IPC on the EKG. The VSC indicators is compared with a threshold value using a comparator 126 threshold values for determining the mode of treatment that is likely to result in successful resuscitation of the patient. This definition of a mode associated with a part of the mode controller, which either selects the desired mode automatically, or is this mode as a recommendation for a rescuer, who then may decide whether to perform the recommended mode or an alternative regimen.

The transmitter 24 VSC can operate in different ways. For example, the VSC indicator can be calculated as the average value of the first derivative, limited bandwidth (or first difference, which is a discrete analogue), ECG over a period of several seconds. Since the first derivative, restricted the I bandwidth, can be designed to detect arrhythmia controller 206, additional calculations may include only the additional calculation of average values. This process can be performed as the measurement in real time using a rolling average value for which you want to perform only one sum and one subtraction per sample. For example, the difference between consecutive samples can be obtained for the stream samples obtained during the period of 4.5 seconds at a rate of 100 samples/second. The sign of the difference between cast to obtain the absolute values are summed over a period of 4.5 seconds. The result is the index value VSC, which is equivalent frequency-weighted average of the amplitude of the ECG waveform. This indicator can be scaled or can be further processed in accordance with the architecture and requirements of a particular system.

Since the range of the first derivative is proportional to the frequency, rate VSC largely not affected by artificially generated noise CPR, most of which have very low frequency.

Another alternative method of calculation of the average value is in receipt of squared differences of successive samples with subsequent summation of the received rezultatai calculate the square root of this sum. It displays the RMS (root mean square value) of the VSC indicator.

Alternatively, the calculation of the average values another approach is to use the median magnitude of the first derivative. This approach requires more calculations, but it preferably may be more reliable and protected from noise. You should pay attention to avoid downplaying signal that provides a measure of its discriminatory power. In another embodiment, the preferred embodiment of the compromise can be obtained using the calculation of the trimmed mean or minimax. When Troubleshooting the largest outlier is possible to provide a lower susceptibility to pulsed artificial interference (e.g., physical interference from the electrode plates). By removing the largest outlier is possible to eliminate artificial random noise with a large amplitude, which can occur relatively infrequently, without a significant reduction in discriminatory power associated with the data obtained in the measurement of cardiac parameters.

1. Automatic external defibrillator (RTH)containing:
a pair of electrode plates;
a controller connected to the electrode plates through the schema of the input cascade ECG and working for analysis of ECG signals defined for the I, it is recommended that if an electric shock;
high-voltage circuit connected to the electrode plates for supplying bi-phase defibrillating shock recommended electroshock, storage, treatment Protocol, which stores one or more treatment protocols, including the Protocol, a single shock, which is controlled by the AWD for filing a single bi-phase defibrillating shock, followed by a period of cardiopulmonary resuscitation (CPR); and
the controller is connected with the drive of the treatment Protocol, which works to implement the Protocol single shock, in which the Protocol is a single shock is a default Protocol for the AWD.

2. Automatic external defibrillator of claim 1, wherein the Protocol is a one-time shock configured by the manufacturer as the default Protocol before delivery RTH to the buyer.

3. Automatic external defibrillator according to claim 1, in which the drive of the treatment Protocol and optionally saves the treatment Protocol of repeated electric shocks, which can be selected by the administrator to perform domain controller.

4. Automatic external defibrillator according to claim 3, in which the treatment Protocol multiple electroshock contains a Protocol with three tazers.

5. Automatically the external defibrillator according to claim 4, additionally contains the display, located on the AWD, in which the Protocol electroshock treatment is chosen by the administrator via the display.

6. Automatic external defibrillator according to claim 4, further containing a loudspeaker for audible prompts, in which the Protocol electroshock treatment is chosen by the administrator in response to the voice prompt.

7. Automatic external defibrillator, comprising:
a pair of electrode plates;
a controller connected to the electrode plates through the schema of the input cascade ECG and working for analysis of ECG signals to determine, it is recommended that if an electric shock, a high-voltage circuit connected to the electrode plates for supplying bi-phase defibrillating shock recommended electroshock;
the drive of the treatment Protocol, which preserves many of the treatment protocols, including the Protocol of a single biphasic shock and the Protocol repeated electroshock;
a controller connected to the drive of the treatment Protocol, which works to implement the Protocol single shock Protocol or a multiple of electroshock;
the battery that is connected with the power circuit RTH; and controls the user interface used by the administrator to select either Protocol odnocratno.sochetanie, a Protocol or a multiple electric shocks through the resident portion of the software in RTH, without removing the battery or connect an external hardware or software to the AWD.

8. Automatic external defibrillator according to claim 7, in which the controls of the user interface contains a button on the AWD.

9. Automatic external defibrillator of claim 8, in which the button also works to control another function of the AWD, in which the operation button to select the Protocol of the shock is different from the operation buttons to control another function.

10. Automatic external defibrillator of claim 8, in which the button further comprises a set of buttons.

11. Automatic external defibrillator according to claim 7, further containing a display located on the AWD, which controls the user interface work with a screen to select the Protocol.

12. Automatic external defibrillator according to claim 7, further containing a loudspeaker, which gives audible cues, which controls the user interface work together with audio prompt to select the Protocol.

13. Automatic external defibrillator according to claim 7, in which when performing Protocol single shock serves the biphasic shock 175 joules or more.

14. Auto is th external defibrillator according to item 13, with the implementation of the Protocol single shock serves the biphasic shock of at least 200 j.



 

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5 cl, 1 dwg

FIELD: medicine.

SUBSTANCE: method involves creating therapeutic circuit fixed on patient body, at least two working therapeutic electrodes, measuring and analyzing patient-dependent electrophysical parameters, charging capacitive storage and its later discharging to the working therapeutic electrodes controlled with control unit. Transmitting defibrillation impulse of given power in discharging is carried out in dosed manner first with the first portion W1 of given power dose with the second portion W2 being accumulated on inductive defibrillation power accumulator and then with the second portion W2 of given power dose. Ratio of the first portion W1 of given power dose to the second portion W2 of given power dose of defibrillation impulse is selected from the range of 0.01 to 150. Defibrillation impulse current intensity is selected only when emitting the first portion W1 of given power dose. Cardiodefibrillation impulse is built as bipolar Gurvich impulse. The given power quantity usable for charging the capacitive defibrillator storage is selected to be equal to a value from the range of 4-500 J, defibrillation impulse current intensity being selected from the range of 0.005 to 175 A and voltage equal to a value from 3 to 30000 V. Means has power supply source having unit for controlling charge level of the capacitive storage, unit for building defibrillation pulses, switchboards formed by controlled keys, at least two working therapeutic electrodes and diodes bypassing the controlled keys, resistive current transducer, analog-to-digital converter and control unit having required functional communications to the analog-to-digital converter and controlled keys. The resistive current transducer is in current feeding bus having minimum potential relative to measuring unit under operation having analog-to-digital converter in its structure.

EFFECT: enhanced effectiveness of usage; high safety of patient treatment procedure.

7 cl, 9 dwg

The invention relates to a device of a charging capacitor

The invention relates to medical equipment, namely, devices for generating stimulus signals

Defibrillator // 2196616
The invention relates to medicine and can be used in devices for intensive care and electro-therapy, in particular in defibrillators

The invention relates to medicine, namely to the portable electronic physiological instrument, in particular to a portable defibrillator with the common port of therapy data

Defibrillator // 2153901
The invention relates to medicine and can be used in devices for intensive care and electro-therapy, in particular in defibrillators

FIELD: medicine.

SUBSTANCE: method involves creating therapeutic circuit fixed on patient body, at least two working therapeutic electrodes, measuring and analyzing patient-dependent electrophysical parameters, charging capacitive storage and its later discharging to the working therapeutic electrodes controlled with control unit. Transmitting defibrillation impulse of given power in discharging is carried out in dosed manner first with the first portion W1 of given power dose with the second portion W2 being accumulated on inductive defibrillation power accumulator and then with the second portion W2 of given power dose. Ratio of the first portion W1 of given power dose to the second portion W2 of given power dose of defibrillation impulse is selected from the range of 0.01 to 150. Defibrillation impulse current intensity is selected only when emitting the first portion W1 of given power dose. Cardiodefibrillation impulse is built as bipolar Gurvich impulse. The given power quantity usable for charging the capacitive defibrillator storage is selected to be equal to a value from the range of 4-500 J, defibrillation impulse current intensity being selected from the range of 0.005 to 175 A and voltage equal to a value from 3 to 30000 V. Means has power supply source having unit for controlling charge level of the capacitive storage, unit for building defibrillation pulses, switchboards formed by controlled keys, at least two working therapeutic electrodes and diodes bypassing the controlled keys, resistive current transducer, analog-to-digital converter and control unit having required functional communications to the analog-to-digital converter and controlled keys. The resistive current transducer is in current feeding bus having minimum potential relative to measuring unit under operation having analog-to-digital converter in its structure.

EFFECT: enhanced effectiveness of usage; high safety of patient treatment procedure.

7 cl, 9 dwg

FIELD: medical engineering.

SUBSTANCE: device has means for producing defibrillation pulse having electric current source, capacitive electric energy storage, high voltage commutator, control unit and control system having patient electrophysical parameter control means and high voltage pulses control means and at least two therapeutic electrodes. The device also has means for compressing human body chest manufactured for instance as elastic cuff having a built-in ultrasonic radiator.

EFFECT: high reliability in delivering defibrillation pulse at given address.

5 cl, 1 dwg

FIELD: medicine.

SUBSTANCE: invention concerns medicine area, namely to area of urgent cardiological resuscitation. The heart defibrillator for treatment of the patient in case of cardiovascular activity termination by means of the shock blow provided with the dosed out diphasic electric discharge of high-voltage condenser through the H-shaped bridge circuitry, contains the high voltage commutator A, B, C or D in each of the branches. According to the invention each of opposite polarity phases of a diphasic shock blow is managed in two stages on time in such a manner that for each pair of the commutators concerning the given phase, the first of pair commutators is changed over in leading state and remains leading during all this phase whereas the second commutator of this pair is shorted with some time delay in relation to the first commutator throughout some operated duration for establishment of a current flow through a body of the patient during this phase, and the second phase is processed in the same way by means of other pair of commutators.

EFFECT: wide use of the defibrillation device.

13 cl, 6 dwg

FIELD: physics.

SUBSTANCE: invention can be used for generating powerful bipolar and multiphase electric pulses. The method involves controlling series-connected single-type power cells containing electrical energy accumulators, and providing switching of positive and negative polarity of the connection of the energy accumulator to leads of the cell, and switching the electrical energy accumulator to leads of the cell, and having bypass diodes which provide flow of current through leads of the cell when electrical energy accumulators are disconnected from the leads of the cell. A signal from a current sensor is transmitted to the analogue input of a digital signal processor (DSP), from the digital outputs of which the power cells are controlled. Before completion of generation of a pulse, the digital signal processor periodically converts the signal from the current sensor, standardises it, calculates deviation from the current value stores in the digital signal processor of the pulse form and compares the deviation with four limiting values. Signals for controlling power cells are output from the outputs of the digital signal processor depending on the comparison results.

EFFECT: simplification of the method of generating pulses and reducing the number of circuit components.

7 dwg, 1 tbl

FIELD: medicine.

SUBSTANCE: group of inventions refers to medical engineering and is designed to restore normal rhythm and contractile function of heart. Automatic external defibrillator includes a pair of electrode plates; a controller connected to the electrode plates through the front-end circuit of ECG and running for analysis of ECG signals to determine whether ECT is recommended, high-voltage circuit connected to the electrode plates for carrying out biphasic defibrillation electric shock when ECT/treatment protocol storage device is recommended, which retains one or more of treatment protocols that include the protocol of single electroshock controlled by AED for carrying out a single biphasic electric defibrillation, followed by a period of cardio-pulmonary resuscitation (CPR); while the controller is connected to the treatment protocol storage device working to implement the protocol of single electric shock where the single electric shock protocol is the default protocol for AED. The second version of defibrillator also contains a battery connected to AED power circuit; user interface control elements the administrator works with to select either a single electric shock protocol, or protocol of repeated electric shocks through the resident piece of software in AED, without removal of battery or linking-up external hardware or software to the AED.

EFFECT: providing opportunities of time management of cardio-pulmonary resuscitation.

14 cl, 10 dwg

FIELD: electricity.

SUBSTANCE: bipolar signal shaping device includes electric energy accumulator, controlled electronic switches switching it and control diagram of the above switches. For shaping of positive and negative polarity signal the electric energy accumulator which is connected to circuit of in-series connected switches is installed. Each of switches is parallel connected to resistor. Control circuit of switches for changing the pulse shape controls the activation of electronic switches and circuit for shaping of bipolar signal. Bipolar signal shaping circuit consists of four switches in-series connected to electric energy accumulator and pulse shape change circuit so that when the first and the fourth switches close, current flows through load in the direction shaping positive polarity signal and when the second and the third switches close, current flows through load in the direction shaping negative polarity signal. Control signals of electronic switches are supplied from control diagram for shaping of bipolar signal.

EFFECT: simplifying and optimising electric circuit.

3 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment, namely to apparatuses for emergency medical care. The apparatus comprises a piece of clothing, a control unit arranged thereon used to control at least one physiological function of the patient to state an emergency, and a therapeutic device arranged on the piece of clothing and operatively connected to the control unit for treating the patient. The therapeutic device is a respiratory therapeutic device applied to supply oxygen, an oxygen-containing gas mixture and/or at least one drug endotracheally, and comprises a perforating unit to perforate the patient's trachea below the larynx.

EFFECT: use of the invention provides extending the range of apparatuses for emergency medical care.

20 cl, 2 dwg

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment, namely to system for carrying out CPR. Device of providing feedback in carrying out CPR contains sensor of compression, adapted for placement between rescuer's hands and victim's chest, module of control with feedback, connected with compression sensor, and programmed for registration of output data of compression, their analysis, identification of single compression cycles and comparison of single cycles of compression with multitude of evaluation criterions. Matrix of comparison is output on presentation device, and each element of matrix corresponds to comparison of one of single compression cycles with one of multitude of evaluation criteria. Method of feedback presentation includes stages of carrying out compression of victim's chest through sensor of compression, registration, analysis, identification and comparison of output data from compression sensor with multitude of evaluation in form of comparison matrix elements.

EFFECT: invention makes it possible to increase efficiency of improvement of technical methods in carrying out CPR.

19 cl, 6 dwg

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment, in particular, to systems of ECG monitoring, which trace indications of ciliary arrhythmia (CA) in real time. System of ciliary arrhythmia monitoring contains source of electrocardiogram data, extractor of P-wave signs, extractor of interval R-R signs, CA classifier, reacting to P-wave sign and interval R-R sign, which classifies cardiac rhythm as that with CA or without CA, display, reacting to CA classifier for displaying CA classification, and user's input for regulation of balance sensitivity/specificity of identification of rhythm with CA, with user's input additionally containing selection of type of patient population for automatic adjustment of nominal working parameters of identification of rhythm with CA for selected type of patient population.

EFFECT: invention will make it possible to simplify adjustment of nominal working parameters Of CA monitoring system for selected type of patient population.

14 cl, 11 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment. An external defibrillator for two-phase defibrillation waveform supply comprises a high-voltage circuit, which accommodates a condenser, as well as a pair of electrodes and a number of switches. The high-voltage circuit is presented to charge the condenser to supply the defibrillation pulse. The switches comprise an H-bridge, connected between the condenser and electrodes and can be connected to first and second phases of the two-phase defibrillation waveform to the electrodes. A second-phase tilt is adjustable. The controlled conduction path comprises the H-bridge switch and enables the controlled conduction path for the second phase of the two-phase waveform.

EFFECT: using the invention enables higher safety and effectiveness of defibrillation.

12 cl, 6 dwg

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