Apparatus for emergency medical care
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
The technical field to which the invention relates.
The invention relates to a device for medical assistance to the patient in an emergency condition in accordance with the preamble of paragraph 1. It additionally relates to a device for medical assistance to the patient in an emergency condition in accordance with the preamble of paragraph 3.
The level of technology
From European patent application EP A known vest, which the patient can wear on the body, provided by multiple sensors and therapeutic devices. As sensors are provided, among other things, pressure sensor, temperature sensor, microphone and biochemical sensor. The sensors are designed, among other things, to measure blood pressure, body temperature, heart rate, oxygen level in the blood and blood sugar levels. As a therapeutic device is provided, among other things, the source of oxygen, air pump, air bags, hypodermal syringe and stun device. Air bags are designed together with the pump, to adjust the patient's position, for locking in position a broken bone, to stop bleeding or to perform the recovery of cardiac activity or receive Heimlich.
U.S. patent US 5,544,661 discloses a system for monitoring a patient that includes a portable device and base station. Portable mouth is eusto includes, among other things, electrocardiograph and photoplethysmograph. The system is able to analyze the detected data and, if necessary, to notify the base station via the mobile telephone network, to transmit the physiological data of the patient and to create a voice connection. Further, therapeutic device attached to the patient, can be activated from the base station, such as an external defibrillator, a pacemaker or an automatic device for infusion of drugs.
From U.S. patent US 5,405,362 known system external defibrillation and injection drugs, which provided, in particular, for the treatment of patients with cardiac disorders outside of the hospital. The system includes a device capable of monitoring multiple physiological parameters of the patient, and an expert system that generates recommendations for the treatment of the operator. Further, it includes an external device for defibrillation and device for automatic injection of drugs in the bone marrow, through which the operator can treat the patient.
U.S. patent US 5,156,148 discloses a system for the automatic treatment of cardiac dysfunction without human intervention. The system receives the physiological signals from the patient relating to his circulatory system, and processes these signals with the use of a microprocessor. The microprocessor will kontroliruet device for treatment including a defibrillator and device for intravenous drug delivery.
Finally, from German utility model DE 20200502525 U1 known system for mobile monitoring cardiac function of the patient. In this system, the electrodes for transmitting the electrocardiogram is connected wirelessly, or through electrodes passing on the garment, with the Central controlling unit. The Central control unit capable of storing and processing data, electrocardiogram, and send a message to an external recipient and to establish voice communication with him. It further includes a GPS unit for positioning systems. The interface to the Central control unit provides data transfer to the external environment.
Disclosure of inventions
The objective of the invention is the provision of an improved device for medical assistance to the patient in an emergency condition.
For solving the problem of the invention describes a device for medical assistance to the patient in an emergency condition with signs of paragraph 1. The device includes a defibrillator as an additional therapeutic device, defibrillation may also be conducted in addition to the compression of the heart, to ensure effective treatment of the patient during the emergency condition.
For solving the problem of the invention stage is niteline describes a device for medical assistance to the patient in an emergency condition with the characteristics of paragraph 3. As a therapeutic device, which includes the respiratory therapeutic device, when state of emergency, it can be achieved using the invention to gain access to the respiratory system of a patient, in particular to perform rescue activities.
The invention can be applied, in particular, for patients with an increased risk due to existing cardio-circulatory disorders, or with sudden cardiac arrest, or cardiac reductions that do not provide cardiac volume (for example, the same ones), or if breathing has stopped. Emergency condition may be, in particular, cardiac arrest or respiratory arrest. Using the invention may be achieved by reducing the probability of death of the patient in the emergency state.
If the device for monitoring and therapeutic devices are located on the garment, it is possible to provide a device that can be worn on the body. This may, in particular, to contribute to improving the mobility of the patient and improve the quality of life. Using the invention can be achieved that the monitoring and treatment of the patient occur without the active participation or a third party. When the control device and therapeutic device operatively connected, the control device when detecting notlong the condition may start treatment or different steps in a logical sequence or medical simultaneously as a result of therapeutic devices.
Preferred embodiments and developments, which can be applied individually or in combination one with the other, set out in the dependent claims.
The device in accordance with the invention preferably includes a defibrillator as a therapeutic device. Preferably the defibrillator is located on the garment. Preferred defibrillator can cardiostimulation and/or defibrillation. It preferably includes at least two electrodes which can be attached to the patient, preferably on his chest wall, so as to give the patient sufficient impulse current for defibrillation. The electrodes preferably are elvisworldwide electrodes which, before application of the pulse current release conductive gel between the electrode and the chest wall, or provide protection of the skin in different ways.
Preferred defibrillator operatively connected with the controlling unit. Preferably the defibrillator performs defibrillation or cardiostimulation, when the control device detects a cardiac arrest, at certain intervals of time and with increasing intensity, until such time as the control device does not detect a recovery of cardiac activity, or up until the defibrillator n is deactivated by an external way, for example, the emergency doctor from the rescue service.
Preferably the device in accordance with the invention includes as a therapeutic device, a device for compression of the heart to restore cardiac activity. With this embodiment of the invention can be achieved that the patient is again initiated and/or supported minimum circulation. Preferably, the controller may start the compression of the heart when it detects a cardiac arrest, and may preferably perform it for varying lengths of time before detection of the recovery of cardiac activity, or up until a device for compression of the heart is not deactivated externally, for example, the emergency doctor from the rescue service.
Device for compression of the heart is preferably controlled so that the resting phase, respectively, accompanied by a predefined number of taps on the heart, which can run other therapeutic measures, preferably one or more different therapeutic devices from the device (for example, artificial respiration, intraosseous drug delivery). Device for compression of the heart is preferably controlled so that when the patient is treated well as a defibrillator, clicking on the heart is respectively occur between individual defibrillation and/or cardiostimulation. The preferred frequency of clicks on the heart is between 30 and 200, preferably between 50 and 120 clicks per minute. Duration of exposure in the maximum compressed position is preferably the same as in a relaxed position, i.e. the contraction phase and phase relaxation are of the same length. The preferred device for compression of the heart uses air bags, which are preferably inflated and emptied by a pump, for example, as disclosed in EP 1550398 A1. The contents of the above document is a part of the present disclosure by reference.
Preferably the device for compression of the heart clicks on the sternum in the transition region from the Central to the lower third of the front of the spine, preferably from 2 to 12 cm, particularly preferably about 6, the Preferred frequency of clicks is approximately from 50 to 70, particularly preferably about 60 clicks per minute. The preferred device for compression of the heart is provided at this end, a pneumatic piston or a spring mechanism. The bearing surface of the piston is preferably between 2 and 10, particularly preferably approximately 5 inches in width and from 5 to 20, particularly preferably about 10 centimeters in length. To achieve sufficient giving is to be placed against the spine garment takes a hard condition in the back, at least during the corresponding duration of compression of the heart.
Additional preferred device for compression of the heart operates in accordance with the method sternal pump. Preferably it consists essentially of a tubular air bag, for example, such increased cuff for blood pressure, located around the chest and inflated and blown off by means of a pneumatic device. With this embodiment of the invention can be achieved essentially homogeneous compression of the chest and, thus, the true reduction of the cross-section of the thorax and in particular also the volume of the chest. Preferred inflated pressure is between 150 and 350, particularly preferably about 250 millimeters of mercury. The preferred frequency of clicks is approximately from 50 to 70, particularly preferably about 60 clicks per minute. An achievable advantage of this embodiment of the invention is that the compression of the chest may also be compression of the lungs. This may also contribute to the fact that in addition to the minimum circulation is also supported minimal breathing.
The preferred device for compression of the heart operates in accordance with the principle of intermediate abdominal counterpulsation(IAC-CPR). In this case, during relaxation of the chest, the abdomen is compressed in the umbilicus, for example, by a piston or by essentially tubular air bag as described above in connection with the method of the thoracic pump. Pressure abdominal pressure is preferably between 50 and 150 millimeters of mercury. Preferably, the compression is performed in accordance with the principle of intermediate abdominal counterpulsation (IAC-CPR) intubirovannah patients. Additionally, the device in accordance with the invention preferably includes a suitable respiratory therapeutic device, particularly preferably, as described below. In a preferred modification of intermediate abdominal counterpulsation is a constant compression of the abdomen, which is also performed during the compression of the chest, oboznachilas as "abdominal binding".
Device for compression of the heart includes, in the preferred embodiment, means for lifting the chest during the phase of relaxation. Such a device for compression of the heart can operate in accordance with the method of active compression-decompression (ACD-CPR). In this embodiment of the invention can be achieved that create an intrathoracic vacuum to enhance diastolic venous return. It increases the ü intrathoracic blood volume, and to improve ventilation of the lungs. Particularly preferably, the device for compression of the heart unites active compression-decompression with intermediate abdominal counterpulsation. To this end it may, for example, include two pistons, respectively, one can attach to the chest and another to his stomach, preferably connected to each other by the arm. Then alternately, as with the two cups of weights, or sternum is compressed and weakened stomach (systole), or Vice versa.
In a preferred modification of the above method for the compression of the heart is more high frequency clicks, preferably between 100 and 200, particularly preferably between 120 and 150 taps per minute. An achievable advantage of this embodiment of the invention is increased by flow cardiac output.
The preferred device in accordance with the invention includes a perforating device, which can deliver medication intraosseous way, particularly preferably in the bone marrow. Perforating device preferably includes a cannula to pierce the bone, particularly preferably breast bone. With this embodiment of the invention may be achieved by obtaining access in the bone marrow cavity, so that, preferably, via cannula, to apply injection or infuse the nnye drug from the drug reservoir. Can be used a mechanism similar to, for example, which was used as a mechanism autoinjection disclosed in US 5,405,362. The contents of the above document is a part of this disclosure by reference.
Instead of or in addition to the endotracheal access respiratory therapeutic device perforating device in accordance with the invention can advantageously provide a similar advantageous method of intraosseous application. Perforating device preferably is located on the garment. Preferably it is operatively connected with the controlling device. In the preferred embodiment of the invention the perforating device is integrated at least partially in the subsystem with block compression of the heart.
In the preferred embodiment of the invention includes the respiratory therapeutic device capable of feeding oxygen and/or at least one medicine endotracheal. Respiratory therapeutic device preferably is located on the garment. Preferably it is operatively connected with the controlling device. The preferred respiratory therapeutic device includes a punching unit to punch the trachea below the larynx. The control device can run perf the radio, when it detects an emergency.
Preferred perforating unit includes a semi-circular perforation cannula, preferably with a diameter between 5 and 20 mm, particularly preferably between 8 and 16 millimeters. He further further includes a valve mechanism for directing perforating cannula in the direction towards the lungs into the trachea. Can be applied to the mechanism, for example, similar to the mechanism of autoinjection, opened in US 5,405,362.
Preferably the respiratory therapeutic device includes a tank of oxygen, particularly preferably medical oxygen, or connected with this tank, to supply oxygen from the tank to the respiratory system of the patient. This embodiment of the invention can be achieved that the supply of oxygen to the patient during resuscitation improves, in particular improved artificial respiration during the minimum passive respiratory movements occurring during cardiac compression. The oxygen supply is preferably triggered by the controlling device. The specific number of medical oxygen blown endotracheal from an oxygen tank, particularly preferably between 4 and 16 liters per minute, particularly preferably between 6 and 10 litres per minute.
The preferred respiratory therapeutic device which also uses a pump for artificial respiration with oxygen or oxygen-containing mixture, preferably the oxygen-air mixture, whereby the amount of artificial respiration, preferably individually predefined, can be blown at a preset pressure and a predetermined frequency in the resting phase of compression of the heart to the pulmonary resuscitation.
The preferred respiratory therapeutic device includes a tube, which may be located endotracheal, which preferably is punching through the cannula. In this embodiment of the invention, oxygen or oxygen-containing mixture can preferably be controlled by means of a pump or by adjusting the pressure in the oxygen tank, moving in the form of individual movements, breathing through a tube.
In the preferred embodiment of the invention provides that as soon as the detecting device determines respiratory arrest after a certain timeout, the trachea is perforated by the perforating unit below the larynx, and the artificial respiration tube is pushed endotracheal through the cavity of the cannula towards the light. The artificial respiration tube preferably has only a slightly smaller diameter than the cannula. She pushed in the direction of light, preferably between 5 and 15 cm, particularly preferably p is IMEMO 10 see Preferably in the upper third of the tube cuff is provided. During the filling of the cuff oxygen to the wall of the trachea is closed. The result can be advantageous to avoid aspiration of foreign bodies, such as vomit.
Preferably the respiratory therapeutic device includes at least one reservoir containing at least one drug or connected with this tank to submit a medication from the reservoir into the respiratory system of the patient. Particularly preferably the respiratory therapeutic device can serve many drugs, and to this end includes one or more drug reservoirs and/or connected with them, for example, as in US 5,405,362 full of relevant content which is part of the present disclosure by reference. Supply of drugs(a) preferably runs the controlling device. Medicine(a) is preferably in solution.
In the preferred embodiment of the respiratory therapeutic device has a thin catheter, which particularly preferably is able to automatically force the way through the cavity endotracheal located tube or through the cavity perforating cannula into the air tube. The catheter may, for example, be used for delivering drugs(a), or may be used for suction aspirated mother of the La by activating the vacuum. Preferably the catheter is moved in the direction of light about 10 to 30, particularly preferably about 20 centimeters in the air tube. The active substance, adrenaline, is discussed as a medicine. In this embodiment of the invention advantageously achieved by the delivery of drugs through the catheter deep into the trachea and/or absorption of aspirated material, to optimize the mechanical resuscitation efforts. The aspirated material is preferably collected in a sealed container.
The garment is a belt system, belt, jacket or blouse, or it preferably includes them. The belt system can be, for example, shoulder strap or shoulder or underarm holster. The jacket may be, for example, constructed in a manner similar to the commercially available LifeShirt. Further components of the invention (e.g., energy) or parts thereof can be adapted to other items of clothing (for example, Shoe soles) or portable support tools (e.g., sticks).
The control device preferably is provided with means for determining the cardiac and/or respiration, particularly preferably at least one means from the group of means, including: ECG unit, ultrasound unit, a stethoscope, an infrared unit, the sensor stretching. ECG unit includes the t at least two electrodes for receiving electrocardiogram. Ultrasonic unit may preferably take the sonogram. With a stethoscope, for example, can be controlled heart sounds and/or pulmonary activity. Preferred is an electronic stethoscope stethoscope, which can turn the heart sounds into an electrical signal, preferably through a microphone. Movement of the chest, associated with breathing can be detected by a sensor strain.
Preferably the device in accordance with the invention includes a storage device for storing data provided by the other devices, in particular controlling device. The storage device preferably stores data provided by one or more means of identifying cardiac arrest or breathing, for example, ECG unit, ultrasound unit, a stethoscope, an infrared unit or sensor stretching. The preferred storage device includes sufficient memory capacity to store signals over a period of time up to 24 hours. The storage device preferably is located on the garment.
In the preferred embodiment of the invention the device for medical assistance to the patient in an emergency condition includes a positioning device for detecting the current coordinates of the location of the media. The positioning is that the relevant device, for example, to include funds whose location can be determined planhouse transmitter and/or receiver. It may also enable the device to determine the location by the application of satellite positioning system, such as a positioning system GPS and the future Galileo system. Positioning device advantageously comprises means of positioning using a mobile radio network, for example GSM (Global system for mobile communications). This type of positioning uses the fact that each mobile transmitter and/or receiver registers to use the service mobile radio sector, the range of which is known. Although this type of positioning may not have the accuracy of satellite positioning, for example, when because of the small number of masts on the area of one sector radio covers a large area, the mobile system radiopositioning can be used as additional positioning when more accurate satellite positioning cannot be used, for example, in confined spaces or tunnels.
Advantageous that the positioning device includes a means for associating the detected coordinates of the location of public local information, e.g. about the place, street, house number and floor. Preferred POS is tianyoude the device includes a means of identifying the point of rescue services, geographically closest to the media. Positioning device preferably is located on the garment.
Preferably the device in accordance with the invention includes a communication device for transmitting messages to a remote receiver, such as the point of rescue services. The communication device preferably sends data to the device alarm to send an alarm signal to the recipient automatically and preferably by phone, for example, in the mobile radio network. The communication device belonging to this end, properly secured mobile radio transmitter and/or receiver, which, for example, use GSM or UMTS services. Mobile radio transmitter and/or receiver may, at the same time, to be a means of GSM positioning or forming with it the block. The system in accordance with the invention, however, is not limited to current conventional services mobile radio (GSM and UMTS); but it is possible transmitter and/or receiver for any type of wireless communication with a wide range.
Preferably, the communication device may provide the recipient with information about the patient's condition. The message transmitted to an external receiver may transmit information about the dysfunction of the patient's heart and/or electrocardiographic with Galy, preferably electrocardiographic signals over a period of time including at least three and at most 60 minutes. As a result of this embodiment of the invention can be achieved that the recipient previously shall be informed of the type of dysfunction of the heart, so it may take appropriate measures more quickly. Preferably the communication device informs the recipient about the identity of the patient, particularly preferably in accordance with the data protection laws. The message for the recipient may, for example, contain the identification number of the patient.
Preferably the communication device informs the recipient about the location of the patient, preferably by automatic synthesis of speech signals. To this end the communication device is preferably operatively connected with the positioning device. It is advisable that the message transmitted to the recipient, included the satellite positioning, the positioning means of the mobile radio network and/or other location information to provide quick and accurate communication with an external receiver on the location of the patient. It is advisable that the message sent to the recipient, included information on whether the transmission of messages induced by the manual or automatically. The communication device preferably has a function of self-control, which is regularly, for example once a day, creates test the connection to an external receiver, and particularly preferably displays this process through a video monitor how successful or unsuccessful. This control function can preferably also at any time be carried out manually by the media by clicking the button.
In another preferred embodiment of the present invention the communication device includes means for manual activation, whereby starts sending messages to an external receiver, preferably the rescue service. By manual activation is provided by the possibility that the patient passes the message to an external recipient, when the patient, for example, is in a state of emergency, which is not recognized by the system in accordance with the invention and/or may not be recognized, for example, in emergency situations, not induced by disturbance of cardiac function, or even when the patient has doubts about whether the system works in accordance with the invention.
Preferably the communication device is designed in the form of a device for establishing voice communication between the patient and/or his environment and the external recipient, preferably a rescue service, or the other external recipient. An achievable advantage of this embodiment of the invention is that possible consultation between the patient and the point of rescue services, for example, to eliminate false alarms, or to speak with a third party, for example, the first assistant, passers-by or relative of a patient, for example, to clarify the place of attack, for a message about the sequence of events or information, whether required immediate action. To this end a communication device provided with suitable means, not requiring manual force. In one embodiment of the invention developed tools that do not require manual exposure, so that passers-by can read about the state of the media. The communication device preferably is located on the garment.
The device in accordance with the invention preferably includes at least one interface device for transmission of data provided by another hardware device, the external environment, particularly preferably to the monitoring device. It is advisable to interface the device interface in accordance with the USB (Universal serial bus) standard and/or in accordance with the Bluetooth Standard. The interface device preferably is located on predpitated.
In the preferred embodiment of the device in accordance with the invention has a visual and/or acoustic and/or vibration display device to display status information, warnings and/or information about the system. For example, you can display information about the state of the energy source, the system information regarding the correct location of the electrodes and/or on the correct connection of the electrodes with a Central controlling unit and a possible warning when doing explicit cardiographic or respiratory-specific signals, or close to the expiration date of the medication or oxygen. Using visual and/or acoustic and/or vibrating the display device the patient can expediently be informed, for example, about the possible presence of errors and, in particular, about the irregularities detected by the controlling device, which may be associated with impaired cardiac and/or respiratory functions. Displays the device preferably is located on the garment.
The device in accordance with the invention preferably includes a power device for providing another device with energy. The energy device may, for example, include a rechargeable battery or fuel cell. Energy is eticheskoe device preferably is located on the garment. Electrical conductors to other devices also preferably located on the garment.
In the preferred embodiment of the device in accordance with the invention, one or more devices or parts from one or more devices of the device group comprising: the control device, power device, a storage device, positioning device, the device that detects the direction of the communication device, an interface device, display device, power device, placed in the Central control unit. The controlling unit does not have to be on the garment or worn directly in front of the body. For example, it is expedient that the control unit was designed so that the patient, for example, when lying in bed, was able to position controlling unit next to him. As a result of this embodiment of the invention, the visit of the emergency services may also be easier for the patient that the patient should not be controlling unit. In another preferred embodiment, the controlling unit reversibly attached, for example, on the belt, to which the control unit can hard to join, so that the weight of the Central control unit as little as possible interfere with and/or load of the patient
Equipment device in accordance with the invention and its components can be in communication with each other in a wired or wireless manner. It is advisable that the wireless connection was a connection type "blue tooth", a combination of different radio frequency or infrared connection. However, there are also other wireless connections, such as the newly developed standard radio with short ranges. Preferably the devices or components, such as electrodes attached to the patient's body, in contact acoustic, or visual, or vibratory manner, when the range of the wireless connection with another device or component with which they are connected, is exceeded.
In the preferred embodiment of the device in accordance with the invention includes a programmable device, preferably at least one microprocessor to control therapeutic device based on the physiological parameters detected by the controlling device. Programmable device is preferably placed in the control device. The device preferably operates a control program, for example, mutatis mutandis, in accordance with that disclosed in US 5,56,148. The respective contents of the above document is that forms part of the present disclosure by reference.
Brief description of drawings
The invention is hereinafter described in more detail with reference to schematic drawings and embodiments with additional details on are:
figure 1 shows a schematic block diagram of a device in accordance with the invention for medical assistance to the patient in an emergency condition;
figure 2 shows a schematic representation of the punching unit of the trachea.
The implementation of the invention
Device for medical assistance to the patient in an emergency condition in accordance with the present invention is shown schematically in Figure 1. The device 1 includes a blouse 2, which is closely adjacent to the body of the carrier. The blouse 2 in the transition area from the Central to the lower third of the sternum media tubular air bag 3 device compression of the heart 4 sewn in blouse 2 to perform under state of emergency, compression of the heart in accordance with the method of the thoracic pump to maintain a minimum circulation. Air bag 3 can be inflated and emptied by a pump, such as disclosed in EP 1550398 A1. In another embodiment of the invention, via the pneumatic piston or a spring-loaded mechanism with a bearing surface of approximately 5×10 cm along the sternum, the sternum is pressed in the transition area from the Central to the lower third with a frequency of approximately 100 per minute approximately a cm against the spine. The duration of exposure in the position of maximum pressing is the same as in the relaxation state, so that the phase of compression and relaxation are of the same length. To provide pressure against the spine, belts and/or blouse must take a hard condition in the rear of the field for the duration of compression of the heart, for example, using air bags located at this point. Further, through this unit can provide access to the bone marrow of the sternum through the perforating cannula for use injectable or intravenous drugs.
Further, in a blouse 2 are sewn two electrodes 5, 6 defibrillator 7, which, if necessary, release the gel or provide protection of the skin in other ways and can then be cardiostimulation. Further, the sensor extension 8 of the controlling device 9 is installed in the blouse to monitor respiratory activity of the media.
At the top of the blouse 2 is located perforating device 11, which can perforate the trachea 18 patient semicircular perforating tip 17 with a diameter of about 14 mm, as perforating unit. At this end are provided with pneumatic tools or pre-strained spring, like autoinjector disclosed in US 5,405,362. Oxygen unit 12 respiratory those who piticescu unit applies a sealed tank 19, stores medical oxygen. The reservoir is installed on the perforating device 10a, 10b or oxygen unit 12 of the Central control unit. As soon as the control device 9 detects respiratory arrest after a certain waiting period trachea carrier is perforated below the larynx through a semi-circular perforation cannula 17, perforating device is moved pneumatically or by means of a spring in the direction of arrow 20 from the position 10a in the position 10b. After that, the artificial respiration tube with a diameter slightly less than that of the perforating tip is pushed by the spring 23 and the piston 24 through the cavity of the cannula endotracheal about 10 cm in the direction of light. After the handset is fully pushed forward, the cuff is filled with oxygen to seal the tube 21 on the wall of the trachea and thus avoid aspiration, for example, of vomitus. From an oxygen tank 19, as shown by the arrow 22, blown about 8 liters per minute of oxygen, to provide oxygen minimum passive respiratory movements occurring during compression of the heart. In the resting phase of the compression of oxygen and/or oxygen-containing gas mixture is injected by a pump, not shown, at the predetermined frequency in the form of individual movements IP is Ustinova breathing.
Medical device 13 applies a sealed vessel, in which there are various emergency medications (such as adrenaline)that are separated from one another and in solution. Through a thin catheter that when an emergency condition is automatically pushed into the cavity endotracheal located tube 21 of about 20 cm in air pipe, medications can be automatically applied deep in the trachea, in order to optimize mechanical resuscitation efforts. Aspirated material may also passivates through the catheter pump as the vacuum source and collected in a sealed container.
Oxygen and medicinal tanks, pumps and controlling and analyzing device and the power device 14, GSM transmitter and receiver, a device that detects the direction and GSM positioning device 15 are combined into a Central control unit 16, which is also sewn into the blouse 2. With the help of wires and tubes sewn into blouse 2, the Central control unit 16 is connected with the other aforementioned components of the device.
The features disclosed in the above description, claims and drawings may be important both individually and in any combination for the development of the invention in its various embodiments.
1. The device (1) is La medical care to the patient in an emergency condition, comprising: a garment (2), which the patient can wear on the body, the control device (8, 9)located on the garment (2), which can control at least one physiological function of the patient to determine the emergency condition, and therapeutic device located on the garment (2), operatively connected with the controlling device (8, 9), in order to treat the patient, when the control device (8, 9) defines an emergency, wherein therapeutic device is a respiratory therapeutic device(10, 11, 12, 13), which can supply oxygen, oxygen-containing gas mixture and/or at least one medicine endotracheal, and includes perforating unit (10)to perforate the trachea of the patient below the larynx.
2. The device (1) according to claim 1, characterized in that therapeutic device moreover is a perforating device, which can deliver medication intraosseous way.
3. The device (1) according to claim 1, characterized in that the drug can be delivered into the bone marrow cavity through the sternum perforating device.
4. The device (1) according to claim 1 or 3, characterized in that it includes a defibrillator (5, 6, 7) as an additional therapeutic device.
5. The device (1) according to claim 1, Otley is aldeasa fact, it includes as an additional therapeutic device a device for compression of the heart (3, 4) for resuscitation of the heart.
6. The device (1) according to claim 1, characterized in that the respiratory therapeutic device (10, 11, 12, 13) includes an oxygen tank (12), or connected with this tank, to supply oxygen or oxygen-containing gas mixture from the reservoir (12) in the respiratory system of the patient.
7. The device (1) according to claim 1, characterized in that the respiratory therapeutic device (10, 11, 12, 13) includes means to apply a predetermined frequency oxygen or oxygen-containing gas mixture endotracheal.
8. The device (1) according to claim 1, characterized in that the respiratory therapeutic device (10, 11, 12, 13) includes at least one reservoir (13) at least one drug, or connected with this tank, in order to give the medication(s) from the reservoir(s) (13) in the respiratory system of the patient and/or bone marrow cavity of the sternum.
9. The device (1) according to claim 1, characterized in that the respiratory therapeutic device (10, 11, 12, 13) includes a catheter that can be crowded into the trachea.
10. The device (1) according to claim 9, characterized in that the respiratory therapeutic device (10, 11, 12, 13) includes means to apply the medication through the catheter or to saywat the material of the tracheal and/or bronchial tubes.
11. The device (1) according to claim 1, characterized in that the garment (2) includes a system of straps, jacket or blouse.
12. The device (1) according to claim 1, characterized in that the control device (8, 9) includes means for determining a cardiac arrest or breathing.
13. The device (1) according to item 12, characterized in that the control device (8, 9) is provided for detecting a cardiac arrest or breathing at least one means from the group of means, including: ECG unit, ultrasound unit, a stethoscope, an infrared unit, the sensor strain (8).
14. The device (1) according to claim 1, characterized in that it includes a storage device to store data provided by other equipment or device.
15. The device (1) according to claim 1, characterized in that it comprises a positioning device (15)to determine the coordinates of the current location of the media.
16. The device (1) according to claim 1, characterized in that it includes a communication device (15) to send a message to a remote recipient.
17. The device (1) according to claim 1, characterized in that it includes an interface device for transmission of data provided by another hardware device, in the external environment.
18. The device (1) according to claim 1, characterized in that it includes a visual and/or acoustic display device to display information about the able, warnings and/or information about the system.
19. The device (1) according to claim 1, characterized in that it includes the power device (14) to supply other equipment devices energy.
20. The device (1) according to claim 1, characterized in that one or more devices, or a component of one or more devices from the device group, including:
therapeutic device(3, 4, 5, 6, 10, 11, 12, 13), the control device (8, 9), power device (14), a storage device, a positioning device (15), a device which determines the direction of the communication device (15), the front-end device, display device, the power device (14), located in the Central control unit (16).
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.
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
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
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: 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
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
SUBSTANCE: group of inventions relates to medicine; the method of manufacturing of the air feed device in the shape of the laryngeal mask airway, wherein the mask comprises the housing with a heel and cephalic ending and a peripheral inflatable cuff, the mask is attached to the air feed pipe for providing the gas flow between the pipe and mask; the method includes the air feed pipe, preparatory forming of the mask housing for the definite air feed pipe and procedure of mounting of the cuff to the mask housing; the air feed device in the shape of a laryngeal mask airway manufactured pursuant to specified method is being described herein.
EFFECT: enhancement of the reliability and provision of the smooth surface of the air feed device at the junction of air feed pipe and the mask housing without increasing the stiffness and boss at the spot of junction.
6 cl, 24 dwg
SUBSTANCE: invention refers to surgery in particular, otorhinolaryngology and anaesthesiology. It can be applied to healing cancer patients with T2 stage larynx cancer. In this connection the trachea is paracentetically catheterized with further high-quality artificial lung ventilation. Then the endotracheal tube is put through the nose and its end is directed to the vestibule of larynx. The larynx is resected vertically preserving the continuity of the upper third shield-like cartilage frame. Before the operational wound closure the intratracheal tube should be set so that its puffed collar is located at the level of the resected segment of the larynx. The operational wound is sewed up.
EFFECT: means allows reducing considerably the potential complications as a result of vertical larynx resection without applying endoprosthesis due to the formation of larynx opening on the endotracheal tube.
1 dwg, 1ex, 1 dwg
SUBSTANCE: invention relates to medical equipment and is used for supporting respiration. Tube contains external cannula, which has distal end and first attaching end with first connecting means, inserted component, introduced into external cannula, and second attaching end, provided with second connecting means. Second connecting means interacts with fist connecting means, fixing inserted component in external cannula. On second attaching end of inserted component installed is rotary fixing element, enveloping section of first attaching end and provided with internal connecting means, which is made with possibility of interaction with first connecting means, placed on external surface of first attaching end.
EFFECT: ensuring safe, reliable, quickly acting and convenient in manipulations tracheostomic tube.
19 cl, 13 dwg
SUBSTANCE: group of inventions refers to medicine, and aims at facilitation of tracheotomy and creation of a fistula through a tracheoesophageal wall. The device comprises a first sector inserted into a trachea or an oesophagus through a mouth so that a distal end of said sector is located below a larynx when said first sector is inserted into the trachea, and the second sector is located outside a neck. The distal end of said sector is located near to a prospected tracheotomy or fistula place. An end of one of the sectors contains a guide for a pointed object. An end of the other sector contains a receiver. The first and second sectors are coupled so that the guide is directed towards the receiver. The pointed object pricking skin, tracheal wall or tracheoesophageal wall is directed to the receiver. There are disclosed methods for tracheotomy and fistula creation, as well as application of the device for fistula creation through the tracheoesophageal wall for introducing a vocal valve into the fistula and for laterofixation of the paralysed vocal chords.
EFFECT: inventions improve surgical safety and provide convenience for a patient.
43 cl, 12 dwg
SUBSTANCE: invention refers to medicine, namely to anesthesiology and intensive therapy, and be used in puncture-dilatation tracheostomy in the patients with multiple organ failure. That is ensured by insertion of a tracheostomy tube to conduct tracheobronchial tree sanation. Then, before the surgical operative intervention, a patient's extubation in a space of puncture-dilatation tracheostomy is executed followed by application of a laryngeal mask and artificial pulmonary ventilation. After the insertion of the tracheostomy tube, the laryngeal mask is removed and further artificial pulmonary ventilation is conducted through said tube.
EFFECT: method allows reducing possibility of respiratory and thereby hemodynamic complications of puncture-dilatation tracheostomy in the critical patients due to continuous pulmonary ventilation.
SUBSTANCE: group of inventions relates to medical equipment. Laryngeal mask contains inflatable cuff, mask element, tubular element, which has end for connection with mask and distal end. Tubular element is fastened to mask element with its distal end. Inflatable cuff has seamless external surface, that is, smooth external surface. Mask element is equipped with reinforcing petal, intended for accepting and holding tubular element with provision of asymmetrical surface of joining between mask element and tubular element on its distal end. Described is method of manufacturing cuff for laryngeal mask and method of manufacturing laryngeal mask, which contains cuff.
EFFECT: ensuring laryngeal mask strength.
28 cl, 27 dwg
SUBSTANCE: invention relates to medical equipment, in particular to device for providing respiratory ducts in patients in unconscious state. Air-conducting device contains air-conducting tube and mask, fixed to air-conducting tube and determining output zone for gas. Mask contains body, which has distal end and proximal end, and peripheral inflatable cuff and is attached to air-conducting tube in order to provide possibility of gas flow between tube and mask. Means of esophagus drainage forms drainage canal between water part near distal end and outlet hole, located, when device is introduced to patient and set into specified position, outside with respect to patient. Drainage canal consists of section inside air-conducting tube and section inside mask, formed in material of mask body integral with body.
EFFECT: reduction of rigidity and elimination of blocking/narrowing of air duct, ie elimination of drawbacks, which are caused by presence of duct for esophagus drainage.
16 cl, 24 dwg
SUBSTANCE: invention relates to field of medicine, namely to thoracic surgery. Tracheotomic tube is made T-shaped with round deviating segments. In lumen of larynx segment 5-10 mm above deviation unit occluder is installed. Occluder is made in form of cylinder with sealing rings on external lateral surface.
EFFECT: invention makes it possible to carry out adequate lung ventilation in treatment of trachea stenosis in early post-operational period and to perform feeding in natural way in post-operational period.
1 ex, 1 dwg
SUBSTANCE: invention relates to medicine and is intended for introduction to patient in order to provide air canal to their fissure of glottis. Air-conducting device in form of laryngeal mask contains air-conducting tube and mask, attached to air-conducting tube and determining output zone for gas. Mask contains body, which has distal end and proximal end, and peripheral inflatable cuff and is attached to air-conducting tube for providing possibility of gas flow between tube and mask. Device additionally contains means which prevents blocking of outlet zone by patient's anatomical elements. Said means contains support component and passage, which allows gas to flow from outlet zone of air-duct beyond said component.
EFFECT: avoidance of blocking air duct narrowing.
15 cl, 24 dwg
SUBSTANCE: invention relates to medicine and is intended for ensuring air duct to patient's fissure of glottis, when patient is in unconscious state. Air conducting device contains air-conducting tube and mask, attached to air-conducting tube and determining outlet hole for gas. Mask contains posterior plate, which has distal end and proximal end, as well as dorsal surface and ventral surface. Mask contains peripheral inflatable cuff and is connected to air-conducting tube to ensure possibility of gas flow between tube and mask. Dorsal surface of posterior plate is made bent in such way that its bent part, which has constant curve, starts from connecting section of posterior plate and ends at distal end of said plate in such way that distal mask end is displaced in ventral direction with respect to its proximal end.
EFFECT: invention ensures facilitation of construction introduction.
9 cl, 24 dwg
SUBSTANCE: invention refers to medicine, neurosurgery, anesthesiology and resuscitation. Critical patients with intracranial hemorrhages are transferred to artificial pulmonary ventilation (APV) and exposed to hyperbaric oxygenation (HBO) in a compression mode 1.5 ATA for 40-50 minutes accompanied with average blood pressure (BPav) control. If the HBO session is accompanied with increasing BPav by 21% and more from the initial pre-compression BPav value with underlying synchronism of the patient and the APV apparatus, intracranial pressure rise is stated that requires hyperventilation by increasing respiratory rate and respiratory volume to normalise the BPav value.
EFFECT: method provides the diagnosis and the adequate correction of intracranial pressure rise following a hyperbaric oxygenation session in the patients with intracranial hemorrhages and wakefulness depression up to 10 points and less of Glasgow coma scale.