Adjustable piston

Abstract

Techniques and devices for extending a piston, for example connected to a medical device such as a mechanical CPR device, to accommodate different sized patients, are described herein. In some cases, a piston of a mechanical CPR device may include an inner piston at least partially slidable into an external piston sleeve. In one aspect, an external piston spacer may be attached to an outward surface of the inner piston to extend the length of the piston. In another aspect an internal bayonet sleeve may contact one or more locking rods at various positions, enabling adjustment of the length of the inner piston. In yet another aspect, a piston adapter may be removably attached to the end of the piston. In all aspects, the change in length of the piston may be detected and used to modify movement of the piston, for example to more safely perform mechanical CPR.

Claims

1. A mechanical cardiopulmonary resuscitation (CPR) device, comprising: a piston having a piston surface; a controller configured to create an oscillation of the piston; a piston adapter contactable with the piston surface comprising: a body; a suction cup attachment surface for removable attachment to a suction cup; a piston connection surface disposed on an end of the body opposite the suction cup attachment surface, wherein the piston connection surface is configured to releasably engage with the piston surface; a piston sensor configured to detect engagement of the piston surface with the piston connection surface; and a release member that when activated allows disengagement of the piston connection surface from the piston surface.

2. The CPR device of claim 1, wherein the piston surface and the suction cup attachment surface have substantially the same configuration.

3. The CPR device of claim 1, wherein the piston surface includes a piston end and a circumferential piston flange disposed at the piston end.

4. The CPR device of claim 3, wherein the piston end includes a substantially flat surface.

5. The CPR device of claim 4, wherein the suction cup attachment surface includes a circumferential adaptor flange and a substantially flat surface.

6. The CPR device of claim 3, wherein the piston connection surface includes a lip having a recess configured to partially encircle the piston flange.

7. The CPR device of claim 1, wherein the piston connection surface includes a retractable engagement member moveable from a locked position in which the engagement member releasably engages the piston surface to an unlocked position in which the engagement member releases the piston surface.

8. The CPR device of claim 7, wherein activation of the release member moves the engagement member to release engagement of the piston surface.

9. The CPR device of claim 7, wherein the piston connection surface includes a recessed portion and the engagement member extends into the recessed portion in the locked position.

10. The CPR device of claim 1, wherein the release member is spring-loaded.

11. The CPR device of claim 1, wherein the piston sensor is configured to send a signal to the controller when engagement of the piston surface with the piston connection surface is detected.

12. A mechanical cardiopulmonary resuscitation (CPR) device, comprising: a piston having a piston surface; a controller configured to create an oscillation of the piston; a piston adapter contactable with the piston surface comprising: a body; a suction cup attachment surface for removable attachment to a suction cup; and a piston connection surface disposed on an end of the body opposite the suction cup attachment surface, the piston connection surface including at least one retractable engagement member disposed on the piston connection surface, wherein the piston connection surface is configured to releasably engage with the piston surface, and wherein the piston connection surface includes a lip having a recess configured to partially encircle a portion of the piston surface, and the engagement member is disposed opposing the lip.

13. The CPR device of claim 12, wherein the piston connection surface further comprises a lip that at least partially encircles a portion of the piston surface and a plurality of retractable engagement members disposed on the lip.

14. The CPR device of claim 12, further comprising a release member that when activated retracts the engagement member.

15. The CPR device of claim 12, wherein the piston surface includes a circumferential piston flange and the engagement member is configured to releasably engage with the flange.

16. A mechanical cardiopulmonary resuscitation (CPR) device, comprising: a piston having a piston surface, wherein the piston surface includes a piston end and a circumferential piston flange disposed at the piston end; a controller configured to create an oscillation of the piston; a piston adapter contactable with the piston surface comprising: a body; a suction cup attachment surface for removable attachment to a suction cup; a piston connection surface disposed on an end of the body opposite the suction cup attachment surface, wherein the piston connection surface is configured to releasably engage with the piston surface, and wherein the piston connection surface includes a lip having a recess configured to partially encircle the piston flange; and a release member that when activated allows disengagement of the piston connection surface from the piston surface.

17. The CPR device of claim 16, in which the release member is disposed opposite the lip.

18. A mechanical cardiopulmonary resuscitation (CPR) device, comprising: a piston having a piston surface, the piston surface including a piston flange disposed at a piston end of the piston; a controller configured to create an oscillation of the piston; and a piston adapter contactable with the piston surface comprising: a body; a suction cup attachment surface for removable attachment to a suction cup; and a piston connection surface disposed on an end of the body opposite the suction cup attachment surface, the piston connection surface including a plurality of retractable engagement members disposed around a recessed portion of the piston connection surface, wherein the piston connection surface is configured to releasably secure the piston flange between the plurality of retractable engagement members and a base of the recessed portion of the piston connection surface.

19. The CPR device of claim 18, further comprising a release member that when activated retracts the plurality of retractable engagement members.

20. The CPR device of claim 19, wherein the release member is spring-loaded.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) Throughout the drawings, reference numbers may be re-used to indicate correspondence between referenced elements. The drawings are provided to illustrate example embodiments described herein and are not intended to limit the scope of the disclosure.

(2) FIGS. 1A and 1B depict an isometric view and a side view, respectively, of one embodiment of a mechanical CPR device.

(3) FIGS. 2A, and 2B, depict example operations of a mechanical CPR device on a patient, in accordance with the present disclosure.

(4) FIGS. 3A and 3B depict example operations of a mechanical CPR device with an adjustable piston on a patient having a small sternum, in accordance with the present disclosure.

(5) FIG. 4 depicts a side view of mechanical CPR device having an adjustable piston, in accordance with the present disclosure.

(6) FIGS. 5A, 5B, 5C, 5D, 5E, 5F, and 5G depict an example of an adjustable piston including a removable external piston spacer, according to an aspect of the present disclosure.

(7) FIGS. 6A, 6B, 6C, 6D, and 6E, depict an example of an adjustable piston including an internal bayonet sleeve, according to an aspect of the present disclosure.

(8) FIG. 7 depicts an example of an adjustable piston including a piston adapter, according to an aspect of the present disclosure.

(9) FIG. 8 depicts an example method of adjusting the length of a piston of a mechanical CPR device, in accordance with the present disclosure.

(10) FIG. 9 depicts a perspective view of a piston adapter, according to an aspect of the present disclosure.

(11) FIG. 10 depicts a side view of the piston adapter of FIG. 9.

(12) FIG. 11 depicts a top view of the piston adapter of FIG. 9.

(13) FIG. 12 depicts a bottom view of the piston adapter of FIG. 9.

(14) FIG. 13 depicts a perspective view of a mechanical CPR device including the piston adapter of FIG. 9, in accordance with the present disclosure.

(15) FIG. 14a depicts a perspective view of the piston adapter of FIG. 9 and a suction cup, the piston adapter in a locked position.

(16) FIG. 14b depicts the piston adapter of FIG. 14a in an unlocked position.

(17) FIG. 15 depicts a perspective view of a piston adapter, according to an aspect of the present disclosure.

(18) FIG. 16 depicts a side view of the piston adapter of FIG. 15.

(19) FIG. 17 depicts a top view of the piston adapter of FIG. 15.

(20) FIG. 18 depicts a bottom view of the piston adapter of FIG. 15.

(21) FIG. 19 depicts a perspective view of a mechanical CPR device including the piston adapter of FIG. 15, in accordance with the present disclosure.

(22) FIG. 20a depicts a perspective view of the piston adapter of FIG. 15 and a suction cup, the piston adapter in a locked position.

(23) FIG. 20b depicts the piston adapter of FIG. 20a in an unlocked position.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

(24) Mechanical CPR compression devices having an adjustable length piston can provide many advantages over manual CPR compressions and/or non-adjustable mechanical CPR compression devices. As will be described in greater detail below, the use of an adjustable piston with a mechanical CPR device may provide additional benefits, including adaptability to accommodate patients of different sizes. It should be appreciated that the devices and techniques described herein may similarly be used in other applications. These other applications may include other mechanical devices, particularly medical devices, where patients of different sizes may require treatment.

(25) FIGS. 1A and 1B depict an isometric view and a side view, respectively, of one embodiment of a mechanical CPR device 100. The mechanical CPR device 100 includes a lower portion 105 and an upper portion 110. The upper portion 110 can have a main portion 115 and two legs 120 and 125. Each of the legs 120 and 125 can be releasably connected to one of the sides of the lower portion 105. Items that are releasably connected are easily disconnected by a user, such as connections that can snap in and snap out, connection that do not require the use of tools to disconnect, quick-release connections (e.g., push button release, quarter-turn fastener release, lever release, etc.), and the like. Items are not releasably connected if they are connected by more permanent fasteners, such as rivets, screws, bolts, and the like. In the embodiment shown in FIGS. 1A and 1B, the legs 120 and 125 are rotatably attached to the main portion 115 about axes 130 and 135, respectively. However, in other embodiments, the legs 120 and 125 can also be fixed with respect to the main portion 115.

(26) The main portion 115 can include a piston 140 with an end 145. The end 145 can be blunt, contoured, or otherwise configured to interact with a patient's torso. The end 145 can also have a suction cup that can temporarily attach to a patient's torso. The main portion 115 can include other components. For example, the main portion 115 can include a drive component, such as a motor or actuator, that can extend and retract the piston 140. The main portion 115 can include a power source, such as a rechargeable battery, that can provide power for the drive component. The main portion 115 can also include a controller that can control the movement of the piston 140 by controlling the drive component. In one embodiment, the controller can include a processor and memory, and the memory stores instructions that can be executed by the processor. The instructions can include instructions for controlling the piston 140 by controlling the drive component. The main portion 115 can also include one or more sensors that can provide inputs to the controller. The one or more sensors can include one or more of a force sensor to sense a force exerted by the piston 140, a spring sensor to sense a displacement of the piston 140, a current sensor to sense an amount of current drawn by the drive component, or any other type of sensor. The main portion 115 can also include one or more user input mechanisms, such as buttons, keys, displays, and the like. A user can input information to adjust the operation of the mechanical CPR device 100, such as a depth of compressions, a frequency of compressions, a maximum exertion force by the piston 140, and the like.

(27) In addition to the mechanical CPR device 100, FIG. 1B also depicts a cross section of a patient's torso 155 with the patient's back against the lower portion 105 and the patient's chest facing the piston 140. While in the configuration depicted in FIG. 1B, the piston can be extended in the space 160 to the patient's torso 155, compress the patient's torso 155, and retract from the patient's torso. This process, wherein the piston 140 compresses the patient's torso 155 and is then retracted from the patient's torso, can be performed repeatedly to mechanically perform CPR.

(28) FIGS. 2A and 2B depict example operations of a mechanical CPR device 100 on a patient 200. FIGS. 2A and 2B depict a portion of a mechanical CPR device 100 that includes a piston 140. The end of the piston 140 includes a suction cup 145. The depictions in FIGS. 2A and 2B show cross sectional views of the mechanical CPR device 100, the piston 140, and the suction cup 145. The mechanical CPR device 100 could also include other components that are not depicted in FIGS. 2A and 2B, such as one or more components of mechanical CPR device 100 described above in reference to FIGS. 1A and 1B.

(29) In FIG. 2A, the piston 140 is at first fully retracted into the mechanical CPR device 100, such that the suction cup 145 is at a position 205 above a torso 220 of patient 200. In this position, the suction cup 145 is not in contact with the patient's torso 220. From this first position 210, the piston 140 can be extended until the suction cup 145 of piston 140 is at a position or height 210. At height 210, the suction cup 145 is in contact with the patient's torso 220. The piston 140 can be extended by a drive component, such as a motor or an actuator, in the mechanical CPR device 100. A controller in the mechanical CPR device 100 may control the drive component.

(30) From position 220, depicted in FIG. 2A, the piston 140/suction cup 145 can be further extended toward the patient's torso 220 until a threshold is reached so that air is forced out from the lower side of the suction cup 145, such as in position 225 depicted in FIG. 2B. In one example, the threshold can be a force threshold and the controller in the mechanical CPR device 100 can measure the force exerted by the piston 140 as the air is forced out from the lower side of the suction cup 145 and air is forced out of the patient 200. Once the force exerted on the patient's torso 220 by the piston 140 reaches the force threshold, the controller can stop the piston 140 from being extended any further, such as at position 225. In another example, the threshold can be a distance threshold and the controller in the mechanical CPR device 100 can measure the distance travelled 230 by the piston 140 as the air is forced out of the patient 200. Once the distance travelled 230 by the piston 140 reaches the distance threshold, the controller can stop the piston 140 from being extended any further. In yet another example, the threshold can be a pressure threshold and a pressure sensor can sense the pressure in the area between the suction cup 145 and the patient's torso 220. As the air is forced out from the patient 200, and the pressure reaches the pressure threshold, the controller in the mechanical CPR device 100 can stop the piston 140 from being extended any further. In any of these examples, the patient's torso 220 may be compressed as the piston 140 is extended, such as in the depiction in FIG. 2B. At the position 225 depicted in FIG. 2B, the suction cup 145 is attached to the patient's torso 220 and the patient's torso 220 is compressed by the piston 140.

(31) From position 230, the piston 140 can be retracted to the position 210, as depicted in FIG. 2A, where the suction cup 145 originally came into contact with the patient's torso 220. From the position 210, the piston 140 can be further retracted until the position 235, where the piston 140 reaches a second threshold. The second threshold can be a force threshold, such as a force exerted when pulling up on the patient's torso 220. This second threshold can be measured by a spring activation sensor or other force sensor. For example, the piston 140 can be retracted until the spring activation sensor is activated and then the drive component can stop retracting the piston 140. From the position 235, the piston 140 can be extended toward the patient's torso 220, contacting the patient's torso at 210, compressing the patient's torso 220 by extending to position 225, and decompressing the patient's torso 220 by moving away from the patient's torso 220 to position 235. By repeating the movement of the piston 140 through positions 235, 210, 225, 210, to 235, mechanical CPR can be performed on patient 200.

(32) In some cases, position 210, where the suction cup 145 engages the patient's torso 220, may be defined as a reference point or position. From this position 210, the compression and decompression stroke of the piston 140 can be determined. Defining and using reference position 210 as a position from which to measure the depth of CPR compressions and the height of CPR decompressions can help to avoid unintended injury to a patient. For example, a manual CPR device can be placed on a patient's torso and a user can manually push or pull on the manual CPR device to cause compressions or decompressions. However, the user of the manual CPR device does not have any reference position from which to measure the depth of compressions or the height of decompressions. Without a reference position, the user can cause additional injuries to the patient. For example, if the user pushes the manual CPR device down too far into the patient's chest during a compression, the compression might break one or more of the patient's ribs. When one or more of the patient's ribs are broken, it may be easier to compress the patient's chest and a subsequent compression by user of the manual CPR device can cause even more of the patient's ribs to be broken, and injury to the patient's internal organs. In contrast, establishing reference position 210 with respect to the patient's torso 220 can prevent CPR compressions from extending too deep. Moreover, even if one injury does occur (e.g., the breaking of a patient's rib), the reference position 230 will not change and the likelihood that a subsequent compression will cause even further injury can be reduced.

(33) Using a reference position can also be beneficial is circumstances where the patient is not located in a stable or a flat position. For example, if a patient is being transported, such as on a stretcher or an ambulance, the patient may be jostled around or otherwise not in a stable position. However, if the mechanical CPR device is moving with the patient (e.g., if mechanical CPR is being performed in an ambulance while the patient is being transported), the reference position of the piston 140 or suction cup 145 can remain relatively fixed with respect to the patient and the mechanical CPR device can avoid over-compression and over-decompression. Thus, the benefits of avoiding unintended injury could still be realized if the patient is otherwise moving. In another example, the patient can be located in a position that is not flat, such as if the patient is being transported down stairs or the patient is on rough terrain. In these cases, if the mechanical CPR device is located with the patient in the same non-flat position, the reference position used by the mechanical CPR device would reflect the patient's non-flat position and the mechanical CPR device could avoid over-compression and over-decompression. A user performing manual CPR under such conditions may have difficulty in maintaining a desired compression depth and/or decompression height.

(34) In some cases, the patient's torso may be of a smaller dimension, such that its maximum height is below position 210. This position is depicted in FIG. 3A as position 305. In this case, the piston 140 may not be of a sufficient length to extend to position 305 and extend further to compress the patient's torso 220. As depicted in FIG. 3B, the piston 140 may be modified by a device or mechanism 315 to extend the length of piston 140, so that the piston 140 may extend a distance 310 to engage a patient's torso 220 at position 305. In this way, by extending the piston 140 via device 315, the piston's reference point may be set correctly to accommodate a patient having a smaller sternum with a height 305. By adjusting the reference point of the piston 140/suction cup 145 to height 305, the movement of the piston may be recalibrated to correctly and safely perform mechanical CPR on patient 200.

(35) FIG. 4 depicts a side view of a mechanical CPR device 100 with an adjustable length piston 140. By modifying piston 140 to include a length adjustment device 315, the piston 140 may be extended to position 305 from position 210. In some aspects, a change in the reference point or nominal height of the piston 140 from position 210 to position 305, represented by displacement 310, may be detected by one or more sensors. The change in height or displacement 310 of the reference point may then be communicated to a controller and/or drive component of the mechanical CPR device 100. The controller/drive component may adjust the movement of the piston based on the detected change 415 in position or displacement of the piston 140, for example, to calibrate the fully extended position and the retracted position of the piston 140 to safely perform mechanical CPR on a patent having a smaller torso/sternum.

(36) FIGS. 5A, 5B, 5C, 5D, 5E, 5F, and 5G depict multiple views, both side and cut-out views, of an example 500 of an external piston spacer 555 that may be used to extend the length of piston of a mechanical CPR device, such as piston 140 of mechanical CPR device 100. In reference to FIG. 5A, a piston of a mechanical CPR device, for example piston 140, may include an external piston sleeve 505 and an inner piston 510 having an outward surface 512. A portion of the length of the inner piston 510 may be slidably located within the external piston sleeve 505. The amount or length by which the inner piston 510 is positioned within the external piston sleeve 505 may adjust a full piston length 522. An end of the piston 515, which in some cases may include a suction cup 145, may be positioned a distance 520 away from the end of the external piston sleeve 505. In some cases, the inner piston 510 may be biased to be located at least partially within the external piston sleeve 505. In some cases, a spring 545 or a member having elastic or semi-elastic properties may be located along a length 522 of the inner piston 510, for example inward from the outward facing surface 512. The spring may at least partially bias the inner piston 510 to slide partially into the external piston sleeve 505. In some cases, a drive component of the attached mechanical CPR device (not shown), such as mechanical CPR device 100, may bias or determine a resting position of the inner piston 510.

(37) In some cases, the external piston spacer 555, the inner piston 510, and/or the external piston sleeve 505 may be defined by a circular or oval cross-section. In other cases, the external piston spacer 555, the inner piston 510, and/or the external piston sleeve 505 may be defined by other cross-sections, such as, rectangular, polygon, and so forth, such that the external piston spacer 555, the inner piston 510, and the external piston sleeve 505 have the same shaped-cross section (but not necessarily the same dimensions). In other examples, the external piston spacer 555, the inner piston 510, and/or the external piston sleeve 505 may have different-shaped cross-sections, that are engagable or slidable about each other.

(38) As depicted in FIG. 5B, the inner piston 510 may be extended 524 away from the external piston sleeve 505. In some cases, the length from the piston end and the end of the external piston sleeve 505 may be extended to a length 521, thus increasing the full piston length an equal amount to length 523. In this scenario, the outward surface 512 of the extended portion of the inner piston 510 (not within the external piston sleeve 505), may include one or more grooves or recesses 530. As depicted in FIG. 5B, one groove 530 may be disposed on the outward surface 512 of the inner piston 510. However, in other scenarios, the outward surface 512 of the inner piston 510 may have two opposed grooves 530, or any other number of grooves or recesses in any angular arrangement/at any position along the outward surface 512 of inner piston 510.

(39) FIG. 5C depicts a cutout-view of piston having extended length 523. The inner piston 510 may include a center piston or center piston portion 535, for example, that may be connected to a drive component or motor of a mechanical CPR device, such as device 100. A slidable ring or inner sleeve 540 may be disposed about the center piston portion 535 at an end of the center piston portion 535 located distal to the external piston sleeve 505. The inner sleeve 540 may contact a spring 545, also positioned axially relative to the inner piston 510 and the inner piston portion 535, between the sleeve 540/center piston portion 535 and the piston end 515. In some cases, the spring 545 may bias the inner piston 510 and/or the center piston portion 535 to move towards the external piston sleeve 505. In yet some examples, the spring 545, additionally or alternatively, may aid in determining and setting the correct compression and decompressions stroke of piston 140, for example via sensing force exerted on the piston end 515. In some examples, a drive component of the mechanical CRP device, and/or one or more other springs may bias the center piston portion 535/ring 540 to contact spring 545. In some examples, the one or more grooves 530 may extend through a thickness of the outward surface 512, such that a portion of the center piston portion 535 and/or the piston ring 540 are exposed.

(40) A removable external piston spacer 555, as depicted in FIG. 5D, having a circular cross-section, may include two flanges or ridges 560, 565. The two flanges 560, 565, may be located on an inward facing surface of the external piston spacer 555. In some cases, the external piston spacer 555 may be ring-shaped in cross-section, having a thickness. In this scenario, the external piston spacer 555 may engage at least a portion of the inner piston 510, for example, when the flanges 560,565 are aligned with grooves 530. In some examples, the flanges 560, 565 may have a substantially rectangular shape to engage and fit within grooves 530. In other cases, the flanges 560, 565 and the grooves 530 may have other corresponding shapes, such as circular, triangular, polygon shape, etc. In some cases, the flanges 560, 565 may extend inward from the external piston spacer 555 a distance. The distance may be equal to or greater than a thickness of the outward surface 512 of the inner piston 510, so as to ensure stable engagement with the inner piston 510.

(41) As depicted in FIG. 5E, the external piston spacer 555 may be placed on the outward surface 512 of the inner piston 510, by aligning the flanges 560, 565 with the grooves 530. In some cases, inserting the flanges 560, 565 into the grooves 530 may push or force 570 the center piston portion 535 and/or the ring 540 upward toward the external piston sleeve 505. In some examples, the flanges 560, 565 may extend inward from the external piston spacer 555 a distance greater than a thickness of the outer surface 512 of the inner piston 510, such that the flanges 560, 565 may separate the center piston portion 535 and/or the ring 540 from contacting the spring 545, as depicted in FIG. 5F. One or more sensors 570, such as a wiper, potentiometer, or other sensor electrical, mechanical, or optical sensor may detect the change in length 523 of the piston 140 caused by the presence of the external piston spacer 555. The sensor(s) 570 may communicate the detected change in position or displacement to a controller or drive component of the mechanical CPR device 100. The controller or drive component may then modify the compression and decompression stroke, e.g., the oscillation of the piston 140 to accommodate the changed length. Modifying the movement of the piston 140 may ensure or help to ensure more safe operation of the mechanical CPR device 100 when a patient having a smaller sternum/torso is treated using the mechanical CPR device 100.

(42) In some examples, the one or more sensors 570 may be part of the drive component or motor of the mechanical CPR device 100. In this scenario, the sensor(s) 570 may be wipers that detect the angular position of the motor or drive component, for example of a drive shaft of a motor. The drive component may be configured, for example via instructions such as computer code and the like, to adjust at least one of a stroke compression and stroke decompression based on the detected change in resting angular position of the drive shaft.

(43) In the example illustrated, the flanges 560 and 565 may be spaced at 180 degrees apart from one another, each positioned at an external edge of the external piston spacer 555. In this example, the external piston spacer 555 may also wrap approximately 180 degrees or less around the inner piston 510.

(44) In some examples, the external piston spacer may have a length that is less than the length of the inner piston 510, so as to be engagable about the outward face 512. In the example illustrated, the flanges 560, 565 may prevent the inner piston 510 from sliding, at least partially, into the external piston sleeve 505, for example by opposing a bias created by spring 545, a drive component, or any number of spring or elastic members. In other examples, a body of the external piston spacer 555 may prevent the inner piston 510 from sliding, at least partially, into the external piston sleeve 505.

(45) FIGS. 6A, 6B, 6C, 6D, and 6E depict multiple views, both side and cut-out views, of an example 600 of an internal bayonet sleeve 620 that may be used to extend the length of a piston of a mechanical CPR device, such as piston 140 of mechanical CPR device 100. In the example descried below, the piston, such as piston 140, may include an external piston sleeve 505, and an inner piston 510 having a piston end 515, as described above in reference to FIG. 5.

(46) The inner piston 510 may include a center piston 615, which may include one or more aspects of center piston portion 535 described above. The center piston 615 may be axially positioned relative to the external piston sleeve 505. The center piston 615 may contact a compression spring 605 at one end proximate to the piston end 515 and may contact a decompression spring 610 at an opposing end proximate to the external piston sleeve 505. The compression spring 605 and/or the decompression spring 610 may bias the center piston 615 to at least partially slide into the external piston sleeve 505. In some cases, the compression spring 605 may detect a force applied between the piston end 515, for example against a patient, and the center piston 615. The compression of the spring 605 may inform a controller or drive mechanism of the mechanical CPR device 100 when a fully compressed position has been reached. Similarly, the decompression spring 610 may detect a force applied between the center piston 615 and the external piston sleeve 505. The decompression of the spring 610 may inform a controller or drive mechanism of the mechanical CPR device 100 when a fully decompressed position has been reached. The center piston 615 and/or the inner piston 510 may be rotatably connected to a mechanical CPR device (not shown), such as device 100, by a retaining ring 640. In some cases, the center piston 615 may be connected to and driven by a drive shaft or other drive component of the mechanical CPR device 100. The drive component may drive the center piston 615 to extend away from and retract toward the CPR device 100 and the external piston sleeve 505.

(47) An internal bayonet sleeve 620 may slidably surround or engage a portion of an outside surface 616 of the center piston 615. The internal bayonet sleeve 620 may form a ring or partial ring around the center piston 615. The bayonet sleeve 620 may have a length 621 and may have a plurality of grooves 625, 630 on one end. The plurality of grooves 625, 630 may be located at different angular positions around the bayonet sleeve 620 and may have varying lengths relative to length 621 of the bayonet sleeve 620. For example, groove 625 may only define a space having a short length, while groove 630 may define a space having a length equal to length 621 of the bayonet sleeve 620. Any number of grooves 625, 630 having varying lengths may similarly define spaces on bayonet sleeve 620.

(48) One or more locking rods 635 may be positioned on the outside surface 616 of the center piston 615. The locking rod(s) 635 may have any number of shapes, such as circular, rectangular, polygon, etc., and may extend beyond the outside surface 616 a distance. The distance may be short enough to allow the center piston 615 and the locking rods 635 to rotate 645 relative to the outward surface 512 and/or the internal bayonet sleeve 620. In some cases, the one or more locking rods 635 may be connected to the outward surface 512, such that rotating the inner piston 510 may rotate the center piston 615.

(49) The one or more locking rods 635 may have a width that is similar to or slightly smaller than a width of grooves 625, 630 of the internal bayonet sleeve 620, such that the locking rod(s) 635 may engage one or more grooves 625, 630. When one or more locking rods 635 engage one or more grooves 625, 630, the center piston 615 may be locked or rotationally fixed relative to the internal bayonet sleeve 620 and/or the outward surface or plate 512.

(50) As depicted in FIG. 6C, the inner piston 510 and/or center piston 615 may be extended 650 away from the external piston sleeve 505, for example, by applying a force to piston end 515 and/or inner piston 510. Extending the center piston 615 relative to the internal bayonet sleeve 620, which may be fixed to the external piston sleeve 505, may disengage the one or more locking rods 635 from one or more of the grooves 625, 630. In one example, two locking rods 635 may be positioned on the center piston 615, 180 degrees apart from each other. Similarly, two grooves 625, having the same length, may also be positioned on the internal bayonet sleeve 180 degrees apart. By extending the center piston 615 away from the internal bayonet sleeve 620 and disengaging the locking rods 635 from grooves 625, the center piston 615 may be made rotatable about the internal bayonet sleeve 620. As depicted in FIG. 6D, the center piston 615 may be rotated 90 degrees clockwise 655 relative to the bayonet sleeve 620. The locking rods 635 may be aligned with grooves 630 (in this example, also spaced 180 degrees apart and having a same length). As depicted in FIG. 6E, once aligned, the center piston 615 may be moved or pushed 660 toward the external piston sleeve 505 until the locking rods 635 engage or stop against an end of grooves 630 or at the decompression spring 610, or until the internal bayonet sleeve 620 contacts the spring 605. In some cases, one or more of springs 605, 610 may bias the center piston 615 to naturally rest at a position closest to the external piston sleeve 505.

(51) In some cases, one or more sensors 665 may be positioned on the outer piston 505 to detect a change in the length of the inner piston 510/the entire piston 140 (including the inner piston 510 and the external piston sleeve 505), caused by positioning the locking rods 635 in different grooves 625, 630. In some cases, the one or more sensors 665 may include a n electrical sensor, such as a wiper or potentiometer, a mechanical sensor, and/or an optical sensors. In some cases, the one or more sensors 665 may detect a position of the inner piston 510 relative to the external piston sleeve 505, may detect the angular position of a drive component of the mechanical CPR device 100, and/or may detect contact between the locking rods 635 and one or more grooves 625, 630. In some examples, each contact position between a groove 625, 630 and a locking rod 635 may be associated with a predetermined or pre-measured distance or displacement. Upon detection by sensor(s) 665, the corresponding displacement value may be accessed and used to calibrate a controller or drive component of the mechanical CPR device.

(52) FIG. 7 depicts an example of an adjustable piston including a piston adapter 700. The piston adapter 700 may be removably attachable to a surface 750 of piston, such as piston 140 attached to a mechanical CPR device 100. In some cases the piston adapter 700 may be attachable to the bottom surface of suction cup 145. The piston adapter 700 may include a piston connection surface 715 connected to one end 721 of a body 720, which may be circular in cross section. At an opposite end of the body 720, a suction cup 705 may be attached and configured, for example, to contact the torso/sternum of a patient. In some cases, suction cup 705 may be similar to and/or include one or more aspects of suction cup 145. In some aspects, the piston connection surface 715 or plate may be connected to the suction cup 705 via one or more members 730, 735, which may add rigidity to the piston adapter 700.

(53) To attach the piston adapter 700 to the piston 140, the piston adapter 700 may be positioned beneath the piston surface 750 and the piston connection surface 715 may be moved to contact the piston surface 715. Upon contact, a gas check valve 725 may be engaged to temporarily or removably adhere the piston connection surface 715 to the piston surface 750. In some examples, the piston surface 750 or other part of piston 140 may include one or more sensors 755. The one or more sensors 755 may detect when the surfaces 750 and 715 come into contact. The one or more sensors 755 may include any of pressure sensors, optical sensors, force sensors, etc. In some aspects, upon detecting contact between surfaces 750 and 715, the piston 140 or a controller thereof may send an indication (e.g., via a wireless connection by a transceiver, a wired connection, etc.) to the piston adapter 700. Upon receiving the indication, the gas check valve 725 may be made operational. A controller of the piston 140 may detect when the piston adapter 700 is attached to the piston 140, and may prevent attachment of the piston adapter 700 to the piston 140 until the piston controller has detected and acknowledged, for example, the change in length of piston 140 due to the attachment of the piston adapter 700. In this way, injury to a patient may be reduced or eliminated that may be caused by the piston 140 being extended toward a patient without proper calibration (e.g., accounting for the length added by the piston adapter 700).

(54) In some cases, a length of the piston adapter may be detected by the piston/sensor 755 or communicated to the piston controller by the piston adapter 700. The piston controller may then adjust a stroke of the piston 140 to account for the changed length of the piston 140.

(55) FIG. 8 depicts an example of a method 800 of configuring a mechanical CPR device, such as device 100, to accommodate a patient, for example having a smaller torso/sternum. At block 805, a height of a patient to be treated may be detected. This may include using one or more sensors. In some cases, a piston, such as piston 140, may be extended toward a patient until contact with the patient is detected, for example, by analyzing the force exerted on one or more springs of the piston 140, such as spring 545 and/or 605. In other cases, one or more optical sensors may be used to detect the height of a patient. In yet some aspects, the height may be received by the mechanical CPR device 100, for example from one or more inputs via an operator.

(56) At block 810, a reference point of the piston 140 may be adjusted based on the detected height of the patient. In some cases, the reference point may be adjusted and/or set according to the techniques described in reference to FIGS. 3A and 3B, for example to height 305 from height 210, which may be a nominal height of the mechanical CPR device 100/piston 140.

(57) In some cases, method 800 may include operations performed at block 815, including adjusting a length of the piston to contact the patient, for example according to the adjusted reference point. The operations at block 815 may be performed by placing an external piston spacer 500 on the piston, as described in reference to FIGS. 5A through 5G, at block 816. The operation at block 815 may additionally or alternatively include adjusting an internal bayonet sleeve 600/one or more locking rods engagable about the bayonet sleeve, as described above in reference to FIGS. 6A though 6E, at block 817. The operation at block 815 may additionally or alternatively include attaching a removable piston adapter 700 to the end of the piston, as described above in reference to FIG. 7.

(58) At block 820, the stroke of the piston may be determined based on the adjusted reference position. Mechanical CPR may then be performed on a patient using the configured mechanical CPR device according to the determined stroke of the piston. In this way, compression and decompression of the piston may be calibrated to account for the added piston length. This may increase the number of patients that may be treated by a mechanical CPR device 100. Additionally or alternatively, the use of an adjustable piston may help reduce risk associated with mechanical CPR, including injury to a patient due to the compression stroke of the piston not being adjusted to a patient having a smaller torso.

(59) FIGS. 9-14 depict an alternative embodiment of a piston adaptor 900 in accordance with the present disclosure. The piston adaptor 900 includes a body 902 having a suction cup attachment surface 904 for removable attachment to a suction cup 906 (FIGS. 14A and 14B). The suction cup attachment surface 904 can include a circumferential adaptor flange 908 and/or a substantially flat surface 910. A piston connection surface 912 is disposed opposite the suction cup attachment surface 904. The piston connection surface 910 is configured to releasably engage with a piston surface 914 (FIGS. 14A and 14B), for example a piston end 918. The piston surface 914 may have substantially the same configuration as the suction cup attachment surface 904. In other words, a suction cup removably attached to the piston surface 914 can be removed and attached to the suction cup attachment surface 904. For example, the piston surface 914 includes a circumferential piston flange 916 and/or a substantially flat surface 920 disposed at the piston end 918.

(60) The piston connection surface 912 includes a recessed portion 922 and one or more retractable engagement members 924 configured to releasably engage the piston surface 914. The recessed portion 922 can be substantially circular and the one or more engagement members 924 can be disposed around the recessed portion 922. The one or more engagement members 924 include a shelf portion 926 having a flat surface 928 facing a base 930 of the recess portion 922.

(61) The piston adapter 900 has a locked position, as shown in FIGS. 13 and 14a and an unlocked position, as shown in FIG. 14b. In the locked position, the one or more engagement members 924 extend into the recessed portion 922 to releasably engage piston surface 914 and prevent removal of the piston surface 914 from the piston connection surface 912. As shown in FIGS. 13 and 14a, the shelf portion 928 protrudes into the recess portion 922 and releasably engages the circumferential piston flange 916 disposed in the recessed portion 922. The one or more engagement members 924 are moveable from the locked position (FIG. 14a) to the unlocked position (FIG. 14b). In the unlocked position, the engagement members 924 are retracted from the recessed portion 922 to allow for removal of the circumferential piston flange 916 from the recessed portion 922. The piston adaptor 900 may be biased via a spring 940 or other biasing means to the locked position.

(62) The piston adaptor may additionally and/or alternatively include a release member 932 that when activated allows disengagement of the piston connection surface 912 from the piston surface 914. For example, activation of the release member 932 may move the one or more engagement members 924 from the locked position to the unlocked position. As shown in FIGS. 13 and 14a, in the locked position the release member 932 is moveably adjacent the piston connection surface 912. As shown in FIG. 14b, in the unlocked position the release member 932 is retracted towards the suction cup attachment surface 904.

(63) The piston adapter 900 has a piston adaptor length L extending from the piston connection surface 912, for example the base 930 of the recessed portion 922, to the suction cup attachment surface 904. FIG. 13 depicts a mechanical CPR device 934 including the piston adapter 900, in accordance with the present disclosure. The piston adaptor length is added to the length of the piston, so that the piston and piston adaptor may extend to engage a smaller patient's torso (not shown). In some embodiments, the CPR device 934 may include a piston sensor 936 configured to detect engagement of the piston surface 914 with the piston connection surface 912. The piston sensor 936 may be configured to send a signal to a controller 938 when engagement of the piston surface 916 with the piston connection surface 914 is detected. In this way, by extending the piston via the piston adaptor, the piston's reference point may be set correctly to accommodate a patient having a smaller sternum. By adjusting the reference point of the piston/suction cup, the movement of the piston may be recalibrated to correctly and safely perform mechanical CPR on a patient (not shown).

(64) FIGS. 15-20 depict an alternative embodiment of a piston adaptor 1000 in accordance with the present disclosure. The piston adaptor 1000 includes a body 1002 having a suction cup attachment surface 1004 for removable attachment to a suction cup 1006 (FIGS. 19, 20A and 20B). The suction cup attachment surface 1004 can include a circumferential adaptor flange 1008 and/or a substantially flat surface 1010. A piston connection surface 1012 is disposed opposite the suction cup attachment surface 1004. The piston connection surface 1012 is configured to releasably engage with a piston surface 1014 (FIGS. 19, 20A and 20B), for example a piston end 1016. The piston surface 1014 may have substantially the same configuration as the suction cup attachment surface 1004. For example, the piston surface 1014 includes a circumferential piston flange 1018 and/or a substantially flat surface 1020 disposed at the piston end 1016.

(65) The piston connection surface 1012 includes a base 1022 and a lip 1024 extending above the base 1022 having a lip recess 1026. The lip 1024 and/or the lip recess 1026 are configured to partially encircle the piston flange 1018. The piston connection surface 1012 further includes at least one engagement member 1028 disposed on the base 1022 configured to releasably engage the piston surface 1014. The engagement member 1028 may be disposed opposite the lip 1024.

(66) The piston adapter 1000 has a locked position, as shown in FIGS. 19 and 20a, and an unlocked position, as shown in FIG. 20b. In the locked position, the engagement member 1028 protrudes above the base 1022 to releasably engage the circumferential piston flange 1018 disposed on the base 1022 and partially encircled by the lip 1024 and/or the lip recess 1026. In other words, in the locked position the engagement member 1028 prevents the piston surface 1014 from sliding out of the lip recess 1026 and/or disengaging from the piston connection surface 1012. The engagement member 1028 is moveable from the locked position (FIG. 20a) to the unlocked position (FIG. 20b). In the unlocked position, the engagement member 1028 is retracted such that it is substantially flush with the base 1022. In the unlocked position, the engagement member 1028 is no longer engaged with the circumferential piston flange 1018 and allows disengagement of the circumferential piston flange 1018 from the lip recess 1026 and/or disengagement of the piston surface 1014 from the piston connection surface 1012. The piston adaptor 1000 may be biased via a spring or other biasing means to the locked position.

(67) The piston adaptor 1000 may additionally and/or alternatively include a release member 1030 that when activated allows disengagement of the piston connection surface 1012 from the piston surface 1014. For example, activation of the release member 1030 may move the engagement member 1028 from the locked position to the unlocked position. See directional arrow in FIG. 20b. The release member 1030 can be attached to the engagement member 1028 such that depression or movement of the release member 1030 also depresses or moves the engagement member 1028. As shown in FIGS. 19 and 20a, in the locked position the release member 1030 protrudes above the base 1022. As shown in FIG. 20b, in the unlocked position the release member 1030 is pushed or retracted towards the suction cup attachment surface 1004 such that the release member 1030 is substantially flush with the base 1022.

(68) The piston adapter 1000 has a piston adaptor length L extending from the piston engagement portion 1012, such as the base 1022, to the suction cup engagement portion 1004. FIG. 19 depicts a mechanical CPR device 1032 including the piston adapter 1000, in accordance with the present disclosure. The piston adaptor length is added to the length of piston, so that the piston and piston adaptor may extend to engage a smaller patient's torso (not shown). In some embodiments, the CPR device 1032 may include a piston sensor 1034 configured to detect engagement of the piston surface 1014 with the piston connection surface 1012. The piston sensor 1032 may be configured to send a signal to a controller 1036 when engagement of the piston surface 1014 with the piston connection surface 1012 is detected. In this way, by extending the piston via the piston adaptor, the piston's reference point may be set correctly to accommodate a patient having a smaller sternum. By adjusting the reference point of the piston/suction cup, the movement of the piston may be recalibrated to correctly and safely perform mechanical CPR on a patient (not shown).

(69) In a number of embodiments discussed here, a suction cup has been described on the end of a piston. The suction cup can attach to a patient's torso so that, among other benefits, active decompression is possible. However, other mechanisms could be used to attach an end of the piston to a patient's torso. For example, a sticker plate configured to stick to patient's torso could be used on the end of the piston to attach to a patient's torso to the piston. In many of the above embodiments, the suction cup could be replaced with a sticker plate. Similarly, the suction cup in many of the above embodiments could be replaced with any number of other mechanisms that can attach to a patient's torso to the piston.

(70) Conditional language used herein, such as, among others, “can,” “could,” “might,” “may,” “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain examples include, while other examples do not include, certain features, elements, and/or steps. Thus, such conditional language is not generally intended to imply that features, elements and/or steps are in any way required for one or more examples or that one or more examples necessarily include logic for deciding, with or without author input or prompting, whether these features, elements and/or steps are included or are to be performed in any particular example. The terms “comprising,” “including,” “having,” and the like are synonymous and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations, and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list.

(71) In general, the various features and processes described above may be used independently of one another, or may be combined in different ways. For example, this disclosure includes other combinations and sub-combinations equivalent to: extracting an individual feature from one embodiment and inserting such feature into another embodiment; removing one or more features from an embodiment; or both removing a feature from an embodiment and adding a feature extracted from another embodiment, while providing the advantages of the features incorporated in such combinations and sub-combinations irrespective of other features in relation to which it is described. All possible combinations and subcombinations are intended to fall within the scope of this disclosure. In addition, certain method or process blocks may be omitted in some implementations. The methods and processes described herein are also not limited to any particular sequence, and the blocks or states relating thereto can be performed in other sequences that are appropriate. For example, described blocks or states may be performed in an order other than that specifically disclosed, or multiple blocks or states may be combined in a single block or state. The example blocks or states may be performed in serial, in parallel, or in some other manner. Blocks or states may be added to or removed from the disclosed example examples. The example systems and components described herein may be configured differently than described. For example, elements may be added to, removed from, or rearranged compared to the disclosed example examples.

(72) Each of the processes, methods and algorithms described in the preceding sections may be embodied in, and fully or partially automated by, code modules executed by one or more computers or computer processors. The code modules may be stored on any type of non-transitory computer-readable medium or computer storage device, such as hard drives, solid state memory, optical disc and/or the like. The processes and algorithms may be implemented partially or wholly in application-specific circuitry. The results of the disclosed processes and process steps may be stored, persistently or otherwise, in any type of non-transitory computer storage such as, e.g., volatile or non-volatile storage.

(73) It will also be appreciated that various items are illustrated as being stored in memory or on storage while being used, and that these items or portions of thereof may be transferred between memory and other storage devices for purposes of memory management and data integrity. Alternatively, in other embodiments some or all of the software modules and/or systems may execute in memory on another device and communicate with the illustrated computing systems via inter-computer communication. Furthermore, in some embodiments, some or all of the systems and/or modules may be implemented or provided in other ways, such as at least partially in firmware and/or hardware, including, but not limited to, one or more application-specific integrated circuits (ASICs), standard integrated circuits, controllers (e.g., by executing appropriate instructions, and including microcontrollers and/or embedded controllers), field-programmable gate arrays (FPGAs), complex programmable logic devices (CPLDs), etc. Some or all of the modules, systems and data structures may also be stored (e.g., as software instructions or structured data) on a computer-readable medium, such as a hard disk, a memory, a network or a portable media article to be read by an appropriate drive or via an appropriate connection. Such computer program products may also take other forms in other embodiments. Accordingly, the present invention may be practiced with other computer system configurations.

(74) While certain example or illustrative examples have been described, these examples have been presented by way of example only, and are not intended to limit the scope of the inventions disclosed herein. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms. The accompanying claims and their equivalents are intended to cover such forms or modifications as would fall within the scope and spirit of certain of the inventions disclosed herein.