Abstract
The present invention provides a medical emergency first aid during accidents using cervical spine collar to insert a splint for stabilization, resuscitation, initiation of mild to moderate external hypothermia, and vital signs monitoring in victims of traumatic brain (TBI) and cervical spinal injury (CSI). The cervical spine collar of the present invention is housed in the head rest of the vehicle seat and could be deployed automatically using artificial intelligence (AI) or manually by an assistant. One embodiment incorporates a protective helmet with cooling apparatus to induce mild to moderate external hypothermia of the brain to prevent deleterious effects of TBI.
Claims
1. A safety system method, wherein a cervical spine collar comprising the inside cooling apparatus for mild to moderate external hypothermia of the cerebrospinal fluid and cerebral blood flow of the spine and brain, used to initiate a splint for immediate neck stabilization and resuscitation after cervical spinal injury and traumatic brain injury.
2. The method of claim 1, wherein the cervical spine collar could be manually or automatically deployed.
3. The method of claim 1, wherein the cervical spine collar is integrated with vital signs monitoring device, screen display, microphone and loud speaker powered by a battery to provide the state of health of the accident victim.
4. The method of claim 1, wherein the cervical spine collar is placed into the head rest of the seat of the vehicle, and in the absence of the automatic system for cooling and deployment could be manually inserted on an accident victim by an assistant.
5. The method of claim 1, wherein the crash sensor of the vehicle initiates the deployment of the cervical spine collar.
6. The method of claim 1, wherein the cervical collar is deployed automatically by the artificial intelligence system of the vehicle after obtaining information from the crash sensors.
7. The method of claim 1, wherein the cervical collar is deployed automatically by the artificial intelligence system of the vehicle using information obtained from pre-departure safety briefings of the persons in the vehicle.
8. The method of claim 1, wherein the artificial intelligence system, monitors the vital signs of the victim with sensors on the cervical collar for assessment of the health status.
9. The method of claim 1, wherein the artificial intelligence system of the vehicle, stores photo images, location information, audiovisual and vital signs recordings of the accident victims in a ‘black box’ storage device and could selectively telemeter the information to emergency medical service.
10. The method of claim 1, wherein the artificial intelligence system after automatic deployment of the cervical collar initiates a complete separation of the cervical spine collar from the head rest of the vehicle seat.
11. A safety system method, wherein a protective helmet with crash sensor and inside cooling apparatus for mild to moderate external hypothermia of the brain to prevent the deleterious effects of traumatic brain injury.
12. The method of claim 11, wherein the protective helmet is adapted to be used to prevent traumatic brain injury in a vehicle accident.
13. The method of claim 11, wherein the protective helmet is adapted to be used to prevent the deleterious effects of traumatic brain injury in sports accident.
14. The method of claim 11, wherein the protective helmet is adapted to be used to prevent the deleterious effects of traumatic brain injury for military applications.
15. The method of claim 11, wherein the protective helmet is adapted to be used by construction workers.
16. The method of claim 11, wherein the protective helmet is adapted to be used by car racing drivers.
17. The method of claim 11, wherein the protective helmet has vital signs monitoring device to report the health status of the victim in the event of traumatic brain injury.
18. The method of claim 11, wherein the protective helmet when used in a vehicle are controlled by the artificial intelligence system which collects data from the crash sensors to initiate mild to moderate hypothermia of the brain in the event of traumatic brain injury during a vehicle accident.
19. A safety system method, wherein the crash sensor initiates expansion of the airbag located at the back of the head within the head rest of the seat of the vehicle to prevent hyperextension of the head and cervical spine of the victim.
20. The method of claim 19, wherein the artificial intelligence of the vehicle deploys the head rest airbag based on information on the severity of the crash from the crash sensors.
Description
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
[0075] FIG. 1 shows the mechanism of heat transfer to the CSF (FIG. 1A) and vessels (FIG. 1B) in the head and neck region.
[0076] FIG. 2, shows the head and neck region where the AIAutoCoolCollar is applied.
[0077] FIG. 3 A-F, shows the assembly of the device (AIAutoCoolCollar) and the various parts.
[0078] FIG. 3A, shows one assembly of the device as a standalone neck collar for initial stabilization and external hypothermia and could be adapted for use in a vehicle.
[0079] FIG. 3B, shows the schematic diagram of the inside of the device with central cooling bladder (black) inflated by coolant for external hypothermia and side bladders (gray) inflated with normal air.
[0080] FIG. 3C, shows the inside surface of the device with the central cooling bladder (black) and side air bladders (gray) placed on the C-arm of the device to move in a semi-circle to close the collar for neck stabilization.
[0081] FIG. 3D, shows the front view of one embodiment of the splint with the device (AutoCoolCollar) put in place as first aid, manually, by a conscious driver or an assistant.
[0082] FIG. 3E, shows the front view of another embodiment of the splint with the device (AIAutoCoolCollar) in place as first aid by the AI system.
[0083] FIG. 3F, shows the front exploded view of feature 47, showing the ultrasonic sensor and display of arterial pulsation.
[0084] FIG. 4, shows a schematic diagram of the side view of the device inside a head rest. The head rest airbag is shown in exploded view.
[0085] FIG. 5 A-H shows the operational sequence of the device (AIAutoCoolCollar) during a motor vehicle accident.
[0086] FIG. 5A, shows the time preceding a crash, the driver's head and neck are in normal position.
[0087] FIG. 5B, shows that at the moment of impact the head and neck are in flexion.
[0088] FIG. 5C, shows the next stage of head and neck hyperextension.
[0089] FIG. 5D, shows the final stage of head and neck hyperflexion.
[0090] FIG. 5E, shows the head rest fitted with the device and the head and neck of the driver in normal position.
[0091] FIG. 5F, shows the moment of crash when the device starts to be deployed.
[0092] FIG. 5G, shows the driver with the head and neck in hyperextension as the device deploys from the head rest. The front airbag deploys and forces the head and neck backwards preventing hyperflexion, while the head rest back airbag prevents hyperextension.
[0093] FIG. 5H, shows the driver with the splint accomplished and the device detached from the head rest.
[0094] FIG. 6, shows the flow chart of the AI program that operates the device and other safety features.
[0095] FIG. 7, shows the driver with the device deployed in the vehicle moments after the impact.
[0096] FIG. 8 A-D shows areas of distribution of blood flow for heat transfer from the detailed parts of the assembly of the device (AIAutoCoolHelmet).
[0097] FIG. 8A, shows the venous sinuses for blood flow distribution in the area covered by the brain cooling system.
[0098] FIG. 8B, shows a protective helmet (AIAutoCoolHelmet) that could be used by race car drivers as a component of the present invention, and is applicable as a standalone for motorbikes.
[0099] FIG. 8C, shows another embodiment of a protective helmet adapted as standalone device according to the teachings of the present invention for use in sports such as in American football.
[0100] FIG. 8D, shows the interior cooling apparatus of the protective helmet.
[0101] FIG. 9, shows a race car driver with the AIAutoCoolCollar and AIAutoCoolHelmet fully deployed.
DESCRIPTION OF THE PREFERRED EMBODIMENT
[0102] FIG. 1 shows the mechanism of heat transfer to the CSF (FIG. 1A) and vessels (FIG. 1B) in the head and neck region. FIG. 1A, shows the mechanism of transfer of heat to the CSF in the head and neck region. The aim of the system of the device 1 is to provide direct heat exchange through the skin of the back of the head and neck 2 with the CSF compartment 3 cooling the CSF that baths the brain tissue which in turn will slow cerebral metabolic rate to conserve energy in the neuronal cells, and would have a positive influence on temperature regulation, decreasing CSF volume leading to reduction in intracranial pressure (ICP), increasing cerebral perfusion pressure (CPP) and preserving cerebral autoregulation mechanisms. The heat exchange is accomplished due to the pulsatile flow of CSF. The choroid plexus 4 of each of the lateral ventricles 5 produce the CSF. The CSF flows through the ventricles and into the subarachnoid space 6 through the median 7 and lateral 8 apertures. The heat exchange follows the pulsatile activity of arteries within both thalami as disclosed in an article by Njemanze P C, Beck O J., entitled ‘MR-Gated Intracranial CSF dynamics: evaluation of CSF pulsatile Flow’, published in AJNR 1989; vol. 10, pp. 77-80. The pulsatile activity described as the thalamic pump, pumps CSF flowing in from the lateral ventricles 5 on both sides of the mid corpus callosum 9, into the third ventricle 10, through the interventricular foremen of Monroe 11. The CSF flows into the aqueduct of Sylvius 12 into the Fourth ventricle 13. The CSF is absorbed into the dural venous sinuses via the arachnoid villi 14 located beneath the arachnoid mater 15. The heat transfer through CSF flow provides cooling to the entire structures of the brain.
[0103] FIG. 1B, shows the mechanism of transfer of heat to the vessels in the head and neck region. The device also facilitates heat exchange through the arteries of the brain. The device is applied directly on the skin overlying the neck 16 and back of the head regions 17, in direct contact with both vertebral arteries 18, that supply the basilar artery 19, into the posterior circulation of the brain. The vertebral arteries 18 also form at the region of the medulla oblongata, the anterior spinal artery which supplies the anterior portion of the spinal cord to facilitate heat exchange with the spinal cord. Blood flow from both common carotid arteries 20, supply to the internal carotid arteries 21, which in turn supply the anterior cerebral arteries 22 and middle cerebral arteries 23, that provides blood circulation in the circle of Willis to the entire brain.
[0104] FIG. 2, shows the head and neck region where the AIAutoCoolCollar is applied. The device is placed over the neck 24 and occiput 25 in the back of the head.
[0105] FIG. 3 A-F, shows the assembly of the device (AIAutoCoolCollar) and the various parts. FIG. 3A, shows one assembly of the device as a standalone neck collar for initial stabilization and external hypothermia and could be adapted for use in a vehicle. There is the back side (black) 26 that is cooled overlying the back side of the neck and head (covering vessels and CSF compartment). The front side of the head and neck is not cooled (gray) 27. Materials for assembling the neck collar for this device are readily available and could be obtained from a number of companies for example Timago International Group, Poland, the manufacturer of the Philadelphia Cervical Collar. FIG. 3B, shows the schematic diagram of the inside of the device with central cooling bladder (black) inflated by coolant for external hypothermia and side bladders (gray) inflated with normal air. The inflation could be both by manual squeezable bulb or automatically controlled pump to the point that it conveniently fits to achieve maximum stabilization of the neck. The central cooling bladder (black) has the head end curvature 28, and the shoulder support end 29, for external hypothermia. The cool air is pumped through a nozzle 30, to inflate the central cooling bladder. In the manual mode the Velcro surface allows manual adjustment to the size of the neck of the victim. The automatic mode controlled by the AI system utilizes the video images and measurements taken for initial assessment of the accident victims and their positions in the vehicle, for the splinting process. The anthropometric variables are used to make adjustments that will allow automatic fitting of the device neck collar to fit the person appropriately. The AI system obtains visual data from inside of the vehicle using the camera mounted on the rear view mirror or elsewhere in the front dashboard. The information includes among others the head position and neck circumference of the driver and passengers in the vehicle. The head rest of the seat fitted with the device has adjustable height to match persons of different heights while seated. The inflation of the bladder is gauged to match the size of the neck for neck collar stabilization. The central cooling bladder 29 is inflated through a nozzle 30, for supply of coolant to a preprogrammed gauge according to neck circumference. This is accomplished by the AI system by regulating how long and at what rate the valve lets in the coolant or air into the bladder. The supply could be from the coolant of the air-conditioning system of the vehicle or a standalone coolant canister. The left side air bladder 31 with locking button 32 and the right side air bladder 33 with locking button 34 are filled through an air nozzle 35, from a supply within the vehicle or standalone canister through a valve regulator.
[0106] FIG. 3C, shows the inside surface of the device with the central cooling bladder (black) and side air bladders (gray) placed on the C-arm of the device to move in a semi-circle from both sides to close the collar for neck stabilization. The device is contained in a head rest 36, and self-deploys under control of the AI system through openings on both sides with automated levers that perform a semicircular movement of the left C-arm 37 with lock 38, to meet the opposite right side.
[0107] FIG. 3D, shows the front view of one embodiment of the splint with the device (AutoCoolCollar) put in place as first aid, manually by a conscious driver or an assistant. A situation could arise when the driver is fully conscious or that the AI system malfunctions or was not even programmed. The device cooling bladder 39 and air bladder 40, could be manually put in place. If in the vehicle, the driver or passenger-assistant could manually detach the device from the head rest and attach it to the victim. The Velcro surface allow adjustment to neck size.
[0108] FIG. 3E, shows the front view of another embodiment of the splint with the device (AIAutoCoolCollar) in place as first aid placed by the AI system. The device upper end is beneath the lower jaw 41. The movement of the C-arms are guided by the camera and optical tracking units of the AI system on the left side 42 and wireless communication such as Bluetooth on the side right 43, such that, the lower 44 and upper 45 locking units slide together appropriately. Beneath the lower 44 and upper 45 locking units are spaces provided for mini battery storage to independently power the electronics in the cervical collar. The battery in one embodiment is made rechargeable. The reflective surfaces on the left 46, reflects light and makes it easy to track victims of accidents especially at night. In one embodiment of the present invention on the right side 47 is an in-built mini wearable ultrasonic sensor for arterial pulse pressure with screen display and a loud speaker to relate the vital signs of the victim for proper triage when there are a number of victims. In another embodiment, the device has in place of the reflective surface on the left 46, a display of oxygen saturation measured using a standard pulse oximetry device placed above the jugular vein, which is a non-invasive method to measure arterial oxygen saturation level. A pulse oximetry device includes a sensor that measures light absorption of hemoglobin and represents arterial SpO2. The basis is that, oxyhemoglobin and unoxygenated hemoglobin absorb light differently. The pulse oxymeter sensor 46 measures the relative amount of light absorbed by oxyhemoglobin and unoxygenated (reduced) hemoglobin and compares the amount of light emitted to light absorbed. This comparison is then converted to a ratio and is expressed as a percentage of SpO2. Pulse oximetry is described in detail by Jubran A. in an article entitled, ‘Pulse Oximetry’, published in Crit Care, 2015; vol. 19(1), p. 272 (doi:10.1186/s13054-015-0984-8). There is a large ventilation central hole 48, and a couple of small ventilation holes on the back surface.
[0109] FIG. 3F, shows the front exploded view of feature 47, showing the ultrasonic sensor and display of arterial pulsation. This wearable ultrasonic device that is placed on the skin surface 47 over the carotid artery has been described in detail by Wang C. et al., in an article entitled ‘Monitoring of the central blood pressure waveform via a conformal ultrasonic device’ published in Nature Biomedical Engineering 2018, vol. 2, pp. 687-695. Both the pulse sensor and the microphone are activated by the crash sensor, and could be shut off manually. The vital signs could include blood pressure and pulse measurements. In some other embodiment infra-red oxygen saturation measurement is displayed. These vital signs help to characterize the cardiovascular status of the victim and prioritize victims in serious conditions during the triage by the EMS. The AI system has the capacity to telemeter the vital signs from victims through wireless communication including use of Bluetooth technology. FIG. 4, shows a schematic diagram of the side view of the device inside a head rest. The head rest airbag is shown in exploded view. The front end of the head rest 49 encloses the central cooling 50 bladder and side air bladders which come in contact with the skin of the person. The device is suspended on left 51 and right 52 detachable rings which are held in place by the left 53 and right 54 suspension rods which could automatically disengage the device from the head rest as soon it is fully deployed. The coolant is pumped through a nozzle 55 to fill the central cooling bladder in case of a crash. The C-arms of the collar are put in place by a system of robotic type levers which comes out from a groove 56 within the head rest, which move the left 57 and right 58 levers in a semi-circular movement to bring the left 59 and right 60 C-arms together at the front systems could be obtained from a number of companies such as Sparton Inc. in Schaumburg, Ill., USA. The separation of the left 59 and right 60 C-arms is facilitated by a spring system 61 situated between them within the inner casing 62 which is placed within the outer casing 63 of the head rest. The front end of the head rest comprising the device separates automatically from the back end at the borderline 64, and could be also done manually by pressing the unlocking button 65. The back of the head rest has a thin slit opening 66 through which the head rest airbag 67 could on impact deploy from underneath, to prevent excessive hyperextension of the head of the passenger or driver.
[0110] FIG. 5 A-H shows the operational sequence of the device (AIAutoCoolCollar) during a motor vehicle accident.
[0111] FIG. 5A, shows the time preceding a crash, the driver's head and neck are normal position 68. FIG. 5B, shows that at the moment of impact the head and neck are in flexion 69.
[0112] FIG. 5C, shows the next stage of head and neck hyperextension 70.
[0113] FIG. 5D, shows the final stage of head and neck hyperflexion 71.
[0114] FIG. 5E, shows the head rest 72 fitted with the device and the head and neck of the driver 73 in normal position. The AI system is designed to work in a vehicle with driver or that is driverless. The AI system performs a pre-departure safety briefing, demonstration and exchange with the persons in the vehicle in a similar way as pre-flight safety demonstration in commercial airplanes. The pre-departure information includes photos, identity, age of the persons, telephone numbers etc. The information of the demonstration includes the safety procedures related to the deployment of the AIAutoCoolCollar and AIAutoCoolHelmet. Both components of the present device could be used independently or together as in race cars. The persons are instructed using a video guide on the deployment procedure and how to keep the head and neck in position. Assurances are given that the AI system has measured their neck circumference and the splint would be fitted to the appropriate neck size and there is no possibility of strangulation. Furthermore, it would be emphasized that, the AI system would only deploy if the crash intensity is high and the video from the inside of the vehicle indicates that there is a high risk of a head and neck injury. The AI system could be built using commercially available Artificial Intelligence platforms and could also use Deep Learning software and Machine Learning software. Deep learning software tools are commercially available and some are open source software written in languages like Python, Cython, C+, C++, CUDA, Java and others, that can run on the usual common platforms like Linux, Mac OS and Windows. Some aspects that involve facial recognition software could also use commercially available software like DeepFace from Facebook, Amazon Rekognition, Local Binary Pattern Histogram (LBPH) and others. FIG. 5F, shows the moment of crash when the device starts to be deployed 74. The head and neck of the driver is moved forward on rear impact 75.
[0115] FIG. 5G, shows the driver with the head and neck in hyperextension as the device deploys from the head rest 76. The front airbag 77 deploys and prevents the ensuing hyperflexion, but quickly collapses forward as shown by thick black arrow. The head and neck are forced backwards in hyperextension 78. As the head and neck remain in hyperextension 78, the device deploys sideways 79, and the left and right C-arms 80 are rolled into place to close at midline. The immediate expansion of the back airbag 81 from the head rest prevents hyperextension. Once deployed, the device separates automatically from the head rest, or a manual button 82 could also be needed for manual separation in case the electronic separation was not accomplished.
[0116] FIG. 5H, shows the driver with the splint accomplished and the device detached from the head rest. The device cools the back and sides of the neck 83, up to the area of the occiput 84. The frontal area of the neck 85 is at normal body temperature. There is a central vent opening 86 for aeration.
[0117] FIG. 6, shows the flow chart of the AI program that operates the device and other safety features. The AI system starts 87 with a pre-departure demonstration to show the safety feature in the vehicle and explain how the device works. The AI system determines the position of the head and neck circumference 88, and alongside other data proceeds to adjust the head rest so the device can be safely deployed in the event of a crash. AI system determines when a crash occurs from a host of crash sensors 89. The AI system performs an initial assessment 90 of the audio-video images from inside the vehicle, to determine if there was a risk of TBI and/or CSI. The AI system initiates deployment of the device by inflating the head rest airbag 91. In situations where the driver has the helmet device as with race car driver involved in a crash, the AI system wirelessly activates the crash sensor on the helmet to begin cooling of the head. The C-arm of the device begins to deploy 92 side ways in preparation to begins full cooling of the head and neck region. The AI system determines the current position and size of the head and neck 93. If the head and neck are in hyperextension 94, the AI system proceeds to splinting 95 by inserting the C-arms in place 96. Thereafter the device is automatically detached from the head rest 97. The AI system calls the EMS 98 and other relevant first responders. It sends images of the accident and vital signs to convey the state-of-being of the victims so as to prepare the first responders for adequate first aid. The event is recorded and stored on audiovideo tapes in the vehicle's ‘Black-Box’. However, if the head of the person was not in hyperextension 99 the AI system repeats from the prior step 100 to determine the position and size of the head and neck 93, if in hyperextension 95 it then proceeds with the successive steps until the end 101. In another embodiment, an assistant could manually take the cervical collar from within the head rest and place it on the victim, especially in the absence of an automatic AI system.
[0118] FIG. 7, shows the driver with the device deployed in the vehicle moments after the impact. The front air bag 102 deploys and prevents the driver from going into hyperflexion, while the back head rest airbag 103 prevents hyperextension. The driver is in position with head on the head rest and neck slightly extended for deployment of the device 104 from the head rest 105. The deployment of the device is guided by the AI system using visual input data from the camera 106, and wireless communication such as infra-red 107.
[0119] FIG. 8 A-D shows areas of distribution of blood flow for heat transfer from the detailed parts of the assembly of the device (AIAutoCoolHelmet).
[0120] FIG. 8A, shows the venous sinuses for blood flow distribution in the area covered by the brain cooling system. The veins of the brain in this region include the superior sagittal sinus 108, the superior anastomatic vein of Trolard 109, the confluence of sinuses 110, the transverse sinus 111, and the occipital sinus 112. The cooling is transferred through cerebral blood flow in these superficially lying veins throughout the entire brain and to the other organs.
[0121] FIG. 8B, shows a protective helmet (AIAutoCoolHelmet) that could be used by race car drivers as a component of the present invention, and is applicable as a standalone. The outer shell of the helmet 113 serves to protect the head with some ventilation holes 114 for aeration. The front face shield 115 protects the face and eyes. There is an outer “crash” sensor 116, which are both mechanical and electronic sensors that sense significant vibration and acceleration to activate the interior cooling system. The “crash” sensor 116 could be activated automatically by the AI system signaling a crash or manually by an assistant.
[0122] FIG. 8C, shows another embodiment of a protective helmet adapted as standalone device according to the teachings of the present invention for use in sports such as in American football. There is a unique face mask 117. A “crash” sensor 118 is positioned on the forehead to detect significant change in vibration and acceleration. The inner core layer of the helmet 119 which lies below the shell provides support for the inner padding with the inner cooling system bladders 220 lying above it.
[0123] FIG. 8D, shows the interior cooling apparatus of the protective helmet. The coolant is stored in a reservoir 221 under a thermal padding insulator 222, connected to a system of cooling bladders for heat transfer. Once a crash occurs, the crash sensor 223 triggers the automatic gas/liquid valve 224 to open and permit heat transfer to a measure. Both the crash sensor and valve function mechanically and electrically, powered by a small battery 225. In one embodiment, in the event of a crash, the crash sensor activates the ultrasound pulse sensor 226, placed above the temporal artery and connected to a small screen to display arterial pulsation as shown in FIG. 9, and a loud speaker, to show the vital signs of the victim. The pulse sensor 226 is battery powered and is only activated by the crash sensor 116, and could be shut off manually. The coolant from the reservoir 221 passes through conduits and pipes 227 into the system of inner cooling bladders along the midline 228 overlying the superior sagittal sinus, the transverse 229 over the superior anastomotic vein of Trolard, the occiput 230, and at the back of the neck region 231. The coolant could be liquid or gas, and should be a natural coolant that is environmentally friendly and has no ozone depletion potential (ODP), and very low or zero global warming potential (GWP). The most common natural coolants are carbon dioxide, propane, isobutene, profane and ammonia. The choice of coolant is influenced by critical temperature and critical pressure parameters selected according to specific use and preferences including cost.
[0124] FIG. 9, shows a race car driver with the AIAutoCoolCollar and AIAutoCoolHelmet fully deployed. The device AIAutoCoolCollar 232 is used to splint the neck in case of cervical spinal injury. The AIAutoCoolHelmet 233 protects against traumatic brain injury. The AI system uses the crash sensors 234 to triggering cooling and vital signs monitoring, which the optical sensor 235 provides head position sensing.
