CARDIOPULMONARY RESUSCITATION SYSTEM
20210186805 · 2021-06-24
Inventors
- Eiichi MATSUI (Bunkyo-ku, Tokyo, JP)
- Mitsuo MATSUI (Bunkyo-ku, Tokyo, JP)
- Yukio SAITO (Bunkyo-ku, Tokyo, JP)
- Hitoshi TAZAKI (Bunkyo-ku, Tokyo, JP)
Cpc classification
A61M2205/3592
HUMAN NECESSITIES
A61H2230/405
HUMAN NECESSITIES
A61M16/024
HUMAN NECESSITIES
A61H2230/425
HUMAN NECESSITIES
International classification
A61H31/00
HUMAN NECESSITIES
Abstract
A cardiopulmonary resuscitation system capable of avoiding fighting in an asynchronous mode in which sternum compression and artificial respiration are performed independently and continuously. The cardiopulmonary resuscitation system includes: a sternum compressor that includes an impact hammer for compressing the chest of a patient and repeats a sternum compression cycle having, as one cycle, a compression period in which the impact hammer is pressed against the chest and a recoil period in which the impact hammer is separated from the chest; an artificial respirator that repeats an artificial respiration cycle having, as one cycle, an inhalation period in which respiratory gas is supplied to the patient and an exhalation period in which supply of the respiratory gas is stopped; and a controller that controls the artificial respirator and the sternum compressor, the controller executes the artificial respiration cycle a predetermined number of times per unit time while executing the sternum compression cycle a predetermined number of times per unit time, and stops pressing the impact hammer against the chest during the compression period overlapping with the inhalation period.
Claims
1. A cardiopulmonary resuscitation system comprising: a sternum compression means that includes an impact hammer for compressing the chest of a patient and repeats a sternum compression cycle having, as one cycle, a compression period in which the impact hammer is pressed against the chest and a recoil period in which the impact hammer is separated from the chest; an artificial respiration means that repeats an artificial respiration cycle having, as one cycle, an inhalation period in which respiratory gas is supplied to the patient and an exhalation period in which supply of the respiratory gas is stopped; and a control means that controls the artificial respiration means and the sternum compression means, wherein the control means executes the artificial respiration cycle a predetermined number of times per unit time while executing the sternum compression cycle a predetermined number of times per unit time, and stops pressing the impact hammer against the chest during the compression period overlapping with the inhalation period.
2. The cardiopulmonary resuscitation system according to claim 1, wherein in a case where the inhalation period is started during the recoil period, the control means extends the recoil period executed at the start time of the inhalation period at least until the inhalation period ends.
3. The cardiopulmonary resuscitation system according to claim 1, wherein in a case where the inhalation period is started during the compression period and the start time of the inhalation period is in the first half period obtained by temporally dividing the compression period into two equal parts, the control means hastens start of the inhalation period by the same time as the time from the start time of the compression period overlapping with the inhalation period to the start time of the inhalation period.
4. The cardiopulmonary resuscitation system according to claim 1, wherein in a case where the inhalation period is started during the compression period and the start time of the inhalation period is in the second half period obtained by temporally dividing the compression period into two equal parts, the control means delays start of the inhalation period by the same time as the time from the start time of the inhalation period to the end time of the compression period overlapping with the inhalation period.
5. The cardiopulmonary resuscitation system according to claim 1, wherein the control means restarts the sternum compression cycle a predetermined time after the end of the inhalation period, and the sternum compression cycle restarted is started from the compression period.
6. The cardiopulmonary resuscitation system according to claim 1, wherein the artificial respiration means and the sternum compression means are configured as an integral device.
7. The cardiopulmonary resuscitation system according to claim 1, wherein the artificial respiration means and the sternum compression means are configured as individual devices.
8. The cardiopulmonary resuscitation system according to claim 7, wherein the control means is mounted on a device constituting the artificial respiration means.
9. The cardiopulmonary resuscitation system according to claim 1, wherein the sternum compression means includes an elevating means for vertically reciprocating the impact hammer, and a driving system of the elevating means is a gas driving system, an electric driving system, or a mixed driving system of the gas driving system and the electric driving system.
10. The cardiopulmonary resuscitation system according to claim 2, wherein the control means restarts the sternum compression cycle a predetermined time after the end of the inhalation period, and the sternum compression cycle restarted is started from the compression period.
11. The cardiopulmonary resuscitation system according to claim 3, wherein the control means restarts the sternum compression cycle a predetermined time after the end of the inhalation period, and the sternum compression cycle restarted is started from the compression period.
12. The cardiopulmonary resuscitation system according to claim 4, wherein the control means restarts the sternum compression cycle a predetermined time after the end of the inhalation period, and the sternum compression cycle restarted is started from the compression period.
Description
BRIEF DESCRIPTION OF DRAWINGS
[0017]
[0018]
[0019]
[0020]
[0021]
[0022]
[0023]
[0024]
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0025] Next, the present disclosure will be described in detail by describing embodiments, but the present disclosure is not construed as being limited to description thereof. As long as an effect of the present disclosure is exhibited, the embodiments may be modified variously.
[0026]
[0027] In the cardiopulmonary resuscitation system 100, as illustrated in
[0028] The artificial respiration means 110 is an artificial respiration unit of the cardiopulmonary resuscitator 100. As illustrated in
[0029] The sternum compression means 120 is a sternum compression unit of the cardiopulmonary resuscitator 100. As illustrated in
[0030] The arch portion 10 has a top surface portion 11 and left and right side surface portions 12 and is disposed so as to extend over the chest of a patient. The arch portion 10 includes the impact hammer 121 projecting downward from the top surface portion 11 and movably supported in the vertical direction by the top surface portion 11 and an elevating means (elevating mechanism) 122 for vertically reciprocating the impact hammer 121. The impact hammer 121 includes an impact hammer rod 121a connected to the elevating means 122 and an impact head pad 121b attached to a lower end of the impact hammer rod 121a and pressed against the chest of a patient. In a case where the driving system of the elevating means 122 is a gas driving system, the elevating means 122 includes a cylinder 123. The cylinder 123 has a container shape and has a gas supply port (not illustrated) and a gas discharge port (not illustrated). A piston (not illustrated) and a spring (not illustrated) for pushing back the piston at the time of discharge are disposed in an internal space of the cylinder 123.
[0031] The driving system (not illustrated) of the elevating means 122 includes a driving gas supply source such as a gas cylinder or an air tank and piping connecting the driving gas supply source to the cylinder 123. In the middle of the piping, for example, a compression depth adjuster for adjusting the stroke width of the vertical reciprocating motion of the elevating means 122 and a compression solenoid valve for supplying driving gas into the cylinder 123 and discharging driving gas from the cylinder 123 are disposed. The driving gas supply source preferably serves also as a gas supply source of the artificial respiration unit 110. The compression solenoid valve is, for example, a three-way solenoid valve.
[0032] A part of the arch portion 10 is preferably the housing 101. The housing 101 houses the gas supply system of the first artificial respiration unit 110, the driving system for driving the elevating means 122, the control means of the cardiopulmonary resuscitator 100, and the like.
[0033] A pair of vertical rods 20 is disposed on the left and right sides and is fixed to fixing portions 13 disposed at lower ends of the left and right side surface portions 12 of the arch portion, respectively. For example, the vertical rod 20 is engaged with a ratchet of the fixing portion 13 to support the arch portion 10 so as to be movable in the vertical direction. As illustrated in
[0034] The back plate 30 is a plate for supporting a lower surface of the chest of a patient. For example, by engaging an engagement portion (not illustrated) such as a groove or a hole formed in the back plate 30 with a projection (not illustrated) formed at a lower end of the vertical rod 20, the back plate 30 is fixed to the arch portion 10 detachably.
[0035] The control means (hereinafter also referred to as a first control unit) is, for example, a printed circuit board. The first control unit controls the gas supply system of the first artificial respiration unit 110 and the driving system of the elevating means 122.
[0036] The first control unit closes the ventilation solenoid valve in a case where a pressure detected by the respiratory tract internal pressure sensor is equal to or higher than a predetermined pressure. It is thereby possible to prevent injection of high pressure gas into a patient.
[0037] The first control unit adjusts the frequency (number of times of ventilation) of the artificial respiration cycle by the first artificial respiration unit 110. Here, the number of times of ventilation is the number of times for performing the artificial respiration cycle in one minute, for example, 6 to 20 times/minute. The flow rate of respiratory gas by the first artificial respiration unit 110 is fixed to, for example, 24 liters/minute. The ventilation amount of respiratory gas is, for example, 200 to 600 ml/time. The length of the inhalation period is, for example, 0.5 to 1.5 seconds. The lengths of the inhalation period and the exhalation period vary depending on the flow rate of respiratory gas, the number of times of ventilation, and the ventilation amount. For example, in a case where the flow rate of respiratory gas is 24 liters/minute, the number of times of ventilation is set to 10 times/minute, and the ventilation amount is set to 200 ml/time, the inhalation period is 0.5 seconds, and the exhalation period is 5.5 seconds.
[0038] The first control unit controls the compression solenoid valve to supply driving gas into the cylinder 123 or discharge the driving gas from the inside of the cylinder 123. When the driving gas is supplied into the cylinder 123, a piston is pushed down against a repulsive force of a spring, and the impact hammer 121 moves downward. When the driving gas is discharged from the inside of the cylinder 123, the spring expands, the piston is pushed up, and the impact hammer 121 moves upward. By repeating these, the impact hammer 121 reciprocates vertically.
[0039] In addition, the first control unit adjusts the frequency of the sternum compression cycle (the number of times of compression) and the stroke width of the vertical reciprocating motion of the elevating means 122. The stroke width is switched, for example, by turning of an adjustment knob 14 by an operator. Here, the number of times of compression is the number of times for performing the sternum compression cycle in one minute, and Guidelines recommend that the number of times of compression is 100 times/minute or more. A compression period and a recoil period preferably have the same length as each other. For example, in a case where the number of times of compression is 100 times/minute, the time per sternum compression cycle is 0.6 seconds, and the compression period and the recoil period are each 0.3 seconds. The stroke width of the vertical reciprocating motion is appropriately adjusted according to a patient, but Guidelines recommend that the stroke width is 5 cm or more in an adult.
[0040] The cardiopulmonary resuscitator 100 preferably includes a mode switching unit 15. The mode switching unit 15 is a switch for switching an operation timing mode of each of the first artificial respiration unit 110 and the sternum compression unit 120. The mode switching unit 15 is, for example, a panel as illustrated in
[0041] The operation timing mode of each of the first artificial respiration unit 110 and the sternum compression unit 120 is roughly divided into a synchronous mode and an asynchronous mode.
[0042]
[0043]
[0044] In
[0045] The avoidance type asynchronous mode is roughly divided into three patterns depending on whether the start time of the inhalation period is during the recoil period (first example), during the first half period of the compression period (second example), or during the second half period of the compression period (third example). Next, a specific example of avoiding fighting will be described with reference to
First Example
[0046]
Second Example
[0047]
[0048] The length of the inhalation period I4′ which has been started earlier is the same as the length of the inhalation period I4 which has been scheduled to be executed before the start time is made earlier. That is, the inhalation period I4′ is temporally shifted forward by the time t1 with respect to the inhalation period I4. In the second example, the number of times of compression is smaller than a set value by the amount overlapping with the inhalation period, and the number of times of ventilation fluctuates with respect to a set value by the amount of shift. The variation in the number of times of ventilation is preferably within ±5% of a set value.
Third Example
[0049]
[0050] The length of the inhalation period I5′ the start of which has been delayed is the same as the length of the inhalation period I5 which has been scheduled to be executed before the start is delayed. That is, the inhalation period I5′ is temporally shifted backward by the time t2 with respect to the inhalation period I5. In the third example, the number of times of compression is smaller than a set value by the amount overlapping with the inhalation period, and the number of times of ventilation fluctuates with respect to a set value by the amount of shift. The variation in the number of times of ventilation is preferably within ±5% of a set value.
[0051] As illustrated in
[0052] In the first to third examples, as illustrated in
[0053]
[0054] In
[0055] The second artificial respiration unit 210 includes an inhalation hose (not illustrated) for injecting respiratory gas into a patient and a gas supply system (not illustrated) for supplying the respiratory gas. One end of the inhalation hose is connected to a hose insertion port (not illustrated) disposed in the housing 201 of the artificial respirator 200. The other end of the inhalation hose is connected to a mask (not illustrated) attached to a patient or a tracheal intubation tube (not illustrated). The gas supply system of the second artificial respiration unit 210 has the same basic configuration as the gas supply system of the first artificial respiration unit 110. A major difference is that a ventilation solenoid valve is disposed in the middle of the piping in the first artificial respiration unit 110, whereas a flow-controllable valve such as a flow regulating valve is disposed in the middle of the piping in the second artificial respiration unit 210.
[0056] The second control unit 230 is, for example, a printed circuit board. The second control unit 230 controls the gas supply system of the second artificial respiration unit 210. The second control unit 230 generates an external signal.
[0057] The second control unit 230 adjusts the frequency (number of times of ventilation) of the artificial respiration cycle by the second artificial respiration unit 210. Here, the number of times of ventilation is, for example, 2 to 40 times/minute. The second control unit 230 adjusts the ventilation amount of respiratory gas and the length of an inhalation period. The first artificial respiration unit 110 includes a ventilation solenoid valve, whereas the second artificial respiration unit 210 includes a flow-controllable valve such as a flow regulating valve. Therefore, the ventilation amount of respiratory gas by the second artificial respiration unit 210 can be adjusted in a wider range than the range of the ventilation amount of respiratory gas by the first artificial respiration unit 110, and is, for example, 50 to 3000 ml/time. The inhalation period of respiratory gas by the first artificial respiration unit 110 is automatically switched according to the flow rate of respiratory gas, the number of times of ventilation, and the ventilation amount, whereas the inhalation period of respiratory gas by the second artificial respiration unit 210 can be continuously switched alone, for example within a range of 0.3 to 3.0 seconds. Therefore, the second artificial respiration unit 210 can adjust the flow rate more finely than the first artificial respiration unit 110.
[0058] The external signal output unit 240 is, for example, a connection terminal of a cable (not illustrated) or a transmission unit of a wireless signal or the like, and outputs an external signal sent from the second control unit 230.
[0059] The respiratory tract internal pressure sensor 250 can detect from a negative pressure to a positive pressure, detects a respiratory tract internal pressure of a patient, and outputs a pressure signal to the second control unit 230.
[0060] In
[0061] In the cardiopulmonary resuscitation system 1, the artificial respirator 200 performs artificial respiration, and the cardiopulmonary resuscitator 100 performs only sternum compression. That is, the sternum compression unit 120 and the second artificial respiration unit 210 are in an operable state, and the first artificial respiration unit 110 is in a stopped state. At this time, the signal transmission means 300 makes it possible to transmit an external signal from the artificial respirator 200 to the cardiopulmonary resuscitator 100.
[0062] In the cardiopulmonary resuscitation system 1, a control means for controlling the artificial respiration means (artificial respirator) 200 and the sternum compression means (sternum compression unit) 120 are preferably mounted on the artificial respirator 200. By control of the sternum compression unit 120 in addition to the second artificial respiration unit 210 by the second control unit 230, the cardiopulmonary resuscitator 100 can be small and lightweight, and sternum compression can be quickly started in an early stage of critical care. The second control unit 230 generates, for example, an external signal including a remote control signal instructing the sternum compression unit 120 to perform sternum compression. The external signal including the remote control signal is output from the external signal output unit 240 and input to the external signal input unit 140 by the signal transmission means 300. The external signal including the remote control signal input by the external signal input unit 140 is sent to the first control unit 130. Upon input of the remote control signal, the first control unit 130 drives the sternum compression unit 120. In this way, the second control unit 230 remotely controls the sternum compression unit 120. In a case where the pressure detected by the respiratory tract internal pressure sensor 250 is a negative pressure, the second control unit 230 outputs a signal for opening a flow regulating valve (not illustrated) to the flow regulating valve (not illustrated) and supplies respiratory gas from the second artificial respiration unit 210.
[0063] Avoidance of fighting by the second control unit 230 is performed in a similar manner to those in
[0064] Up to this point, the form in which the elevating means 122 of the sternum compression means 120 is a gas driving system has been described, but the present disclosure is not limited to the driving system of the elevating means 122. The driving system of the elevating means 122 may be, for example, an electric driving system or a mixed driving system of a gas driving system and an electric driving system. In a case where the driving system of the elevating means 122 is a gas driving system, according to the classification of the medical apparatus law or the like, the sternum compression means 120 may also be referred to as a “mechanical cardiopulmonary artificial resuscitator”. By adopting the gas driving system, the setting width of the sternum compression depth can be wide, and sternum compression by a method with hands can be reproduced. In a case where the driving system of the elevating means 122 is an electric driving system, according to the classification of the medical apparatus law or the like, the sternum compression means 120 may also be referred to as an “electric cardiopulmonary artificial resuscitator”. By adopting the electric driving system, a device can be simpler. The electric driving system is, for example, an internal battery, an external battery, an external power source such as an AC 100 V power source, or a combination thereof. In a case where the electric driving system is adopted as the driving system of the elevating means 122, the impact hammer 121 reciprocates vertically by motor driving, for example.
REFERENCE SIGNS LIST
[0065] 1 Cardiopulmonary resuscitation system [0066] 10 Arch portion [0067] 11 Top surface portion [0068] 12 Left and right side surface portions [0069] 13 Fixing portion [0070] 14 Adjustment knob [0071] 15 Mode switching unit [0072] 20 Vertical rod [0073] 21 Scale [0074] 30 Back plate [0075] 100 Cardiopulmonary resuscitation system (cardiopulmonary resuscitator) [0076] 101 Housing [0077] 110 Artificial respiration means (first artificial respiration unit) [0078] 111 Hose [0079] 112 Hose insertion port [0080] 120 Sternum compression means (sternum compression unit) [0081] 121 Impact hammer [0082] 121a Impact hammer rod [0083] 121b Impact head pad [0084] 122 Elevating means [0085] 123 Cylinder [0086] 130 First control unit [0087] 140 External signal input unit [0088] 200 Artificial respiration means (artificial respirator) [0089] 201 Housing [0090] 210 Second artificial respiration unit [0091] 230 Second control unit [0092] 240 External signal output unit [0093] 250 Respiratory tract internal pressure sensor [0094] 300 Signal transmission unit [0095] 901 Execution period [0096] 902 Standby period [0097] I1, I2, I3, I4, I4′, I5, I5′, and I6 Inhalation period [0098] Ex Exhalation time [0099] P1, P2, P3, P4, P5, P6, P7, P8, P9, P10, P11, P12, P12, P13, and P14 Compression period [0100] P71, P91, P121 First half period of compression period [0101] P71, P92, P122 Second half period of compression period [0102] R1, R1′, R2, R2′, R3, and R3′ Recoil period [0103] s1 Start time of compression period [0104] s2, s3, and s4 Start time of inhalation period [0105] e1 End time of compression period [0106] t1, t2 Time