Appliance for cardiopulmonary massage and/or resuscitation

Abstract

The appliance according to the invention serves for cardiopulmonary massage and/or resuscitation of a patient and is provided with a massage device (17) which can be driven reversibly by a drive device (18) in an actuation direction (23) and which has a pressure area (20) that can be positioned on the chest (12) of a patient (11) at a target contact area (21). In order to ensure that deviations of the pressure area of the massage device from a target pressure point can be determined promptly and reliably, the invention proposes a position sensor device (22), for determining changes in the position of the massage device (17) and/or of the pressure area (20) thereof relative to the target contact area (21) on the chest (12) of the patient in a plane normal to the actuation direction (23) of the massage device (17).

Claims

1. An appliance for cardiopulmonary massage and/or resuscitation, comprising a massage device which can be driven reversibly in an actuation direction by a drive appliance and which comprises a pressure area which can be positioned on the ribcage of a patient at a target contact region, further comprising a position sensor device configured to detect changes in the position of the massage device and/or the pressure area thereof relative to the target contact region on the patient's ribcage in a plane normal to the actuation direction of the massage device, wherein the position sensor device operates according to an inductive, capacitive, and/or magnetic measurement method, and wherein the position sensor device comprises a radio link configured to provide radio communication of position data, detected by the position sensor or the evaluation device, to a monitoring unit.

2. The appliance according to claim 1, wherein the radio link comprises a radio transmitter which is arranged on the massage device near the pressure area and which can be activated by the trigger element provided on the position marker.

3. The appliance according to claim 1, wherein the position sensor device is arranged at least in part on the pressure area of the mounting appliance.

4. The appliance according to claim 1, wherein the position sensor device comprises a position sensor, which is arranged on the pressure area and which cooperates with a position marker fastened to the target contact region on the ribcage of the patient.

5. The appliance according to claim 4, wherein the position marker comprises a preferably flexible holding layer, which can be detachably fixed to the ribcage of the patient using an adhesive layer and on which a marking detectable by the position sensor or a pickup which acts on the position sensor is arranged.

6. The appliance according to claim 4, wherein the position sensor device has a capacitive sensor arrangement, the position sensor arranged on the pressure area comprising at least one sensor electrode and the position marker comprising at least one metal pickup element, the position sensor device comprising an evaluation device and/or a monitoring unit having a detector configured to detect capacitance changes between the pickup element and the at least one sensor electrode and to determine the consequent changes in the relative position between the pressure area and the position marker.

7. The appliance according to claim 6, wherein the position sensor comprises a central sensor electrode and at least three electrode segments arranged around the central sensor electrode.

8. The appliance according to claim 4, wherein a trigger element, preferably a trigger magnet, is arranged on the position marker and cooperates with a proximity switch element arranged on the massage device to activate the position sensor device or the position sensor thereof.

9. The appliance according to claim 1, further comprising an alarm and/or a switch configured to switch off the drive device, which are acted on by the position sensor device.

Description

(1) Further features and advantages of the invention can be found in the following description and the drawings, which describe and illustrate a preferred embodiment of the invention in greater detail by means of an example. In the drawings:

(2) FIG. 1 is a perspective drawing from diagonally above of an appliance for cardiopulmonary massage according to the invention applied to a patient's chest;

(3) FIG. 2 is a perspective drawing from diagonally below of the subject matter of FIG. 1;

(4) FIG. 3 is an elevation of the massage device, applied to the patient, of the appliance according to the invention;

(5) FIG. 4 is a schematic horizontal section, along the line IV-IV in FIG. 3, of the position sensor device of the appliance according to the invention together with an evaluation device assigned thereto; and

(6) FIG. 5 is a section, along the line V-V, of the subject matter of FIG. 4.

(7) FIGS. 1 and 2 show an appliance, denoted as a whole by 10, for cardiopulmonary massage and/or resuscitation of a patient 11 in the position thereof on the chest 12 of said patient. The appliance 10 comprises a counter-bearing board 14, which is placed underneath the back 13 of the patient 11 and in one corner region of which an upwardly projecting portal support 15 is arranged. The portal support 15 is arranged so as to be pivotable about a vertical axis and vertically displaceable relative to the counter-bearing board 14. It can be locked in various vertical positions, preferably continuously. At the upper end thereof, it carries an arm 16, which is likewise mounted on the portal support 15 so as to be articulated about a vertical axis. In turn the arm 16 is provided on the outer, free end thereof with a massage device 17, which is driven reversibly up and down in a substantially vertical direction by a drive device 18 arranged in the interior of the arm housing. The massage device 17 is shown in greater detail in FIG. 3.

(8) The massage device 17 has a massage plunger 19 (Gellert: not provided with a number in FIG. 1please add this in) comprising a lower pressure area 20 which, when the appliance is used as intended, is positioned on the ribcage 12 of the patient 11 at a target contact region 21specifically normally at the upper end of the lower third of the sternumand carries out cardiopulmonary massage on the patient during the operation of the massage device in that the massage plunger 19 which moves up and down compresses and releases the ribcage 12 at the set frequency.

(9) It is important that during this cardiopulmonary massage the target contact region or pressure point 21 at which the pressure area 20 of the massage plunger 19 acts does not change, or at least not significantly. To provide these even for example during transportation of the patient, according to the invention a position sensor device, denoted as a whole by 22, is provided, and serves to detect changes in the position of the massage device or of the pressure area 20 of the massage plunger 19 thereof relative to the target contact region 21 on the chest 12 of the patient 11 in a plane normal to the actuation direction 23 of the massage device 17. This position sensor device 22 basically consists of two components, specifically a position sensor 24 arranged on the pressure area 20 of the massage plunger 19 and a position marking means 25 which is fastened to the target contact region 21 on the patient's ribcage and with which the position sensor (24) cooperates. In the preferred embodiment shown, the position marking means 25 is adhered to the chest 12 of the patient above the target contact region 21 in the manner of a large plaster. For this purpose, it comprises a flexible holding layer 27, which is provided with an adhesive layer 26 and in the interior of which a pickup 28 is arranged, which acts on the position sensor 24 and consists of a round piece of thin metal film.

(10) In the shown and described preferred embodiment of the invention, a capacitive measurement method is used for monitoring the position of the massage device. Accordingly, the position sensor device has a capacitive sensor arrangement in which the position sensor 24 arranged on the pressure area 20 of the massage plunger 19 has a total of five sensor electrodes in the form of conductive metal plates or films, specifically a central sensor electrode 29 and four electrode segments 30 extending around the central sensor electrode (Gellert: FIG. 4 bottom right sensor surface is not labelled with 30; please add this in!), which are in the form of annular ring segments and each extend over an angular range of 90 (FIG. 4). As can also be seen in FIG. 4, the pickup 28 arranged on the position marking means 25 has a greater diameter than the central sensor electrode 29. If the pickup and the central sensor electrode are arranged so as to be mutually coaxial, the peripheral edge of the pickup 28 (continuous line in FIG. 4) is also positioned uniformly under all four electrode segments 30, in each case approximately of the area of each of the outer sensor elements 30 in the form of an annular ring segment being covered by the metal film of the pickup element 28.

(11) The pickup element arranged on the position marking means 25 and the sensor electrodes 29, 30 located above and provided on the pressure area 20 of the massage plunger 19 form the plates of a total of five plate capacitors, the capacitance of which is dependent on the size of the area by which the electrodes 29, 30 cover the pickup element 28 in each case. A lateral displacement e of the pressure area 20, together with the sensor electrodes 29, 30 arranged thereon, relative to the position marking means attached to the patient, together with the pickup element 28 arranged therein, always results in a change in the capacitance between the pickup element 28 and the outer electrodes 30 in the form of annular ring segments, since in this case the effective areas between the pickup element and the electrode segments are changed. This is illustrated in FIG. 4 by the dashed representation 28 of the pickup element displaced by the amount e from the central target position of the pickup element 28. The respective present values of the capacitors of the five (plate) capacitors are determined by means of an evaluation device 27 and communicated from a transmitter 33 via a radio link 32 to a monitoring unit 31, which in the embodiment shown is located so as to be easily accessible on top of the arm 16 (FIG. 1). From the type of capacitance change (increase or decrease in the effective area) and the finding as to the extent to which the changes are detected at each of the four electrode segments, the monitoring unit 31 (merely shown schematically in FIG. 4) can detect not only the magnitude but also the direction of the lateral displacement.

(12) Once the monitoring unit 31 establishes a lateral displacement e of the massage plunger relative to the position marking means which is larger than a set threshold, it emits an optical or acoustic warning signal, which gives an alert as to the displacement. Once the monitoring unit 31 also establishes a change in capacitance between the central sensor electrode 29 and the pickup element 28, the drive device 18 for the massage plunger 19 is stopped, since the change in capacitance between the central sensor electrode in the pickup element is a sign that the lateral displacement has reached a value at which risk-free continuation of the massage is no longer ensured.

(13) For transmitting the capacitance values determined by the evaluation device 37, which result from the active areas between the electrodes and the pickup element, via the radio link 32, a radio transmitter 33 is provided on the massage plunger 19 just above the pressure area 20, and in the preferred embodiment shown obtains the power supply thereof from a battery 23 likewise arranged on the massage plunger. This battery also provides the current required for the evaluation device 37. The radio transmitter 33 is activated by a proximity switch 35, which is triggered by a trigger magnet 36, arranged below the pickup element 28 on the position marking means 25, when the massage plunger 19 enters the vicinity of the position marking means and the proximity switch 35 thus enters the action range of the trigger magnet 36. The current supply of the evaluation device 37 and the radio link 33 is thus generated automatically by the battery 34, and only when the device is actually applied to patients for use. This therefore ensures that the evaluation device and the radio link 33 are only activated when the pressure area 20 of the massage device 17 is located above the position marking means 25 applied to the chest of the patient. Thus, when the appliance is not in use, the evaluation device 37 and the radio link 33 are not active and thus do not consume any current from the battery.

(14) The invention is not limited to the embodiments described and shown thus far, but rather various alterations and additions are conceivable without departing from the scope of the invention. Thus, it is possible for example to use an inductive, magnetic or optical measurement method instead of a capacitive measurement system. If an optical measurement method is used, in which for example a reflected-light barrier is used, the differences in the light reflection between bright and dark surfaces of a position marking are established, and a conclusion is thus reached as to the extent and direction of a lateral migration of the massage plunger from the desired pressure point. If an optical method of this type is used, the position marking means may in the simplest case be a marking, for example a cross, made in the region of the pressure point on the patient's ribcage using a pen, for example a fibre-tip pen.

(15) If an inductive measurement method is to be used, this may be implemented in such a way that a resonator circuit actuated by the evaluation device is provided in the base of the massage plunger, and cooperates with a coil or metal surface accommodated on the position marking means and changes amplitude or frequency when the massage plunder changes lateral position relative to the position marking means. For a magnetic measurement method, a thin magnet is arranged in the position marking means and is measured by a Hall element arranged in the base of the massage plunger. In this case, a fall in the measured field strength is a sign of a lateral displacement of the massage plunger from the target position.

(16) The invention is also suitable for active position regulation of the massage device in that if a lateral displacement from the target position is detected the massage device is repositioned and thus brought back into the target position. For this purpose, adjusting motors (not shown) which act between the counter-bearing board 14 and portal support 15 on the one hand and the portal support 15 and arm 16 on the other hand may be provided, and adjust the portal support and the arm, in each case as a function of the position data communicated by the position sensor device on the monitoring unit, and thus bring the massage plunger 19 back into the desired position thereof coaxial with respect to the position marking means. In this context, the (small) adjustment movements of the adjusting motors occur (only) when the massage plunger 19 is located in the raised position thereof, in other words is raised some distance from the patient's chest 12 and is not currently in physical contact with the position marking means 25.