Institute of Critical Care Medicine

Nihon Kohden Corporation

Weil Institute of Critical Care Medicine

Sunlife Science Inc.

Cardio Pulminary Laboratory Research Foundation

Max Harry Weil

Wanchun Tang

Jose Bisera

Joe Bisera

Carlos Castillo

James H Carrington

Clayton Young

Victor E Kimball

Yongqin Li

Alain L Fymat

Giuseppe Ristagno

A chest compressor includes a piston () that moves in downward and upward strokes within a cylinder (), with the piston undergoing a smooth reversal at the bottom of the downward stroke. A compression spring, such as a wave spring (), is positioned to engage the piston only near the end of its downward stroke, to smoothly reverse the piston motion, limit downward force on the patient at the end of the stroke, and avoid a downward pulse due to the momentum of the downwardly-moving piston. A stop () is latchable in an inward position to allow reduction in the piston stroke by engaging an outward flange () on the piston before the piston has moved fully downward. In one embodiment the piston () is made as an outer piston part () and an inner piston part () that telescope in one another in which the outer piston part is slidably engaged with and guided by the cylinder along a path and the inner piston part is slidably engaged with and guided by the outer piston part and the spring () engages the inner piston part near the end of its downward stroke, to smoothly reverse the piston motion, limit downward force on the patient at the end of the stroke, and avoid a downward pulse due to the momentum of the downwardly-moving piston.

Enhanced chest compressor

A chest compressor includes a piston () that moves in downward and upward strokes, with the piston undergoing a smooth reversal at the bottom of the downward stroke. A compression spring such as a wave spring (), is positioned to engage the piston only near the end of its downward stroke, to smoothly reverse the piston motion, limit downward force on the patient at the end of the stroke, and avoid a downward pulse due to the momentum of the downwardly-moving piston. A stop () is latchable in an inward position to allow reduction in the piston stroke by engaging an outward flange () on the piston before the piston has moved fully downward.

An automatic chest compressor () for repeatedly compressing the chest of a patient, is constructed to have a small thickness (H) and light weight so it can be readily carried by an emergency worker. The chest compressor includes a piston support () at the top, a pressing part () at the bottom that presses towards the chest of the patient, and piston side walls () that repeatedly elongate to depress the pressing part. The piston side wall are flexible material that is repeatedly curled and uncurled as the side walls move the pressing part respectively up and down.

Low profile chest compressor

Devices for treating a patient by measuring a condition, such as the partial pressure of CO, at a location on a mucosal membrane surface in the mouth region of the patient, includes a sensor () with an end () that lies against the mucosal surface, and a seal () that extends 360&#xb0; around the sensor end and presses against the mucosal surface. The sensor end and the seal lie on the first end portion () of a holder () which has a second end portion () that presses against the outside of the patient at a location opposite the sensor and seal. The holder is a clasp which can be formed as a single piece of resilient material that extends in a loop, or which can be formed in the manner of a clothespin with a spring that pivots two bars to urge their end portions towards each other.

Mucosal sensor adaptor

An image is created of blood circulation deep (e.g. a plurality of millimeters) below the surface of living tissue to aid in evaluating a patient. A first beam () of circularly polarized light is directed forwardly (F) against an outer surface () of the tissue. Light that has penetrated to only a shallow depth before moving rearwardly and out of the tissue remains polarized and is blocked by a filter (). Light that has penetrated to greater depths (), is scattered more and becomes depolarized, and a portion of it passes through the depolarizing filter () and is focused on a photodetector () to create an image. Light spots () on the image that move, represent spaces between blood platelets () that are moving through a capillary, and indicates the velocity of blood through the capillary.

Microcirculation imaging

Apparatus is provided for treatment of a victim to reverse cardiac arrest by chest compression and by electrical defibrillation through electrodes applied to the chest area of the victim. The apparatus includes a dielectric layer which is placed on the victim to electrically isolate the rescuer who is performing chest compressions. The protective sheet includes a layer of electrically conductive material sandwiched between two dielectric layers to electrically isolate the rescuer. The sandwiched conductive layer is connected to a location on the body of the victim that is spaced a plurality of inches from each of the electrodes.

Enhanced CPR protector system

A method is provided for analyzing the condition of a patient to determine whether or not a defibrillation shock should be applied, without stopping CPR (primarily chest compressions). While chest compressions continue to be applied to the victim, the system differentiates between (1) a perfusing rhythm that has the capability of leading to a beating heart without a shock and (2) ventricular fibrillation (VF) which sometimes occurs in the presence of ventricular tachycardia (VT), in which there is no capability for leading to a beating heart without a shock. Defibrillation shocks should be applied only when needed and that is in the presence of VF and sometimes in the presence of VT. Electrocardiographic (ECG or EKG) signals obtained from electrodes applied to the patient's chest are analyzed so that the presence of a QRS signal characteristic of a rhythm which has the potential of supporting a beating heart, or the absence of a QRS signal which indicates ventricular fibrillation, may be detected in the presence of artifacts resulting from chest compressions.

Enhanced rhythm identification in compression corrupted ECG

Apparatus for compressing the chest of a patient to stimulate blood circulation, includes a torso wrap () that has a back portion () lying at the back of the patient's chest and a front portion () lying at the front of the patient's chest, and includes a compressor assembly with an actuator () having a pressing member () that can apply a series of force pulses to the sternum of the patient to stimulate blood circulation. The actuator is energized by pressured fluid, with a controlled pressured fluid source () connected by an elongated flexible hose () to the actuator so the pressured fluid source and a control () can lie on the ground and only the actuator lies on the torso wrap. The actuator includes a cylinder () and a plurality of telescoping piston parts () to provide a long stroke in an actuator of small height. A stabilizer () that limits tilt of the actuator from the vertical, includes a saucer-shaped member that presses against the front of the patient.

Chest compressor

A method is provided for controlling an automatic external defibrillator without stopping CPR (primarily chest compressions). While chest compressions continue to be applied to the victim, the system differentiates between (1) a perfusing rhythm that has the capability of leading to a beating heart without a shock and (2) ventricular fibrillation (VF) which sometimes occurs in the presence of ventricular tachycardia (VT), in which there is no capability for leading to a beating heart without a shock. Defibrillation shocks should be applied only when needed and that is in the presence of VF and sometimes in the presence of VT. Electrocardiographic (ECG or EKG) signals obtained from electrodes applied to the patient's chest are analyzed so that the presence of a QRS signal characteristic of a rhythm which has the potential of supporting a beating heart, or the absence of a QRS signal which indicates ventricular fibrillation, may be detected in the presence of artifacts resulting from chest compressions.

Rhythm identification in compression corrupted ECG signal

The condition of a patient who has signs of cardiopulmonary arrest, is evaluated by applying a pair of electrodes ( ) to the chest of the patient and passing a low level of alternating current through the patient to detect changes in transthoracic impedance which represent cardiopulmonary activity of the patient. An analyzing circuit determines the average frequency of those signals ( ) representing heartbeat rate impedance and determines the average frequency of signals ( ) representing breathing of the patient. When the heart rate is below about 20 beats per minutes, the respiratory rate is below about 4 breaths per minute, and cardiac and respiratory impedances are below 0.01 ohms, this indicates cardiac arrest of the patient and signifies that CPR (cardiopulmonary resuscitation) should start.

Cardiac/respiratory arrest detector

Methods, formulations and kits are described for resuscitating a patient suffering from cardiac arrest, for enhancing the efficacy of cardiopulmonary resuscitation, for treating post-resuscitation hypotension, and for reducing the incidence of ventricular arrhythmias and myocardial dysfunction in a patient following cardiopulmonary resuscitation. Prior methods and agents often cause inotropic or chronotropic effects, which can lead to undesirable post-resuscitation myocardial dysfunction. The invention comprises administering a therapeutically effective amount of an &agr; -receptor agonist that does not cross the blood-brain barrier, such as &agr;-methylnorepinephrine, to enhance cardiopulmonary resuscitation.

Administration of an &agr;2-adrenergic receptor agonist to enhance cardiopulmonary resuscitation

Apparatus is provided for use during the treatment of a victim undergoing cardiac arrest, to facilitate treatment by chest compression as well as by shocks from an automatic defribrillator. The apparatus includes a sheet of dielectric material that covers much of the victim to electrically isolate a rescuer who is performing chest compressions, from the victim to whom electric shocks are being delivered. Defribrillator electrodes are mounted on the lower face of the sheet and are connected to the defribillator. The sheet extends down along the sides of the victim to isolate the rescuer, who is either standing or kneeling beside the victim to apply chest compressions.

CPR protector

Methods and devices are provided for assessing impairment of blood circulation in a patient, such as that in perfusion failure, by measurement of blood flow in the gastrointestinal tract or upper respiratory/digestive tract of the patient. The method comprises introducing a blood-flow sensor into the gastrointestinal tract or the upper respiratory/digestive tract of a patient, placing the sensor adjacent a mucosal surface therein, and measuring blood flow in adjacent tissue to determine blood flow in that tissue. The method may also involve measurement of PCO,and/or pH in combination with the blood flow determination. The invention affords rapid measurement and detection of perfusion failure.

Method and device for assessing perfusion failure in a patient by measurement of blood flow

Methods and devices are provided for assessing impairment of blood circulation in a patient, such as that in perfusion failure, by measurement of pCO,(partial pressure of carbon dioxide) in the upper digestive and/or respiratory tract of the patient. The method comprises introducing a carbon dioxide sensor into the upper digestive and/or respiratory tract of a patient, without passing the sensor down through or beyond the patient's epiglottis. Specifically, a carbon dioxide sensor is placed adjacent a mucosal surface within the upper digestive and/or respiratory tract, preferably within the patient's mouth or inside the patient's nose. By avoiding passage through the mouth into the throat and esophagus, discomfort is substantially avoided and the potential for injury minimized. Previously, the belief in the art was that increased partial pressure of carbon dioxide was a localized phenomenon during perfusion failure; however, applicants have now discovered that increases in tissue CO,occur throughout the body during perfusion failure, and the method and device of the invention are premised on this discovery.

Method and device for assessing perfusion failure in a patient

A method and system (,) for predicting the immediate success of a defibrillatory shock during cardiac arrest are shown. The sequencing of cardiopulmonary resuscitation is determined by an electronic computer (,) based on the probability of success as determined by a comparison of the amplitude spectrum area or the power spectrum area of an electrocardiogram sample and to empirical data. When the probability of successful resuscitation is 80% or greater, immediate defibrillation is implemented. When the probability of success is 20% or less, advanced cardiopulmonary resuscitation is implemented. When the probability of success remains greater than 20% but less than 80% for a period of four minutes, the patient is also defibrillated.

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Rancho Mirage, CA, United States of America

Max Harry Weil