EP1913924A1

EP1913924A1 - Support for chest compression device

Info

Publication number: EP1913924A1
Application number: EP07020602A
Authority: EP
Inventors: Frederik Hansen; Oyvind Tjolsen
Original assignee: Laerdal Medical AS
Current assignee: Laerdal Medical AS
Priority date: 2006-10-20
Filing date: 2007-10-19
Publication date: 2008-04-23
Anticipated expiration: 2027-10-19
Also published as: JP2008119460A; EP1913924B1; JP5073445B2; AU2007229410A1; DE602007009618D1; AU2007229410B2; ATE483440T1

Abstract

The invention relates to a support for a chest compression system comprising a back plate (1), a front part (2) and a side part (3), characterised in that the front part (2) comprises a seat (4) for a compression member (5) and that the side part (3) is adapted to provide adjustable spacing between the seat (4) and the back plate (1). The invention relates also to a chest compression system comprising such a support.

Description

This invention is related to resuscitation systems, and more particularly to a support device for a chest compression system and a chest compression system provided with such a support.
Sudden cardiac arrest is a leading cause of death in developed countries in the Western World, like the United States and Canada. To increase the chance for survival from cardiac arrest, important aspects are CPR (Cardio Pulmonary Resuscitation) and heart defibrillation given in the first few critical minutes after the incident. CPR is performed to ensure a sufficient flow of oxygenated blood to vital organs by external compression of the chest combined with rescue breathing. Heart defibrillation is performed to re-establish normal heart rhythm by delivery of an external electric shock. The quality of CPR is essential for survival. Chest compressions must be given with a minimum of interruptions, and be of sufficient depth and rate. Performing chest compressions manually is an extremely exhausting task, and it is practically impossible to give manual CPR of sufficient quality during transportation of a patient.
To overcome this problem, a number of chest compression systems for cardiopulmonary resuscitation have been developed. These systems comprise a chest compression member in charge of performing the compressions, and it is necessary to ensure that said member compresses the patient's chest in a correct place. It is also necessary to ensure that the correct positioning is maintained during the resuscitation process.
US 5743864 describes a device for automatic mechanical external chest compressions consisting of a vertical column attached to a base plate. A cantilevered arm with a cylinder and piston assembly is connected to an annular collar adapted to surround the patient. The annular collar is formed by a single membrane or by an outer and an inner membrane. The collar does not permit adaptation to different patient sizes and shapes.
US 6398745 is another example of an automatic CPR-device. This device comprises a compression belt around the chest of the patient which compression belt is repetitively tightened and relaxed through the action of a belt tightening spool. During use the compression belt will compress and decompress and can easily get caught in the patient's clothes. For this reason the patient must be unclothed before the chest compression procedure can start, and valuable time is lost.
Belt devices have other disadvantages, among other things that the belt covers a large area of the patient's chest interfering with defibrillation electrodes (requiring that the belt is removed before defibrillation can take place), that it makes stethoscope check of correct intubation and check of chest rise cumbersome.
US 2003181834 describes another chest compression apparatus. The device comprises a back plate for positioning behind the patient's back posterior to the patient's heart and a front part for positioning around the patient's chest anterior to the patient's heart. The front part comprises two legs which can be coupled to the back plate, these legs have a fixed position on the back plate and thus do not permit adaptation to the patient's width. The front part comprises a compression unit which automatically compresses or decompresses the patient's chest and a compression member which can be fastened to the patient's chest by means of a vacuum cup. This vacuum cup will get correctly fixed in some patients but will displace on the chest in other patients leading to incorrect chest compressions (unstability).
The above mentioned devices are either complicated and time-consuming to apply, cumbersome to install and operate, or are unstable on the chest. They are further heavy and expensive to purchase.
The object of the invention is to provide a support which maintains a substantially constant positioning and force direction of the chest compression system on the patient's chest (stability) and at the same time is easily and swiftly ready for use. A substantially constant positioning of the chest compression system on the patient's chest is important in order to obtain the necessary quality of the compressions and for safety reasons.
The object of the invention is to provide a device which comprises few pieces, which can be assembled swiftly, and which can be adapted to different patient body shapes and sizes. Another object of the invention is to provide a device which is easy to use, rugged, portable and light weight, safe and reliable.
These and other objects are achieved by means of a support for a chest compression system comprising a back plate, a front part and a side part, where the front part comprises a seat for a compression member. The support is characterised in that it is adapted to provide adjustable spacing between the seat and the back plate.
The invention comprises also a chest compression system comprising such a support.
The back plate comprises a patient receiving surface which is limited by the side part. In one embodiment of the invention the patient receiving surface has an adjustable area. The object of this feature is to ensure that most patients regardless of their size will be limited in their lateral movement by the side part, this being displaceable on the back plate to a wanted distance from the patient's sides.
The support according to the invention can comprise rotatable and/or telescopic and/or sliding devices to provide said adjustable spacing between the seat of the compression member and the back plate. One possibility is to provide a side part in the form of telescopic legs with a length adjustable to the patient's size and which can le locked into place thereafter. Another possibility is to provide hinges in the side part to provide an adjustable length. It is also possible to equip the front part with devices for adjusting the distance while the side part has a constant length and configuration.
In an embodiment of the invention the adjustable area of the patient receiving surface is provided by the side part being slidably connected to the back plate. This can be achieved by providing one or more slides and protrusions in the back plate and in the side part. Said slides can have transversal recesses with circular cross permitting rotation of the side part. This permits displacement of the lower edge of the side part (e.g. legs) on the back plate to situate said lower edge against the patient's body and thus provide stability in the chest compression. Once the side part is slid into position, it can be locked. Locking of the side part can be performed by means of locking devices or e.g. by providing slides with separated locking positions (notches).
It is also possible for the side part to be rotatable and not slidably fastened to the back plate. Rotation of the side part to a position near the patient's side will provide the wanted limitation of the patient's lateral movement.
A rotatable coupling can be provided during the manufacturing process if the side part (e.g. in the form of legs) is integrated to the back plate or by elements (e.g. hinges) situated between the side part and the back plate if the back plate and side part are separate elements.
In one embodiment of the invention the side part comprises two legs with adjustable length. In a variant of this embodiment, a variation in the length of one leg leads to a similar variation in the length of the other leg. The legs can be fastened to or integrated in the front part and comprise coupling elements for coupling to the back plate, they can be fastened to or integrated in the back plate and comprise coupling elements for coupling to the front plate or they can comprise an upper part fastened to or integrated into the front plate and a lower part fastened to or integrated into the back plate, said parts comprising coupling elements for connection to one another.
The support according to the invention will in use surround the patient's body, and it will ensure that the compression member exerts a force on a determined place on the patient's body and in a determined direction. Said place corresponds to the lower sternum and said direction is substantially perpendicular to the patient's chest surface. The support according to the invention is in one embodiment symmetric in relation to an axis longitudinal to the patient, to provide further precision. The positioning of the patient relative to the support is partly or fully an inherent property of the support. As mentioned above, the positioning relative to the patient's width may be performed by arranging the side part of the support close in contact with the patient's sides and thus adapting the area of the patient's receiving surface to the actual patient's size. The positioning relative to the patient's length may be facilitated by means of illustrations on the support or by other display devices, by means of straps, etc.
The support according to the invention can easily be adapted to patients with different body shapes and sizes by varying the distance between the back plate and the seat for the compression member in addition to the above mentioned width adaptation.
The chest compression system may be any system suitable for compressing the chest of a patient, such as pneumatic, hydraulic or electric actuated pistons, bladders, etc. The chest compression member may be fixed to the patient's chest by means of fastening devices such as tape or by vacuum, or it can be merely in contact with the chest without being fastened to the chest.
The support according to one embodiment of the invention will be placed on the patient by first situating the back plate under the patient's back, then placing the front part over the patient and coupling the back plate to the front part by means of the side part. The lower edge of the side part will be displaced until it comes into contact with the patient or is situated at a desired distance from the patient's sides, will be locked in position and finally the seat of the compression member will be lowered until it is situated at the desired distance from the patient's chest and locked into position. It is also possible to exchange the order of the above mentioned steps e.g. by positioning the seat in the correct distance before displacing the legs towards the patient.
In one embodiment of the invention the legs are provided with an adhesive or a high friction material on the lower end to permit secure positioning on the patient's body.
In an embodiment of the invention the seat comprises fastening devices for the compression member, which fastening devices ensure that the compression force has a direction substantially perpendicular to the patient's chest. In an embodiment of the invention the compression member is integrated in the seat and the seat is attached to the front part in a manner which ensures that the compression force has a direction substantially perpendicular to the patient's chest.
In one embodiment of the invention the support comprises straps to provide correct positioning of the patient in the longitudinal direction.
In one embodiment, the seat for the compression member comprises a transverse plate, which is arranged substantially parallel to the back plate when the support is deployed. In this way, the support forms a quadrangle round the patient. As mentioned before the width and the height of the quadrangle may be adjusted to fit each patient.
In a variant of this embodiment the side part in the form of legs is rotatably fastened to the front part and comprises coupling elements for coupling to the back plate. The legs are telescopic, and the connection between the legs and the back plate is adjustable. In one embodiment, the legs are interconnected in such a way that the lateral adjustment of one leg leads to an equal lateral adjustment of the other leg. In this embodiment of the invention the compression member is firmly and fixed connected to the transverse plate in a position which ensures correct positioning on the patient's chest and correct direction of the force applied on the patient's chest..
The support according to the invention can be implemented as a frame, a stand, etc. of suitable design.
The support may be collapsible, demountable or foldable in order to minimize volume of the system when not in use. Preferably, the support is easy to assemble and prepare for use, in order to minimize time wasted on assembling and mounting. This will be illustrated in the exemplary embodiments.
The invention will now be described in more detail by devices of examples and with reference to the attached figures, where:

Figure 1 is a block diagram of the invention.
Figure 2 is a perspective view of a first embodiment of the invention in a deployed position.
Figure 3 is a view of the back plate in said first embodiment of the invention.
Figure 4 is a view of said first embodiment of the invention in a folded position.
Figure 5 is a view of a second embodiment of the invention in a deployed position.
Figure 6 is a view of said second embodiment of the invention in a folded position.
Figure 7 is a view of a third embodiment of the invention.
Figure 8 is a view of a fourth embodiment of the invention.

Figure 1 is a block diagram showing the support according to the invention schematically. It comprises a back plate 1, a front part 2 and a side part 3, where the front part comprises a seat 4 for a compression member 5 and the side part 3 can be coupled to the back plate 1 and to the front part 2 and is adapted to provide an adjustable distance d between the seat 4 and the back plate 1. The term "hinges" used in the present invention relates to any element which permits at least rotational connection between two parts. Said elements can permit slidable connection in addition.
Figure 2 shows a first embodiment of the invention. In this embodiment of the invention the front part comprises a transverse plate 10 where the chest compression system is situated. The chest compression system comprises in this embodiment of the invention a chest compression member 5 in the form of a piston, a transmission mechanism for transmitting energy to the piston, a motor, a power supply (riot shown). It is possible within the scope of the present claims that part of the chest compression system is situated externally to the support, the support being mechanically attached to the compression member.
Transverse plate 10 is substantially rectangular in this embodiment of the invention and is coupled on its short edges to two lateral legs. The connection between transverse plate 10 and the side part in the form of legs is implemented by hinges 11, this permitting to rotate the legs towards the transverse plate 10 to provide a storage position for the chest compression system and the support. The legs are adapted for abutment against the sides of the patient's body. The legs comprise an upper part 12 and a lower part 13. The upper part 12 is hinged to the transverse plate 10 and is also situated telescopically inside the lower part 13. This arrangement permits easy adaptation of the legs' length to the patient's chest height. The devices for locking the legs at the wanted length are not shown in the figure. The lower edge of the lower part 13 is connected to the back plate 1 adapted for placement under the patient's back and defines the patient receiving surface 100. The legs' lower parts 13 can be fixed or rotatably connected to back plate 1. In one embodiment of the invention they are rotatably and slidably connected to plate 1 (hinges 14).
Figure 3 shows back plate 1 which in this embodiment of the invention is provided with coupling devices or slides 20 which permit displacement of the lower edge of the legs on the back plate. These devices 20 permit to displace the lower edge of part 13 towards the patient to adjust the area of the patient receiving surface to the patient's size. It is also possible to provide a single slide for each leg.
In this embodiment of the invention the assembly formed by the front plate 10 and the legs 12, 13 provides a first section of the support and the back plate 1 provides a second section of the support.
Figure 4 shows the support according to the invention in a folded storage position. The legs 12, 13 are reduced telescopically in length and transverse plate 10 with the chest compression system is situated adjacent to the legs. Back plate 1 is situated under the first section comprising transverse plate 1 and legs 12, 13. The support can be packed in a bag of suitable dimensions and one possibility is to situate back plate 1 on top of the first section so that the back plate is available for the operator when the bag is opened. In use the operator will place the back plate 1 under the patient, thereafter get hold of the first part by means of handles (not shown) and the legs 12, 13 will rotate away from the transverse plate 10 either by means of spring devices or by gravity or by a combination of these. The legs 12, 13 will also expand to their full length. This movement can be controlled e.g. by release mechanisms in connection with the handles. Thereafter the first element is placed over the patient, coupled to the back plate 1 and adjusted to the patient's size.
In an embodiment of the invention (not shown) the upper and lower part 12, 13 of the legs can be separated, this operation providing two separate sections, one comprising the transverse plate 10 with the above mentioned devices on it and one comprising the lower part of the legs 13 and the back plate 1. The separate parts can be folded to a flat position permitting easy storage of the device.
Figure 5 shows a second embodiment of the invention. In this embodiment the chest compression system is situated in a body 30. The upper parts of the legs 12 are rotatably connected to the body 30 by means of hinges 31 or similar devices. Hinges 31 are situated in the vicinity of one another and are in one embodiment of the invention interconnected. The upper and lower parts of each leg (12 and 13 respectively) are also rotatably coupled to one another by means of hinges 32. Hinges 31 and 32 provide also in one embodiment of the invention locking of the body 30 at a determined distance from the back plate 1. The lower part of each leg is rotatably and slidably connected to back plate 1. This device can be divided in a first and a second section in a manner similar as that described in relation to figures 1-4.
As mentioned earlier the support according to the invention can be provided with devices to ensure symmetry with respect to the patient's longitudinal direction during height and width adjustment. These devices can comprise toothed wheels, rods, ribbons, etc.
Although different features of the invention are explained in relation with different embodiments it is possible to combine these features in another manner to provide further embodiments of the invention (e.g. the support can comprise a body 30 and telescopic legs).
Figure 7 shows a third embodiment of the invention where block 30 comprises elements 40 which can rotate and slide and where the connection 14 between the lower part of legs 13 and plate 1 permits sliding but rot rotation.
Figure 8 shows a fourth embodiment of the invention, where the front part comprises a body 30 provided with means for adjusting the distance between seat 4 for the compression member 5 and back plate 1. In this embodiment legs 50 are inextensible, are slidably connected to back plate 1 and can be locked in different positions to provide an adjustable area for the patient receiving surface.

Claims

Support arranged for use with a chest compression system, said support comprising a back plate, a front part and a side part, wherein the front part comprises a seat for a compression member,
characterised in that the support is arranged to provide adjustable spacing between the seat and the back plate.
Support according to claim 1,
characterised in that the back place has a patient receiving surface with adjustable area.
Support according to claim 1,
characterised in that the side part or the front part comprises rotatable and/or telescopic and/or sliding devices to provide said adjustable spacing.
Support according to claim 2,
characterised in that the side part is slidably connected to the back plate to provide said adjustable area.
Support according to claim 1,
characterised in that the back plate is provided with elements which permit rotation of the side part.
Support according to claim 1,
characterised in that the side part comprises two legs with adjustable length.
Support according to claim 6,
characterised in that it comprises elements to ensure that a variation in the length of one leg leads to a similar variation in the length of the other leg.
Support according to claim 1,
characterised in that the side part comprises legs fastened to or integrated in the front part and coupling elements for coupling to the back plate, or legs fastened to or integrated in the back plate and coupling elements for coupling to the front plate or legs comprising an upper part fastened to or integrated into the front plate and a lower part fastened to or integrated into the back plate, said parts comprising coupling elements for connection to one another.
Support according to claim 1,
characterised in that it is adapted to ensure that the compression member exerts a determined force to a determined place on the patient's body and that said force has a determined direction.
Support according to claim 1,
characterised in that it is symmetric in relation to an axis longitudinal to the patient.
Support according to claim 1,
characterised in that it comprises elements for controlling the positioning of the support on the patient in the longitudinal direction, as e.g. straps.
Support according to claim 1,
characterised in that the chest compression system comprises pneumatic, hydraulic or electric actuated pistons or bladders.
Support according to claim 1,
characterised in that the side part is provided with an adhesive or a high friction material on the lower end to permit secure positioning on the patient's body.
Support according to claim 1,
characterised in that it is collapsible, demountable or foldable in order to minimize volume of the system when not in use.
Chest compression system,
characterised in that it comprises a support according to any of the preceding claims.