CN103635229B - For the system and method providing collaborative recovery perfusion to support - Google Patents

Abstract

Presents relates to, by electromagnetic stimulation physiological tissue, treat the system and method for asystole victim.

Description

For the system and method providing collaborative recovery perfusion to support

Cross-Reference to Related Applications

The application requires the Application U.S. Serial No 61/473 submitted on April 8th, 2011 according to 35U.S.C. § 119 (e), The priority of 273.The whole themes proposed in above-mentioned related application are all incorporated by reference into the application, as being entirely herein Middle elaboration.

Technical field

Presents relates to system and the technology being treated asystole victim by electromagnetic stimulation physiological tissue.

Background technology

Asystole or sudden death are the descriptions to the physically different diverse collection with the generic cardiac cause of disease, wherein Patient typically exhibits pulseless, apnea and unconscious symptom.Asystole is very universal, and only in the U.S., annual estimation just has 300,000 victims, and other victims worldwide can be estimated similarly.Defibrillation is asystole suddenly in early days The principal element survived.It practice, without defibrillation therapy, the situation of the asystole victim saved is considerably less.Exist and permitted The most different types of abnormal electrocardiographic pattern (ECG) rhythm and pace of moving things, some of them can pass through defibrillation therapy, and some can not.Standard art to this Language is " can shock by electricity " and " can not shock by electricity " ECG rhythm and pace of moving things respectively.The ECG rhythm classification that can not shock by electricity further is that hemodynamics is steady Determine and the hemodynamic instability rhythm and pace of moving things.The hemodynamic instability rhythm and pace of moving things is to utilize enough blood flows to support patient's good fortune Deposit those rhythm and pace of moving things of (non-viable).Such as, it is believed that regular sinus rhythm can not shock by electricity, and hemodynamic stability (can survive).Run into during asystole, can not shock by electricity and some common ECG rhythm and pace of moving things of hemodynamic instability For: bradycardia, idioventricular rhythm, pulseless electrical activity (PEA) and heartbeat are static.Bradycardia, heart beating is the slowest therebetween, is Can not shock by electricity, and may be non-viable.If patient is unconscious during the bradycardia, perform external chest compression until obtaining Pace-making may be helpful.Property autonomous cardiac rhythm in room is likely to as that can not shock by electricity and non-viable that (generally, power mode starts from the heart Room), in room property autonomous cardiac rhythm, the electrical activity making cardiac muscle start to shrink at occurs in non-atrial at ventricle.Room property autonomous cardiac rhythm Typically result in the slow rhythm of the heart of 30-40 beats/min, usually make patient unconscious.Because ventricle generally responds atrium Activity, so there is the slow rhythm of the heart, but when atrium stops their electrical activity, occurs slower, substitute in ventricle The rhythm and pace of moving things.The pulseless electrical activity (PEA) that electromechanical separation (EMD) causes is that can not shock by electricity and non-viable, and need to Want external chest compression as the first response, in pulseless electrical activity (PEA), heart exists rule property electrical activity, but does not deposits At myocardial contractility.Defibrillation successful treatment heartbeat can not be utilized static, can not shock by electricity for other, the non-viable rhythm and pace of moving things in the case of Also it is so, in heartbeat is static, heart neither exists electrical activity, the most there is not mechanical activity.Recommendation static to heartbeat Pace, and the life support team that there is advanced person is able to carry out helping the other treatment mode of this patient, such as, intubate Or be administered.Can utilize defibrillation successful treatment can the prime example of shockable rhythm be: ventricular fibrillation, ventricular tachycardia and the heart Flutter in room.

Generally, the electrochemical activity in human heart causes the meat fiber of tissue shrink in a synchronous manner and loosen.The heart This being synchronized with the movement of visceral muscle meat tissue causes effectively being pumped to blood from ventricle the vital organ of health.But, at the heart In the case of room fibrillation (VF), the abnormal electrical activity in heart causes individual muscle fiber to shrink with asynchronous and disordered fashion.Make For this result losing synchronization, heart loses the ability of its effective pump blood.Defibrillator produces heavy current pulse, and this is big The unordered electrical activity of heart that current impulse interruption is associated with ventricular fibrillation, and defibrillator is to the electro-chemical systems offer of heart The chance of re-synchronization self.Once recover organized electrical activity, usually accompanied someone with synchronizing muscle contraction, cause recovery to have The heart pumping of effect.

Paul doctor Zoll in 1956 describe first medical-therapeutic treatment of human body use after, external defibrillation have been changed to use In asystole, ventricular tachycardia (VT) and the main therapy of atrial fibrillation (AF).Monophasic waveform defibrillation occupies leading, until 1996, when first biphasic waveform becomes available for medical treatment use.Actual survival rate of leaving hospital be maintained at extremely low 10% or Lower.In the big city of the U.S., having the city of medical infrastructure before a large amount of, advanced being admitted to hospital including those, heart stops The survival rate fought is kept as low as 1-3%.

In recent years, medical circle has rediscovered high-quality, the degree of depth pressing importance to improving survivability.U.S.'s heart Splanchnology can state that in the guides in 2010 that they are nearest " scientist and the medical services that participate in comprehensive evidence evaluation process carry Donor, according to current scientific progress, analyzes order and the priority of CPR step, has survivability maximum potential with identification The factor of impact.Intensity based on available evidence, they propose suggested design, reveal maximum desired intervention with support matrix.In the least Support the high-quality CPR continuing to emphasize that there is the pressing of suitable speed and the degree of depth unanimously, it is allowed to chest bounce-back completely, minimum Change interruption during chest compression, and avoid Hyperventilation.”

Although AHA and other authentication of medical main bodys are recommended, for the survivability of asystole, without the high-quality suspended Pressing critically important, but be actually difficult to the pressing without suspending, being specially designed for realizing suspending without ventilation even if using The medical scheme of continuously pressing be also such.It has been shown that utilize continuous pressing method to eliminate ventilation temporarily even for those The system stopped, CPR mark is also only 60-70%, CPR mark and refers to there is the hundred of the persistent period of the resuscitation process of pressing therebetween Proportion by subtraction.When utilizing defibrillator, it is possible to improve CPR mark to 80-85% further, defibrillator includes being in deliverer's hand Under motion sensor, and provide Real-time Feedback (the Chelmsford city Zhuo Er of pressing quality about them to deliverer The RealCPRHelp defibrillator of Medical Products).

By combining, defibrillation is static to heartbeat and the bradycardia paces, and the device increasing circulation has been available many years ?.United States Patent (USP) No.4,088,138 describes a kind of device, when detecting that severe bradycardia or heartbeat are static, this device Before or after defibrillation shock, automatically patient is paced.

Wang and colleague thereof are at Crit Care Med (critical care medicine) 2008,36 [supplementary issue]: in S458-S466 Through describing, during CPR, it is similar to traditional breastbone chest compression, uses the electricity irritation to skeletal muscle to carry blood flow.So And, author notices, the meaning of the method is limited, because Skeletal Muscle Fatigue outbreak is quite fast, even if in best laboratory condition Under be also such；Have been found that in most of the cases, tired outbreak both less than 1 minute.It should be noted that typical chest compression Medical advice interval is two minutes, thus even for a complete CPR interval, also can not be reliably achieved effectively thorn Swash.Such as, in United States Patent (USP) No.5,782,883,6,185,457,5,978,703,6,314,319 and 6, enter one in 567,607 Step illustrates this technology.

During chest compression in cardiopulmonary resuscitation (CPR), there are two kinds of main blood flow generation mechanisms: heart pump blood machine System and breast pump blood mechanism." heart pump blood is assumed to think, during closure chest compression, when oppressing the heart between breastbone and spinal column Time dirty, just produce blood flow.This flow mechanism implies, ventricle pressing causes atrioventricular valves (A V valves) to close, and the discharge of blood reduces the heart Room volume.Loosening period at chest, ventricular pressure decreases below atrial pressure, it is allowed to chamber valve is opened, and atrium is filled out Fill.This event sequence is similar to normal cardiac cycle, and when using open chest CPR, sends out during cardiac compression Raw." [edited by Bradley doctor of medicine P.Fuhrman and Jerry doctor of medicine J.Zimmerman, doctor, In Pediatric Critical Care (pediatric first aid nursing) (third edition), Peter Trinkaus, Charles The Physiologic Foundations of Cardiopulmonary Resuscitation (cardio-pulmonary resuscitation of L.Schleien Physiological Foundations), Philadelphia Mosby company 2006,1795-1823 page, ISBN978-0-32-301808-1, DOI: 10.1016/B978-032301808-1.50121-8.] Trinkaus then says that " during normal cardiac function, vascular follows Minimum pressure in ring occurs in the side, atrium of chamber valve.This low-pressure chamber is the downstream pressure of system circulation, and its permission is quiet Arteries and veins blood returns heart.Angiography research shows, during single chest compression, blood is entered by right side heart from caval vein Enter pulmonary artery, and enter aorta from pulmonary vein by left cardiac.Ultrasoundcardiogram research shows, with normal heart activity Or during open chest CPR differently, during the closure chest CPR of Canis familiaris L. and the mankind, chamber valve is all penetrating the blood phase Between open, and during penetrating blood, the diameter of aorta reduces rather than increases.These during closure chest CPR find to prop up Hold breast pump blood theoretical, and advocated that heart is the passive conduit of blood flow." (Fig. 1) it practice, during chest compression, blood flow Generation mechanism be the heart and two kinds of mechanism of breast, relative scale of its impact according to the individual body vessel of patient and valve state, and The performance parameter of chest compression, especially with respect to the degree of depth, speed and the release of pressing.

The power that typical patient will need deliverer to apply about 100-200 pound, so that the pressing of breastbone reaches 2 inches Recommend the degree of depth.Guide it is further recommended that, pressing speed is every 600 milliseconds and once presses.During normal recovery, due to this water Flat effort, be responsible for perform chest compression deliverer will be tired due to this effort, even if the time be as short as one minute be also So.As to tired response, deliverer will or by with another deliverer's changing role, or pressed by time-out, Or being responded by the effort level reducing them, this will inevitably lead to press not sufficiently effective.Conversion deliverer In the case of, this process will cause pressing to suspend at least 10 seconds, and if this action executing ground efficient, the most potentially 30 Second.At this section of interval, patient does not accepts to save the chest compression treatment of life certainly, and does not has blood to be transported to the heart Dirty, brain and other vital organs.Accordingly, it is desirable to have a kind of at the conversion period of deliverer, deliverer's fatigue period, time-out During other pressing Quality Downs, the means of conveying perfusion.

About combining chest compression device and the United States Patent (USP) of the electrostimulation to the neural stimulation controlling ventilation No.6, in 213,960, also illustrate during CPR, use the trial of electricity irritation in order to take a breath.United States Patent (USP) No.6,463, 327 and 6,234,985 also illustrate by phrenic nerves use barrier film stimulation, in order to increase venous return and blood during CPR Power.It is in following several reason, does not also find that asystole victim uses barrier film stimulate the most effective: 1) in treatment Before, during asystole, patient's anoxia is the most long-time, causes whole nervous system, and including phrenic nerves, metabolism state moves back Change so that with ratio compared with conscious patient, electrical stimulating effect is far short of what is expected；2) stimulating electrode noinvasive position on chest is also stung Having swashed intercostal muscle, this causes exhaling, and directly stimulates the inspiratory effects caused and the diaphragm contraction phase associated thereof with by barrier film Opposition；With 3) although the phrenic nerves in cervical region can non-invasively be stimulated, but it is generally difficult to position this nerve, before institute in environment Rapid, the most especially true with at asystole.

Summary of the invention

Presents describes and can be used for suffering from ventricular fibrillation or the patient of similar disease or victim provides the breast of improvement The system of portion's pressing and technology.

In some respects, a kind of providing the medical system of electromagnetic stimulation to include to patient: sensor, it is oriented to sensing The existence of the artificial chest compression implemented to patient by deliverer.This system also includes: processor, and it is arranged to receive sensing The data that device produces, and the change of detection administration chest compression；And circuit, it is configured to once detect execution chest The change of pressing, just to patient transmission's electromagnetic stimulation, to stimulate blood flowing in the patient.

Embodiment can include following in one or more.

This change can include the degeneration of chest compression quality.

The degeneration of chest compression quality can include the change of chest compression depth.

The degeneration of chest compression quality can include the change of the pressing release of chest compression.

This processor can be configured to, and the time period being exceeded threshold value by detection does not exist chest compression, detects and executes The change of pedestrian's work chest compression.

This processor can be configured to, and there is not chest compression by the detection time period more than 2 seconds, carrys out detection administration The change of artificial chest compression.

This processor can be configured to, and data and sensor by being produced during first time period by sensor exist The data produced during the second time period occurred after first time period compare, and carry out the change of the artificial chest compression of detection administration Change.

This sensor can be configured to detect the motion of patient's breastbone.

This sensor can include motion sensor, pressure transducer and/or velocity sensor.

The circuit being configured to transmit electromagnetic stimulation can also be configured to, and automatic and no user intervenes ground transmission electromagnetism thorn Swash.

The circuit being configured to transmit electromagnetic stimulation can include electrode assemblie, and it is attached on the chest of patient.

This electrode assemblie can be attached on the chest of patient removably.

This circuit can include following circuit, its be configured to the Inter-pulse interval with 5-15 millisecond and 300-700 volt Amplitude, the impulse train of transmission 100-200 musec duration period pulse.

This circuit can include following circuit, and it is configured to the dutycycle with 2-95% and the amplitude of 50-2000 volt, passes The impulse train of defeated 20-1000 musec duration period pulse.

This system also is able to include display device, and it is configured to once to patient transmission's electromagnetic stimulation, with regard to vision Prompting deliverer restarts artificial chest compression.

This system also is able to include speaker, and it is configured to, once to patient transmission's electromagnetic stimulation, carry with regard to audition Show that deliverer restarts artificial chest compression.

This processor can be configured to the degeneration by detecting chest compression quality, comes in detection administration chest compression Change.

This circuit can be configured to, and once detects chest compression quality degradation, just implements artificial chest deliverer While pressing, transmit electromagnetic stimulation.

At the aspect that some are other, a kind of for providing the external defibrillator bag of controlled electric shock to the victim of cardiac problems Including: electrical storage device, it can be to patient transmission's defibrillation shock.This defibrillator also includes: proximity transducer, and it is configured to really Determine the hand position relative to patient of deliverer；And controller, it is programmed, to be carried out manually with deliverer by analysis Implement the data received by proximity transducer during the time period that chest compression is corresponding, calibrate this proximity transducer, and Electrical storage device is caused to be at least partially based on the data from proximity transducer, to patient transmission's defibrillation shock.

Embodiment can include following in one or more.

This proximity transducer can be capacitance type sensor.

This proximity transducer can also be configured to, and the hand of detection deliverer is removed at patient.

This controller can also be configured to, and once detects that deliverer removes at least 2 inches at patient, results in electricity Storage device is to patient transmission's defibrillation shock.

This proximity transducer can be ultrasonic sensor.

This proximity transducer can be optical transmitting set-receptor pair.

At the aspect that some are other, a kind of for providing the medical system of electromagnetic stimulation to include to patient: first group Electrode, it is configured to position to make blood start to flow based on heart pump blood mechanism, and second group of electrode, and it is configured to location To make blood start flowing based on breast pump blood mechanism.This system also is able to include controller, and it is programmed to from first group of electrode Transmit electric energy successively with second group of electrode, be configured to cause that blood is in the two benches electricity irritation flowed in the patient to produce.

Embodiment can include following in one or more.

This two benches electricity irritation can include first stage and second stage, and during the first stage, controller is configured Become to activate first group of electrode, and during second stage, controller is configured to activate second group of electrode.

Second group of electrode can be configured to be positioned in the position of main stimulation of chest muscle group, and this breast muscle group is being received During contracting, main breast pump blood mechanism of passing through produces blood flow.

Second group of electrode can be configured to be positioned on the left side of patient and right side and be in bottom rib cage.

Controller can also be programmed, to pass through at 100-500 millisecond after first group of electrode transmission pulse from second group Electrode transmission pulse, successively from first group of electrode and second group of electrode transmission electric energy.

Controller can also be programmed, to pass through at 100-200 millisecond after first group of electrode transmission pulse from second group Electrode transmission pulse, successively from first group of electrode and second group of electrode transmission electric energy.

At some other aspects, a kind of method promoting costa sternales air-breathing includes: electricity irritation is attached on the some parts of rib First group of muscle；With second group of muscle of electricity irritation, when deflated, this second group of muscle causes the adverse movement of spine.

Embodiment can include following in one or more.

Second group of muscle of electricity irritation can result in spine adverse movement on sagittal axis or lateral shaft.

First group of muscle of electricity irritation can include, uses the first cathode electrode being positioned at above right rhomboideus major and is positioned at a left side First group of muscle of the second cathode electrode electricity irritation above rhomboideus major.

First group of muscle of electricity irritation can also include, uses and is positioned at the first group of flesh of anode electrode electricity irritation above scapula Meat.

Second group of muscle of electricity irritation can include, before using the first cathode electrode being positioned at above left front serratus and being positioned at the right side Second group of muscle of the second cathode electrode electricity irritation above serratus.

Second group of muscle of electricity irritation can include, at first group of muscle of electricity irritation time subsequently, second group of flesh of electricity irritation Meat.

First and second groups of muscle of electricity irritation can include, electricity irritation the first He during the up stroke of artificial chest compression Second group of muscle.

First and second groups of muscle of electricity irritation can include, uses pulse width modulated waveform electricity irritation first and second groups Muscle.

First and second groups of muscle of electricity irritation can include, uses the waveform electricity irritation first and second comprising sloped forward edge Group muscle.

Accompanying drawing explanation

Fig. 1 illustrates two kinds of major blood flow patterns during CPR.

Fig. 2 a and 2b is shown respectively the front and rear electrode assemblie being applied to patient.

Fig. 3 is the flow chart of the method for producing electromagnetic stimulation pulse.

Fig. 4 is for the nearness of deliverer being detected and used to determine when to transmit the flow process of the method for defibrillation shock Figure.

Fig. 5 illustrates for stimulating the electrode to improve Thorax volume to arrange.

Fig. 6 illustrates that the electrode in wearable defibrillator braces is arranged.

Fig. 7 is the block diagram of system.

Fig. 8 illustrates the schematic diagram of E field proximity transducer 216.

Detailed description of the invention

Presents describes a kind of mechanism, by this mechanism, for the chest compression energy of the patient of the trouble by sudden cardiac arrest Enough electromagnetic stimulations with diverse location on the patient's chest are worked in coordination with.

For the survivability of asystole, (such as, substantially continuous execution is pressed less or without the high-quality pressing that suspends Pressure) critically important.But, common deliverer is difficult to provide artificial pressing continuous, high-quality with not suspending.In this article, will system System and method are described as automatically detecting termination or the time-out of the chest compression of deliverer Manual administration, and at this time out During Duan, supplement the treatment to patient with electricity irritation.Based on the detection characteristic being associated with Manual administration's chest compression, automatically open Beginning electricity irritation so that termination or the time-out of artificial chest compression are of short duration (such as, less than 10 with the time period implemented between electricity irritation Second, less than 5 seconds, less than 3 seconds).The example of this electricity irritation includes: the electricity irritation to skeletal muscle, to be similar to pass during CPR The breastbone chest compression ground transmission blood flow of system；With two benches stimulate, with based on be described in more detail below the heart pump blood mechanism and Breast pump blood mechanism, applies electricity irritation successively, thus promotes circulation.

Due to the rapid onset of Skeletal Muscle Fatigue, it reduce electricity irritation utilization rate, so applying electricity irritation to stimulate blood The time period of flowing is limited (such as, less than 1 minute, less than 30 seconds).In order to encourage deliverer to restart artificial chest compression, System can provide vision and/or auditory cues to deliverer, instruct deliverer start electricity irritation short time after (such as, Detect effectively pressing terminate or start electricity irritation after 5 seconds, detect effectively pressing terminate or start after electricity irritation 10 seconds, Detect that effectively pressing terminates or starts after electricity irritation 20 seconds), restart manual chest compression.

In some instances, such as can be attached on the chest of patient 102 by below with respect to described in Fig. 2 A and 2B Front electrode assemblie (AEA) 100 implement electricity irritation.Fig. 2 A and 2B is shown respectively the front and rear electrode assemblie being applied to patient.

AEA 100 is made up of defibrillation/pace well known by persons skilled in the art/monitoring electrode 101, and this electrode is by contacting trouble The conduction adhesive gel of person's skin, the leading on Signa Gel of the usual electric current also having for distributing stimulating apparatus 103 transmission Electric metal surface, and insulating top layer composition.Thus, AEA 100 can be attached on the chest of patient removably.Accommodate fortune The shell 104 of dynamic sensor and power and signal regulation electronic installation is positioned on the breastbone of patient, and at CPR The motion of breastbone is measured during chest compression.Motion sensor can be accelerometer (horse Sa commercial in such device Chelmsford city, Zhu Sai state, the CPR Stat-Padz of Zhuo Er Medical Products), or can be pressure transducer, speed Sensor, such as utilizes those sensors changing over magnetic flux and coil arrangement, or other various motion sensors. Defibrillator 10 is by breastbone motion analysis subsystem 3 treatment conditions motion sensor signal, to determine that deliverer is the most eventually Stop chest compression, suspended and implement chest compression, or no longer implement effective chest compression.Such as, breastbone motion analysis System 3 can be software function, its part being typically to run the software code of defibrillator 10, or can be in defibrillator Or the specialized hardware in shell 104, such as, it can pass through serial communication channel, such as USB, RS232 or bluetooth, with defibrillator Microprocessor 14 communicates.During any typical CPR interval procedure, its persistent period is usually the magnitude of 2 minutes, deliverer Can be sometimes few to the 3-10 second in the of short duration stopping of multiple time points.During recovery cut-and-try process, each these suspend patient The probability realizing spontaneous circulation recovery (ROSC) causes the impact of significant adverse.With reference now to Fig. 3, letter analyzed by microprocessor 14 Number, so that it is determined that when deliverer has timed out or terminates chest compression (130).When microprocessor 14 detects artificial chest The time-out of pressing is when exceeding threshold length of time (132), such as, exceed about 2 seconds, exceed about 3 seconds, when exceeding about 5 seconds, and system is just Automatically begin to by electrode 101 and 101b transmission electromagnetic stimulation (134).Finding in animal testing, optimal stimulus waveform is The impulse train of 100-200 musec duration pulse, its interpulse spacing is 10 milliseconds, and chain length is 5-10 pulse, amplitude It is about 500 volts.Meanwhile, starting electromagnetism perfusion and stimulate (EPS), defibrillator starts to point out user to start electric pressing the most temporarily, And/or prompting user restarts manual chest compression (136).This prompting can be the vision literary composition on the display screen of defibrillator This, or the form for voice message.The persistent period of EPS is limited to the certain time period of typically not greater than 1 minute, but can It is to be as short as the time period of 5-10 second by EPS persistent period minimum limit.When the deliverer performing pressing is tired and succours Person is just when changing role, or when performing the deliverer of pressing due to tired or beaten by the some events in relief environment Disturb, defibrillator alarm or have to carry out is when suspending such as the function of endotracheal intubation, and the time period of about 15 seconds is by particularly useful. System continues monitoring signal, so that it is determined that when deliverer restarts artificial chest compression.Once detect deliverer Having restarted artificial chest compression (138), system just terminates providing electricity pressing (140), and restarts to monitor artificial breast The quality (130) of portion's pressing.

By analyzing pressing characteristic, it is possible to determine that deliverer is the most tired.Such as, in the examples described above, except or replace The detection of these changes based on chest compression quality detects and terminates completely implementing chest compression and implementing electricity irritation, system Fatigue can also be detected based on the degeneration of chest compression quality.The method being commonly used for detection tired can include: really Determine the initial statistical property of deliverer's pressing；Then to any obvious, lasting degradation analysis pressing characteristic.For example, as it is known that skill Art such as changes point analysis, those described in such as following documents, Basseville (Basseville M, Nikiforov IV., Detection of Abrupt Changes:Theory and Application (detection of cataclysm: theoretical with should With), New Jersey En Geer Wood, Pei Sheng publishing house 1993) or Pettitt (Pettitt AN, A simple cumulative sum type statistic for the change point problem with zero-one Observations (changing the simple accumulative and statistics of some problems for having 0-1 observation) Biometrika (biometrics Learn) 1980,67:79-84).Other known methods, such as Shewhart control chart can be used for first detecting characteristic variations, then comments The change that valency is detected whether degenerate and whether be enough amounts thus cause defibrillator first start prompting, to improve pressing The particular aspects of characteristic, then, if quality the most fully improves, begins to interim EPS as makeshift, and transmits prompting Change deliverer.

In certain embodiments, substantially can carry out EPS while deliverer manually presses, the most still carry out Pressing, but quality is especially true in the case of reducing.In order to prevent the electric shock to deliverer, sensor outer housing 104 and electrode 101 can be integrated into thin, flexible dielectric insulating trip 105.For this material, can use to step and draw (Mylar) plastics, preferred thickness It is about 0.5 mil.

In certain embodiments, sensor outer housing and electrode are configured to, it is ensured that implementing defibrillation shock or transmission use Before the electricity irritation of electricity pressing, the hand of deliverer removes (such as, not contacting patient) at patient.Such as, sensing Device shell can include proximity transducer (such as, capacitance type sensor), and it determines whether deliverer contacts patient, and when rescuing When the person of helping contacts patient, prevent patient transmission's electric current.In the example that some are other, as will be described in more detail, it is System can be configured to the detection association that his/her hand has been removed at patient by the transmission making defibrillation shock with deliverer With.Such as, once detect that his/her hand is removed at patient by deliverer, it becomes possible to automatically transmit defibrillation shock, And need not further user action.

More particularly, sensor outer housing 104 also can comprise the proximity transducer 216 for measuring deliverer's hand position (such as, as shown in Fig. 7 and 8).Can by several possible by the way of use this measurement to deliverer's hand position.? In the case of electrode assemblie AEA 100 does not comprise insulating trip 105, hand position measurement can be used (such as, to prevent to delay EPS Transmission electric pulse), until their hand is removed at the chest of patient by deliverer.It addition, once detect fatigue Or the termination of artificial chest compression, device just can provide audition and/or visual cues to deliverer, instruct them by theirs Hand is removed from the chest of patient, until they remove their hand.Also hand can be measured and be used as trigger mechanism, with to trouble Person transmits therapeutic electromagnetic energy (such as, defibrillation shock).It is believed that and remove transmission the most automatically once the hand detecting deliverer Therapeutic electromagnetic energy can shorten the time terminated between artificial chest compression and transmission therapeutic electromagnetic energy.Such as, may be used During carrying out artificial chest compression, defibrillator is charged, so as to after terminating artificial chest compression, (such as, short immediately Within 1 second) transmission therapeutic electromagnetic energy.

Remove and use this detection to trigger transmission therapeutic electromagnetic energy at the hand the most automatically detecting deliverer In the case of, when treatment have can the patient of shockable rhythm time, can be when first deliverer presses, by second Defibrillator is charged by deliverer.But, when transmission electric shock, first deliverer controlling defibrillator will make this deliverer Stop pressing, until first deliverer shocks by electricity.Life is opened at this one group of station related between two deliverers Order, such as shouts that " station is opened.You open at station.I opens at station.We open at stations ", then confirm nobody as first deliverer When touching patient, just press shock button.This process can result in the 5-10 second (such as, until transmission electromagnetic energy time, breast Between portion's pressing terminates, elapsed time can be for the 5-10 second) the time period not carrying out therapeutic pressing.By detection automatically Close to patient of deliverer, the first deliverer equips defibrillator, and then, by its hand placement at sensor outer housing 104 On the second deliverer of carrying out pressing actually by simply its hand being removed from sensor, just actually result in defibrillator Transmission defibrillation shock.Thus, once detect that the hand of deliverer is removed at patient, the most automatically transmit electromagnetic energy.It is believed that This is effective especially, because on this time point, the people of contact patient is only pressing person, and they are in optimum position, with Evaluate whether that any other people may contact.When their hand is lifted by deliverer from sensor outer housing 104, close to passing Sensor 216 just detects that the hand of deliverer is removed near patient, and automatically transmits electric shock.

In some embodiments it is possible to use E field sensing, such as by MC33941 (TM, reference number of a document: MC33941, edition 4) E field sensing (such as, as shown in Figure 8) that provided.Due to this close to method for sensing it is fundamentally Measurement to the stray capacitance that deliverer's hand is specifically embodied, so while use the variable capacitance that medical gloves etc. inserts And each deliverer is calibrated critically important.During there is the time of pressing, it is automatically performed calibration.Due in the pressing phase Between, the shell of pressure sensor, it is possible to be safe to assume that, particularly when pressing is in its deepest point it is assumed that deliverer The surface of hand direct touch sensor shell 104.Take the measurement electric capacity at this point as zero distance datum mark.

In addition to minimizing the pressing during defibrillation and suspending, there is also other benefit.For example, it is believed that make defibrillation shock Significantly raising electric shock effect Tong Bu with the commitment of pressing up stroke.By detecting that the hand losing deliverer contacts After shock by electricity immediately, defibrillation shock can with pressing circulation optimal state be in step with.

In some further embodiments, not remove at patient once the hand detecting deliverer and just transmit defibrillation Electric shock, it is possible to proximity transducer 216 and processor have been detected by losing with after the contacting of deliverer's hand, in defibrillation shock 1 to 10 EPS pulse of transmission the most immediately.Then, make defibrillation shock Tong Bu with the optimal state of final EPS pulse.

Replace E field proximity transducer 216 is ultrasonic sensor, such as MINI_A PB ultrasonic transducer (Michigan State, Senscomp company), it has the measurement scope of 1-12 inch.Alternatively, optical transmitting set-receptor is to can position In sensor outer housing 104 in the face of deliverer upper surface on, and be used to detect presence sensor shell 104 surface with The moment of the physical separation between deliverer's hand.

Fig. 4 is a kind of removing at patient based on the hand detecting deliverer and the method for automatically transmitting defibrillation shock Flow chart.System, by arranging datum mark based on measurement capacitance when implementing pressing, calibrates proximity transducer (142).System System analyzes ongoing capacitance measurement, to detect the electric capacity change (144) relative to datum mark.Once detect the bright of electric capacity Aobvious change (such as, the change that the hand of instruction deliverer is removed at patient), system is just from trend patient transmission's defibrillation shock (146)。

As it has been described above, in some embodiments it is possible to artificial chest compression similarly, use electricity irritation to cause blood stream Dynamic, thus during deliverer's fatigue or execution chest compression terminate, supplement the artificial chest compression manually carried out.At some In embodiment, electricity irritation can include two benches electricity irritation, and it is configured to open based on heart pump blood mechanism and breast pump blood mechanism electricity Dynamic blood flowing, it is believed that both mechanism is to produce the main machine of blood flowing during the chest compression in cardio-pulmonary resuscitation (CPR) System.Two benches electricity irritation uses two arrays of electrodes: first group of electrode, it is oriented to stimulate during shrinking main by heart pump blood Mechanism produces the muscle group of blood flow；With second group of electrode, it is oriented to stimulate during shrinking main by breast pump blood mechanism Produce the muscle group of blood flow.

Owing to the position of electrode 101a is oriented to transmit its blood flow mechanism mainly by so-called heart pump blood mechanism EPS, mainly will produce the chest of blood flow when deflated it is preferable that also provide for mainly stimulating by so-called breast pump blood mechanism The other EPS electrode position of muscle.Preferably, this position is in left side and the right side of patient, is in the bottom of rib cage.From solution Cuing open above to say, electrode is by lateral register, centered by the anterior axillary line of patient, and is vertically positioned, with the rib of the 10th root bone Centered by bone edge.In this way, EPS stimulation concentrates on obliquus externus abdominis m. and abdominal muscle, thus causes horizontal thoracic cavity diameter (edge to edge width) and sagittal thoracic cavity diameter (the anterior-posterior spacing between spine and rib cage front portion) rapid drop, causes then Intrathoracic pressure quickly raises.These electrodes are referred to as normal pressure breast pump EPS (PPTP-EPS) electrode by us, because they are stimulating Period mainly produces the most intrathoracic pressure.The electrode position of electrode 101a and 101b is referred to as malleation centre of force pump EPS (PPCP-by us EPS) electrode position.

The boost pulse that can make PPCP-EPS and PPTP-EPS electrode is collaborative (such as, passing through electronic controller) so that two Their hematodinamics action is worked in coordination with by individual electrode, flows with optimization blood.Such as, by first transmitting PPCP-EPS arteries and veins Punching, then suspends 100-500 millisecond, preferably 100-200 millisecond, is then penetrated from heart by blood, and raise breast in transmission Interior pressure and cause higher aortic pressure PPTP-EPS pulse before, the time being given abundance is closed by aortic valve Close.Because owing between optimum pulse, timing causes aortic valve more likely to close at this time point, the active raised after reason Pulse pressure will cause blood flow forward, and this adverse current being redirected back into left ventricle with aortic valve when opening is contrary.

In certain embodiments, stimulate patient breaths thus provide oxygen to patient, make deliverer can continue to simultaneously Implementing chest compression can be useful.A kind of method of electricity irritation air-breathing is by stimulating Intercostal muscle, as producing negative intrathoracic pressure Means, to cause suction air exchange action.However, it is believed that this method is unreliable.Thus, in order to provide more reliable ventilation to move Make, using the teaching of the invention it is possible to provide electricity irritation, to be attached to some parts of one group of muscle of rib by stimulation, and by stimulating when shrinking Time cause spine in sagittal or lateral shaft heterodromous second group of muscle, promote costa sternales air-breathing.

More particularly, air-breathing can be completed by two groups of different muscle movements.For most people, main mechanism is Transeptate contraction, which increases the volume in thoracic cavity, thus, reduce intrathoracic pressure and introduce air.Alternatively, The supplementary means increasing Thorax volume is to be breathed by so-called costa sternales, otherwise referred to as costal respiration or thoracic respiration.Generally Taking exercise or during other anaerobic exercises, as the means of increase eupnea tide volume, using this breathing pattern.Logical Cross common rib to lift, by the pivoting action of the rib on the vertebral body of spine, especially at costal tubercle and rib head , to increase one or both of horizontal breast diameter or sagittal breast diameter, there is the increase of breast volume in the pivoting action at place.

Prior art has been described with the means stimulating Intercostal muscle as the negative intrathoracic pressure of generation, thus causes air-breathing to be taken a breath Action.It is believed that this is the most insecure mechanism of one, because the contraction of Intercostal muscle may will be closer under transeptate at it When portion's rib pulls up, the top rib closer to cervical region is pulled down.Unfortunately, top rib is pulled down actually result in The intrathoracic pressure raised and expiration, this is contrary with desired.

Having discovered that by with particular combination and stimulate more than a muscle group in mode time coordination, rib cage can Raise to carry out costa sternales breathing.As shown in Figure 5, by placing multi-group electrode (such as, 150,151 and on patient skin 152) promote that costa sternales is breathed.Electrode can be controlled by control circuit contained in defibrillator 208.Blood is also moved by these electrodes Mechanics plays the effect of negative pressure breast pump blood (NPTP) mechanism.In one constructs, on scapula, directly place diameter be about 2 English Very little anode electrode, the circumference approximation of electrode meets inferior angle of scapula.Each anode (anode after left back anode [PAL] and the right side [PAR] 152) be all about with two diameters 2 inches cathode electrode pairing: the first cathode electrode is placed on above rhomboideus major (negative electrode [PCRR] 151 after negative electrode [PCLR] and right rhombus after left rhombus), and the second cathode electrode is placed in serratus anterior Side, its center is approximately at the 5th or the 6th root bone (negative electrode [PCRS] 150 after negative electrode [PCLS] and right saw after left saw) place. The electrode being positioned at patient's rear left and those electrodes placing right side in the drawings are mirror image.Before serratus anterior, the most right Rhomboideus major bilateral stimulation will cause scapula to block spine, and after this, bilateral stimulation serratus anterior will cause horizontal breast diameter to increase Greatly, intrathoracic volume increases, intrathoracic pressure reduces and costa sternales is breathed.Although first stimulating rhomboideus major, but this not being must Want key element, and this method still works when first or simultaneously stimulating serratus anterior.

Generally, this carry out the method for costa sternales air-breathing by EPS and worked by following manner, i.e. stimulate and be attached to rib Some parts of one group of muscle, and cause heterodromous in sagittal or lateral shaft of spine when deflated by stimulating Second group of muscle.Another kind of method is and is placed on by anode as above on right and left oxter or scapula, and negative electrode is placed Must less than processus coracoideus and above trapezius muscle spinally.Negative electrode stimulation to trapezius muscle causes the anchoring at back, then passes through Pectoralis minor, teres major and latissimus dorsi m. are stimulated to a certain degree by the electrode stimulating that processus coracoideus is placed, thus mainly result in rib and rise, To increase sagittal breast diameter.

It is predominantly located at rear portion owing to being used for increasing these NPTP electrodes of breast volume, so do not produce during stimulating Electric current impact touches the risk of the deliverer of patient.Especially, it has an advantage that, it now is possible to be prone to get involved deliverer's by stimulating Artificial pressing.Preferably, the triggering of NPTP electrode stimulating is timed to during the up stroke of artificial pressing occur, and by auxiliary Before at next manually by depression stroke, make thoracic cavity recover naturally to construct to it, and increase venous blood is back to tremulous pulse, from And improve and preload hemodynamic.

EPS electrode package can be contained in wearable defibrillation system, such as Zhuo Er Medical Products (nurse is cut in Massachusetts This Ford city) in the braces of Lifevest defibrillator that manufactures.Such as, the electrode during Fig. 6 shows wearable defibrillator braces 150, the exemplary arrangement of 151 and 152.

Also can sequentially or simultaneously combine three kinds of EPS pulses for PPCP, PPTP and NPTP, with strengthen hemodynamic and Produce preferably flowing.Such as, after PPCP pulse can be PPTP pulse, followed by NPTP.

By following manner, EPS stimulus waveform itself can be modulated, i.e. pwm pulses chain, or slope is provided Leading edge, thus create softer ventilation cycle, it is used for introducing air into pulmonary.This by reduce intrathoracic pressure instantaneous definitely Value, when attempting ventilation, this is probably desired, strengthens blood with attempting producing the intrathoracic pressure of peak value (just or negative) Motion is contrary.More particularly, stimulation is can be by a series of high-frequency impulses of the same circuit transmission for defibrillation, this area skill The known this circuit of art personnel: capacitor, it can store the voltage of up to 2000-4000 volt；Charging circuit, it is for generally Use kickback transformer to arrange this capacitor is charged；High pressure, high speed solid switching mechanism, for by current carring cable and patch It is attached to the self-adhesion defibrillation electrode with patient, the capacitor of charging is connected to patient.Above-mentioned switching mechanism is usually arranged to With two kinds of polarity, capacitor is connected to patient, and is typically configured to tradition H bridge electric switch network topology.Stimulate at EPS Period, the voltage on capacitor is maintained expectation voltage, usually 500 volts of magnitudes by charging circuit.H-bridge circuit transmission can be controlled Single-phase or bidirectional pulse chain, it is preferable that this pulse train is single-phase.Pulse can pulse width-modulated, with transmission pulse Chain, the leading edge of pulse train has the dutycycle of as little as 0.1%, and is ramped to stimulate kept to account for by remaining EPS Empty ratio.Terminating place stimulates the dutycycle kept can be as little as 0.1% on slope for EPS, up to 100% (that is, DC's) Dutycycle.Effective DC value of the waveform during the ramp portion stimulated can have linearity configuration, or may be more complicated, adopts Fetching number or logarithm or any polynomial form.Terminating place stimulates the dutycycle that kept may be on slope for EPS Change during the most transmitting the interlude that EPS stimulates, this is because send out during the EPS stimulation of usually 30 seconds Raw muscle fatigue.Such as, if be set to 30 seconds the maximum persistent period that EPS stimulates, then the dutycycle kept may be with 10% start continue 30 seconds first 10 seconds, then residue 20 seconds during, be gradually increased to 30%.

Can be as diphasic pulse to transmitting each 100-200 microsecond pulse.Owing to N&M response impulse is to putting down All voltage, it is possible to by the voltage of fixing positive and negative voltage, and with the equal positive and negative 100 microsecond pulse persistent period Realize 0 average voltage, make average voltage ramp up.While it is preferred that, voltage is 100-200 microsecond, but they can be short To 5 microseconds, or for multiple-pulse chain, long to 10 milliseconds, and pulse is stimulated, long to 200 milliseconds.

The moment also being able to make EPS stimulate works in coordination with ECG waveform, in order to such motion is not when cardiac cycle fragile Duan Fasheng, or minimize in this time period.Such as, defibrillator can be controlled, in order to just start in the past until the fragile period Stimulate, or can be Tong Bus with the R ripple of ECG, but shorten the persistent period stimulated, in order to pressing up stroke not with fragility T ripple Overlapping.Secondly, it is possible to modulation EPS waveform, to reduce the speed of thorax, because fair speed may cause being reintroduced back to ventricle fibre Quiver, just especially true after defibrillation shock, it is then gradually increased the dynamics of stimulation so that it is closer to the beginning of electric shock next time. In this way, blood circulation can be maximized by following manner, bigger pumping is i.e. provided when shocking by electricity loop ends Power (and the most thus increasing the effect of electric shock next time), simultaneously when the circulation that heart is more fragile starts, minimizes heart Interference.

Fig. 7 illustrates the example system 200 for providing dynamically controlled chest compression to patient in schematic form.Generally, it is System 200 includes many medical treatment devices, and they can be used for the victim to sudden cardiac arrest, and such as victim 202 provides help property to protect Reason.Multiple device can be individual unit or a part for multiple unit, and can be used for monitoring the various realities of victim 202 Time body parameter, with between the components, and with the remote system communication of such as center caregiver, and carry to victim 202 For nursing, or to caregiver, the most provide the caregiver 204 of nursing to victim 202, it is provided that instruct.

In this example, victim 202 is the individuality substantially experiencing sudden cardiac arrest, is treated by caregiver 204.Example If, caregiver 204 can be to train limited citizen's responder, Emergency Medical Technique personnel (EMT), doctor in help technology Or another medical professional.In this example, caregiver 204 can be with independent action, or can be from such as assistant Take action with the help of other caregivers one or more of EMT.

Victim 202 is in the position providing treatment to victim 202.Such as, with typical way to being injured The trunk of person is applied with one group of defibrillator electrode 210, and it is connected to portable external defibrillator 208 through a cable.Such as, remove The device 208 that quivers can be typical automated external defibrillator (AED), specialty defibrillator or the defibrillation device of other similar type.It is subject to Evil person 202 has had ventilation bag 206, thus provides compulsory air to enter in the pulmonary of victim, to help relief to be subject to The breathing of evil person 202.Defibrillator 208 and ventilation bag 206 can be operated in the way of various caregivers are familiar with and synergistically.And And, ventilation bag 206 is also equipped with various sensor and emitter, in order to defibrillator 208 electronic communication.Such as, volume flow Sensor can be provided to ventilation bag 206, and can be by about flowing to victim and from the air stream of victim's outflow The data of volume pass to defibrillator 208, in order to defibrillator 208 can relay this information, or is used as this information shadow Ring the mode that defibrillation is supplied to victim 202.

Tablet PC 214 is also depicted as communicating with other devices, and is handled by caregiver 204.This flat board can be used Make the universal electric order station of caregiver 204, to receive the information about victim 202 and sundry item and other caregivers The input of the operation of the various parts in communication, and offer control system 200.This tablet PC 214 can have short scope With the wireless communication ability of long scope, on the one hand such as bluetooth or WiFi, on the other hand such as honeycomb 3G or 4G.Caregiver 204 Can enter information in tablet PC 214, such as describe the information of the situation of victim 202 and will be known by caregiver 204 Not with other similar information recorded.This flat board 214 also can communicate with multiple sensing datas, with sensing about victim 202 Real time information, such as blood pressure, pulse and similar real time patient's parameter.Caregiver 204 also can enter information into flat board 214 In, in order to control the one or more medical treatment devices victim 202 used.Such as, user's scalable is supplied to be injured The type of the treatment of person 202, intensity, speed or collaborative.

Chest compression is manually carried out by caregiver 204.In this case, will by speaker 236a and display 224 Audiovisual feedback is supplied to caregiver 204.If desired, the pressing that feedback will guide caregiver 204 to carry out low-force degree.

As shown in this example, the current real time status of victim 202 or the multiple different of body parameter feature are described Input signal is received.Such as, ECG signal 222 can be received by MPU 212, and can represent the current and real-time of victim 202 ECG waveform, can obtain this ECG waveform by being connected to the wire of defibrillator 208.

SpO₂Other physiology derivative signals of the direct or indirect measured value of signal 223 or recycle stream or perfusion also exist Be captured at square frame 224, and can be used to further determine when and with great power to victim 202 apply chest by Pressure.

Note now that, although Fig. 7 shows such as SpO₂The particular example of input signal, but equipment can use life Any combination of reason signal, such as, but is not limited to: ECG；Kinemic measured value；The measured value of heart rate；One or more blood Pressure；Oxygen saturation (SpO₂)；Heart sound (includes phonocardiogram)；Heart imaging (includes ultrasound wave)；Impedance cardiogram.Pressing parameter can make With feature or any combination of measured value of pressing, include, but are not limited to: pressing speed；According to pressing depth；Dutycycle；Up stroke Speed with down stroke；Intrathoracic pressure during pressing；Pleural pressure during pressing；Sternal position, speed or acceleration；Breast Wall or breastbone strain or deformation；The power applied to chest；The pressure that mechanical breast depressor pressing chest is used.

Thering is provided signal processing unit 228 with to the input received at patient, such as ECG input, is filtered, thus by Microprocessor 230 is analyzed further.Such as, signal processing unit 228 can cross noise filtering from input signal, and at ECG number In the case of according to, may filter that the artifact that the chest compression motion of victim 202 is caused, in order to remove this artifact.Can be by this The preparation planting ECG signal is referred to as SEE-THRU CPR, and entitled " the ECG SIGNAL that can submit to by January 23rd, 2002 PROCESSOR AND METHOD (ECG signal process and method) " United States Patent (USP) No.6, discuss in 865,413 and perform, its Teaching is incorporated herein by reference in their entirety.

Can at Fundamental Digital Circuit, or in computer hardware, firmware, software or a combination thereof implement described by Feature.Can be at information carrier, such as the meter visibly embodied in the machine-readable storage device performed by programmable processor Calculation machine program product implements this equipment；And method step can be performed by the programmable processor performing instruction repertorie, with The function of described embodiment is performed by operating and produce output on the input data.Can advantageously at one or Implementing described feature in more computer programs, this one or more computer program can include that at least one can Performing on the programmable system of programmed process device, this programmable processor is through being coupled at least one input equipment and at least one Individual output device is to receive data and instruction from data-storage system, and it is sent data and instruction.Computer program is Can the most directly or indirectly use, to perform specific action or to bring one group of instruction of particular result.Computer journey Sequence can be write by programming language in any form, including compilation or interpretative code, and can dispose in any form, bag Include independent program, or as module, parts, subroutine, or it is applicable to other unit of computing environment.

As example, include general and special microprocessor for performing the appropriate processor of instruction repertorie, and individually Processor, or in multiple processors of any kind of computer.Generally, processor from read only memory or with Machine accesses memorizer or both receive instruction and data.The necessary element of computer is performed for the processor of instruction, and For storing one or more memorizer of instruction and data.Generally, computer also will include for storing data file One or more mass storage devices, or be operatively coupled thus with for store data file one or more greatly Mass storage devices communicates；This device includes disk, such as internal hard drive and dismantled and assembled disk；Magneto-optic disk；And CD.It is suitable for The storage device of tangible embodiment computer program instructions and data includes the nonvolatile memory of form of ownership, as example, Including semiconductor storage, such as EPROM, EEPROM and flash memory device；Disk, such as internal hard drive and dismantled and assembled disk； Magneto-optic disk；And CD-ROM and DVD-ROM dish.Processor and memorizer can be supplemented or quilt by ASIC (special IC) It is included in.

Mutual in order to provide with user, it is possible to implementing feature on computers, this computer has: display device, all Such as CRT (cathode ray tube) or LCD (liquid crystal display) monitor, it is used for displaying to the user that information；With keyboard with instruction device, Such as user can provide mouse or the trace ball of input by it to computer.

Can implement feature in computer systems, this computer system includes back-end component, such as data server, or Person includes middleware component, such as apps server or Internet server, or includes front end component, such as has figure Shape user interface or the client computer of explorer, or their any combination.The parts of system can pass through The medium of the digital data communications of any form or such as communication network connects.The example of communication network includes LAN (" LAN "), wide area network (" WAN "), peer-to-peer network (there is self-organizing network or stationary member), grid computing infrastructures and because of Special net.

Computer system can include client and server.Client and server is generally remote from each other, and generally By network, the most above-mentioned network interaction.The relation of client and server is by the calculating run on corresponding computer Machine program, and each other there is client-server relation and produce.

Computer system can include the software for implementing electronic patient nurses' notes, such as Zhuo Er data system company The ePCR software in (state of Colorado, Broomfield county).This software provides typing, stores and send patient information, and The ability that therapeutic is interactive.Generally, this computer is so-called " flat board " computer system, has been reinforced and has made before institute With, and the form of iPhone or iPad can be taked.Preferably, real between portable " flat board " computer 214 and MPU 212 Time send data.

Electromagnetic stimulation can be realized by electricity irritation, this electricity irritation is all as is known to persons skilled in the art, be used as pace-making or The current source of defibrillation circuit or voltage source.Also can realize electromagnetic stimulation by Neural stem cell, this Neural stem cell is by usually 10 amperes Or bigger, be transferred to the high-current pulse to needing the muscle group being stimulated to close the magnetic coil placed and realize.Such System commercially can be able to be used by Kai Wei company (device model: MES-10).

Have been described with many embodiments.However, it should be understood that in the case of without departing from the spirit and scope of the present invention, Various modification can be made.Therefore, other embodiments are the most within the scope of the following claims.

Claims (19)

1. a medical system for electromagnetic stimulation is provided to patient, including:

Sensor, described sensor is oriented to the existence of the artificial chest compression that sensing is implemented to patient by deliverer；With

Processor, described processor is arranged to receive the data that described sensor produces, and detects described chest compression Change in execution；And

Circuit, described circuit is configured to the described change once detecting in the execution of described chest compression, described change bag Include the degeneration of the quality of described chest compression, just transmit for stimulating chest muscle via the electrode on the chest being positioned at described patient The electromagnetic stimulation of meat group, with stimulate described in the patient blood flowing.

System the most according to claim 1, the degeneration of the quality of wherein said chest compression includes described chest compression The change of the degree of depth.

System the most according to claim 1, the degeneration of the quality of wherein said chest compression includes described chest compression The change of pressing release.

System the most according to claim 1, wherein said processor is configured to, and is exceeded the time period of threshold value by detection There is not chest compression, detect the change in the execution of described chest compression.

System the most according to claim 1, wherein said processor is configured to, by the detection time period more than 2 seconds There is not chest compression, detect the change in the execution of described chest compression.

System the most according to claim 1, wherein said processor is configured to, by by described sensor when first Between the number that produces during the second time period of occurring after the first time period of the data that produce during section and described sensor According to comparing, detect the change in the execution of described chest compression.

System the most according to claim 1, wherein said sensor is configured to detect the motion of the breastbone of described patient.

System the most according to claim 1, wherein said sensor includes motion sensor.

System the most according to claim 1, wherein said sensor includes pressure transducer.

System the most according to claim 1, wherein said sensor includes velocity sensor.

11. systems according to claim 1, the described circuit being wherein configured to transmit electromagnetic stimulation is further configured to, Automatic and no user intervenes ground transmission electromagnetic stimulation.

12. systems according to claim 1, wherein said electrode is attached on the chest of described patient.

13. systems according to claim 12, wherein said electrode is attached on the chest of described patient removably.

14. systems according to claim 1, wherein said circuit includes being configured to the Inter-pulse interval of 5-15 millisecond The circuit of the impulse train of 100-200 musec duration period pulse is transmitted with the amplitude of 300-700 volt.

15. systems according to claim 1, wherein said circuit includes being configured to the dutycycle with 2-95% and 50- The amplitude of 2000 volts transmits the circuit of the impulse train of 20-1000 musec duration period pulse.

16. systems according to claim 1, also include that display device, described display device are configured to once right Electromagnetic stimulation described in described patient transmission, restarts artificial chest compression with regard to deliverer described in visual cues.

17. systems according to claim 1, also include that speaker, described speaker are configured to once to described Electromagnetic stimulation described in patient transmission, restarts artificial chest compression with regard to deliverer described in auditory cues.

18. systems according to claim 1, wherein said processor is configured to the matter by detecting described chest compression The degeneration of amount, detects the change in the execution of described chest compression.

19. systems according to claim 18, wherein said circuit is configured to, and once detects described chest compression The degeneration of quality, just while described deliverer implements artificial chest compression, transmits described electromagnetic stimulation.