CN113057874B - Method and device for measuring chest compression parameters, defibrillation electrode assembly and automatic external defibrillator - Google Patents

Method and device for measuring chest compression parameters, defibrillation electrode assembly and automatic external defibrillator Download PDF

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CN113057874B
CN113057874B CN202110303003.2A CN202110303003A CN113057874B CN 113057874 B CN113057874 B CN 113057874B CN 202110303003 A CN202110303003 A CN 202110303003A CN 113057874 B CN113057874 B CN 113057874B
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compression
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shape sensor
chest compression
shape
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CN113057874A (en
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郑杰
徐海山
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Suzhou Weisi Medical Technology Co ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004Heart stimulation
    • A61H31/007Manual driven
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004Heart stimulation
    • A61H31/005Heart stimulation with feedback for the user
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39Heart defibrillators
    • A61N1/3904External heart defibrillators [EHD]
    • A61N1/39044External heart defibrillators [EHD] in combination with cardiopulmonary resuscitation [CPR] therapy

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Abstract

The invention discloses a method for measuring chest compression parameters, which measures the chest deformation state of a compressed object through a shape sensor and calculates the chest compression parameters according to shape data of the shape sensor. The invention also discloses a chest compression parameter measuring device, a defibrillation electrode assembly and an automatic external defibrillator for realizing the method. The method and the device provided by the invention can accurately reflect the thoracic shape of a pressed object in the chest pressing process in real time, can accurately acquire the pressing parameters such as the pressing depth, the pressing frequency, the pressing detention depth, the pressing interruption duration and the like in real time, are not easily influenced by the environment, and can be applied to the environment with acceleration.

Description

Method and device for measuring chest compression parameters, defibrillation electrode assembly and automatic external defibrillator
Technical Field
The invention belongs to the technical field of medical treatment, and particularly relates to a method and a device for measuring chest compression parameters, a defibrillation electrode assembly and an automatic external defibrillator.
Background
According to the statistical estimation of 'Chinese cardiovascular health and disease report 2019', the number of Sudden Cardiac Death (SCD) cases which occur every year in China is up to 54.4 thousands, when sudden cardiac arrest occurs in SCD patients, the timely implementation of high-quality effective cardiopulmonary resuscitation (CPR) is the key for rescuing the SCD patients, chest compression is one of the core processes in the cardiopulmonary resuscitation process, and the quality effect of the chest compression is directly related to the rescue success rate and the discharge survival rate. Specific compression parameter recommendations for cardiopulmonary resuscitation and chest compressions have been made in some authoritative rescue guidelines. For example, AHA guidelines, which over the years of clinical study accumulation and data statistics, suggest that at chest compressions: 1. the pressing depth is not less than 5cm and not more than 6 cm; 2. the pressing frequency is between 100 and 120 (times/min); 3. reducing press interruptions as much as possible; 4. complete release without retention (after complete release of the thoracic cage after the end of each compression, the next compression is started). Therefore, monitoring and feedback of these compression parameters is an important means to improve CPR quality and rescue success in clinical applications.
In the current measurement feedback technology of chest compression parameters, there are two main schemes:
the first is a solution using an acceleration sensor, as described in US7220235B2 patent: the method is characterized in that an acceleration sensor is configured on a pressing point for performing chest compression on the thorax of a patient, the acceleration sensor synchronously moves with the surface of the thorax of the patient, the real-time displacement variation of the acceleration sensor can be obtained by acquiring the acceleration value of the acceleration sensor and performing secondary integration on the acceleration value, the real-time displacement variation can represent the compressed depth value of the pressing point of the thorax, the compression frequency can be synchronously calculated according to real-time parameters, whether the thorax is completely released when each compression is finished or not, and the time accumulation of the interruption of the chest compression is realized.
The second one is to use the principle of magnetic field measurement, as described in patents US10098573B2 and US9585603B2, which comprise two parts, one of which is a measurement part, and is applied to the pressing point of the thorax of a patient, and moves synchronously with the chest when being pressed, and the part contains a magnetic field sensor, and can measure the magnetic field change corresponding to the change of the pressing depth; the other part is the source of the magnetic field, which is applied directly under the patient's back (US10098573B2) or beside the patient (US9585603B2), which produces a steady, constant and definite magnetic field. The two parts cooperate to measure the real-time depth of compression, and the other 3 parameter information of the corresponding AHA guideline.
Both of the above two existing solutions have mature products for clinical applications, but still have some disadvantages or shortcomings.
The acceleration sensor solution, although it can obtain clinical measurement accuracy in normal application, is prone to generate very large measurement errors when subjected to vibration interference, especially when subjected to external vibration or subjected to acceleration in a moving environment, such as measurement feedback when a machine is pressed, or when in an ambulance, vehicle body jolts and moves, or when in an airplane, the change range of the acceleration value of the airplane is very large, cannot be filtered and is larger than the acceleration range of pressing, the acceleration signal of the pressing depth can be completely submerged, or when a patient lies on a soft bed and is pressed, the depth value calculated by the acceleration sensor also includes the value of the collapse of the soft bed.
The scheme of magnetic field measurement needs at least two parts to work in coordination, which increases the operation of application in clinical application, especially in emergency rescue environment, and increases the inconvenience of application; also, the two-part configuration can add significant cost, especially if it is difficult to make a disposable product, which increases the cost of managing the clinical facility. More importantly, the magnetic field measurement scheme, which has a low measurement accuracy in normal applications, is generally applied qualitatively to determine whether the threshold analysis is in the interval of 5-6cm (as described in patent US10098573B 2).
Therefore, in order to solve the above technical problems, it is necessary to provide a new method and apparatus for measuring chest compression parameters.
Disclosure of Invention
The invention aims to provide a method and a device for measuring chest compression parameters, a defibrillation electrode assembly and an automatic external defibrillator, which are used for solving the problems in the prior art.
In order to achieve the purpose, the technical scheme provided by the invention is as follows:
a method for measuring chest compression parameters specifically comprises the following steps:
s1: fitting a shape sensor on the thorax of the compressed object, wherein the shape sensor is configured to generate corresponding deformation according to the shape change of the thorax of the compressed object during the compression process;
s2: acquiring shape data of the shape sensor;
s3: chest compression parameters are calculated from the shape data of the shape sensor.
Further, the step S3 specifically includes:
establishing a function image corresponding to the shape of the shape sensor in a coordinate system according to the shape data of the shape sensor;
wherein the function images include an initial function image corresponding to an initial shape of the shape sensor prior to performing chest compressions and a real-time function image corresponding to a real-time shape of the shape sensor during chest compressions.
Further, the step S3 further includes:
and calculating the maximum common normal line length between the initial function image and the real-time function image, and representing the real-time compression depth in the chest compression process by using the maximum common normal line length.
Further, the step S3 further includes:
and establishing a depth change waveform diagram of the compression depth changing along with time in the chest compression process according to the real-time compression depth.
Further, a compression depth during chest compressions is determined from the depth variation waveform map.
Further, a compression frequency during chest compressions is determined from the depth variation waveform map.
Further, a compression interruption duration during chest compressions is determined from the depth variation waveform map.
Further, a compression dwell depth during chest compressions is determined from the depth variation waveform map.
Further, the amount of sternal collapse of the subject being compressed during chest compression is determined from the depth variation waveform map.
Further, the shape sensor is a one-dimensional linear shape sensor arranged to be attached to a chest compression point of a compression target.
Further, the coordinate system is a planar rectangular coordinate system configured to have an end point or a middle point of the initial function image as an origin.
Further, the real-time compression area amount in the chest compression process is determined according to the area defined between the initial function image and the real-time function image of the one-dimensional linear shape sensor in the plane rectangular coordinate system.
Further, the shape sensor is a two-dimensional planar shape sensor arranged to be attached to a chest compression point of a compression target.
Further, the coordinate system is a space rectangular coordinate system.
Further, the real-time compression volume amount in the chest compression process is determined according to the volume defined between the initial function image and the real-time function image of the two-dimensional surface-shaped sensor in the space rectangular coordinate system.
Further, a volume change waveform diagram of the compression volume quantity changing with time in the chest compression process is established, and the compression parameters in the chest compression process are determined according to the volume change waveform diagram.
Furthermore, a point corresponding to the external chest compression point on the initial function image of the two-dimensional planar shape sensor is processed into a cross section perpendicular to the initial function image and the real-time function image of the two-dimensional planar shape sensor in the spatial rectangular coordinate system, and the real-time compression area amount in the external chest compression process is determined according to the areas defined on the cross section by the initial function image and the real-time function image.
Furthermore, an area change waveform diagram of the compression area quantity changing with time in the chest compression process is established, and the compression parameters in the chest compression process are determined according to the area change waveform diagram.
The invention also provides a chest compression parameter measuring device, which comprises:
a shape sensor for monitoring changes in the shape of the thorax of a subject being compressed;
and the processor is used for acquiring the shape data of the shape sensor and processing the shape data to obtain the chest compression parameters.
Further, the shape sensor is a one-dimensional linear shape sensor or a two-dimensional planar shape sensor.
Furthermore, a gasket for placing the palm of the pressing action executor is arranged on the shape sensor.
Further, a pressing portion for aligning with a chest pressing point of a subject to be pressed when performing chest pressing is provided at the center of the pad, and the shape sensor is arranged to pass through the pressing portion.
Further, a sticker is provided on a back surface of the shape sensor.
Further, the chest compression parameter measuring device further comprises a data/charging interface connected with the processor.
Furthermore, the chest compression parameter measuring device further comprises a display unit connected with the processor, and the display unit is used for displaying the chest compression parameters processed by the processor.
The present invention also provides a defibrillation electrode assembly comprising:
a first electrode sheet;
a second electrode sheet;
chest compression parameter measuring means as hereinbefore described;
and the lead cable is connected to the first electrode plate, the second electrode plate and the chest compression parameter measuring device.
Furthermore, the lead cable comprises a first branch cable, a second branch cable and a third branch cable which are respectively connected with the first electrode plate, the second electrode plate and the chest compression parameter measuring device.
Further, the first, second, and third breakout cables are integrated onto a plug for interfacing with a defibrillation device through a breakout connection.
The present invention also provides an automatic external defibrillator comprising:
a defibrillation host;
a defibrillation electrode assembly as described above, the defibrillation electrode assembly being configured to be connectable to the defibrillation host.
The invention has the beneficial effects that:
compared with the prior art, the method and the device for measuring the chest compression parameters have the following advantages:
1. the thoracic shape of a pressed object in the chest pressing process can be accurately reflected in real time;
2. the pressing parameters such as pressing depth, pressing frequency, pressing retention depth, pressing interruption duration and the like can be accurately obtained in real time;
3. the sternum collapse amount of the pressed object can be calculated to evaluate the fracture degree of the pressed object;
4. the volume of the chest compression of the object to be compressed or the volume of the chest compression on a certain section can be calculated in real time, so that the chest compression degree of the object to be compressed can be reflected more accurately;
5. the device is not easily influenced by the environment, can be applied to the environment with acceleration, such as the bumpy environment of an airplane, an ambulance and the like, and can improve the measurement precision;
6. the second mode can be used in the scenes such as a soft bed and the like to avoid interference;
7. the measurement can be completed only by configuring the shape sensor, and complex matching operation of a plurality of parts is not needed;
8. the device for measuring the chest compression parameters can be easily configured to other devices as an auxiliary device for auxiliary monitoring of chest compression.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings required to be used in the description of the embodiments are briefly introduced below, and it is obvious that the drawings in the description below are only some embodiments described in the present application, and it is obvious for those skilled in the art to obtain other drawings without creative efforts.
FIG. 1 is a schematic structural diagram of an apparatus for measuring chest compression parameters according to an embodiment of the present invention;
FIG. 2 is a flow chart of a method of measuring chest compression parameters in accordance with one embodiment of the present invention;
FIG. 3 is a schematic diagram of one embodiment of a method for measuring chest compression parameters according to the present invention;
FIG. 4 is a cross-sectional view taken along line A-A of FIG. 3;
FIG. 5 is a functional image of the one-dimensional linear shape sensor of the embodiment of FIG. 3;
FIG. 6 is a waveform illustrating depth variation according to an embodiment of the present application;
FIG. 7 is a waveform illustrating a depth variation in another embodiment of the present application;
FIG. 8 is a schematic diagram of another embodiment of a method for measuring chest compression parameters provided by the present invention;
FIG. 9 is a schematic diagram of another embodiment of a method for measuring chest compression parameters provided by the present invention;
FIG. 10 is a functional image of the two-dimensional linear shape sensor of the embodiment shown in FIG. 9;
figure 11 is a schematic diagram of the structure of a defibrillation electrode assembly in accordance with one embodiment of the present invention;
figure 12 is a schematic structural view of a defibrillation electrode assembly in accordance with another embodiment of the present invention;
FIG. 13 is a schematic structural view of an automatic external defibrillator according to an embodiment of the present invention;
fig. 14 is a schematic diagram of an application scenario of the automatic external defibrillator of the embodiment of fig. 13.
Detailed Description
The present invention will be described in detail below with reference to embodiments shown in the drawings. The embodiments are not intended to limit the present invention, and structural, methodological, or functional changes made by those skilled in the art according to the embodiments are included in the scope of the present invention.
It will be understood that when an element is referred to as being "secured to" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. In the illustrated embodiment, directional references, i.e., up, down, left, right, front, rear, etc., are relative to each other and are used to explain the relative structure and movement of the various components in the present application. These representations are appropriate when the components are in the positions shown in the figures. However, if the description of the position of the element changes, it is assumed that these representations will also change accordingly.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used in the description of the invention herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.
The invention provides a method and a device for measuring chest compression parameters, which are used for monitoring the shape change of the thorax of a compressed object when the compressed object is subjected to chest compression through a shape sensor and determining the chest compression parameters (including at least one of compression depth, compression frequency, compression interruption time, compression detention depth and sternum collapse amount of the compressed object) based on shape data of the shape sensor.
Referring to fig. 1, a chest compression parameter measuring device according to a preferred embodiment of the present invention includes a shape sensor 1 and a processor 2.
Wherein, the shape sensor 1 is configured to be able to be attached to the thorax of the compressed object to monitor the change of the thorax shape of the compressed object, and the shape sensor 1 is configured to be able to generate corresponding deformation along with the change of the thorax shape of the compressed object when the compressed object is compressed, so as to monitor the change of the thorax shape of the compressed object in real time. The shape sensor 1 may be a strip-shaped one-dimensional linear shape sensor or a sheet-shaped two-dimensional planar shape sensor. The signal output by the shape sensor 1 is shape data of at least a part of the shape sensor 1, and may be, for example, geometric parameters of some specific point, line, plane, or the like on the shape sensor 1.
The processor 2 is used for acquiring the shape data of the shape sensor 1 and performing processing calculation based on the shape data of the shape sensor 1 to obtain relevant chest compression parameters. For example, the processor 2 may construct a function image capable of reflecting the shape of the shape sensor 1 in the coordinate system according to the shape data of the shape sensor 1, that is, a mapping relationship is established between the shape of the shape sensor 1 and the function image; the function image includes an initial function image corresponding to the initial shape of the shape sensor 1 (the shape of the shape sensor 1 attached to the chest of the subject to be compressed before chest compression is performed) and a real-time function image corresponding to the real-time shape of the shape sensor 1 (the shape of the shape sensor 1 corresponding to the deformation of the thorax of the subject to be compressed) at each time during compression, and the processor 2 may calculate the compression depth at each time during compression based on the initial function image and the real-time function image of the shape sensor 1 and calculate other compression parameters (such as compression frequency, compression interruption time, compression sternum retention depth, collapse amount of the subject to be compressed) according to the compression depth.
The processor 2 may be arranged on the shape sensor 1 or as a separate element from the shape sensor 1. The processor 2 may receive information from the shape sensor 1 through wired communication or wireless communication, thereby obtaining shape data of the shape sensor 1. The processor 2 may also contain a memory for storing shape data of the shape sensor 1 to facilitate subsequent data tracking or to form a data report.
In an exemplary embodiment, the shape sensor 1 is provided with a pad 3 for placing the palm of the hand of the person performing the compression, the pad 3 is provided at the center with a pressing portion 31 for aligning with the external chest pressing point of the object to be compressed (in the current medical clinical conclusion, especially in the AHA guideline, the external chest pressing point is located at the center of the line connecting the two nipples of the human body, i.e. the intersection point with the midsagittal plane, and is also located on the sternum of the human body) when performing the external chest compression, and the shape sensor 1 is configured to pass through the pressing portion 31. The spacer 3 is preferably made of a flexible material, for example, rubber, cloth, or the like.
When a compression action executor performs chest compression on a compression object, the shape sensor 1 and the pad 3 are firstly attached to the chest of the compression object, and the pressing part 31 of the pad 3 is aligned with the chest pressing point of the compression object; then, the user of the compression motion starts the compression motion by placing the palm on the pad 3, and the shape sensor 1 outputs the shape data to the processor 2 in real time in response to the deformation of the thorax of the object to be compressed as the compression motion is performed.
In an exemplary embodiment, the back side (the side for contacting the chest skin of the subject) of the shape sensor 1 is provided with an adhesive, by which the shape sensor 1 can be tightly adhered to the chest of the subject, so that the shape change of the shape sensor 1 is always consistent with the shape change of the thorax of the subject during the chest compression. The adhesive may be a double-sided tape attached to the back surface of the shape sensor 1, or may be an adhesive applied to the back surface of the shape sensor 1.
In particular, the device for measuring the chest compression parameters further comprises a data/charging interface 4 connected with the processor 2, and data transmission with the processor 2 and power supply to the processor 2 can be realized through the data/charging interface 4. The data/charging interface 4 may be a USB interface.
The device for measuring the chest compression parameters can further comprise a display unit 5 connected with the processor 2, wherein the display unit 5 can be used for displaying the chest compression parameters processed by the processor 2, so that real-time feedback of the compression parameters to a compression action executor is realized, and the compression action executor can adjust the compression action. The display unit 5 may be a liquid crystal display. The processor 2, the data/charging interface 4 and the display unit 5 may be integrated on one module or may be configured as separate components.
Referring to fig. 2, a specific flow of a method for measuring a chest compression parameter according to an embodiment of the present invention is shown, the method includes the following steps:
s1: fitting a shape sensor on the thorax of the compressed object (directly contacting with the thorax skin of the compressed object or having a spacer between the shape sensor and the thorax skin of the compressed object), wherein the shape sensor is configured to generate corresponding deformation according to the shape change of the thorax during the compression of the compressed object;
s2: acquiring shape data of a shape sensor;
s3: calculating chest compression parameters according to the shape data of the shape sensor.
The shape sensor may be a strip-shaped one-dimensional linear shape sensor or a sheet-shaped two-dimensional planar shape sensor.
The step S3 specifically includes:
establishing a function image corresponding to the shape of the shape sensor in a coordinate system according to the shape data of the shape sensor;
wherein the function images include an initial function image corresponding to an initial shape of the shape sensor prior to performing chest compressions and a real-time function image corresponding to a real-time shape of the shape sensor during chest compressions.
The aforementioned step S3 further includes:
calculating the maximum common normal line length between the initial function image and the real-time function image, and representing the compression depth in the chest compression process by using the maximum common normal line length;
establishing a depth change oscillogram of the compression depth changing along with time in the chest compression process according to the real-time compression depth;
and determining compression parameters such as real-time compression depth, compression frequency, compression detention depth, sternum collapse amount of a compressed object and the like in the chest compression process through the depth change waveform map.
The foregoing process is further illustrated by the following specific examples:
referring to fig. 3, a typical fitting manner is shown when the shape sensor is configured as a one-dimensional linear shape sensor 11, the one-dimensional linear shape sensor 11 is configured to fit to a chest compression point 61 of the object 6 to be compressed and fit to the thorax of the object 6 to be compressed along a line connecting two nipples of the object 6 to be compressed, so that the one-dimensional linear shape sensor 11 can be deformed correspondingly with the change of the shape of the thorax of the object 6 to be compressed when the object 6 to be compressed is compressed.
Referring to fig. 4, which shows a cross-sectional view along the direction a-a in fig. 3, fig. 4 shows a shape schematic of the one-dimensional linear shape sensor 11 before compression, which is consistent with the initial thorax shape of the object 6 to be compressed before compression; fig. 4 b is a schematic view of the shape of the one-dimensional linear shape sensor 11 at the time of compression, which is in accordance with the shape of the thorax of the object 6 to be compressed at the time of compression. When compression is applied to the external chest compression point 61 (sternum position of the thorax) of the object 6 to be compressed, the thorax is deformed, as shown by 11b in fig. 4, which is a typical thoracic deformation feature.
The depth of compression in our clinical sense is the depth of maximum deformation of the thorax. When we perform compressions rhythmically (e.g. 100-.
Fig. 5 is a functional image obtained by mapping the shape of the one-dimensional linear shape sensor 11 in the embodiment shown in fig. 3 to a rectangular plane coordinate (or other plane coordinate system, such as a polar coordinate system). Wherein, curve C0For the initial function image of the one-dimensional linear shape sensor 11, the left end point of the initial function image is used as the origin of the rectangular plane coordinate (in other embodiments, a coordinate system may be established by using any point on the initial function image as the origin, for example, the midpoint of the initial function image is used as the origin), and one coordinate axis of the rectangular plane coordinate system is tangent to the initial function image, and the curve C is obtainedtIs a real-time function image of the one-dimensional linear shape sensor 11.
In the rectangular plane coordinate system, curve C0For uniquely defined function images, the curve C0Represents the shape of the thorax before compression (at a compression depth of 0), which can be expressed as a function y in a coordinate system0=f(x0). As compression progresses, at any time t, the shape of the thorax changes, and the function of the curve created by the one-dimensional linear shape sensor changes in real time, as shown by curve C in FIG. 5tIts representation in the coordinate system can be expressed as the function y ═ f (x). In the rectangular plane coordinate system, curve C is calculated0And CtThe length of all common normal lines in the chest compression process is represented by the maximum common normal line length (as h in fig. 5) to represent the real-time compression depth (compression depth at the time t) in the chest compression process, and the maximum common normal line length value is the deepest depth of chest subsidence of chest external compression at the time t.
Fig. 6 is a waveform diagram showing the time-dependent change of the compression depth during chest compression, which is created according to the real-time compression depth at each time point measured in the embodiment shown in fig. 5. As can be seen from the depth variation waveform chart, the real-time compression depth varies periodically during the compression process. In clinical significance, the peak value of the waveform in each compression period in the depth variation waveform map represents the compression depth of the compression period; the number of waveforms formed in each pressing time period is the pressing frequency in the pressing time period (the AHA guideline recommends that the pressing frequency is 100-.
In an actual medical treatment scenario, the compression depth may fluctuate. For example, during a compression event, the compression is not fully released (after a compression event, the thorax fully rebounds to the initial position), and the next compression event is initiated, resulting in a certain dwell depth of compression, t in FIG. 61The time corresponds to the situation. In the medical treatment scenario, it is common that the compression is not completely released, the compression detention depth is generated, and the compression detention depth is usually fluctuated, and the compression detention depth can be calculated by a depth change waveform map (as in fig. 4, a value corresponding to R represents the compression detention depth).
In the actual medical treatment scenario, there may also be a case where chest compression is interrupted, that is, no compression action is performed for a time period exceeding a certain compression period, and a depth-varying waveform is not generated in the depth-varying waveform diagram during the time period, as shown by t in fig. 62~t3And under the condition corresponding to the moment, the pressing interruption time can be calculated through the depth change oscillogram.
In clinical practice, as chest compressions continue, the subject 6 being compressed may be fractured or the sternum may collapse, perhaps in a frequent case; at this time, the thorax of the compression target 6 cannot rebound to the position height before fracture after compression. In current clinical practice, there is no good means to monitor this process or to assess the degree and risk of fracture, since the return of cardiopulmonary resuscitation to restore spontaneous circulation is far greater than the risk of fracture, chest compressions will still be performed, generally neglecting their effect, and chest compressions will still be performed with a series of the same chest compression parameters, such as 5-6cm compression depth.
When the shape sensor is attached to the thorax of a patient to monitor the chest compression parameters, the condition of fracture or sternal collapse can be well recorded and evaluated. As shown in fig. 7, which shows a waveform of depth change of sternal collapse during compression, the thorax of the compressed subject 6 can be rebounded to the initial position (the position corresponding to time 0) after each compression in the early stage of compression; however, as the sternal collapse occurs, the thorax of the subject 6 gradually fails to return to the initial position, and at this time, the valleys in the waveform diagram of depth change gradually deviate from the baseline, and we record the deviation of the baseline as D (as shown in fig. 7), and the D value is the sternal collapse amount.
There is a difference between the sternal collapse amount D shown in fig. 7 and the compression retention value R shown in fig. 6. The D value is a position at which the thorax of the compressed subject 6 is returned to the original position after the thorax is completely released after chest compression has been performed for a while, and is a difference in depth between the chest compression and the initial position. The R-value is the depth of residence that results from incomplete release, since the thorax has not been completely released in a single chest compression. Therefore, the D value is calculated based on the average position of the valleys from the baseline within a certain interval as shown in FIG. 7.
Fig. 8 shows another typical attachment method of the one-dimensional linear shape sensor 11, in which the one-dimensional linear shape sensor 11 passes through a chest compression point and a straight line (the heart position shown in fig. 8) passing through the apex (located in the left ventricle). Because the nature of chest compression is to cause the heart to produce compression by external pressure to produce cardiac output, the key to producing cardiac output is to compress the blood in the left ventricle to produce pumping; thus, the fit shown in fig. 8 facilitates obtaining more accurate chest compression parameters during measurement.
Referring to fig. 9, a typical fitting method is shown when the shape sensor is configured as a two-dimensional planar shape sensor 12, and the two-dimensional planar shape sensor 12 is configured to be fitted to a chest compression point 61 of the object 6 to be compressed and to cover the thorax of the object 6 to be compressed, so that the two-dimensional planar shape sensor 12 can be deformed according to the change of the shape of the thorax of the object 6 to be compressed when chest compression is performed on the object 6 to be compressed.
Fig. 10 shows a function image obtained by mapping the shape of the two-dimensional planar shape sensor 12 in the embodiment shown in fig. 9 to a spatial rectangular coordinate (or other spatial coordinate system, such as a spherical coordinate system). Wherein, the curved surface S0As an initial function image of the two-dimensional planar shape sensor 12, a curved surface StWhich is a real-time function image of the two-dimensional planar shape sensor 12.
In the rectangular plane coordinate system, the curve S0The surface S being a uniquely defined functional image0The shape of the thorax before compression (when the compression depth is 0) is shown. When the compression is performed, the shape of the thorax changes at any time t, and the function of the curve created by the two-dimensional planar shape sensor 12 changes in real time, as shown by the curved surface S in fig. 4t. In the rectangular space coordinate system, a curved surface S is calculated0And StThe length of all common normal lines in the chest compression process is represented by the maximum common normal line length (as shown in fig. 10H) to represent the real-time compression depth (compression depth at time t) in the chest compression process, and the maximum common normal line length value is the deepest depth of chest subsidence of chest external compression at time t. And establishing a depth change oscillogram based on the real-time compression depth, and calculating to obtain related external chest compression parameters.
In other embodiments, the pressing parameters may also be calculated by establishing a function image according to the shape of a cross section of the two-dimensional planar shape sensor 12, such as a B-B cross section or a C-C cross section in fig. 9, where the function image is similar to fig. 5, and the detailed calculation method is not repeated.
In current clinical practice, the meaning of the compression depth is that when a predetermined range (5-6 cm) is reached, the heart, in particular the left ventricle, of the subject 6 to be compressed can be squeezed relatively safely and effectively, resulting in a cardiac output. However, the compression depth is only used to estimate the degree of heart compression in the thorax from the linear dimension in the normal direction of the thoracic surface or to make a request, but from the mechanism of chest compression, if the amount of heart compression is measured from more dimensions, the degree of heart compression can be better reflected. The shape sensor of the present invention can be used to better assess the amount of chest compression in more dimensions.
For example, when the pressing parameters are measured using the one-dimensional linear shape sensor 11, a function image as shown in fig. 5 may be created from the initial function image (curve C) of the one-dimensional linear shape sensor 110) With real-time function image (curve C)t) The real-time compression area amount in the chest compression process is determined according to the area defined by the area, and the real-time compression area amount represents the area compression amount of the thorax of the object 6 to be compressed on a certain section at a certain moment in the chest compression process, so that the degree of the chest compression can be more accurately represented by replacing the real-time compression depth with the real-time compression area amount. An area change waveform chart similar to the depth change waveform chart can be established according to the real-time compression area amount at each moment, and the compression parameters in the chest compression process can be calculated according to the area change waveform chart.
For another example, when the pressing parameters are measured by the two-dimensional planar shape sensor 12, a function image as shown in fig. 10 may be created, and an initial function image (curved surface S) from the two-dimensional planar shape sensor 12 may be used0) With real-time function image (curved surface S)t) The real-time compression volume amount during chest compression is determined by the volume defined in (A) to (B), and the real-time compression volume amount represents the volume compression amount generated by the thorax of the object 6 to be compressed at a certain moment during chest compression in real timeThe volume of compression instead of the real-time compression depth also more accurately characterizes the degree to which the thorax is compressed. According to the real-time compression volume at each moment, a volume change waveform similar to the depth change waveform can be established, and the compression parameters in the chest compression process can be calculated according to the volume change waveform.
When the pressing parameters are measured by the two-dimensional planar shape sensor 12, an initial function image (curved surface S) passing through the two-dimensional planar shape sensor 12 may be displayed on the function image shown in fig. 100) An initial function image (curved surface S) perpendicular to the two-dimensional planar shape sensor 12 is formed at a point corresponding to the external chest compression point 610) And a section of the real-time function image (curved surface St), and determining the real-time compression area amount in the chest compression process according to the area defined on the section by the initial function image and the real-time function image. An area change waveform chart similar to the depth change waveform chart can be established according to the real-time compression area amount at each moment, and the compression parameters in the chest compression process can be calculated according to the area change waveform chart.
Defibrillation is a necessary treatment means in the cardiopulmonary resuscitation process, and defibrillation and chest compression are generally alternately implemented in AED defibrillation application, therefore, the invention also provides a defibrillation electrode assembly, which comprises a first electrode plate 71, a second electrode plate 72, a lead cable 8 and the chest compression parameter measuring device.
Referring to fig. 11, a defibrillation electrode assembly according to an embodiment of the present invention is shown, in which the lead cables 8 of the defibrillation electrode assembly include a first branch cable 81, a second branch cable 82, and a third branch cable 83 connected to the first electrode pad 71, the second electrode pad 72, and the chest compression parameter measuring device, respectively, and the first branch cable 81, the second branch cable 82, and the third branch cable 83 are integrated with a plug 85 for interfacing with a defibrillation device through a branch connector 84, and the plug 85 is configured to interface with a host of the defibrillation device. The aforementioned defibrillation apparatus is not limited to an automatic external defibrillator, and the defibrillation electrode assembly can be applied to all apparatuses such as defibrillators requiring the use of defibrillation electrode pads.
Referring to fig. 12, a defibrillation electrode assembly according to another embodiment of the present invention is shown, in which the first electrode pad 71, the second electrode pad 72 and the external chest compression parameter measuring device are prefabricated in a specific positional relationship, so that the first electrode pad 71, the second electrode pad 72 and the external chest compression parameter measuring device can be attached to the predetermined portion of the body of the object 6 to be compressed more quickly in clinical use, and the structure of the lead cable 8 is simpler.
Referring to fig. 13, the present invention further provides an automatic external defibrillator, which includes a main defibrillation unit 9, and the aforementioned defibrillation electrode assembly, wherein the defibrillation electrode assembly is configured to be connected to the main defibrillation unit 9 to control the defibrillation electrode assembly by the main defibrillation unit 9. FIG. 14 illustrates one application scenario of the automated external defibrillator on the human body.
In summary, the method and the device for measuring chest compression parameters provided by the invention have the following advantages:
1. the thoracic shape of a pressed object in the external chest pressing process can be accurately reflected in real time;
2. the pressing parameters such as pressing depth, pressing frequency, pressing retention depth, pressing interruption duration and the like can be accurately obtained in real time;
3. the sternum collapse amount of the pressed object can be calculated to evaluate the fracture degree of the pressed object;
4. the volume of the chest compression of the object to be compressed or the volume of the chest compression on a certain section can be calculated in real time, so that the chest compression degree of the object to be compressed can be reflected more accurately;
5. the device is not easily influenced by the environment, can be applied to the environment with acceleration, such as the bumpy environment of an airplane, an ambulance and the like, and can improve the measurement precision;
6. the second mode can be used in the scenes such as a soft bed and the like to avoid interference;
7. the measurement can be completed only by configuring the shape sensor, and complex matching operation of a plurality of parts is not needed;
8. the device for measuring the chest compression parameters can be easily configured to other devices as an auxiliary device for auxiliary monitoring of chest compression.
It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative embodiments, and that the present invention may be embodied in other specific forms without departing from the spirit or essential attributes thereof. The present embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein.
Furthermore, it should be understood that although the present description refers to embodiments, not every embodiment may contain only a single embodiment, and such description is for clarity only, and those skilled in the art should integrate the description, and the embodiments may be combined as appropriate to form other embodiments understood by those skilled in the art.

Claims (28)

1. A method for measuring chest compression parameters is characterized by comprising the following steps:
s1: fitting a shape sensor on the thorax of the compressed object, wherein the shape sensor is configured to generate corresponding deformation according to the shape change of the thorax of the compressed object during the compression process;
s2: acquiring shape data of the shape sensor;
s3: establishing a function image corresponding to the shape of the shape sensor in a coordinate system according to the shape data of the shape sensor, and calculating chest compression parameters according to the function image;
wherein the function images include an initial function image corresponding to an initial shape of the shape sensor prior to performing chest compressions and a real-time function image corresponding to a real-time shape of the shape sensor during chest compressions.
2. The method for measuring parameters of chest compressions as claimed in claim 1, wherein said step S3 further comprises:
and calculating the maximum common normal line length between the initial function image and the real-time function image, and representing the real-time compression depth in the chest compression process by using the maximum common normal line length.
3. The method for measuring parameters of chest compressions as claimed in claim 2, wherein said step S3 further comprises:
and establishing a depth change oscillogram of the compression depth changing along with time in the chest compression process according to the real-time compression depth.
4. The method of claim 3, wherein the depth of compressions during chest compressions is determined from the depth variation waveform map.
5. The method of claim 3, wherein the frequency of compressions during chest compressions is determined from the depth variation waveform map.
6. A method of measuring chest compression parameters according to claim 3, wherein the duration of the compression interruption during chest compression is determined from the depth-varying waveform map.
7. The method of claim 3, wherein the depth of compression dwell during chest compression is determined from the depth variation waveform map.
8. The method of claim 3, wherein the amount of sternal collapse of a subject being compressed during chest compression is determined from the depth-variation waveform map.
9. The method of claim 1, wherein the shape sensor is a one-dimensional linear shape sensor configured to be attached to a chest compression point of a subject to be compressed.
10. The method of claim 9, wherein the coordinate system is a planar rectangular coordinate system configured to originate from an end point or a midpoint of the initial function image.
11. The method of claim 10, wherein the real-time volume of chest compressions is determined based on the area defined between the initial function image and the real-time function image of the one-dimensional linear shape sensor in the rectangular planar coordinate system.
12. The method of claim 1, wherein the shape sensor is a two-dimensional planar shape sensor configured to be attached to a chest compression point of a subject to be compressed.
13. The method of claim 12, wherein the coordinate system is a spatial rectangular coordinate system.
14. The method of claim 13, wherein the real-time volume of compressions during chest compression is determined from a volume defined between the initial function image and the real-time function image of the two-dimensional planar shape sensor in the spatial rectangular coordinate system.
15. The method of claim 14, wherein a waveform of the volume change of the volume of compressions over time during chest compressions is created and the compression parameters during chest compressions are determined from the waveform of the volume change.
16. The method of claim 13, wherein a cross section perpendicular to the initial function image and the real-time function image of the two-dimensional planar shape sensor is formed at a point on the initial function image of the two-dimensional planar shape sensor corresponding to the chest compression point in the rectangular spatial coordinate system, and the real-time compression area amount during chest compression is determined according to the area defined by the cross section of the initial function image and the real-time function image.
17. The method of claim 11 or 16, wherein an area change waveform of the amount of the compression area over time during the chest compression is created, and the compression parameter during the chest compression is determined based on the area change waveform.
18. An external chest compression parameter measurement device, comprising:
a shape sensor for monitoring changes in the shape of the thorax of a subject being compressed;
the processor is used for acquiring shape data of the shape sensor, establishing a function image corresponding to the shape of the shape sensor in a coordinate system according to the shape data, and obtaining chest compression parameters based on the function image;
wherein the function images include an initial function image corresponding to an initial shape of the shape sensor prior to performing chest compressions and a real-time function image corresponding to a real-time shape of the shape sensor during chest compressions.
19. The chest compression parameter measurement device of claim 18, wherein the shape sensor is a one-dimensional linear shape sensor or a two-dimensional planar shape sensor.
20. The chest compression parameter measurement device of claim 19, wherein the shape sensor is provided with a pad for placement of the palm of the compression stroke practitioner.
21. The chest compression parameter measurement device of claim 20, wherein the center of the pad is provided with a compression portion for aligning with a chest compression point of a subject being compressed when performing chest compressions, the shape sensor being configured to pass by the compression portion.
22. The chest compression parameter measurement device of claim 21, wherein a sticker is provided on the back side of the shape sensor.
23. The chest compression parameter measurement device of claim 18, further comprising a data/charging interface coupled to the processor.
24. The chest compression parameter measurement device of claim 23, further comprising a display unit coupled to the processor, the display unit configured to display chest compression parameters processed by the processor.
25. A defibrillation electrode assembly, comprising:
a first electrode sheet;
a second electrode sheet;
the chest compression parameter measurement device of any one of claims 18-24;
and the lead cable is connected to the first electrode plate, the second electrode plate and the chest compression parameter measuring device.
26. The defibrillation electrode assembly of claim 25, wherein the lead cables include first, second, and third shunt cables connected to the first and second electrode pads and the chest compression parameter measurement device, respectively.
27. The defibrillation electrode assembly of claim 26, wherein the first, second, and third breakout cables are integrated by a breakout head on a plug for interfacing with a defibrillation device.
28. An automatic external defibrillator, comprising:
a defibrillation host;
the defibrillation electrode assembly of claim 25, configured to be connectable to the defibrillation host.
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