WO2015189275A1

WO2015189275A1 - Device for assisting rescue staff in performing a cardiopulmonary resuscitation

Info

Publication number: WO2015189275A1
Application number: PCT/EP2015/062949
Authority: WO
Inventors: Martial Desiré Fotso; Ziad Mabrouk; Gero VON WAGNER
Original assignee: Metrax Gmbh
Priority date: 2014-06-11
Filing date: 2015-06-10
Publication date: 2015-12-17
Also published as: DE102014108197A1

Abstract

The invention relates to a device for assisting rescue staff in performing a cardiopulmonary resuscitation, comprising a monitoring apparatus for the cardiac massage, which has at least one sensor unit (1) for application of pressure and one processing device (2) for sensor signals fed thereto. Advantages for the design and function emerge by virtue of the fact that the sensor unit (1) comprises at least one strain sensor element (10) made of a material that changes the electrical properties thereof when strained and it is provided with a holding device by means of which the at least one strain sensor element (10) is fixable in relation to the chest of the person to be saved in such a way that the at least one strain sensor element (10) is deformed synchronously with the application of pressure and the sensor signal is formed thereby.

Description

A device for assisting rescue personnel in performing cardiopulmonary resuscitation

The invention relates to a device for supporting the rescue personnel, such as trained professionals or z. As a layman as a first responder, in carrying out a cardiopulmonary resuscitation with a monitoring device for cardiac massage, which has at least one sensor unit for the pressure actuation and a processing device for their supplied sensor signals. A device of this kind is disclosed in US 2008/0171311 A1. In this known device, the performance of a cardiopulmonary resuscitation is monitored by means of a monitoring device for cardiac massage, which has a sensor unit and a processing unit for the sensor signals. The sensor unit comprises sensors for detecting various parameters of cardiac pressure massage and patient information. The information can be the print depth, Compression rate, pressure angle, patient heart rate, hand position, body temperature, patient's body characteristics, and patient oxygen concentration include distinguishing pressure sensors, position sensors, physiologic sensors, and motion sensors. The pressure sensors, which may be configured to detect the rate of compression and provide information about the cardiac massage for the rescuer, are mounted either in a rescuer's glove or on the patient's body. The pressure sensors are based, for example, on the piezoelectric effect, wherein the electrical resistance of the pressure sensor changes, or on capacitive properties. One possible embodiment of the pressure sensor includes sensor components that may be embedded in the article itself, such as woven conductive or non-conductive yarns whose capacitance changes upon application of compression. Another type of pressure sensor is called a gauge. Velcro (Registered Trade Mark) ribbons are also mentioned in connection with sensors that can be positioned on the patient. Specifically, however, it is difficult to obtain the most accurate and reliable detection signals in the printing operation.

Another device for assisting the rescuer in performing cardiopulmonary resuscitation is shown in US 2008/0312565 A1. This device comprises a so-called CPR sensor (cardiopulmonary resuscitation sensor), which has a thin, flexible carrier on which one or more sensor arrays, a power source, an output interface and a processor or analog circuit are applied. The sensor arrays are designed as so-called MEMS (microelectromechanical systems). The flexible substrate may be made stretchable. By means of the sensor arrays, pressure parameters, namely the pressure depth, pressure force, pressure frequency and pressure acceleration, can be detected in order to determine on the basis of the rescue person (helper) a return value. avoiding the success of the performed cardiac massage. However, a reliable determination of pressure parameters in cardiac massage is difficult and still associated with relatively large uncertainties, but on the other hand important for the success of the resuscitation measures.

Various other devices for assisting the rescue personnel in carrying out cardiopulmonary resuscitation are shown, for example, in US 2012/0089055 A1, EP 1 491 176 B1, WO 2013/044226 A6 and DE 10 2007 014 136 A1.

In the case of cardiac massage, exceeding a minimum force and a minimum compression depth in the case of pressure actuation are essential parameters, and also an evaluation of the direction of the force effect in cardiac massage is essential since it provides valuable clues for the assessment of the efficiency of CPR. Corresponding feedback provides the helper with a check on how well he succeeds in initiating the force applied via the palm of his hand vertically to the thorax of the patient during the pressure actuation. Therefore, it is also desirable to determine the angle at which the force is applied to the pressure point during cardiac massage. Correct discharge of the chest is also one of the important cardiopulmonary resuscitation parameters (CPR parameters or CPR parameters) in cardiac pressure management, in order to ensure that the heart is sufficiently filled with blood and subsequently sufficient ejection volume can be achieved. Therefore, the detection of correct chest relief during the pressure massage is a quality feature of cardiopulmonary resuscitation. Also, the detection of a phase in which the Hands no longer exert pressure (so-called hands-off time), in which therefore no cardiac massage takes place, is a quality feature of cardiopulmonary resuscitation. Since this time must be kept as short as possible, as accurate as possible detection of the beginning of the hands-off time is also important.

It is an object of the present invention to provide a device for assisting rescue personnel to perform cardiopulmonary resuscitation to achieve increased cardiopulmonary resuscitation efficiency.

This object is achieved with the features of claim 1. It is provided that the sensor unit comprises at least one strain sensor element from a material which changes its electrical properties upon elongation and is provided with a holding device, by means of which the at least one strain sensor element can be fixed in relation to the breast of the person to be rescued in such a way that the at least one strain sensor element is deformed synchronously with the pressure operation and thereby the sensor signal is formed.

With these measures, advantageous detection possibilities are offered when performing a cardiac pressure massage, wherein the sensor unit with the at least one strain sensor element, in particular at least one elastomer sensor element, enables advantageous signal detection. There are also advantageous customization options for different requirements. An advantageous mode of action is obtained in that the at least one strain sensor element can be fixed in relation to the breast such that it is stretched or relieved synchronously with the pressure actuation. Hands no longer exert pressure (so-called hands-off time), in which therefore no cardiac massage takes place, is a quality feature of cardiopulmonary resuscitation. Since this time must be kept as short as possible, as accurate as possible detection of the beginning of the hands-off time is also important.

With these measures, advantageous detection possibilities are offered when performing a cardiac pressure massage, wherein the sensor unit with the at least one strain sensor element, in particular at least one elastomer sensor element, enables advantageous signal detection. There are also advantageous customization options for different requirements. An advantageous mode of action is obtained in that the at least one strain sensor element can be fixed in relation to the breast such that it is stretched or relieved synchronously with the pressure actuation. Another advantageous embodiment for the signal detection is that the strain sensor element is mechanically biased in its initial position.

To a reliable function, the measures contribute to the fact that the sensor unit generates electrical energy even during the pressure actuation and is ready for operation without additional power supply or that the sensor unit is supplied from the outside via high-frequency energy pulse packets.

Advantageous embodiments further consist in that the sensor unit is designed as a pressure sensor, force sensor, position sensor or angle sensor. For example, the function of an angle sensor can be used to monitor that the helper is using his power efficiently.

An embodiment which is advantageous for the function is that the deformation of the at least one strain sensor element causes a capacitance change, by which the sensor signal is formed.

For the structure and the function, the measures are also advantageous in that the at least one strain sensor element is formed from an elastomeric film and coated on one or both sides with flexible electrodes.

Various advantageous embodiments of the device are obtained in that the processing device for determining the extent of the pressure actuation from the strength, the frequency and / or the phase of the sensor signal or the change of at least one of these sizes is formed. Further advantageous measures for the construction and the function of the device are that the processing device for determining the frequency of the pressure actuation from the repetition of the same strength, frequency and / or phase of the sensor signal is formed.

Further advantageous design variants result from the fact that the extent of the pressure actuation comprises the pressure depth, the pressure force, the speed of the pressing and / or unloading, the pause time or a combination of at least two of these parameters.

Embodiments that are advantageous for the function and the construction also result from the fact that the holding device has at least one holding part and two fixing units attached or attachable to the respective strain sensor element, between which an extensible section of the relevant strain sensor element extends Strain sensor element is attached by means of a fixing means to the associated holding part and with the aid of the other fixing means to a in the printing operation relative to the holding part of this away and during unloading to this moving body. It contributes to an advantageous function in that the moving body is an operating part acting on the chest of the person to be rescued in the pressure actuation by the manual force.

Various further advantageous embodiment variants result from the fact that the holding part is a fastening piece attached to the breast or a holding member attached to a supporting body. Also, the measures that the processing device for determining the pressure depth depending on the changing in the pressure actuation angle between the direction extending in the vertical direction of gravity and the extension of the strain sensor element is formed at a known or detected length of the same, advantageously contribute to the function of the device. In this case, a constant horizontal distance between the fixing points of the strain sensor element can also be included.

Differentiated assessment options for the execution of the pressure actuation result from the fact that the sensor unit has a plurality of strain sensor elements and a plurality of holding parts associated therewith or a holding part common thereto and that all strain sensor elements are attached to the moving body at a distance from the holding part or parts. A further advantageous feature for the construction and the function is that the common holding part is designed as a retaining ring.

For an advantageous signal detection, the measures contribute to the fact that a sensor arrangement of a surface (two-dimensional, in a plane) related Dehnungssensorelement or several strain sensor elements is extended as a sensor array in an xy direction and along its peripheral edge by means of a fixing unit continuously or on individual fixing points is attached to the then circumferentially formed holding part and that the moving body is attached by means of the other fixing unit in the central region of the sensor arrangement. For a differentiated evaluation, the measures are advantageous in that the capacitances of the individual strain sensor elements of the sensor arrangement are detected by the processing device by the sensor signals and included in the evaluation.

The reliability of the signal evaluation can be increased by configuring the sensor unit such that at least one strain sensor element can be placed around the breast transversely to the longitudinal extent of the person to be rescued and the respiratory muscles of the chest changed by a change in strain of the at least one strain sensor element during respiration by the processing device can be detected and included in the evaluation for determining the pressure depth and / or the pressure frequency. As far as the activity of the respiratory muscles is recorded, conclusions about the effectiveness of the ventilation can be drawn. In general, the circumferential change of the rib cage can also be determined in this arrangement and correlated with the pressure depth.

An advantageous for the pressure actuation by the helper and the signal derivative training is that the sensor unit is provided at least in the region of the at least one strain sensor element with an insulating protective layer.

Various advantageous output signals for user guidance and / or control of a defibrillator device are obtained by virtue of the fact that at least one threshold value is predetermined in the processing device, with which the sensor signal is compared, and by means of the processing device from the comparison result the start of printing, a minimum pressure depth , a maximum pressure depth and / or a complete relief in the printing operation can be determined / are. A further advantageous embodiment for the structure and the function results from the fact that the sensor unit has at least one switching stage for specifying at least one threshold value for the start of printing, a minimum pressure depth, a maximum pressure depth and / or a complete relief in the pressure actuation.

A further advantageous embodiment for the function and signal generation is that at least one strain sensor element is received in a receiving unit of the sensor unit under bias and that the receiving unit is designed such that the at least one strain sensor element is relieved when pressurized.

The measures contribute to a reliable signal evaluation in that it comprises at least one further detection unit for recording the respiratory activity, the respiratory gases, the blood flow, the oxygen saturation or the carbon dioxide accumulation of the blood, the volume pulse and / or a body impedance of the person to be rescued is formed, and that the detection signals of the at least one further detection unit of the processing device during operation can be fed and evaluated by this.

It is advantageously provided for the user guidance that the device has a display device controlled by the processing device with an optical display unit and / or acoustic output unit in order to inform the rescue person performing the cardiac pressure mask via the pressure actuation. Further, in the context of cardiopulmonary resuscitation, the measures are advantageous in that the device comprises a defibrillator device that is signaled or brought into signal communication with the processing device to tune the initiation of a defibrillation shock to cardiac massage.

It is advantageous for the efficiency of the resuscitation measures that a trigger time for the triggering of a defibrillation shock by means of the processing device is tuned to the sensor signal during the pressure actuation, that the shock triggering takes place when the thorax is maximally compressed or maximally relieved during a pressure cycle.

Advantages for the construction and the operation are obtained by the fact that at least one strain sensor element is integrated in at least one defibrillation electrode.

For a reliable signal evaluation, the measures contribute that the device has a selection device for a setting on the body height, the body weight, the age group and / or the sex of the person to be rescued, the selected setting being included in the evaluation by the processing device becomes.

The reliability of the evaluation can also be assisted by providing it with an additional pressure detection unit comprising a fluid enclosed in a closed volume. As a result, z. B. the pressure relief can be detected advantageous. Various advantageous design variants are that the at least one strain sensor element is designed as an elastomeric film, piezoelectric film, strain gauges or potentiometer film. The invention will be explained in more detail by means of embodiments with reference to the drawings. Show it:

1 is a schematic view of a device for assisting the rescue personnel in performing a cardiopulmonary resuscitation, which is assigned to a person to be rescued,

2 shows an exemplary embodiment of a strain sensor element that can be used in the device according to FIG. 1, in a schematic view,

3 shows an exemplary embodiment of a sensor unit which can be used in the apparatus according to FIG. 1,

FIGS. 4A and 4B

two further embodiments of the device according to

1 usable sensor units,

Fig. 5 shows another embodiment of a rescue at one

Person connected device for assisting the rescuer in performing cardiopulmonary resuscitation comprising a defibrillator device, a further embodiment of a connected to a person to be rescued device to assist a rescuer in performing a cardiopulmonary resuscitation and a graphical representation of the procedure for determining a pressure depth, a schematic representation of another embodiment of a sensor unit with assignment to a person to be rescued, wherein a flat strain sensor element which can be stretched in an xy plane (horizontal plane) is used, a schematic illustration of a further exemplary embodiment of a sensor unit with a plurality of strain sensor elements arranged in different directions of the xy plane, a further exemplary embodiment for a sensor unit comprising Another embodiment for a person to be rescued associated device for supporting the rescuer at d he performing a cardiopulmonary resuscitation and a sensor unit used in plan view and front view, a further embodiment of a mounted on a person to be rescued sensor unit, wherein two strain sensor elements are arranged transversely over the chest, in a schematic view, another embodiment of a sensor unit, which is arranged on an insulating mat and a display unit is assigned, another Exemplary embodiment of a sensor unit applied to a person to be rescued, another exemplary embodiment of a device connected to a person to be rescued to assist the rescuer in carrying out a cardiopulmonary resuscitation and two different views for arranging a sensor unit of the device in the thoracic region rescuing person, Fig. 13 shows another embodiment of a to be rescued

Person connected device to assist the rescuer in performing a cardiopulmonary resuscitation and a separate view of the sensor unit used,

14 shows an exemplary embodiment of a display unit which can be used in the apparatus in schematic view and FIG Figs. 15A, 15B and 15C

Various display situations of a portion of the display unit of FIG. 14 in the implementation of a cardiac pressure massage.

Fig. 1 shows a device for assisting the rescue personnel in carrying out a cardiopulmonary resuscitation (CPR) with the arrangement of a sensor unit 1 on the chest of a patient. The sensor unit 1 is connected via a connection cable 21 for data transmission of sensor signals to a processing device 2, which in the embodiment shown with a defibrillator unit 20, such. B. an automatic external defibrillator device (AED), is brought together in a housing thereof. The processing device 2 or parts thereof may instead be spatially z. B. in the region of the sensor unit 1, in particular of the actuating part 3 may be arranged.

Sensor signals detected by the sensor unit 1 during the pressure massage are supplied to the processing device 2 and processed there and evaluated to provide suitable output signals for informing the pressure operator operating a helper about the quality of the cardiac massage and / or triggering a defibrillation shock via the defibrillator unit 20 depending on the cardiac massage.

Via the connection cable 21, instead of or in addition to the data transmission, a power supply of the sensor unit 1 can also be made. The device may be designed for bidirectional data transmission in order, for example, to control a display unit arranged in the region of the sensor unit 1 or integrated into it for the information of the helper. The information output can optically via the display unit and / or acoustically, wherein the electro-acoustic transducer for the sound output (speech and / or other acoustic signals) in the region of the sensor unit 1 or z. B. is arranged in the region of the defibrillator 20.

In an alternative embodiment, the data transmission can be carried out wirelessly, wherein the device can also be designed for unidirectional signal or data transmission between the sensor unit 1 and the processing device 2 or for bidirectional transmission.

In a further embodiment variant, an energy source for supplying the sensor unit 1 may be arranged in the region thereof, such. As a battery, an accumulator or other energy storage, such as a capacitor or an inductively operating unit. Since the sensor unit 1 operates advantageously with low energy consumption, it can also be equipped or connected to a power generation unit which, for. B. converts the energy generated by the pressure actuation into electrical energy and provides for the supply (energy harvesting). Particularly in the case of a wireless connection between the sensor unit and the processing device 2, energy coupling via high-frequency pulse packets is also a possible design variant.

The sensor unit 1 has at least one strain sensor element 10, which is designed in the embodiment of FIG. 1 as a film strip which extends between an actuating part 3 and a fixing piece 11 on the chest of the person to be rescued in the longitudinal direction. The operating member 3 serves as an intermediate member between the pressure-exerting hand of the helper and the pressure-receiving point of the chest, which is for efficient pressure over the sternum. The actuating part 3 forms during the cardiac massage a moving th body and is advantageous as a hand-adapted print edition, z. B. formed as a pressure pad. The attachment piece 11 is z. B. in the region of the neck or collarbone on the chest fixed by gluing and the strain sensor element 10 is fixed with its end side portions on the one hand to the actuating part 3 and on the other hand to the attachment piece 11, such. B. by means of an adhesive bond, welded joint, by sewing or a stable Velcro connection, clip connection, clamp connection or the like .. By the vertical (in the z-direction, with respect to the body from front to back or perpendicular to the plane in Fig. 1) at the pressure exerting breast movement in the region of the pressure point, the strain sensor element 10 is stretched and generates an electrical signal, for example by a change in capacitance of the strain sensor element 10th

The change in capacitance can be detected, for example, by means of a change in the amplitude, the frequency and / or the phase of an alternating voltage applied to the strain sensor element 10 which is expressed in the sensor signal. The strain sensor element 10 is advantageous z. B. made of an elastomeric film. The elastomeric film is provided on one or both sides with electrodes, which are preferably formed as a thin, highly flexible layer. Between the electrodes, a voltage signal changing as a result of stretching and the change in capacitance caused thereby can be tapped in order to form the sensor signal. The region of the elastomeric film forms a dielectric.

Alternatively, the strain sensor element 10 may be formed as a piezo film, strain gauge film or potentiometer film, which can also be used to generate voltage signals which change during deformation, in particular also strain. FIG. 2 shows an exemplary embodiment of a strip-shaped strain sensor element 10, for example made of elastomer material, with a sensor section 100 in the middle region, which extends between two end-side side sections 101. The sensor section 100 forms the stretch-responsive region for generating the sensor signal, while the side sections 101 are for attachment to respective attachment locations whose pitch changes during cardiac massage in synchronism with the push operation and thus results in a change in the sensor signal is evaluated by means of the processing device 2. In a further exemplary embodiment of a sensor unit 1 shown in FIG. 3, a fastening device 4 for attaching the sensor unit 1 to the breast of a person to be rescued is present, which can be fixed in the region of the collarbone of the person to be rescued by gluing large-scale holding part 40 at the one end of the strain sensor element 10. The other end region of the strain sensor element 10 is connected by means of a connecting means 41 to the actuating part 3 in the form of a cushion-like pressure pad 30. The pressure pad 30 is in turn provided on its underside with an adhesive surface 31 in order to fix it in the region of the pressure point on the chest. Before use, the adhesive surfaces of the holding part 40 and the pressure pad 30 are preferably covered with a peelable protective film. The sensor unit 1, if necessary, including the holding part 40 or the like. Or even the strain sensor element 10 may be configured for single or multiple use.

In the further exemplary embodiment of a sensor unit 1 shown in FIG. 4A, a strain sensor element 10 is likewise fixable by a holding part 40 fixable in the upper area of the breast of the person to be rescued and an actuating part 3 which can be arranged in the area of the pressure point, in particular a pressure pad which can also be fixed by gluing 30, positioned and with its end-side Side sections on the holding part 40 on the one hand and the fastening device 3 on the other hand set. Adjoining the pressure pad 30 to the upper chest area is a display unit 5 which is arranged on a flat carrier associated with the actuating part 3. The helper can thus be displayed advantageously in his field of view information about the quality of the cardiac massage. In the lower chest area, an arrow-type tongue-like grip portion is attached to pull the sensor unit 1 with the strain sensor element 10 when mounted in the correct position on the chest. The correct positioning of the sensor unit 1 on the breast is pictorially shown on the upper side of the holding part 40 in the manner of a pictogram.

In the embodiment shown in FIG. 4B, the display unit 5 is integrated into the holding part 40 in comparison to FIG. 4A, with which the displayed information during the cardiac pressure massage can also be easily recognized by the rescue person.

5 shows the arrangement of a sensor unit 1 with a similar construction as in FIGS. 4A and 4B when arranged on the chest of a person to be rescued and with a connection to a processing device 2 in combination with a defibrillator unit 20. The processing device 2 and the defibrillator unit 20 have a common, easy to handle housing. The defibrillator unit 20 is part of a defibrillator device which comprises on the chest of the person to be rescued at appropriate locations defibrillator electrodes 22 which are connected via relevant connection cable 21 to the defibrillator unit 20 for acting on the rescued person with a defibrillation shock. The defibrillator electrodes 22 can additionally be used to derive measurement signals in order to adequately control the defibrillation shock. Since the processing device 2 is placed in electrical communication with the defibrillator unit 20, the initiation of the defibrillation shock be optimally adapted to the chest compressions, in order to bring about a suitable time of the shock release and an adapted control of the shock energy in the context of the heart-lung resuscitation measures. For example, the shock triggering may occur at a moment when the thorax is maximally compressed, since in this situation the lung is also compressed and the defibrillation current can optimally flow through the heart without the need for applying too much energy. Alternatively, the moment of maximum or near maximum relaxation may be favorable for the choice of shock triggering. Conversely, any information received from the defibrillator electrodes 22 may be included in the assessment of cardiac massage efficiency and taken into account in the information displayed to the assistant.

In a further embodiment shown in FIGS. 6A and 6B, the sensor unit 1 has a support device 12 supported in the shoulder region of the person to be rescued with an upwardly projecting columnar support body which can be telescopically extendible and at its upper end portion a strain sensor element 10 by means of a Holding parts 40 is fixed. The other end portion of the strain sensor element 10 is in turn fixed to the actuating part 3. As can be seen from FIG. 6B, the pressure depth can be determined from the difference between a vertical end position H2 at maximum pressure and an initial position H1 at a defined start of pressure, wherein the starting position is determined from the length L1 present at this time and the angle .phi. Direction of gravity) and the end position H2 from the length L2 present and the angle phi2 of the strain sensor element 10 relative to the vertical. The respective length L1, L2 is given by the strain of the strain sensor element 10 and the respective angle phil, phi2 can z. B. by means an angle detector are detected. As additional information, the known horizontal distance between the fastening points on the holding part 40 and the actuating part 3 can be used. 7A, 7B and 7C show further embodiments of the sensor unit 1. This has in common that they have a two-dimensionally extended in the horizontal XY plane sensor array and thus can also be used to capture parameters that depend on the position and / or motion components in the xy direction are dependent, such. As an inaccurate positioning of the pressure point in the xy plane or deviates from the vertical direction of the pressure force. Since the efficiency of CPR is greatest when the helper initiates the force applied via the palms of the hand perpendicular to the thorax of the person to be rescued, the detection and display of an angular deviation from the vertical for him is an important piece of information provide differential information in the xy-direction dependent sensor signals to more accurately analyze the sensor signals in the processing device 2 for other parameters such as compressive force and pressure depth. In the exemplary embodiments shown in FIGS. 7A, 7B and 7C, an actuating part 3, in particular in the form of a pressure pad 30, is arranged centrally in the region of the strain sensor element 10 or a plurality of strip-like strain sensor elements 2 extending in the xy direction and in the outer space radially spaced therefrom Edge region, a holding part in the form of a circumferential retaining ring 112, to which the ends facing away from the center of the or the strain sensor elements 10 are attached. The sensor unit 1 can be easily positioned with the retaining ring 112 on the chest of the person to be rescued, the central area with the operating part 3 just above the optimum pressure point on the Breast is to be arranged. While FIG. 7A shows an embodiment of the sensor unit 1 with a contiguous expansion sensor element 10 extended flat within the retaining ring 112, in the exemplary embodiment according to FIG. 7B, four strip-shaped strain sensor elements 10 which are oriented at right angles to one another are also located in different numbers between them Operating part 3 and the retaining ring 12 and arranged in the embodiment of FIG. 7C eight strip-shaped strain sensor elements 10 at an angle of 45 ° to each other. Other similar planar arrangements of strain sensor elements 10 in different numbers are possible. By structuring strip-shaped strain sensor elements 10 in two-dimensional arrays, their capacitance can be measured separately via individual electrode fields and thus the differentiation of the deformation or the acting force can be localized.

Also in the case of the further exemplary embodiment of the sensor unit 1 shown in FIG. 8, a plurality of strain sensor elements 10, for example based on elastomer strips, are arranged two-dimensionally in the xy plane. In this case, individual strip-shaped strain sensor elements 10 extend between a centrally arranged fastening device or an actuating part 3 and a surrounding holding part, which is likewise designed as a rigid retaining ring 112 or at least comprises such. The fastening device is in this case formed as a fixed inner body 1 13 or includes such. The strip-shaped strain sensor elements 10 are on the one hand fixed to the fixed inner body 13 and on the other hand to the retaining ring 112, so that they are stretched when applied to the actuating part 3 pressure and thereby effected movement and cause a signal change associated therewith. Advantageously, the strain sensor elements 10 by means of a protective film 102 z. B. covered by a textile or other insulating laminate material. In a further embodiment shown in FIG. 9, two strip-shaped strain sensor elements 10 with their one end portion on the centrally arranged actuating part 3, such. B. a pressure pad 30, extend to the side across the chest and are fixed in the side region of the chest or in the back of the person to be rescued with its other end portion. With this arrangement of the strain sensor elements 10, in particular based on strip-shaped elastomer films, the change in the respiratory muscles of the chest z. B. are detected for determining the compression depth and the compression frequency. The change in the volume of air in the lung during the cardiac pressure massage changes the sensor signal obtained via the strain sensor elements 10, for example as a result of a capacitance change, and the change in the sensor signal is a measure, for example, for the compression depth or compression frequency. Similar arrangements as in FIG. 9 also show the exemplary embodiments of the sensor unit 1 shown in FIGS. 11 and 12. Here, too, two strip-shaped strain sensor elements 10 extend transversely across the breast of the person to be rescued and with their one end section on the central actuating part 3 and fixed with its other end portion on lateral holding parts 40. Furthermore, they are covered with a protective film 102.

10 shows an insulation mat 6, by means of which an assistant is electrically insulated from the body of the person to be rescued so as not to jeopardize it when a defibrillation shock is triggered. This avoids unnecessary waiting times before triggering a defibrillation shock. On the insulation mat 6, a strain sensor element 10 is arranged, which can be positioned with its central region above the pressure point for the cardiac massage. This is done in the cardiac pressure massage stretching of the strain sensor element 10, this is fixed together with the insulation mat 6 at its peripheral edge on the chest of the person to be rescued or provided to the strain sensor element with a retaining ring. The insulation mat 6 also serves as a support for a display unit 5 to inform the assistant of the efficiency of his printing operation. The display unit 5 can be omitted or attached elsewhere. An isolation mat per se can also be used in conjunction with the other embodiments of the device for assisting the rescue personnel disclosed herein. Instead of the insulation mat 6, an insulation pad in the area of the actuating part can also help to prevent the risk of touching the thorax with the hands.

Fig. 13 shows another embodiment of the device for assisting a rescuer in performing cardiopulmonary resuscitation. In this case, an electrode arrangement with two defibrillator electrodes 22 is attached to the sensor unit 1 to be arranged on the breast of the person to be rescued so that it can be positioned in a simple manner on the patient's chest together with the sensor unit 1. The actuating part 3 of the sensor unit 1 is positioned at the pressure point of the person to be rescued and the sensor unit 1 is aligned with the strain sensor elements 10 extending from the actuating part 3 on the one hand downwards and on the other hand upwards in the longitudinal direction of the person to be rescued. The defibrillator electrodes 22 come in the correct position for the defibrillation, by simply being able to be unfolded laterally. In this embodiment, the leads to the defibrillator electrodes 22 can also be routed in the connection cable 21 so that a simple connection with the defibrillator unit 20 and the processing device 2 results when connecting to the person to be rescued. Other sensor units 1, such as. B. such transversely extending strain sensor elements 10 as described above may be implemented as a unit associated with defibrillator electrodes 22. FIG. 14 shows a display unit 5 which can be advantageously used in the case of the aid described above for assisting the rescuer in performing a cardiopulmonary resuscitation. The display unit 5 preferably has self-illuminating or actively backlit or backlit display elements. The display unit comprises two display sections 50, one of which forms a frequency display part 51 for the print frequency and the other a pressure display part for the pressure force or pressure depth. The display unit 5 is advantageously arranged in the field of vision of the helper during cardiac massage in the region of the sensor unit 1, such. For example, Figs. 4A and 4B, described above. Further details on the design of the display unit 5 are in the (not previously published) German patent application no. 10 2013 1 14 565 made. Figures 15A, 15B and 15C show, by way of example, displays of the frequency indicating portion 51 in various situations of cardiac pressure massage.

In the exemplary embodiments described above, in a further embodiment, a selection device may be present for adjustment to the height, the body weight, the age group and / or the gender of the person to be rescued, the selected setting being included in the evaluation by the processing device. The selection device can be configured for manual adjustment via a switch or pushbutton and / or for language selection or for selection via a communication interface to the defibrillation unit 20. For example, a children's mode or baby mode can be selected be. Furthermore, it can be provided that the setting selected by means of the selection device is displayed via the display unit 5 or another display device. When the rescue personnel support device is operated in conjunction with a defibrillator device, a detection signal may be generated during cardiopulmonary resuscitation that suppresses artifacts (CPR artifacts) in the ECG signal caused by CPR, such that the defibrillator device (FIG. AED) in the analysis phase is able to perform a rhythm analysis more quickly. For example, by measuring the CPR artefacts or the disturbance variable via an ECG channel, a signal for suppressing interference can be made available by a feedforward control of the defibrillator unit 20, thus reliably enabling rhythm analysis during cardiopulmonary resuscitation.

In a further embodiment, it may be provided that the strain sensor elements 10 are integrated in the defibrillation electrodes or attached thereto or in or attachable. In the exemplary embodiments described above, various threshold values are furthermore provided, by means of which, by comparison with the current sensor signals or variables derived therefrom, excessive pressurization or too low compression, insufficient relaxation in the pressure relief and / or too high or too low Pressure frequency can be signaled and displayed. Thus, proper chest pressure relief during the cardiac pressure massage is an important CPR parameter to ensure that adequate filling of the heart with blood and, as a result, sufficient ejection volume can be achieved, as stated at the outset. It can It can be assumed that the restorative forces of the thorax achieve complete relief of the chest from a certain minimum force, which the assistant applies directly or indirectly to the pressure point. Furthermore, the detection of the beginning of a loading phase by the pressure force and the detection of a minimum compression depth are important CPR parameters, as explained in the introduction.

The determination of the times for exceeding or falling below the minimum force (detection of a correct discharge or start of a stress phase) can be achieved in various ways by means of the device described. Thus, by means of the sensor unit 1, the zero position of the strain sensor elements 10 or elastomer sensor elements can be determined on the basis of their complete relief or a defined preload. The bias can z. B. advantageously in the above-described sensor unit 1 with the rigidly formed retaining ring 1 12 done. In another embodiment, the strain sensor element 10 or an array of multiple strain sensor elements 10 may be biased in the starting position and relaxed upon pressurization. Such a structure exists z. B. in that the one or more strain sensor elements 10 mounted in a housing formed as an actuating part 3 perpendicular or with a vertical component and z. B. by means of a spring, such as. B. compression spring, are biased in the starting position. Upon pressure on the actuating part 3, the compression spring is compressed and the one or more strain sensor elements 100 or are more or less relaxed and pull together as a result of their elasticity together, whereby a detectable and evaluable capacity change or signal change takes place.

The exceeding or falling short of a minimum force for detecting a correct discharge or the beginning of a load phase can also take place in that a switching element is used, which is structurally integrated into the device, that it is only activated or deactivated when the minimum force is exceeded or fallen short of. For example, the switching element can be realized so that it is activated when the minimum force is exceeded and is deactivated when the minimum force is exceeded (power switch). However, it is also a reverse logic conceivable (off switch).

Constructively, the exceeding or falling below the minimum force can also be detected in other ways, namely:

a switching element is combined with a spring which is compressed in the pressure operation with the minimum force so that the switching element is actuated.

For this purpose, the spring may be integrated by a corresponding receptacle in a pressure plate, so that the switching element can respond even when the force is laterally offset from the spring. - It can be used a prestressed pressure plate which jumps when the minimum force is exceeded in another plastic contour and thereby activates the switching element, falls back falls below the minimum force but in the original contour and thereby deactivates the switching element. It is also possible to use a plurality of switching elements in the aforementioned combinations in order to increase the reliability of the device with regard to the correct detection of the occurrence of the minimum force. This is especially true in the event that the helper does not press centrally on the area designated for the application of the heelballs in the cardiac massage.

A further embodiment variant is that by applying conductive structures on a spherically or cylindrically configured pressure body, a minimum movement (and thus the occurrence of the minimum force) is detected. For this purpose, a film with electrically conductive structures is applied to the pressure body or to a surface-shaped substructure of the sensor unit 1 (for example, in the case of the areal strain of strain sensor elements 10 in a ring which is applied to the thorax). These can be z. B. vapor-deposited or printed metallic. The counterpart is a spherically shaped pressure body, which serves as a hand rest. If the minimum force applied, this is accompanied by a movement of the pressure hull, which then dips into the substructure or film. On the surface of the pressure body contact surfaces are applied, which are short-circuited by conductive structures on the substructure. When falling below the minimum force this electrical connection is released.

A determination of the minimum compression depth can be achieved by the same construction with conductive structures on a spherical or cylindrical pressure body and sub-structure or film. For this purpose, the geometric arrangement of the conductive structures is selected so that the electrical contact is made only when the minimum pressure depth is reached. This arrangement can be realized alone or in addition to an arrangement for detecting the minimum movement. With the same principle, it is also possible to determine the angle of the force on the pressure body. This will tilt according to the direction of the force relative to its mounting point on the film and therefore not make contact with the film as in a vertical force on concentric circles around the mounting point around, but only in some areas. By means of a corresponding configuration of the conductive structures, a contact array can be produced which allows conclusions to be drawn about the angle of the action of force to the vertical. When forming the at least one strain sensor element 10 from one or more piezo foils, an exemplary embodiment is that Various piezo films are arranged in radial alignment in a aufzustbenden on the sternum or sternum in the pressure point film around the pressure point around. The piezo films can be integrated to improve the signal generation in so-called bimorph orientation. In CPR resuscitation, the piezo foils thus arranged are alternately stretched and unloaded, giving an electrical response or signal change proportional to the extent of the strain. This can be used to easily determine the pressure frequency or number of pressurizations. By combining the various signals, it is also possible to determine the pressure depth due to the known geometric arrangement of the piezo-films. In the pauses of the pressure massage, the rib cage movement during ventilation can also be detected, drawing a conclusion on the effectiveness of the ventilation. It is also possible to model the HLW artifact signal and then correct the ECG signal to perform an ECG analysis during CPR resuscitation.

In order to increase the reliability of the evaluation of the sensor signals in the various design variants or to obtain additional statements, the processing device 2 can be supplied with various additional information or additional signals which can be included in the evaluation. Thus, the discharge in the cardiac massage can be measured by the fact that a fluid-filled chamber is provided or connected in the region of the pressurization, and the change in pressure in the closed volume, such as. As a gas-filled pad is detected.

As further additional information for the assessment of the efficiency of cardiopulmonary resuscitation measures, signals of a blood flow sensor, an impedance measuring device, an oximetry measuring device (Sp02-, rS02 and / or ETCO2 measurement) and / or a photoplethysmogram measuring device (PPG) are additionally used in the evaluation in the processing device 2. The device described is easy to use and has low energy consumption. With low construction costs, an efficient cardiac massage is achieved even in a disturbing environment. Especially in connection with defibrillation measures, interruptions are minimized and this also increases the efficiency of the resuscitation measures.

Claims

1. A device for assisting the rescue personnel in carrying out cardiopulmonary resuscitation with a monitoring device for cardiac massage, which has at least one sensor unit (1) for the pressure actuation and a processing device (2) for its supplied sensor signals,

characterized,

in that the sensor unit (1) comprises at least one strain sensor element (10) made of a material which changes its electrical properties during elongation and is provided with a holding device, by means of which the at least one strain sensor element (10) acts in such a way with respect to the breast of the person to be rescued can be fixed, that the at least one strain sensor element (10) is deformed synchronously with the pressure actuation and thereby the sensor signal is formed.

2. Apparatus according to claim 1,

characterized,

in that the at least one strain sensor element (10) can be fixed relative to the breast in such a way that it is stretched or relaxed synchronously with the pressure actuation.

3. Apparatus according to claim 1 or 2,

characterized,

that the strain sensor element (10) is mechanically biased in its initial position. Device according to one of the preceding claims,

characterized,

the sensor unit (1) generates electrical energy even during the pressure actuation and is ready for operation without an additional power supply or that the sensor unit (1) is supplied externally via high-frequency energy pulse packets.

Device according to one of the preceding claims,

characterized,

the sensor unit (1) is designed as a pressure sensor, force sensor, position sensor or angle sensor.

Device according to one of the preceding claims,

characterized,

in that the deformation of the at least one strain sensor element (10) causes a change in capacitance, by which the sensor signal is formed.

Device according to one of the preceding claims,

characterized,

in that the at least one strain sensor element (10) is formed from an elastomer foil and coated on one or both sides with flexible electrodes. Device according to one of the preceding claims,

characterized,

in that the processing device (2) for determining the extent of the pressure actuation is formed from the strength, the frequency and / or the phase of the sensor signal or the change of at least one of these variables. Device according to one of the preceding claims,

characterized,

the processing device (2) for determining the frequency of the pressure actuation is formed from the repetition of the same strength, frequency and / or phase of the sensor signal.

Device according to claim 8 or 9,

characterized,

the extent of the pressure actuation comprises the pressure depth, the pressure force, the speed of the pressing and / or unloading, the pause time or a combination of at least two of these parameters.

11. Device according to one of the preceding claims,

characterized,

in that the holding device has at least one holding part and two fixing units attached or attachable to the respective strain sensor element (10), between which an extensible section of the relevant strain sensor element (10) extends, wherein the respective strain sensor element (10) with the aid of one fixing means is attached to the associated holding part and with the aid of the other fixing means to a in the pressing operation relative to the holding part of this away and during unloading to this moving body.

12. Device according to claim 11,

characterized,

in that the moving body is an actuating part (3) acting on the chest of the person to be rescued in the pressure actuation by the manual force.

13. Device according to claim 12,

characterized,

in that the holding part (40) is a fastening piece (11) attached to the breast or a holding member attached to a supporting body.

14. Device according to claim 13,

characterized,

in that the processing device (2) for determining the printing depth is formed as a function of the angle (phi) changing in the pressure actuation between the vertically extending vertical and the extension of the strain sensor element (10) with known length thereof.

15. Device according to one of claims 11 to 14,

characterized,

in that the sensor unit (1) has a plurality of expansion sensor elements (10) and a plurality of holding parts respectively assigned to them or a holding part which is common to them, and

in that all the strain sensor elements (10) are attached to the moving body at a distance from the holding part (s). Device according to claim 15,

characterized,

that the common holding part as a retaining ring (1 12) is formed. 17. Device according to claim 12,

characterized,

in that a sensor arrangement comprising a surface-connected strain sensor element (10) or a plurality of strain sensor elements (10) is extended in a xy direction as a sensor array and is mounted along its peripheral edge by means of the one fixing unit continuously or at individual fixing points on the then peripherally formed holding part and that the moving body is mounted by means of the other fixing unit in the central region of the sensor arrangement. 18. Device according to claim 17,

characterized,

the capacities of the individual strain sensor elements (10) of the sensor arrangement are detected by means of the processing device (2) and included in the evaluation.

19. Device according to one of the preceding claims,

characterized,

in that the sensor unit (1) is designed such that at least one strain sensor element (10) can be placed around the breast of the person to be rescued transversely to the longitudinal extent of the person to be rescued and the change of the circumference of the thorax and / or the

Respiratory musculature of the chest during respiration by strain change the at least one strain sensor element (10) can be detected by means of the processing device (2) and included in the evaluation for determining the pressure depth and / or the pressure frequency. 20. Device according to one of the preceding claims,

characterized,

the sensor unit (1) is provided with an insulating protective layer at least in the region of the at least one strain sensor element (10). 21. Device according to one of the preceding claims,

characterized,

that in the processing device (2) at least one threshold value is predetermined, with which the sensor signal is compared, and

in that by means of the processing device (2) from the comparison result the beginning of printing, a minimum printing depth, a maximum printing depth and / or a complete discharge in the printing operation can be determined.

22. Device according to one of the preceding claims,

characterized,

the sensor unit (1) has at least one switching stage for specifying at least one threshold value for the start of printing, a minimum pressure depth, a maximum pressure depth and / or a complete relief during the pressure actuation. 23. Device according to one of the preceding claims,

characterized,

that in a receiving unit of the sensor unit (1) at least one strain sensor element (10) is received under prestress and the receiving unit is designed in such a way that the at least one strain sensor element (10) is relieved when pressure is applied.

24. Device according to one of the preceding claims,

characterized,

that it comprises at least one further detection unit, which is designed to detect respiratory activity, blood flow, oxygen saturation or carbon dioxide accumulation of the blood, the volume pulse and / or a body impedance of the person to be rescued, and

in that the detection signals of the at least one further detection unit can be fed to the processing device (2) during operation and can be evaluated by it.

25. Device according to one of the preceding claims,

characterized,

in that it has a display device controlled by the processing device with an optical display unit (5) and / or acoustic output unit in order to inform the rescue patient performing the cardiac massage via the pressure actuation.

26. Device according to one of the preceding claims,

characterized,

that it includes a defibrillator device that is signal-communicable or engageable with the processing device (2) to adjust the initiation of a defibrillation shock to the cardiac massage. Device according to claim 26,

characterized,

in that a triggering time for the triggering of a defibrillation shock by means of the processing device (2) is matched to the sensor signal during the pressure actuation such that the triggering of the shock takes place at a selectable time during the printing cycle.

Device according to claim 26 or 27,

characterized,

in that at least one strain sensor element (10) is integrated into at least one defibration electrode.

Device according to one of the preceding claims,

characterized,

that it has a selection device for adjustment to the body height, the body weight, the age group and / or the sex of the person to be rescued, the selected setting being included in the evaluation by the processing device (2).

Device according to one of the preceding claims,

characterized,

in that it is provided with an additional pressure detection unit comprising a fluid enclosed in a closed volume. Device according to one of the preceding claims, characterized

in that the at least one strain sensor element (10) is in the form of an elastomer foil, piezo film, strain gauges or potentiometer foil.