Abstract:
A CPR device depicted and disclosed provides for ergonomically administering CPR from the side of a patient, thereby reducing or eliminating the risk of injury and providing a means for maximally effective CPR. One embodiment is optionally attachable to a bed or gurney and provides a leveraged structure with a CPR pad, so that CPR can be performed from the side of the bed or gurney. Other devices may be portable, and can be unfolded to encircle a patient&#39;s chest and so that CPR can be more effectively administered from the patient&#39;s side by means of a lever or by means of compressed air-driven compression devices.

Description:
CROSS-REFERENCES TO RELATED APPLICATIONS 
       [0001]    This application claims priority under 35 U.S.C. §1.19 (e) to, and hereby incorporates by reference, U.S. Provisional Application No. 61/069,030, filed Mar. 12, 2008. 
     
    
     BACKGROUND 
       [0002]    Cardiopulmonary resuscitation (CPR) is administered to a patient whose heart has either stopped beating or is undergoing fibrillation and functions to restore blood flow from the patient&#39;s heart to the patient&#39;s brain and other organs. Normally, CPR, as chest compression, is performed by straddling the patient or leaning over the patient from the side to compress the chest with proximal palms to thereby provide rhythmic chest compressions. Both procedures expose the practitioner to risk of injury. Additionally, the patient is often in a bed or on a gurney on which a soft mattress is present. The mattress absorbs much of the force exerted on the patient&#39;s chest, thereby decreasing the effectiveness of the compression. Practitioners in these situations often straddle the patient on a soft surface, thereby risking injury to the practitioner&#39;s back or injury due to the practitioner falling from the bed or gurney while administering CPR. It is known that CPR administered from a patient&#39;s side is considerably less effective than CPR administered while straddling the patient. When a patient is disposed on a gurney, the underlying surface is firm; however, CPR must still be administered while either straddling the patient or from the patient&#39;s side. Either position is less than optimally effective and/or exposes the practitioner to injury as described above. Additionally, a practitioner&#39;s hands are not optimal instrumentalities for administering CPR to a patient&#39;s chest. In the situation where a patient is disposed on a mattress, a board or other stiff structure placed under the patient improves compression. 
       SUMMARY 
       [0003]    The CPR device of this invention provides an ergonomic method for administering chest compression that both safeguards a practitioner from injury and administers CPR effectively. The CPR device of this invention includes an optionally smooth, e.g., plastic, surface, which can be placed beneath the patient. In some embodiments, the surface is hinged to an upper component surface lying over the chest of the patient and having an effective, efficient plunger aligned over the heart so as to provide more efficient compression. This upper surface may have an extension permitting health-care workers to kneel or stand next to the patient and to use the leverage of this extension to effectively compress the chest. Chest compression using the CPR device of this invention, accordingly, is more efficient and can be accomplished without risk of injury to a health-care worker. Embodiments of this device may be folded neatly for easy storage. Other embodiments of the CPR device of this invention may include an elongated, retractable-extendable handle, providing leverage when extended during use, yet retracting for storage, so as to conserve space and fit beneath a bed or cart. 
         [0004]    The CPR device of this invention may include a lever extending over the patient&#39;s chest and anchored to a bed rail, cart rail, or frame by a swivel-type receptacle having a flexible or pivoting hinge and receiving the lever at one end. The free end of the lever may be used to exert a pumping action across the patient&#39;s chest when administering CPR. Present on the lever may be a compression device adapted to the chest wall over the patient&#39;s heart. The lever may have a compression device, which can be adapted to the chest wall over the patient&#39;s heart. The compression device may be manufactured from inert material and may further include a controlling device regulating compression force applied to the patient. The lever may be restricted, or the amount of compression determined, by use of a compression gauge or the like. 
         [0005]    The CPR device of this invention may be in the embodiment of a CPR kit comprising a flat surface, a lateral component, and a ventral component. The flat surface may provide a dorsally positioned base under the patient&#39;s chest. The lateral component provides elevation and a base for attaching a hinged lever. The ventral component covers the patient&#39;s chest and may have a compression component to conform to the area over the patient&#39;s heart. Optionally, the foregoing operating components may be unfolded to form the compression unit of this invention, then refolded into a small, easily stored kit. 
     
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
         [0006]      FIG. 1  is a plan view depicting a first embodiment of a CPR device of this invention being used on a patient. 
           [0007]      FIG. 2  is a side view of the CPR device of  FIG. 1  being used on a patient. 
           [0008]      FIG. 3  is another side view of the CPR device of  FIG. 1  being used on a patient. 
           [0009]      FIG. 4  is a cross-sectional view of one embodiment of an attachment member of the CPR device depicted in  FIG. 1 . 
           [0010]      FIG. 5  is a side view of a second embodiment of the CPR device of this invention configured in a storage configuration. 
           [0011]      FIG. 6  is a perspective view of the CPR embodiment depicted in  FIG. 5  in a use configuration. 
           [0012]      FIG. 7  is a perspective view of the CPR embodiment depicted in  FIG. 5  in a storage configuration. 
           [0013]      FIG. 8  is a perspective view of the CPR device depicted in  FIG. 5  being used to administer CPR to a patient. 
           [0014]      FIG. 9  is a side view of a third embodiment of the CPR device of this invention configured in a storage configuration. 
           [0015]      FIG. 10  is a perspective view of the CPR device depicted in  FIG. 9  in a use configuration. 
           [0016]      FIG. 11  is a perspective view of the CPR device depicted in  FIG. 9  being used to administer CPR to a patient. 
           [0017]      FIG. 12  is a perspective view of the CPR device depicted in  FIG. 9  in a storage configuration. 
           [0018]      FIG. 13  is a side view of a fourth embodiment of the CPR device of this invention configured in a storage configuration. 
           [0019]      FIG. 14  is a perspective view of the CPR device depicted in  FIG. 13  in a use configuration. 
           [0020]      FIG. 15  is a perspective view of the CPR device depicted in  FIG. 13  being used to administer CPR to a patient. 
           [0021]      FIG. 16  is a perspective view of the CPR device depicted in  FIG. 13  in a storage configuration. 
       
    
    
       [0022]    It is understood that the above-described figures are only illustrative of the present invention and are not contemplated to limit the scope thereof. 
       DETAILED DESCRIPTION 
       [0023]    Each of the additional features and methods disclosed herein may be utilized separately or in conjunction with other features and methods to provide improved devices of this invention and methods for making and using the same. Representative examples of the teachings of the present invention, which examples utilize many of these additional features and methods in conjunction, will now be described in detail with reference to the drawings. This detailed description is merely intended to teach a person of skill in the art further details for practicing preferred aspects of the present teachings and is not intended to limit the scope of the invention. Therefore, combinations of features and methods disclosed in the following detailed description may not be necessary to practice the invention in the broadest sense and are instead taught merely to particularly describe representative and preferred embodiments of the invention. Additionally, a person of ordinary skill in the art will appreciate that individual components shown on various embodiments of the present invention are interchangeable to some extent and may be added or interchanged on other embodiments without departing from the spirit and scope of this invention. 
         [0024]    Referring to  FIGS. 1-4 , one embodiment of the cardio-pulmonary resuscitation (CPR) device of this invention is indicated generally at  100  and is mounted to a bed  110 . The bed  110  includes a mattress  112  supported by a bed frame  114 , as well as rails  116 ,  118 . The rails  116 ,  118  may be raised or lowered as needed in a hospital environment. The bed  110  may be stationary or portable; indeed, a gurney modified as described below may be used in place of the bed  110 . 
         [0025]    The CPR device  100  depicted in  FIGS. 1-3  includes a flat member (insert)  130 , attachment member  132 , and compression member  134 . 
         [0026]    The flat member  130  is operationally positioned beneath the chest of the patient when the CPR device  100  is being used. While a variety of materials may be used, the flat member  130  includes a synthetic resin such as polyethylene, polypropylene, or polycarbonate. However, a person of ordinary skill in the art will readily recognize that other polymers may be utilized as well. Accordingly, suitable polymers are disclosed and described in the Handbook of Plastics, Elastomers, and Composites, Third Edition, Charles A. Harper, Editor-in-Chief, McGraw-Hill, New York (1996), hereby incorporated by reference in its entirety. A person of ordinary skill in the art will further recognize that other materials could be used in manufacturing the flat member  130 , including wood and metals such as aluminum and steel alloys. In one embodiment the flat member  130  is substantially impervious to liquids and can be cleaned and sanitized between uses. However, other embodiments include materials suitable for a single use, then discarded. Factors determining the materials used for the flat member  130  of this invention include cost, rigidity, weight, and reusability (or lack thereof). 
         [0027]    The attachment (side) member  132  is depicted as attached to the rail  116  in  FIGS. 1-3 . In one embodiment, the attachment member  132  attaches reversibly to the rail  116 . In another embodiment, the attachment member  132  is a permanent fixture of one or both of the rails  116 ,  118 . Referring to  FIG. 4 , the attachment member  132  depicted is generally circular, following a cross sectional contour of the rails  116 ,  118  and includes attachment member halves  136 ,  138  connected at a hinge  139  and secured about the rails  116 ,  118  by a pair of clamp members  140 . The clamp members  140  may be utilized to quickly attach at a desired location, then reversibly detach the attachment member  132  from one of the rails  116 ,  118 . Also envisioned but not depicted, are embodiments wherein the compression member  134  reversibly snaps into a socket present on the rail and which the ball  160  thereof swivels when attached. Alternatively, an eccentric (swivel) clamp (not shown) could be used for reversible attachments of this invention. Also shown in  FIG. 1 , but not depicted in  FIG. 4 , is a socket  142 , optionally attached to the attachment member  132 . A person of ordinary skill in the art will readily recognize that a horizontally oriented hinge or pair of hinges arranged normally with respect to each other may also be present in other embodiments, wherein structure facilitating pivoting or rotation of the compression member  134  is present. Additionally a flexible material such as cloth, or a synthetic polymer (e.g., living hinge) may be used, optionally fixed to the rail by a hook and loop mechanism. Alternatively, anchoring structure may be present on the rails  116 ,  118 , wherein the compression member  134  can be optionally reversibly attached. As discussed above briefly, the attachment member  132  may be adapted for a gurney by a person of ordinary skill in the art. For example, the present CPR device could be mounted to the undercarriage of a gurney, optionally reversibly so, to be available for use, optionally providing an insert for the compression member frame  150  (discussed below). 
         [0028]    The compression member  134 , in the embodiment shown, includes a compression member frame  150  and compression element  152 . The frame  150 , in turn, has a ball  160 , a ball shaft  162 , frame elements  163 ,  164 ,  166  and a handle  168 . The ball  160  is disposed within the socket  142 , the socket  142  being attached to the attachment member  132 . Consequently, in the embodiment shown, the attachment member  132  and compression member  134  are unitary and functional when the attachment member  132  is attached to one of the rails  116 ,  118 . The ball shaft  162  is attached to, and extends between, the ball  160  and the frame element  163 . Alternate mechanisms for the ball and socket are described above. The frame element  163  and handle  168 , in turn, are perpendicularly, or otherwise transversely, attached to the frame elements  164 ,  166 . The compression member frame  150  may be formed from materials such as wood, steel alloys, aluminum, or synthetic resins such as polycarbonate, polyethylene, polypropylene, and the like, alternatives readily selected by a person of ordinary skill in the art from The Handbook of Plastics, Elastomers, and Composites (incorporated by reference above). In one embodiment, the compression member frame  150  has a degree of rigidity such that only a certain force can be applied to a patient&#39;s chest during use, forces in excess bending or flexing the compression member frame to thereby avoid injuring the patient. Alternatively or additionally, the amount of force applied to the patient during CPR may be governed or indicated by a device such as a compression gauge. 
         [0029]    The compression element  152  as depicted is longitudinally adjustable along the compression member frame  150  by means of slots or bores in which the frame elements  164 ,  166  are reversibly disposed. While depicted as a pad with a lower, relatively planar, surface, the compression element  152  may also have an attached suction element  170  to “grip” the patient&#39;s chest during use and may be compressible, e.g., by the presence of a bellows  172 . Suitable materials for the compression element  152  include natural and synthetic polymers such as rubber and foamed synthetic rubbers with the requisite amount of firmness and rigidity. Optionally, the compression element  152  includes electrode attachments (not shown) for cardioversion or defibrillation. Corresponding electrodes may optionally be present in the flat member  130 . One suitable defibrillator pad and assembly is disclosed in U.S. Pat. No. 4,779,630 issued to Scharnberg et al. and in U.S. Pat. No. 4,998,536, issued to Scharnberg, each hereby incorporated by reference. However, a person of ordinary skill in the art will readily comprehend other arrangements for cardioversion and/or defibrillation. 
         [0030]    In use, the flat member  130  is placed beneath the patient&#39;s chest as shown in  FIG. 3  and the remainder of the CPR device  100  is attached to the bed or gurney as described above. A health practitioner then grasps the handle  168 , maneuvers the device such that the compression element  152  is situated above a left portion of the patient&#39;s chest (longitudinally adjusting the compression element  152  as needed), then exerts sufficient rhythmic, repeated force downwardly on the patient&#39;s chest until the person&#39;s heart resumes beating or until it is determined that further efforts are to be discontinued. 
         [0031]    Referring to  FIGS. 5-8  another embodiment of the CPR device of this invention is depicted generally at  200  and includes respective horizontal and vertical members  204 ,  208 , a compression member  210 , and strap assembly  212 . The vertical member  208  is pivotally attached to the horizontal member  204  by means of one or more pivots or hinges  214  and also attached to the compression member by means of one or more hinges  216 . The vertical member  208  may further include indicia  218 , such as written and pictorial directions for use. The horizontal member  204  may be dimensioned to fit under a patient&#39;s chest, so as to provide a firm support to the patient during use. By way of illustration and not limitation, one suitable size for the horizontal member  204  is 24 inches×30 inches (60 cm×76 cm). Alternatively, the horizontal member may include a tacky surface to maintain the patient&#39;s thorax in place. Accordingly, the vertical member  208  is dimensioned so as to span the thickness (e.g., from dorsal to ventral surfaces) of a patient&#39;s chest region and may be optionally adjustable in doing so. The compression member  210 , in turn, includes a compression pad  220 , compression structure  230 , and a framework, such as telescoping elements  240 ,  242  connected to a handle  244 . The compression pad  220  may include materials such as those described above with respect to the compression element  152 . The compression structure may be a bellows or other compressible material such as foam rubber or the like and optionally allows a specific amount of force to be exerted on a patient&#39;s chest before further compressing to protect the patent from injury. The telescoping elements  240 ,  242  are extended for use and retracted for storage, optionally including materials to govern the amount of force exerted on a patient&#39;s chest during use, wherein the telescoping elements  240 ,  242  bend or flex in response to a force beyond a certain magnitude. 
         [0032]    For storage, the CPR device  200  is folded along hinges  214 ,  216 , the handles retracted, and the stored CPR configuration is then secured by means of straps  246 ,  248  and carried using a handle  250 . During use, the CPR device  200  is reconfigured from the storage configuration shown in  FIG. 5 , into the use configuration shown in  FIG. 6 . The horizontal member  204  is disposed beneath the patient&#39;s chest, then the straps  246 ,  248  secure the device about the patient, the telescoping elements  240 ,  242  are extended as shown in  FIGS. 6 ,  8 , and a practitioner begins CPR by grasping the handle  244  as depicted in  FIG. 8 . As shown in  FIG. 8 , the practitioner ergonomically, and considerably more effectively, administers CPR from the side of patent, rather than being forced to straddle the patient or by using the practitioner&#39;s arms and hands to directly compress the patient&#39;s chest. 
         [0033]    Referring to  FIGS. 9-12 , another embodiment of the CPR device of this invention is shown at  300 , and, where numbered identically, includes structural elements present in the CPR device  200  (described above). The differences between the CPR device  300  and the CPR device  200  include a compression member  310  connected to a bellows  320  by means of a pneumatic line or hose  322 . The bellows  320 , in turn, includes disk elements  324 ,  326  and a bellows element  328  operably disposed between the disk elements  324 ,  326 . Storage and use configurations of the CPR device  300  are depicted in respective  FIGS. 12 and 10  and are achieved in a similar manner to those described above with respect to the CPR device  200 . The compression member  310  may be airtight with generally rigid upper and lower elements  340 ,  342  and an inflatable member, e.g. bladder  344  or the like, disposed between the upper and lower elements  340 ,  342 . In use, and as depicted in  FIG. 11 , the CPR device  300  is unfolded from the storage position shown in  FIG. 12  into the use position depicted in  FIG. 10 , then secured about the patient as described above with respect to CPR device  200 . Then and as depicted in  FIG. 11 , a practitioner compresses the air within the bellows  320 , thereby conveying compressed air through the pneumatic line  322  and into the compression member  310 . Once the compressed air enters the compression member  310 , the bladder  344  is expanded to exert a force on the patient&#39;s chest, thereby performing CPR upon the patient. In this case again, CPR is ergonomically and more effectively administered from the patient&#39;s side when the CPR device  300  is used. 
         [0034]    Referring now to  FIGS. 13-16 , another embodiment of the CPR device of this invention is shown at  400 . Similar or substantially identical structural elements to those shown with respect to the CPR devices  200  and  300  are numbered identically. The CPR device  400  may be folded or unfolded between a storage configuration as shown in  FIG. 16  and a use configuration as shown in  FIG. 14  as described above with respect to the CPR device  200 . Differences between the CPR device  400  and the CPR devices  200  and  300  include a compressor housing  420  with compressor handles  430 ,  434  and a compressor or air pump disposed within the compressor housing (compressor or air pump not shown). In use, the CPR device  400  is disposed about a patient as described above with respect to the CPR device  200  and as shown in  FIG. 15 . A practitioner then operates the compressor handles  430 ,  434  shown in  FIG. 15  to administer CPR to the patient. 
         [0035]    Similarly to the CPR device  100 , any of the CPR devices  200 ,  300 , and  400  may include electrodes for administering cardioversion or defibrillation and a person of ordinary skill in the art would readily appreciate how to select and dispose such structure therewithin. 
         [0036]    Because numerous modifications of this invention may be made without departing from the spirit thereof, the scope of the invention is not to be limited to the embodiments illustrated and described. Rather, the scope of the invention is to be determined by the appended claims and their equivalents.