English:
[0002] Emergency medical procedures have been studied by the medical establishment for many years. It is commonly understood that patient outcomes can be improved by modifying procedures, by eliminating harmful or unnecessary steps, or by training personnel who are not performing the procedures correctly. A typical study involves the assignment of an observer who records the time and manner of the actions taken during the medical event. In some cases, equipment which is used in the event automatically generates time-ordered logs of recorded data as well.
[0003] One example of a medical event is the emergency treatment of sudden cardiac arrest (SCA). SCA is a leading cause of death in the United States. In about 40% of sudden cardiac arrest (SCA) patients, the initial cardiac rhythm observed is ventricular fibrillation (VF). CPR is the protocol treatment for SCA, which consists of chest compressions and ventilations that provide circulation in the patient. Defibrillation is interposed between sessions of CPR in order to treat underlying VF. It is known that the probability of a successful patient outcome depends upon the quality and timeliness of CPR and defibrillation. Unfortunately, many events lack both of these factors. Thus, the study and evaluation of SCA medical treatment events is of considerable importance to medicine.
[0004] FIGURE 1 illustrates a prior art SCA medical treatment event in which the electrodes 16 of a prior art defibrillator 10 have been applied by a rescuer 12 to resuscitate a patient 14 suffering from cardiac arrest. The defibrillator 10 may be in the form of an AED capable of being used by a first responder. The defibrillator 10 may also be in the form of a manual defibrillator for use by paramedics or other highly trained medical personnel in a hospital environment.
[0005] In sudden cardiac arrest, the patient is stricken with a life threatening interruption to the normal heart rhythm, typically in the form of VF or VT that is not accompanied by spontaneous circulation (i.e., shockable VT). If normal rhythm is not restored within a time frame commonly understood to be approximately 8 to 10 minutes, the patient will die. Conversely, the quicker that circulation can be restored (via CPR and defibrillation) after the onset of VF, the better the chances that the patient 14 will survive the event. It is thus a matter of great interest to the administrators who oversee the medical response organization that the rescuers perform the resuscitation quickly and effectively.
[0007] Automatically generated data, however, cannot capture all of the important information about the progress and effectiveness of the rescue. Hence there is a need for a manual report that is produced by an on-scene observer. The manual report may document information such as the names of the rescue team, the equipment used, the observed quality of CPR compressions and ventilations, drugs administered, patient responsiveness to rescue efforts, and the times of each of these events. This data must be collected and manually merged with the automatically generated data in order to provide a comprehensive and accurate record of the event.
[0008] All of this event data which is generated by the various sources is merged together to form the incident report at a centralized computer using software such as the Event Review software sold by the Healthcare division of Philips Electronics North America Company of Andover Massachusetts. FIGURE 2 illustrates a typical prior art incident report generation screen 20. As shown there, the user views the automatically generated data on one tab. The user then works from the event's other manual reports to enter notes and annotations about the treatment onto the software screens. Despite the computer software, this process of manually generating an incident report is inconvenient and time- consuming. The end product may also not reflect the overall effectiveness of the treatment event because of errors or omissions in the manual reports, the need for post- event reconstruction necessitated by the haste and urgency of the rescue event, or by a lack of time-synchronization of the manual and automated sources of data.
[0009] One solution to the problem of accurately documenting a medical treatment event may lie with the ubiquitous handheld computing device. These compact devices, such as commercially available smartphones, include touch screen displays, video cameras, microphones, and wireless communication capabilities. The handheld computing devices could be used at the scene by the observer to record the progress of the treatment, and to create a diary of the rescue. Unfortunately, today's audio/video and hand-entered data is not automatically consolidated into one event log by the prior art devices. Nor are the data entry screens and the video record displayed simultaneously. Thus, significant time and effort must be expended to create a meaningful incident report from this information.
[0010] What is needed therefore to address each of these deficiencies in the prior art is a device and method which offers a simplified data entry interface for recording important information during a medical treatment event. The interface should be capable of generating annotated event logs through the selection of contextually relevant icons on the touch screen. The device preferably merges audio and video records of the event with the annotated event logs. The device would be particularly useful in the documentation of CPR during cardiac arrest.
[0011] Similarly, what is needed is an improved graphical user interface for a handheld computing device which facilitates an accurate and thorough documentation of a medical treatment event. The graphical user interface should be intuitive and should require a minimum of manipulation to record important event information.
[0012] What is also needed is a system which efficiently and accurately conveys collected event logs to a central location for editing and review by medical administrative staff. Such a system would improve patient outcomes by enabling the staff to adjust procedures, add resources to future events, or identify needed training of personnel.
[0014] It is another object of the invention to describe a graphical user interface (GUI) for use with a handheld computing device for generating and storing annotations about a medical treatment event in an event log. The GUI preferably operates on a touch screen display showing icons that are contextually relevant to the current protocol step in the medical treatment. The icons that are presented to the user change as information is entered.
[0015] It is yet another object of the invention to describe an improved system and method for transferring event logs from a handheld computing device to a central computer. Preferably, the transfer is conducted wirelessly. A remote server, known as a cloud server, may provide an intermediate data storage capability for the event logs. The central computer preferably operates under a novel computer program which combines event annotations with video to provide a comprehensive record of the medical treatment event. If not already combined, the central computer may optionally merge data from a therapeutic device used in the event, such as a defibrillator, to recreate a more comprehensive report.

中文:
[0002]紧急医学流程已经被医学机构研究了很多年。众所周知,能够通过修改流程,通过排除有害或不必要的步骤或者通过培训未正确执行流程的人员,来改进对患者的结果。典型的研究涉及指派记录在医学事件期间采取的动作的时间和方式的观测人员。在一些情况下,用在事件中的装备也自动生成记录的数据的时序日志。
[0003]医学事件的一个范例是心脏骤停(SCA)的紧急处置。SCA在美国是死亡的主要原因。在大约40%的心脏骤停(SCA)患者中,观测到的初始心律是心室纤颤(VF)。CPR是用于SCA的方案处置,CPR包括在患者中提供循环的胸部按压和通气。除颤被插入在CPR过程之间,以便处置潜在的VF。已知,成功的患者结果的概率取决于CPR和除颤的质量和及时性。遗憾的是,许多事件缺乏这些因素。因此,对SCA医学处置事件的研究和评估对医学来说是相当重要的。
[0004]图1图示了现有技术SCA医学处置事件,其中,救援人员12已经将现有技术除颤器10的电极16应用于使患有心脏停止的患者14复苏。除颤器10可以呈现为能够由第一应答者使用的AED的形式。除颤器10还可以呈现为在医院环境中由急救医师或其他受过高度培训的医学人员使用的人工除颤器的形式。
[0005]在心脏骤停中,患者遭受危及生命的对正常心律的中断,中断通常呈现为VF或并不伴随自发循环的VT(即,可电击性VT)的形式。如果正常节律在公知为大约8至10分钟的时间框架之内没有恢复,则患者将死亡。相反地,在VF起始之后,循环能够越快地恢复(经由CPR和除颤),患者14将有越大的机会幸免于该事件。因此对于管理医学响应组织的管理人员而言,救援人员快速并且高效地执行复苏是非常感兴趣的主题。
[0007]然而,自动生成的数据不能够捕捉与救援的进展与效果有关的全部重要信息。因此,存在对于由现场观测者产生的人工报告的需要。人工报告可以记载诸如以下的信息:救援团队的名称、所使用的装备、所观测到的CPR按压和通气的质量、施予的药物、对救援效果的患者响应以及这些事件中的每个的时间。这些数据必须被收集并且与自动生成的数据人工地融合,以便提供事件的全面并且准确的记录。
[0008]由各种源生成的这一事件数据的全部被融合到一起,以在使用软件的中央计算机处形成事件报告,所述软件例如是由Philips Electronics North America Company(Andover Massachusetts)的Healthcare部门出售的Event Review软件。图2图示了典型的现有技术事件报告生成屏幕20。如这里示出的,用户在一个标签上观察自动生成的数据。用户然后根据事件的其他人工报告进行工作,以将与处置有关的注释和标注输入到软件屏幕上。尽管有计算机软件,但是人工生成事件报告的这一过程是不方便的并且耗费时间的。末端产品也可能因为人工报告中的错误或遗漏,对事件后重建的需要而不反映处置事件的整体效应,所述事件后重建由于救援事件的仓促和紧迫,或由于缺乏人工数据源和自动数据源的时间同步而是必须的。
[0009]对准确地记载医学处置事件的问题的一个解决方案可以依赖普遍存在的手持计算设备。诸如市场上可买到的智能电话的这些紧致设备包括触摸屏显示器、摄像机、麦克风以及无线通信能力。手持计算设备能够由观测者在现场处使用,以记录处置的进展,并且创建救援的日记。遗憾的是,现在的音频/视频和手动输入数据不由现有技术设备自动合并到一个事件日志中。数据输入屏幕和视频记录也不同时显示。因此,必须花费大量的时间和努力来从这一信息创建有意义的事件报告。
[0010]因此,对于解决现有技术中的这些不足中的每个而言,需要提供用于记录在医学处置事件期间的重要信息的简化数据输入界面的设备和方法。所述界面应当能够通过在触摸屏上选择情境相关的图标来生成标注的事件日志。所述设备优选地将事件的音频和视频记录与标注的事件日志融合。所述设备尤其有用于在心脏停止期间记载CPR。
[0011]类似地,需要用于手持计算设备的改进的图形用户界面,所述图形用户界面方便了对医学处置事件的准确并且深入的记载。图形用户界面应当是直观的并且应当需要最小的操控来记录重要事件信息。
[0012]还需要将收集的事件日志高效并且准确地传递到中央位置以由医学管理人员编辑并察看的系统。这样的系统将通过使得所述人员能够进行以下来改进患者结果:调整流程;增加用于未来事件的源;或者识别人员所需要的培训。
[0014]本发明的另一个目的是描述一种图形用户界面(GUI),所述图形用户界面与手持计算设备一起使用,以在事件日志中生成并且存储与医学处置事件有关的标注。所述GUI优选地操作在示出与所述医学处置中的当前方案步骤情境相关的图标的触摸屏显示器上。当输入信息时,呈现给用户的所述图标改变。
[0015]本发明的又一个目的是描述用于将事件日志从手持计算设备转移到中央计算机的改进的系统和方法。优选地,所述转移是无线地进行的。远程服务器,已知为云服务器,可以提供用于所述事件日志的中间数据存储能力。所述中央计算机优选地操作在新颖的计算机程序下,所述新颖的计算机程序组合事件标注与视频,以提供所述医学处置事件的全面记录。如果并未组合,则所述中央计算机可以任选地融合来自用在所述事件中的诸如除颤器的治疗设备的数据,以重新创建更全面的报告。