Abstract:
In one embodiment, a method of rehabilitating a patient&#39;s cardiac/pulmonary activity and achieving increased fluid distribution, includes placing one inflatable/deflatable chest cuff over the patient&#39;s chest area and another inflatable/deflatable cuff over the patient&#39;s abdominal area, the chest cuff, when inflated, being arranged to depress the chest and force air out of the patient&#39;s lungs, the abdominal cuff being arranged, when inflated to apply pressure to the underlying vessels to direct blood into the patient&#39;s chest area; inflating and deflating the chest cuff and the abdominal cuff; connecting an intravenous (IV) line to one of the patient&#39;s blood vessels, the IV line connected to a fluid source, to facilitate the distribution of medications, by enhancing IV medication and fluid infusion rates, the chest and abdominal cuff inflation and deflation serving as multiple external circulatory pumps to increase the fluid infusion rate. 
     In another embodiment, a patient interface kit includes an inflatable chest cuff adapted to extend over a patient&#39;s chest, the cuff including an inflatable bladder and a fastener system to secure the cuff in position for use on a patient, and at least a first electrode attached to a surface of the chest cuff and positioned to be adjacent the patient&#39;s heart with the cuff secured in position on the patient&#39;s chest, and a second first wiring lead configured for attachment to a utilization device. 
     In another embodiment, a patient interface kit for a system for providing cardiopulmonary resuscitation or circulatory support to a patient, the system including a control unit, the kit including an inflatable abdominal cuff adapted to extend over a patient&#39;s abdomen and including an elongated flexible strap, an inflatable bladder and a fastener system to secure the abdominal cuff in position for use on a patient; an inflatable chest cuff adapted to extend over a patient&#39;s chest and including an elongated flexible strap, an inflatable bladder and a fastener system to secure the chest cuff in position for use on a patient; a patient platform or backboard configured for disposition against the patient&#39;s back during use; and a cuff prepositioning system configured to secure the chest and abdomen compression cuffs to the patient platform in a ready position and to facilitate rapid deployment of the cuffs for use on the patient.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    This application is a continuation-in-part of, and claims priority to, application Ser. No. 12/493,005, filed Jun. 26, 2009, the entire contents of which are incorporated herein by this reference. 
     
    
     BACKGROUND 
       [0002]    U.S. Pat. No. 5,806,512 describes an apparatus to implement a resuscitation method. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0003]    Features and advantages of the disclosure will readily be appreciated by persons skilled in the art from the following detailed description when read in conjunction with the drawing wherein: 
           [0004]      FIG. 1  is a schematic drawing illustrating elements of an exemplary embodiment of a portable resuscitation system in place on a person. 
           [0005]      FIG. 1A  is a schematic view of an embodiment of a portable resuscitation system. 
           [0006]      FIG. 2  is a schematic drawing of an exemplary embodiment of one of three modules in the system of  FIG. 1A  that control the flow of air to and from the chest, abdomen and leg inflation cuffs. 
           [0007]      FIG. 3  is a schematic of a ventilator circuit formed by the ventilator supply module of the system illustrated in  FIG. 1A . 
           [0008]      FIG. 3A  depicts an exemplary embodiment of a disposable patient circuit or module of the system of  FIG. 1A . 
           [0009]      FIG. 4  is a simplified block diagram of an exemplary embodiment of the control unit of the system of  FIG. 1 . 
           [0010]      FIG. 4A  is a simplified functional block diagram of an exemplary embodiment of the timer module of the system of  FIG. 1A . 
           [0011]      FIG. 4B  illustrates an exemplary circuit implementation of the timer module. 
           [0012]      FIG. 5A  is a graph illustrating control of gas pressure to the ventilator and cuff bladders in an exemplary embodiment.  FIG. 5B  illustrates operation of the corresponding solenoid valves to provide the gas pressure control illustrated in  FIG. 5A . 
           [0013]      FIG. 6  is a top plan view illustrating an exemplary embodiment of a backboard suitable for use in combination with the system of  FIG. 1 . 
           [0014]      FIGS. 7A-7B  illustrate top and bottom views of an exemplary embodiment of the chest cuff for the system of  FIG. 1 . 
           [0015]      FIGS. 8A-8B  are respective top and bottom views of an exemplary embodiment of the abdomen cuff for the system of  FIG. 1 . 
           [0016]      FIG. 9  is a top view of an exemplary embodiment of a leg cuff for the system of  FIG. 1 . 
           [0017]      FIG. 10  is a perspective view illustrating a carrier for the gas cylinders of the system of  FIG. 1 . 
           [0018]      FIG. 11  illustrates one exemplary embodiment of a port connector for the system unit of  FIG. 1 . 
           [0019]      FIG. 12  illustrates an exemplary embodiment of a connector set for connecting an air hose to an inflatable cuff. 
           [0020]      FIG. 13  illustrates an exemplary embodiment of a chest cuff having a pair of electrodes attached to the bladder surface facing the patient&#39;s chest. 
           [0021]      FIG. 14  illustrates an exemplary embodiment of a patient backboard or platform having the chest and abdomen cuffs secured in a ready configuration by a lanyard system.  FIG. 14A  is a diagrammatic cutaway view along line  14 A- 14 A of  FIG. 14 , illustrating an exemplary lanyard rigging embodiment to secure the cuffs in the ready position. 
           [0022]      FIG. 15  is a diagrammatic top view illustrating an exemplary embodiment of a lanyard configuration suitable for use with the patient backboard system illustrated in  FIG. 14 .  FIG. 15A  illustrated the underside surface of a distal end of retaining strap portions of the lanyard configuration. 
           [0023]      FIG. 16  is a diagrammatic view illustrating a patient arranged on an exemplary embodiment of a backboard as in  FIG. 14  with the chest and abdomen cuffs deployed in preparation for attachment to the patient&#39;s chest and abdomen, and showing an IV connected to the patient&#39;s arm. 
       
    
    
     DETAILED DESCRIPTION 
       [0024]    In the following detailed description and in the several figures of the drawing, like elements are identified with like reference numerals. The figures are not to scale, and relative feature sizes may be exaggerated for illustrative purposes. 
         [0025]    An exemplary embodiment of a resuscitation/respiration apparatus in accordance with aspects of the invention is adapted for portable use, e.g. by emergency medical technicians or other first responders, or others. This embodiment is powered by a small battery and utilizes compressed gas as found in typical fireman&#39;s breathing apparatus and medical oxygen as used by emergency teams. 
         [0026]    An exemplary embodiment may be simplified by the elimination of adjustments such as flow, cycle rate and pressure controls, which are factory set for optimum performance. In other embodiments, some or all these parameters may be adjustable by the user. An exemplary embodiment may utilize an integrated ventilator that is simple to operate and may be synchronized with operation of inflatable cuffs for chest, abdomen and leg compression, as described below. 
         [0027]    The American Heart Association recommends that cardiopulmonary resuscitation (CPR) be provided for 20 minutes or until the patient is resuscitated, whichever comes first. In an exemplary embodiment, an air injection system dilutes the compressed air with ambient air, providing more than 20 minutes of operation, and in one embodiment approximately 30 minutes, from a full firemen&#39;s air cylinder filled to 4500 PSI. 
         [0028]    An exemplary embodiment of the system, adapted for portable use, may be housed in a shock and water resistant container that may be carried or worn as a back-pack. The inflation cuffs may be mounted on a backboard in a ready position for immediate application to the patient. 
         [0029]      FIG. 1  is a schematic drawing illustrating elements of an exemplary embodiment of a resuscitation/respiration system  10  in place on a reclining patient  1 . The system  10  includes a cylinder  22  of compressed air, a cylinder  24  of breathing oxygen, a system unit  30 , a ventilator mask  40 , a chest cuff  50 , an abdomen cuff  60 , and leg cuff garments  70 . The cuffs have inflatable bladders that are held in place by straps with hook and loop fasteners. They are attached to a backboard  100  for easy positioning. The cylinders  22 ,  24  are connected to the system unit  30  by air lines/hoses and connectors. Air lines are attached from the system unit to the cuffs with connectors. 
         [0030]    The system unit  30  in an exemplary embodiment has six connector ports  36 A,  36 B,  36 C,  36 D,  36 E and  36 F configured for removable engagement with the respective air hoses. Connector port  36 A is attachable to the hose  22 A attached to the air cylinder  22 . Connector port  36 B is configured for attachment to hose  24 A attached to the oxygen cylinder  24 . Connector port  36 C is configured for attachment to a hose attached to the face mask  40  of a patient ventilator module. Connector port  36 D is configured for attachment to hose  58  attached to the chest cuff  50 . Connector port  36 E is configured for attachment to hose  68  attached to the abdomen cuff  60 . Port  36 F is configured for attachment to a hose attached to the leg cuffs  70 . 
         [0031]    In an exemplary embodiment, the system unit  30  includes a meter  32 A depicting the airway pressure supplied to the ventilator mask, and a manual control  112  with control knob  116  which allows manual control of several patient tidal volume settings, as well as a “demand” setting. The “demand” position is essentially an “off” mode so that oxygen is only provided when demanded by the patient. The valve is set by rotating the knob  116  to a demand position. Valves  32 B,  32 C and  32 D have control handles on the control panel of the system unit  30 , and control the bleed flow to the air module reference chambers (described below) for the respective chest, abdomen and leg cuffs. Valves  32 B and  32 C can be turned to the OFF or AUTO positions. In the OFF position, the valve is closed, and does not allow flow to the respective cuff. In the AUTO position, the flow is controlled automatically by a timer module (described below) opening and closing solenoid valves in the corresponding circuits. Valve  32 D is a 3-way valve, for controlling pressure applied to the air module reference chamber for the leg cuff. This valve has OFF and AUTO positions as described above for valves  32 B and  32 C, and also has an ON position. In the ON position, the flow is on, so that a constant pressure is applied to the leg cuff. 
         [0032]    The system unit  30  in an exemplary embodiment includes a rechargeable battery, and is small and light enough for ready portability, in an application suitable for portable use. 
         [0033]    The portable resuscitation system  10  includes several modules, as illustrated in the schematic view of  FIG. 1A . One module is the tank module  20  that includes an air cylinder and an oxygen cylinder. Each cylinder has an attached regulator that is set to provide the proper pressure output to the rest of the system. 
         [0034]    The module  20  is connected by air and oxygen lines  22 A,  24 A to an input module  26 . In an exemplary embodiment, this module has connectors  26 A,  26 B that conform to a diameter indexed safety system, developed by the Compressed Gas Association, known as a DISS system, that prevents the lines from being connected incorrectly. In this exemplary connector system, non-interchangeable indexing is achieved by a series of increasing and decreasing diameters in the components of the connections. These specific diameters act in a key-like fashion, so the fittings within one gas service family will connect only with their own family members. Other types of connectors may alternatively be employed. The module  26  also contains pressure regulators that further adjust the pressures for close control of supply pressure to the other modules. 
         [0035]    Oxygen is supplied to ventilator supply module  110  by line  24 B. This module includes a tidal volume control  112  and a demand regulator  114 . In an exemplary embodiment, the tidal volume control  112  has five positions for various levels of tidal volume, which are set by knob  116  on the control panel of the system unit  30 . Each position is calibrated for a flow that, when matched with the actions of the timer module, allows for a fixed volume of gas to flow to the outlet of the demand regulator  114 . At any time that the patient demands more flow than the tidal volume control  112  puts out, the demand regulator will provide this flow in response to this demand. Thus, if the patient demands more flow than is delivered by the tidal volume control, it will result in the mask pressure becoming negative. This will trigger the demand regulator to add gas so as to maintain only a slight negative pressure. 
         [0036]    A patient ventilator module  120  includes a hose  122  connected to the demand regulator  114 , a patient valve  124  and the patient mask  40 . The hose  122  delivers output from the ventilator module  110  to the patient. The hose is collapsible for easier storage and the patient valve  124  is equipped with an inhalation/exhalation valve that prevents re-breathing of expired gas. The valve  124  may also be equipped with an alarm whistle that sounds a tone when pressure in the outlet exceeds a threshold pressure, e.g., 55 cm of water. 
         [0037]    Air module  130  includes three air pressure modules  132 ,  134 ,  136  to control the flow of air to the inflatable bladders in each cuff  50 ,  60 ,  70 L and  70 R. Regulated air is supplied to the module inlets through a manifold. The air module has a pressure regulator to set the outlet pressure for the cuff bladders. For each cuff, inlet pressure is fed through a restrictor to a diaphragm chamber in the regulator that sets the outlet pressure. A solenoid valve in the timer module opens and closes to turn the regulator on and off. The reference pressure is sensed by a compensated exhaust valve that operates to deflate the cuff bladders in proper sequence and serves as a relief valve to protect against overpressure. 
         [0038]    A timer module  140  includes circuitry that sets the proper sequence and timing of solenoid valves to control both the air modules and the ventilator operation. The module  140  is preferably operated by a rechargeable battery power source in an exemplary embodiment. 
         [0039]    A cuff module or kit  150  includes the cuffs  50 ,  60  and  70 L- 70 R, which respectively include inflatable bladders for “chest”, “abdomen” and “legs”. 
         [0040]      FIG. 2  is a schematic drawing of an exemplary one ( 132 ) of three modules  132 ,  134 ,  136  that control the flow of air to and from the chest, abdomen and leg inflation cuffs  50 ,  60 ,  70 . Compressed air from tank  22  is introduced at port  132 - 10 . A restrictor  132 - 11  allows a small bleed via channel  132 - 12  to branch  132 - 13  to chamber  132 - 14 . When solenoid valve  140 - 2  is closed by timer module circuit  140 , the pressure in chamber  132 - 14  increases until relief valve  132 - 16  opens to maintain a preset pressure in chamber  132 - 14 . This pressure acts against diaphragm  132 - 17  to depress paddle  132 - 18 , which in turn opens pilot valve  132 - 19 . This reduces the pressure on holding the main valve  132 - 22  closed, and initiates flow through the nozzle  132 - 23 . The nozzle flow is directed to the throat  132 - 24 . The high velocity of the nozzle flow causes the pressure in chamber  132 - 25  to drop so as to open check valve  132 - 26  and entrain ambient air. The pressure in outlet chamber  132 - 27  is sensed through passage  132 - 28  so as to cause the pressure on the diaphragm  132 - 17  to balance the reference pressure in chamber  132 - 14  and thus allow the pilot valve  132 - 19  to close and shut off the flow. The pressure in chamber  132 - 14  is sensed through line  132 - 29  by diaphragm  132 - 30  in the compensated discharge valve  132 - 31 . A spring  132 - 32  biases the valve to a closed position so that when the pressure at the outlet is a small amount (e.g., approximately 25 mm Hg.) higher than the reference pressure (in chamber  132 - 14 ) the valve opens and relieves the pressure in the outlet. This allows the compensated valve  132 - 31  to act both as a relief valve and as an exhaust valve. Retaining pressure in the cuff bladders (e.g. 25 mm Hg) has two advantages. It increases peripheral resistance in the patient&#39;s circulatory system and reduces air consumption by preventing complete deflation of the inflation cuffs. The timer module  140  exhausts the reference pressure in chamber  132 - 14  through solenoid valve  140 - 2 ; this in turn causes the compensated valve  132 - 31  to open and exhaust the cuffs. The solenoid valve  140 - 2  is open to allow flow from chamber  132 - 14  to the ambient. 
         [0041]    Thus, the air module  132  operates in the following manner. Compressed air is supplied to port  132 - 10 , which in turn flows to a diaphragm valve  132 - 22  in the regulator assembly. This diaphragm is held closed by the pressure in chamber  132 - 20  which is pressurized by inlet pressure through restrictor  132 - 21 . Pilot valve  132 - 19  acts to seal this chamber through a spring biased paddle assembly  132 - 18 . One side of the diaphragm senses the pressure in the outlet chamber  132 - 27  through passage  132 - 28  while the other side senses the reference pressure in chamber  132 - 14 . 
         [0042]    When the pressure at the outlet chamber  132 - 27  drops below the reference pressure in chamber  132 - 14 , the diaphragm  132 - 18  moves to open the pilot valve  132 - 19  which in turn causes the diaphragm valve  132 - 22  to open and permit flow from the inlet  132 - 10  to flow through nozzle  132 - 23  to the outlet chamber  132 - 27 . This flow enters the throat  132 - 24  at high velocity resulting in the pressure in chamber  132 - 25  dropping below ambient pressure due to the Bernoulli effect which in turn initiates flow of ambient air through check valve  132 - 26  into mixing chamber  132 - 25 . This operation thus is provided by an ambient air injection system which dilutes the pressurized air from the cylinder  22 , and thus prolongs the operation of the system and its chest, abdomen and leg cuffs from the compressed air cylinder. 
         [0043]      FIG. 3  is a schematic of the ventilator circuit formed by the ventilator supply module  110  of the system  10 . The ventilator module has an oxygen inlet port  110 - 1 . Pressurized oxygen is introduced to port  110 - 1  and passed through bypass channel  110 - 2  to demand regulator valve  114 . Simultaneously it is ported to the tidal volume control  112  through channel  110 - 3 . The tidal volume control  112  contains a series of orifices  112 - 1 , which may be adjustable restrictors, which limit the flow through passage  112 - 2  to diaphragm valve  112 - 3 . A restrictor  110 - 4  allows a small bleed through passage  110 - 5  to the opposite side of valve  112 - 3  so that the opening and closing of valve  112 - 3  is responsive to solenoid  140 - 1 . When solenoid  140 - 1  is closed, valve  112 - 3  is biased closed, and when valve  140 - 1  is open, valve  112 - 3  is opened to allow flow through outlet passage  110 - 6  to the outlet  114 - 1  of the demand regulator  114 . The opening and closing of the solenoid valve  140 - 1  is controlled by the timer module  140 . Thus, pressurized oxygen is bled through restrictor  110 - 4  and through channel  110 - 5  to hold the valve  112 - 3  in a closed position until solenoid valve  140 - 1  is opened by the timer module  140 , at which time the pressure in line  110 - 5  is exhausted and valve  112 - 3  is opened to port flow through channel  110 - 6  to the demand valve outlet  114 - 1  which provides a ventilator outlet port. Demand regulator  114  is a servo valve similar to that described above in  FIG. 2 . When the pressure in the outlet of the demand regulator  114  becomes negative, the demand regulator  114  responds to supply oxygen to the outlet  114 - 1 . If the pressure at the outlet exceeds a prescribed maximum limit, a relief valve  114 - 2  will open and bleed off excess oxygen, preventing the oxygen flow to the patient circuit from exceeding safe limits. 
         [0044]    The ventilator circuit operates in the following manner. Pressurized oxygen flows into port  110 - 1  and is channeled directly to the demand regulator  114  through channel  110 - 2 . It is also ported to the tidal volume control  112  through channel  110 - 3 . Regulated pressure is fed through restrictor  110 - 4  and passage  110 - 5  to diaphragm valve  112 - 3 . This channel may be vented through solenoid valve  140 - 1  in automatic mode which allows diaphragm valve  112 - 3  to open and cause a flow to outlet channel  110 - 6 . The flow is restricted by one of four adjustable restrictors  112 - 1 , which is positioned by rotating knob  116 , so as to limit the flow to the valve  112  outlet and thus with the timer  140  determine the volume of gas flowing to the patient. 
         [0045]      FIG. 3A  depicts an exemplary embodiment of a disposable patient circuit or module  120 . The module connects to the ventilator outlet port  114 - 1  of the controller and delivers breathing gas to the patient. The patient circuit includes a hose  122 , a patient valve  124  and a mask  40 . The patient valve  124  includes an inhalation/exhalation valve  124 - 1 , a relief valve  124 - 2  and a whistle  124 - 3 . When the pressure in the mask exceeds a threshold pressure, e.g., 55 cm. of water, the relief valve will open to prevent the pressure from rising further. The gas from the relief valve operates an audible alarm, in this example the whistle  124 - 3 , to alert the care-giver that the patient&#39;s airway is blocked and requires attention. 
         [0046]      FIG. 4  is a general schematic block diagram illustrating elements of the system unit  30 . The system unit is housed in a metal cabinet or enclosure, and includes an electronic timer circuit or module  140 , a power switch  148  for turning the unit on/off, and six connectors for connection to the pneumatic supply (i.e. the tank  20  and oxygen tank  22 ), the ventilator mask and cuffs  50 ,  60 ,  70 . A rechargeable battery  142  is mounted within the cabinet to power the timer module  140 . A connector is provided for electrical connection of a battery charger to the system unit  30  to charge the battery  142  through a fuse. 
         [0047]    Referring now to  FIG. 4A , a simplified functional block diagram of an exemplary embodiment of the timer module  140  is illustrated. The timer module  140  includes circuitry for implementing several functions, including: Time Base  140 -A, Oscillator  140 -B, Counter  140 -C, Decoder  140 -D, Reset Pulse Generator  140 -E, Power Switch and Reduced Energy Hold Timer functions  140 -F,  140 -G,  140 -H,  140 -I which control the electrically operated pneumatic valves  140 - 3 ,  140 - 2 ,  140 - 4  and  140 - 1 . The respective pneumatic valves control air/oxygen delivery to the abdomen, chest and leg cuffs  50 ,  60  and  70 , and to the ventilator module  110 . 
         [0048]    The time base  140 -A provides a means for the oscillator  140 -B to produce an accurate, stable frequency. The time base may be achieved, for example, with a crystal or ceramic resonator, or combinations of resistor-inductor-capacitor networks depending on the requirements of the system. A resistor-capacitor (R-C) circuit is utilized in an illustrative implementation. 
         [0049]    The oscillator  140 -B produces an electrical timing reference utilizing the electrical characteristics of the time base  140 -A. It may be implemented with three gate elements, or, in an exemplary embodiment, by a ripple-carry counter-divider (U 1 ),  FIG. 4B . 
         [0050]    The counter  140 -C and decoder  140 -D essentially count the timing reference pulses produced by the oscillator and produces electrical outputs when appropriate counts have been achieved. Depending on the implementation, the counter may be reset to a known value when a full cycle count has been achieved. In other implementations, resetting of the counter may be inherent and unnecessary, if the total count is 2 n , for example. One exemplary implementation uses a ripple-carry counter and multi-input gates to decode the count registers. CMOS logic elements are used but the implementation may be accomplished with TTL, or any other logic family including the use of a read-only memory or a microprocessor. 
         [0051]    The outputs of the decoder  140 -D drive the power switches  140 -F . . .  140 -I which supply current to the electrically operated pneumatic valves  140 - 1 ,  140 - 2 ,  140 - 3  and  140 - 4 . The input signals to the power switches are at a very low power level. When switched ON, the power switches provide the current necessary to operate the pneumatic valves. Additionally, in an exemplary embodiment, the power switches include a circuit to provide high pull-in drive to the valves and then reduce the drive current to that necessary to sustain their powered position. 
         [0052]    As described above, the electronic timer module  140  controls the timing and valve operation of the system  10 . It includes a battery powered digital controller to implement a specified operational sequence. In an exemplary embodiment, the control is provided by a hardware-based state-machine which sequences the system through  12  discrete operational states (Table I) before resetting and repeating. 
         [0000]    
       
         
               
             
               
               
               
               
               
               
               
               
               
               
               
               
               
               
             
           
               
                 TABLE 1 
               
             
             
               
                   
               
               
                 Timer States 
               
             
          
           
               
                 STATES 
                 1 
                 2 
                 3 
                 4 
                 5 
                 6 
                 7 
                 8 
                 9 
                 10 
                 11 
                 12 
                 RESET 
               
               
                   
               
               
                 CHEST 
                 ON 
                 OFF 
                 ON 
                 OFF 
                 ON 
                 OFF 
                 ON 
                 OFF 
                 ON 
                 OFF 
                 ON 
                 OFF 
                 ON 
               
               
                 ABDOMEN 
                 OFF 
                 ON 
                 OFF 
                 ON 
                 OFF 
                 ON 
                 OFF 
                 ON 
                 OFF 
                 ON 
                 OFF 
                 ON 
                 OFF 
               
               
                 VENTILATOR 
                 OFF 
                 ON 
                 OFF 
                 OFF 
                 OFF 
                 ON 
                 OFF 
                 OFF 
                 OFF 
                 ON 
                 OFF 
                 OFF 
                 OFF 
               
               
                 LEGS 
                 OFF 
                 OFF 
                 OFF 
                 OFF 
                 OFF 
                 OFF 
                 OFF 
                 OFF 
                 OFF 
                 OFF 
                 ON 
                 ON 
                 OFF 
               
               
                   
               
             
          
         
       
     
         [0053]    Table 1 shows the twelve states of the counter-divider, and the operational status of each pneumatic solenoid in the respective states. In an exemplary embodiment, the duration of each state is about one (1) second. Table 1 also shows a thirteenth or reset state. The reset state is a very brief period when the counter is returned to State 1. The duration of the reset state in an exemplary embodiment is less than 1 millisecond, or less than 0.1% of the duration of each of the other states. After completion of State 12, the timer enters the Reset State. The timer logic is configured so that the solenoid valve outputs in the Reset State are the same as State 1, so that the cuffs function as they do in State 1, and the Reset State is not functionally discernable in the operation of the equipment. Once reset is complete, the timer enters State 1. There is no transition effect on the cuffs other than a 0.1% stretch of the State 1 condition to complete reset. 
         [0054]    In an exemplary embodiment, the timer module may be implemented with CMOS logic elements and does not utilize a microprocessor or software to achieve this function. The use of CMOS components results in extended battery-powered operation due to their low current demand. In addition, operation at 12V achieves noise immunity in excess of 2V. 
         [0055]      FIG. 4B  is a schematic diagram illustrative of circuitry of an exemplary embodiment of the timer module  140 . In this embodiment, the primary timing function is provided by a resistor-capacitor (RC) (R 18 , C 2 ) controlled oscillator and a ripple-carry counter-divider (U 1 ). A worst case timing tolerance of less than +/−5% considering components, temperature, and supply voltage is expected by the use of R and C components with tolerances of 1% and 2% respectively. Decoding of the timing states is accomplished by several 2-input NAND gates (U 2 A, U 2 B, U 2 C, U 3 A, U 3 D) with Schmitt trigger outputs, such as type 4093 NAND gates circuits. The Schmitt trigger outputs further increase the noise immunity of the circuit and improve the reset pulse generation. 
         [0056]    Reset of the Counter-Divider  140 -C is provided by the Reset Pulse Generator  140 -E ( FIG. 4A ). In an exemplary embodiment illustrated in  FIG. 4B , the Reset Pulse Generator may be implemented by resistor R 5 , capacitor C 1 , and inverter U 3 C. The Reset Pulse Generator  140 -E responds to the decoding and detection of a count in excess of the objective twelve states which occurs when both inputs to NAND gate U 2 D are concurrently high. The high inputs to gate U 2 D result in a low output to R 5  and ultimately to U 3 C after a delay due to the R 5 -C 1  time constant. U 3 C is a gate which has a Schmitt trigger input and functions as an inverter because both inputs are tied together. The low input of U 3 C results in a high input to the Counter-Divider, U 1 , which resets its count to State 1 and forces all of its outputs low. Once the inputs to U 2 D are set low, its output becomes high. After the effect of an R 5 -C 1  time constant, the output of U 3 C is driven low, removing the reset of U 1  and allowing it to proceed through the objective twelve states. Properly resetting U 1  involves a salient condition that the reset input must be asserted for a minimum time interval. This requirement is achieved by the R-C circuit and Schmitt trigger gate U 2 D. There is no assurance that the reset is complete when the two inputs to U 2 D are zeroed. But the R-C circuit and Schmitt trigger gate assure that the reset remains asserted for the required time after the inputs to U 2 D are zeroed. 
         [0057]    Without the hysteresis of the Schmitt trigger, there is essentially little control of the reset duration and a “race” will exist in the reset circuit. U 2 D reacts immediately to its two high inputs and charges C 1  through R 5  to the trip level of U 3 C. Once the output of U 3 C goes high, reset is immediately asserted, forcing of the inputs to U 2 C low and its output high. Now C 1  is discharged through R 5  to the trip level of U 3 C. The time duration of the reset assertion is the sum of the time for the reset to return the output of U 2 D high and the time required to discharge C 1  sufficiently to return to the trip level of U 3 C. The former is a function of the gate speed and is very short. The latter time is determined by the charge that C 1  has attained during reset pulse which now must be removed to reduce the input of U 3 C to the trip level. In a typical gate with no input level hysteresis, the charge interval of C 1  and resulting charge is very small because it is determined by the reset time of two outputs of U 1  and the propagation delay of U 2 D, both of which are very short compared with the required reset duration. The hysteresis of the Schmitt trigger gate requires that C 1  discharge from the high trip level to the low trip level before the reset is terminated. These voltage levels along with the RC parameters reliably assure controlled reset duration in excess of 100 times that required with a minimum of components. 
         [0058]    In an exemplary embodiment, a low battery level detector circuit  146  is included to monitor the battery voltage. This circuit is powered continuously by the battery  142  and flashes an indicator LED  146 A when the battery discharges to a level insufficient for more than 45 minutes of operation. The flashing function results in asymmetric flashing, ON time less than OFF time, to reduce power consumption while achieving an attention demanding visual effect. The level detection circuit may be implemented using a dual, low power comparator, and preferably draws little current, e.g. less than 2 mA, from the battery during monitoring. 
         [0059]    The interface between the electronic control circuit and the pneumatic module  130  is provided by four solenoid valves ( 140 - 1 ,  140 - 2 ,  140 - 3 ,  140 - 4 ). The valve coils are driven by power MOSFET&#39;s (Q 1 , Q 2 , Q 3 , Q 4 ). The power MOSFET&#39;s interface well with the CMOS gates because they can operate from the low steady-state drive current available from the gates and have very low resistance in the ON state to drive the solenoid valves without dissipation losses in the switches. In addition, the limited current available from the gates combined with the large gate capacitance of MOSFET&#39;s results in a switching speed limitation, often considered a problem. Here it is an advantage because the reduced switching speed softens the valve transitions and renders them unresponsive to switching transients resulting from minor skew of the ripple counter outputs. 
         [0060]    Decoding from a single time base maintains the operating relationship between the body cuffs and ventilator independent of the operating frequency. 
         [0061]      FIGS. 5A and 5B  illustrate graphically the gas pressure ( FIG. 5A ) resulting from operation of the timer module and solenoid valve operation. Thus, the relative pressures in the cuff bladders and ventilator circuit resulting from the opening and closing of the controlling solenoid valves are illustrated. In an exemplary embodiment, the chest bladder pressure is in counter phase to the abdominal bladder giving the interposed abdominal compression (IAC)-CPR effect. The leg bladders cycle on every fifth cycle of the chest bladder. The ventilator is synchronized with the abdominal bladder to eliminate the possibility of insufflations of the stomach. Thus the ventilation and compression can be carried on without interruption. In an exemplary embodiment, each abdomen and chest cycle have durations of one second on and one second off in counter phase. 
         [0062]    Very low thermal dissipation of the timer is achieved by the use of MOS technology components. This is a two-fold advantage because battery power is conserved for longer operation and component temperatures remain near ambient levels. In addition, valve driver RC circuits for each valve, R 14  and C 3  for valve  140 - 2 ; R 15  and C 4  for valve  140 - 3 ; R 16  and C 5  for valve  140 - 1 ; R 17  and C 6  for valve  140 - 4 , reduce the power provided to the solenoid valves to an approximate 66% maintenance level once the solenoid is seated, again reducing battery drain and component heating. In an exemplary embodiment, each solenoid valve dissipates less than 0.5 W average. 
         [0063]    In an exemplary embodiment, the battery  142  is a sealed lead-acid unit. It is charged via an external charger through a connector mounted on the control unit  30 . A line mounted fuse limits the charge circuit current to 0.5 A. The circuit board includes a resettable 0.375 A fuse to limit battery current. A unidirection 15V, 1500 Watt transient suppression diode is also included on the circuit board. It, with the circuit fuse, provides protection from applied transient voltages in excess of approximately 18V and reverse polarity voltages. The fuse resets itself after the excessive current condition has been removed for several minutes. The unit may be powered directly by the charger or may be operated while the battery is being charged. 
         [0064]    The circuit board is interfaced with the power inputs and operating controls via three connectors. Each of the connectors (P 1 , P 2 , P 3 ) is different and keyed so that they may not be inadvertently installed incorrectly. 
         [0065]    In an exemplary embodiment, the circuit is designed to tolerate an electrically noisy environment resulting from high frequency communication radios. It is also housed in an aluminum enclosure (Faraday cage) to attenuate potential electrical interference. The internal clock oscillator operates at 64 Hz and at low power levels to preclude the emission of high frequency EMI. 
         [0066]    While an exemplary embodiment of the timer module is implemented as an electronic circuit, with electrically operated solenoid valves to operate the air pressure modules and the ventilator module, these elements may be implemented by pneumatic circuits in other embodiments. These pneumatic circuits may be operated by the pressurized gas supplies. 
         [0067]    The system  10  may include a backboard  100  to support the patient where needed, (such as on a bed) and accommodates the chest and abdominal compression cuffs  50  and  60  ( FIG. 1 ). The cuffs may be mounted on the board so as to facilitate placement on the patient and speed of donning. In an exemplary embodiment illustrated in  FIG. 6 , the backboard  100  is fabricated of a rigid material, such as PVC plastic or fiberglass, with opposed slots  102 A,  102 B and  104 A,  104 B at the sides of the board designed to allow movement of the cuffs to accommodate different size patients. The cuffs are threaded through the slots so that when the patient is positioned on the board, the cuffs are easily fastened using hook and loop fasteners. 
         [0068]      FIGS. 7A-7B  illustrate an exemplary embodiment of the chest cuff  50 . The cuff  50  includes an elongated flexible strap  52 , which has affixed at a top surface of one end a hook fastener portion  52 A. In an exemplary embodiment, the hook fastener portion is sewn to the top of the strap, as shown in  FIG. 7A , and has a sufficient size to withstand the forces applied in use due to inflation of the bladder  54 . In one embodiment, the hook fastener portion is 4 inches wide by 7 inches long. On the underside of the strap, and at the opposite strap end from the hook fastener portion, a loop fastener portion  52 B is attached to the strap, e.g. by sewing or by adhesive. The loop fastener portion is considerably longer than the hook fastener portion to allow the strap to be fitted to patients of varying sizes and fastened in place. The bladder  54  may be fabricated of a flexible material such as polyurethane, and has a port connector  56  which may be connected to a corresponding connector attached to hose  58  ( FIG. 1 ). In an exemplary embodiment, the connector between the hose and the controller is a color coded, sliding sleeve type as shown in  FIG. 11 , and the connectors  56  between the hoses and the cuffs are color coded, snap connected units as shown in  FIG. 12 . The connectors between the hoses and cuffs are designed to be permanent, with no provision for disconnecting. Alternatively the hose may be permanently attached to the bladder port. The opposite end of hose  58  is configured for connection to a port on the unit  30 . The bladder may be filled with pressurized air to inflate and apply pressure to the chest of the patient in an exhaling portion of a respiratory cycle, and deflated to allow air into the lungs of the patient, under control of the timer unit and operation of pneumatic solenoid valve  140 - 2  ( FIG. 4A ), as described above. The bladders may be of different sizes for different size cuffs, dependant on patient size. 
         [0069]      FIGS. 8A and 8B  illustrate the abdomen cuff  60 , which includes a flexible strip portion  62 , with a corresponding hook fastener portion  62 A and loop fastener portion  62 B attached at opposite ends and on opposite sides of the strap portion. The bladder  64  has a connector  66  for attachment to hose  68 . Alternatively, as described above regarding the chest cuff, the hose may be permanently attached to the bladder port. The bladder  64  may be inflated and deflated by operation of the pneumatic solenoid valve  140 - 3  ( FIG. 4A ). 
         [0070]      FIG. 9  illustrates an exemplary leg cuff  70 A, which may be used for the right leg or the left leg of the patient. The cuff includes a flexible strap portion  72 , with a corresponding hook fastener portion  72 A and loop fastener portion  72 B attached at opposite ends and on opposite sides of the strap portion. The bladder  74  has a connector  76  for attachment to hose  78  ( FIG. 1 ). Alternatively, as described above regarding the chest cuff, the hose may be permanently attached to the bladder port. The bladder  74  may be inflated and deflated by operation of the pneumatic solenoid valve  140 - 4  ( FIG. 4A ). The system preferably includes a leg cuff for each leg, and the bladder connectors joined together by a Y-hose to inflate/deflate the respective leg cuff bladders in unison. 
         [0071]    The hoses may be manually attached to the respective cuff bladders by connectors that are designed to make a permanent connection. The cuffs are intended to be a single use only so as to assure sanitation and eliminate any fatigue failures. The connectors on the control unit  30  engage the hoses with a sliding sleeve disconnect for easy connection and disconnection. 
         [0072]    In an exemplary embodiment, the patient disposable cuffs comprise a disposable patient kit which may be separately marketed or produced, while being compatible with attachment to the system unit  30 . In this regard, each cuff hose will have a connector which is distinguished from the other connectors for the other cuff hoses. This may be a visual feature, e.g. color coding with connectors on the system unit  30 , or the connectors may be designed so that the leg cuff hose can only be connected to the proper hose connector on the system unit, for example, or both. The kit may also include a mask with ventilator valve and hose, with the ventilator hose connector further being selected so that it may not physically attached to any of the cuff connectors on the control unit  30 . 
         [0073]      FIG. 10  illustrates a tank transport and storage unit  200  designed to allow easy transport of the air and oxygen tanks  22 ,  24 . The tanks fit into cavities formed in the caddy and are retained by bolts  210  and plastic clips  212 . The clips are such that by turning them 90 degrees the tanks are released for easy replacement. The hoses are wrapped around the caddy and a hand hold  214  is situated on the side for easy carrying. A detachable back pack  216  allows the tanks to be carried on the back, thus freeing hands for other items. 
         [0074]    While the system has been described in the context of a portable resuscitation/respiration system, the system unit  30  may be employed in a stationary or even a built-in application, e.g. in a hospital setting such as an emergency room or critical care unit. The pressurized gases may be supplied by lines from pressurized air and oxygen sources. The system unit can be mounted on a cart, or even built into a wall, and supplied with power by permanent connection. It is anticipated that the patient kit will be for one-time use, for sanitary reasons, and connected to the system unit in the same manner, i.e. by connectors/hoses. 
         [0075]    One application for the system illustrated in  FIG. 1  is to perform resuscitation on a patient. An exemplary procedure for operating the system in a resuscitation mode may employ two persons, preferably trained in CPR. Before use the control unit  30  may be pre-set to the following positions: Oxygen tidal volume selector to one position of 400, 600, 800 or 1000 ml. The chest cuff valve and the abdomen cuff valve are set to AUTO. The leg cuff valve is set to Off. 
         [0076]    1. After determining the condition of the patient, sit the patient upright. 
         [0077]    2. Place the backboard with the attached chest and abdomen compression cuffs behind the patient. 
         [0078]    3. Lay patient onto the back board. 
         [0079]    4. Alternately, place the backboard and cuffs to the patient&#39;s side and roll the patient onto the backboard. 
         [0080]    5. First attendant: a. apply chest cuff around patient and secure fasteners, b. apply abdomen cuff around patient and secure fasteners, c. connect color coded air supply hoses to cuffs, d. apply leg cuffs and connect color coded air supply hoses, e. turn controller valve for leg cuffs to Auto. 
         [0081]    6. Second attendant: a. connect and turn ON air and oxygen supply to controller, b. connect air supply hoses to controller, c. connect oxygen ventilation hose to controller, d. press ON/OFF button—green indicator lights and chest, abdomen and leg cuffs cycle, e. apply oxygen ventilator mask to patient. 
         [0082]    Upon successful resuscitation: a. turn tidal volume selector to the Demand position or apply oxygen continuous flow mask to patient, b. turn controller valve for chest cuff to OFF, c. continue to cycle abdomen and leg cuffs to provide circulation support Thus, if the patient returns to spontaneous breathing, the tidal volume selector can be set to the “demand” mode. In this mode, the ventilator is disconnected from automatic ventilation and provides oxygen ventilation with each breath of the patient. 
         [0083]    If the patient returns to cardiac arrest: a. reset tidal volume selector to previous setting, b. turn controller valve for chest cuff to ON, and automatic cardiopulmonary resuscitation resumes. 
         [0084]    Upon completion of resuscitation procedure: press the ON/OFF button—green indicator turns off and automatic oxygen ventilation and cuff cycles cease, disconnect the color coded air supply hoses from controller and cuffs, disconnect the oxygen ventilator hose from the control unit, disconnect the air and oxygen supply hoses from the control unit, open the cuff fasteners and remove from the patient. 
         [0085]    Exemplary embodiments of the resuscitation/respiration system can be used in several applications or operating modes, and may thus perform the functions of one of more of the following applications. 
         [0086]    1. Cardiopulmonary resuscitation, as described above. 
         [0087]    2. Circulation support mode. After resuscitation a weakened heart may produce low cardiac output which results in inadequate blood pressure and reduced blood flow to the brain, heart, kidneys and lungs. The circulation support feature helps reduce stress on the weakened heart during transportation to the hospital. In this mode: a. turn tidal volume selector to Demand position or apply oxygen continuous flow mask to patient, b. turn controller valve for chest cuff to OFF, c. continue to cycle abdomen and leg cuffs to provide circulation support. 
         [0088]    3. Transport ventilation. Patients in respiratory arrest or respiratory stress may require ventilation, where the ability to breathe is absent or impaired. In a transport ventilation mode, the system can act as a transport ventilator, and its selectable oxygen volume provide artificial oxygen ventilation of the lungs at a frequency of 15 breaths per minute. In this case the patient would need only respiratory support and would be fitted with a mask and connected to the ventilator. If the patient were breathing spontaneously the tidal volume selector would be set in the “demand” mode, if not it would be set to the appropriate tidal volume setting. The valves  36 B,  36 C and  36 D would be set to the OFF position. 
         [0089]    4. Anti-Shock system. Medical anti-shock trousers (MAST) have been used to increase venous return to the heart during traumatic and hemorrhagic shock until definitive care could be given. This, combined with compression of blood vessels, causes the movement of blood from the lower body to the brain, heart and lungs. The cycling action of the leg and abdomen cuffs may be used to restore blood pressure and return heart rate to normal. For anti-shock applications, the system would be set for legs only inflation, with valve  36 D in the “ON” position and valves  36 B and  36 C in the OFF position. As such it would function similar to anti-shock trousers (MAST). In more severe cases, e.g. for patients in a traumatic and/or hemorrhagic shock condition, the system would be set to cycle the abdomen and legs in “automatic” mode. Unlike conventional medical anti-shock trousers that are statically inflated to force blood from the lower body to the brain, heart and lungs, the abdomen and leg cuffs may be cycled in the usual rhythm described above for the resuscitation mode. Those patients in shock with either no or low blood pressure and rapid heart rate, (a typical shock condition) may have their condition reversed relatively quickly, e.g. in 1-3 minutes. 
         [0090]    In accordance with a further embodiment, the system may be employed to facilitate the distribution of medications, by enhancing intraveneous (IV) medication and fluid infusion rates. Cardiac arrest and resultant circulatory shock lead to organ hypoperfusion, circulatory shunting, cellular dysfunction, and ultimately death. Circulatory shock also complicates distribution of medications that are administered during cardiopulmonary resuscitation, such as epinephrine, lidocaine, etc., even when conventional manual CPR protocols are being utilized. Clearly, medications must reach their sites of action in order to increase the likelihood of Return of Spontaneous Circulation (ROSC), but will not as long as circulatory pumping is impaired. 
         [0091]    In accordance with this aspect, as illustrated in  FIGS. 1 and 16 , an IV line  380  is intraveneously connected to the patient  1  prior to or during the use of the system  10  with the medication and/or fluid to be administered in an IV bag  382 . With the system  10  connected to the patient and in operation, blood flow is greatly augmented by the inflation/deflation cycling of the chest, abdomen, and, if connected, the leg compression cuffs, since there are now multiple external circulatory pumps instead of the single point manual chest compression site over the sternum. This overcomes the vicious cycle of shock, facilitating volume replacement and concomitantly proper distribution of cardio-stimulatory drugs to improve chances of ROSC. 
         [0092]    A further embodiment involves the integration of defibrillator pads with the compression cuffs. The American Heart Association (AHA) protocol for patients in cardiac arrest with certain dangerous arrhythmias is to apply defibrillator electrode pads to the patient chest, followed by rhythm analysis and up to a series of three shocks, followed by cardiopulmonary resuscitation for one minute. After one minute, interrupt CPR, apply three more shocks to the patient and resume CPR. AHA guidelines advise that “patient chest hair may prevent effective electrode pad contact with the skin causing high transthoracic impendence resulting in ineffective defibrillator shock.” If the defibrillator produces a message to check electrodes or check electrode pads the problem may be resolved by pressing firmly on the pads,” according to AHA guidelines. 
         [0093]    An enhanced patient kit provides the means to preposition defibrillator electrode pads into the compression cuffs thereby reducing the vital time to apply the pads to the patient prior to or during the resuscitation process. The tight circumferential wrapping of the compression cuffs enhance electrode contact with the patient minimizing the possibility of transthoracic impedance. An exemplary embodiment is illustrated in  FIG. 13 , in which the chest cuff bladder  54  has affixed to the underside surface  54 A at least one, and in this example, two electrode pads  310  and  312 , each with a respective electrode wire  310 A and  312 A for connection to a system such as a defibrillator, or other patient monitoring or treatment system such as an EKG. The electrode pads are positioned in a position on the surface  54 A selected so that the electrodes will be properly positioned for contact against the patient&#39;s chest. The electrode pads may be attached to the chest cuff by adhesive or other attachment methods, such as by adhesive, rf welding or ultrasonic welding. The patient&#39;s clothing will typically be removed to allow direct contact of the electrodes with the patient&#39;s skin. 
         [0094]    To further facilitate rapid and proper positioning of the patient kit elements on the patient, the backboard or patient platform may be provided with a patient positioning system. The anatomical symbol for man, (shown as element  318 ) in  FIG. 14 ) is located at the top of the patient platform. After the patient is placed into the sitting position, the backboard  100  is positioned behind the patient. The anatomical symbol  318  serves as an orientation guideline when applying the backboard  100  and the chest and abdomen cuffs to the patient. 
         [0095]    Abdomen and chest compression cuffs are threaded into the patient backboard  100  in a ready, prepositioned position for application to the patient. Prepositioned cuffs on the platform facilitate alignment with patient abdomen and chest thereby reducing CPR initiation time. 
         [0096]    To further facilitate the rapid attachment of the compression cuffs to the patient, a cuff prepositioning system, in an exemplary embodiment a cuff lanyard system  320  ( FIGS. 14 ,  14 A and  15 ), may be employed to secure the chest and abdomen compression cuffs  50  and  60  to the patient platform  100  in a storage or ready position and facilitate rapid deployment of the cuffs for use on the patient. In an exemplary embodiment, the ends of abdomen and chest compression cuffs  50  and  60  are folded in an accordion-like fashion and the folded end portions  50 A,  50 B and  60 A,  60 B are secured on either side of the patient platform by the cuff prepositioning system, in this embodiment the retaining strap portions  330  and  340  of the lanyard system  320 . The retaining straps are wrapped around each folded cuff flap portion and are secured by hook and loop fasteners sewn to the straps. The two straps are joined together with a pull ring  322  to form the lanyard system  320 . Alternatively, the lanyard system could be formed of a single strap, folded and secured at its midpoint to the ring  322 . After the patient is set upward and the platform  100  positioned behind him, the medical attendant on the right side of the patient pulls the lanyard away from the platform and the folded cuff flaps fold away from the platform in opposing directions. The patient is laid back on the exposed platform and the opposing cuff flaps are enclosed around the patient and fastened with their hook and loop fasteners. 
         [0097]    In an alternate embodiment, the cuff prepositioning system may be an elastic or tearable member such as an elastic cord or a tearable wrapper arranged to release upon manual manipulation by an attendant, allowing individual manual deployment of each folded cuff portion. 
         [0098]    Inflation compression cuffs  50  and  60  for application to a patient in a state of circulatory impairment such as cardiac arrest, shock or similar condition are attached to a patient platform to facilitate rapid application. As described above with respect to  FIGS. 7A-9 , for example, the chest and abdomen compression cuffs  50  and  60  have inflatable bladders, and end portions that are folded and secured on either side of the patient platform by retaining straps. One end or portion  330  of the retaining strap or lanyard system  320  wraps around the folded chest compression cuff portions and the opposite end portion  340  of the lanyard system wraps around the folded abdomen compression cuff portions. The two strap portions join together with the pull ring  322  to form the lanyard that when rapidly pulled in a right angle away from the patient platform causes the folded chest and abdomen cuff portions to unfold in opposing directions from the platform  100 , thereby exposing the platform for patient positioning and rapid application of cuffs around the patient chest and abdomen. 
         [0099]    The lanyard system  320  is illustrated in further detail in  FIGS. 15 and 15A . Retaining strap portion  330  has one end attached to the ring  322 , and hook fastener portion  330 C formed on its upper or first surface  332  adjacent its terminal end  334 . The strap portion  330  also has a hook fastener portion  330 A and a loop fastener portion  330 B formed on the surface  332  in spaced relation. Similarly, the retaining strap portion  340  has one end attached to the ring  322 , and hook fastener portion  340 C formed on its upper or first surface  342  adjacent its terminal end  344 . The strap portion  340  also has hook fastener portion  340 A and loop fastener  340 B formed on the surface  342  in spaced relation. Both strap portions have a loop fastener portion  330 D,  340 D on the under side or second surface  336 ,  346  adjacent the respective terminal end. 
         [0100]      FIGS. 14 and 14A  illustrates an exemplary rigging configuration for securing the chest and abdomen cuffs to the patient platform  100  using the lanyard system  320 . Only the chest cuff  50  and lanyard strap  330  are shown in  FIG. 14A , although the rigging of the abdomen cuff with strap  340  may be identical. The chest cuff  50  has its midsection under the platform, with the opposed ends passed through the slots  102 A,  102 B of the platform and brought up through the slots. The opposing end portions are folded accordion-style, to form the folded chest cuff portions  50 A,  50 B. In this folded position, the hook fastener portion  52 A and loop fastener portion  52 B are exposed on top of the respective folded cuff portions. In a similar fashion, the abdomen cuff  60  has its midsection under the platform, with the opposed ends passed through the slots  104 A,  104 B of the platform and brought up through the slots. The opposing end portions are folded accordion-style, to form the folded chest cuff portions  60 A,  60 B. In this folded position, the hook fastener portion  62 A and loop fastener portion  62 B are exposed on top of the respective folded cuff portions. The strap portion  330  is wrapped around the patient platform, with the terminal end  334  passed through slot  102 A, under the patient platform, and up through the slot  104 B or over the side of the patient platform. The hook fastener portion  330 C on the terminal end of the retaining strap portion  330  attaches to the loop fastener portion  52 B of chest cuff  50 . The portion of the strap portion  330  on the top of the platform is folded over onto itself at the chest cuff portion  50 A. The strap portion is tightened, and loop fastener portion  330 B of the strap portion  330  attaches to hook fastener portion  52 A of the chest cuff  50 . The hook fastener portion  330 A on the surface  334  of the distal end  334  of the strap portion  330  attaches to the retaining strap loop fastener portion  330 D, on the underside  336  of retaining strap  330 . 
         [0101]    In a similar fashion, retaining strap portion  340  is wrapped around the patient platform and hook fastener portion  340 C on the terminal end  344  attaches to loop fastener portion  62 B of abdomen cuff  60 . The portion of the strap portion  340  on the top of the platform is folded over onto itself at the chest cuff portion  60 A. The strap portion is tightened, and loop fastener portion  340 B of the strap portion  340  attaches to hook fastener portion  62 A of the abdomen cuff  60 . The hook fastener portion  340 A on the surface  342  of the distal end  344  of the strap portion  340  attaches to the retaining strap loop fastener portion  340 D, on the underside  346  of retaining strap  340 . 
         [0102]    The retaining strap portions  330  and  340  join together at pull strap portion  324  and pull ring  322  to form the cuff lanyard assembly. 
         [0103]    In accordance with an exemplary embodiment, the patient in a state of circulatory impairment such as cardiac arrest, shock or similar condition is positioned forward in a folding like motion by medical attendants. The patient platform  100 , with chest and abdomen cuffs  50  and  60  retained in place by the lanyard system  320 , is placed longitudinally behind the patient in accordance with the platform&#39;s anatomical symbol  318  of a human. The medical attendant to the right of the patient grasps the lanyard pull ring and rapidly pulls at a right angle away from the patient platform. The rapid pull of the lanyard causes hook fasteners  330 A and  340 A of retaining strap portions  330  and  340  to detach from the loop fasteners  330 D and  340 D of the respective strap portions  330  and  340 . As the lanyard is pulled away from the platform, loop fasteners  330 B and  340 D attached to the folded portions  50 B and  60 B of the chest cuff and abdomen cuff pull on the folded portions  50 B,  60 B, causing these portions to unfold in the same direction from the platform as the ring is being pulled. As the medical attendant completes the right angle pull on the lanyard system, now the lanyard portion under the platform is pulled, exerting a pull force on the distal ends  334 ,  344 , and the hook fastener portions  330 C,  340 C attached to the folded chest cuff portions  50 A and  60 A of the chest cuff and abdomen cuff pull in the direction opposed to the lanyard ring pull, causing the cuff portions  50 A,  60 A to unfold in an opposite direction from the platform. With the cuff assemblies unfolded away from the platform, the patient is laid back upon the platform and each cuff is secured around the patient with its hook and loop fasteners. Rapid deployment is complete and the medical procedure commences. 
         [0104]    Although the foregoing has been a description and illustration of specific embodiments of the subject matter, various modifications and changes thereto can be made by persons skilled in the art without departing from the scope and spirit of the invention.