Abstract:
A cardiopulmonary resuscitation (CPR) timer for use with a bag mask resuscitator provides a visual pacing device when a cardiopulmonary resuscitation procedure is being performed on a patient is disclosed. The CPR timer includes a plurality of visual indicators arranged in an array that sequentially activate at a predetermined pace that matches the recommended pace for air delivery times and/or chest compressions when using a bag mask resuscitator to provide life support to a patient. The CPR timer further includes a pressure sensor in operative association with the bag mask resuscitator for detecting when the bag mask resuscitator is actuated.

Description:
FIELD 
       [0001]    The present document relates to a bag mask resuscitator, and more particularly to a cardiopulmonary resuscitation (“CPR”) timer used with the bag mask resuscitator. 
       SUMMARY 
       [0002]    In an embodiment a cardiopulmonary resuscitation timer may include a housing, said housing including a plurality of visual indicators arranged in an sequence, said plurality of visual indicators being adapted to be sequentially activated at a predetermined pace as a visual pace setting device for pacing breaths and/or chest compressions to a patient. 
         [0003]    In another embodiment, a bag mask resuscitator may include a hollow, flexible resuscitation bag in fluid flow communication with a valve assembly through a hollow, flexible hose, said valve assembly being in operative engagement with a mask, said valve assembly including an adaptor defining an outlet port adapted to engage a hollow flexible tubing, and a cardiopulmonary resuscitation timer defining an inlet port engaged to said tubing, said tubing in operative association with a pressure sensor for monitoring air pressure being applied by the bag mask resuscitator through the tubing, said cardiopulmonary resuscitation timer further including a plurality of visual indicators for providing a predetermined pace for actuating said resuscitation bag. 
         [0004]    In yet another embodiment, the bag mask resuscitator may include a hollow, flexible resuscitation bag in fluid flow communication with a valve assembly, said valve assembly being in operative engagement with a mask, said valve assembly including an adaptor defining an outlet port adapted to engage a hollow flexible tubing, and a cardiopulmonary resuscitation timer defining an inlet port engaged to said tubing, said tubing in operative association with a pressure sensor for monitoring air pressure being applied by the bag mask resuscitator through the tubing, said cardiopulmonary resuscitation timer further including a plurality of visual indicators for providing a predetermined pace for actuating said resuscitation bag. 
         [0005]    Implementation of the above embodiments may include one or more of the following features: 
         [0006]    The plurality of visual indicator includes a start indicator and a plurality of timing indicators. 
         [0007]    The activation of said start indicator provides a visual cue to the user to begin providing breaths and/or chest compressions to a patient. 
         [0008]    The plurality of timing indicators are sequentially activated in order to provide a visual pace setting device for pacing the frequency of breaths and/or chest compressions provided to a patient after the start indicator has been activated. 
         [0009]    Each of said plurality of visual indicators is an LED. 
         [0010]    The predetermined pace includes providing a pace established for either an adult or a child. 
         [0011]    The visual indicators are deactivated in reverse sequence during an expiratory time period. 
         [0012]    The cardiopulmonary resuscitation timer further includes a pressure sensor for sensing air pressure indicative of a breath being provided to a patient. 
         [0013]    The cardiopulmonary resuscitation timer further including a pressure sensor for sensing air pressure indicative of a breath being provided to a patient, wherein said start indicator is activated when the air pressure sensed by said pressure indicator exceeds a predetermined threshold. 
         [0014]    The plurality timing indicators are one color and said start indicator is a different color. 
         [0015]    The cardiopulmonary resuscitation timer further includes an inspiratory time indicator for providing the amount of inspiratory time taken to provide one or more breaths to a patient. 
         [0016]    The cardiopulmonary resuscitation timer further includes a breaths per minute indicator for indicating the number of breaths per minute provided to a patient. 
         [0017]    The cardiopulmonary resuscitation timer further includes airway pressure indicator in operative association with said pressure indicator for indicating the presence of air pressure. 
         [0018]    The timing indicators may be non-visual indicators. 
         [0019]    The cardiopulmonary resuscitation timer is operable between a CPR operation mode and a rescue breathing operation mode. 
         [0020]    The cardiopulmonary resuscitation timer further includes a mode change selector for changing the mode of operation between said CPR operation mode and a rescue breathing operation mode. 
         [0021]    The cardiopulmonary resuscitation timer further includes a patient selector for providing different kinds of said predetermined pace when operating in either said CPR operation mode or a rescue breathing operation mode. 
         [0022]    Additional objectives, advantages and novel features will be set forth in the description which follows or will become apparent to those skilled in the art upon examination of the drawings and detailed description which follows. 
     
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0023]      FIG. 1  is a side view of a bag mask resuscitator with a CPR timer; 
           [0024]      FIG. 2  is a front plan view of the CPR timer; 
           [0025]      FIG. 2A  is a front plan view illustrating the connection of a flexible tubing with a pressure sensor inside the CPR timer; 
           [0026]      FIG. 3  is a schematic circuit diagram of the CPR timer; 
           [0027]      FIG. 4  is a flowchart illustrating a method of operating the CPR timer; 
           [0028]      FIG. 5  is a flowchart illustrating a method of sampling a power source; 
           [0029]      FIG. 6  is a flowchart illustrating a method of sampling a sensor; and 
           [0030]      FIG. 7  is a timing diagram of a breath using the bag mask resuscitator. 
       
    
    
       [0031]    Corresponding reference characters indicate corresponding elements among the several views. The headings used in the figures should not be interpreted to limit the scope of the figures. 
       DETAILED DESCRIPTION 
       [0032]    Referring to the drawings a cardiopulmonary (“CPR”) timer for use with a bag mask resuscitator  2  is illustrated and generally indicated as  10  in  FIG. 1 . In one embodiment, CPR timer  10  may be used with bag mask resuscitator  2  for providing a visual pace setting device to pace the user&#39;s actuation of the bag mask resuscitator  2  and/or pace the number of chest compressions provided to a patient during emergency life saving support. Bag mask resuscitator  2  may include a hollow, flexible resuscitation bag  4  that provides oxygen to the patient when the user repeatedly squeezes the resuscitation bag  4  to force oxygen through a flexible, hollow hose  8  and into the patient&#39;s respiratory system through a mask  6  seated on the patient&#39;s face which is in fluid flow communication with the resuscitation bag  4 . Bag mask resuscitator  2  may also provide air to the patent as an option to providing oxygen as herein described. 
         [0033]    Bag mask resuscitator  2  may also provide air to the patient as an option to providing oxygen as herein described. 
         [0034]    Bag mask resuscitator  2  may provide emergency life saving support to a patient, for example when the patient suffers a heart attack and requires manual ventilation to force oxygen or air into the patient&#39;s respiratory system and/or chest compressions to the patient. As shown, the flexible, hollow hose  8  includes a distal end  104  attached to a valve assembly  3  and a proximal end  106  attached to the resuscitation bag  4  such that fluid flow communication is established between the valve assembly  3  and resuscitation bag  4 . 
         [0035]    The valve assembly  3  is operatively engaged to mask  6  which is seated on a patient&#39;s face for providing oxygen or air to the patient when the resuscitation bag  4  is actuated. As further shown, valve assembly  3  includes an adaptor  11  that defines an outlet port  15  adapted to be in fluid flow communication with the CPR timer  10  through a hollow, flexible tubing  7  for the passage of air flow therethrough caused by the actuation of resuscitation bag  4  in order to detect and determine current detected pressure by the CPR timer  10  as shall be discussed in greater detail below. 
         [0036]    In an alternative embodiment, the resuscitation bag  4  may be directly engaged to the valve assembly  3  without use of the flexible hose  8 . As noted above, the CPR timer  10  acts as a visual pace setting device to pace the user&#39;s actuation of the resuscitation bag  4  when the CPR timer  10  is in the rescue breathing operation mode so that the user can provide the recommended number of breaths per minute to the patient when providing emergency life saving support. For example, the CPR timer  10  may provide a visual pace setting that paces the user to provide a greater number of breaths to a child than to an adult when giving emergency life saving support. 
         [0037]    Alternatively, in the CPR operation mode the CPR timer  10  acts as a visual pace setting device to pace the user&#39;s actuation of the resuscitation bag  4  in addition to pacing the number of chest compressions provided to a patient between each manual ventilation of a patient&#39;s respiratory system. For example, the CPR timer  10  may provide a visual pace setting that paces the user to provide a different number of chest compressions and breaths per minute to an adult than a child. 
         [0038]    Referring to  FIGS. 2 and 2A , CPR timer  10  may include a housing  12  having a circuit board  17  for providing the various pace setting operations required to visually pace the number of chest compressions applied to the patient or the user&#39;s actuation of the resuscitation bag  4  when manually ventilating the patient&#39;s respiratory system. As further shown, housing  12  defines an inlet port  13  adapted to engage tubing  7  for providing monitoring air pressure as shall be discussed in greater detail below. CPR timer  10  may further include an ON/OFF switch  14  for selectively permitting or preventing operation of the CPR timer  10 . ON/OFF switch  14  may be an alternating action switch that permits power to flow to the electronics when the switch is closed. However, other types of switches, such as momentary switches and tactile switches, are also contemplated. 
         [0000]    As further shown, housing  12  may define a front surface  44  which may be configured to have light diffusing characteristics. In one aspect, front surface  44  may be made from polycarbonate and define a textured finish. In addition, front surface  44  may have a dome or stepped shaped having multiple rectangles that decrease in size. However, front surface  44  may have other ergonomic shapes that provide a better gripping surface and enhanced viewing and use by the user. In one embodiment, housing  12  may be made from a molded plastic or metal, however other lightweight, durable and/or water resistant materials are contemplated. 
         [0039]    CPR timer  10  may also include an inspiratory time indicator  16 , Breaths Per Minute (BPM) indicator  18  and an airway pressure indicator  19  which are visible through front surface  44  to provide information to the user regarding various operations of CPR timer  10  as shall be discussed in greater detail below. 
         [0040]    Inspiratory time indicator  16  may indicate the amount of inspiratory time being taken to provide one breath to the patient when actuating resuscitation bag  4 . In one embodiment, inspiratory time indicator  16  may be two seven-segment light emitting diodes (LED display) for displaying inspiratory time, however other types of indicators such as liquid crystal displays (LCDs), are also contemplated. For example, the two seven-segment LEDs may be manufactured by Ledtech Electronics Corp. 
         [0041]    BPM indicator  18  may indicate the number of breaths per minute being provided to the patient as the resuscitation bag  4  is being actuated by the user. In one embodiment, BPM indicator  18  may be two seven-segment LED display, however other types of indicators, such as LCDs, are also contemplated. 
         [0042]    In addition, airway pressure indicator  19  may indicate the presence of air pressure above a predetermined threshold being detected through flexible  7 . Airway pressure indicator  19  evidences actuation of the resuscitation bag  4  when the air pressure detected exceeds a predetermined air pressure threshold so that various pace setting operations of CPR timer  10  may be initiated. 
         [0043]    As noted above, CPR timer  10  provides a means for visually pacing a user when operating the bag mask resuscitator  2 . CPR timer  10  may include a start indicator  20  and timing indicators  22 ,  24 ,  26 ,  28  which may provide visual indications to the user for pacing breaths provided to the patient by actuation of resuscitation bag  4  as described in greater detail below. 
         [0044]    The timing indicators  22 ,  24 ,  26   28  (with or without start indicator  20 ) may be sequentially illuminated in series at predetermined intervals to visually indicate the pace of breaths to be provided to the patient when actuating resuscitation bag  4 . As such, the sequential illumination of timing indicators  22 ,  24 ,  26 ,  28  enables a user to visually follow timing indicators  22 ,  24 ,  26 ,  28  in order to pace the actuation of the resuscitation bag  4  and provide the proper number of breaths per minute to the patient. 
         [0045]    In one embodiment, four timing indicators  22 ,  24 ,  26 ,  28  may be used with CPR timer  10  although other number of timing indicators are also contemplated for providing a visual pace setting indication. The timing indicators  22 ,  24 ,  26 ,  28  may be bi-color LEDs, however other visual and non-visual indicators for pacing the number of breaths to be provided to the client are also contemplated. 
         [0046]    The operation of CPR timer  10  may be adjusted by actuating mode change selector  30  and patient selector  36  on housing  12 . In operation, actuation of mode change selector  30  may enable a user of CPR timer  10  to select between a CPR operation mode or a rescue breathing operation mode as shall be discussed in greater detail below. Mode change selector  30  may be a momentary switch, however other types of switches such as alternating action switches and tactile switches are also contemplated. In addition, CPR indicator  32  may indicate that CPR timer  10  has been placed in CPR operation mode, while the rescue breathing indicator  34  may indicate that CPR timer  10  has been placed in rescue breathing operation mode. 
         [0047]    Patient selector  36  may allow the user to select between a child patient mode and an adult patient mode when the CPR timer  10  is in either the CPR operation mode or rescue breathing operation. In particular, child patient indicator  38  may indicate that CPR timer  10  is in the child patient mode and adult patient indicator  40  may indicate that CPR timer  10  is in the adult patient mode. 
         [0048]    Referring to  FIG. 3 , an implementation of a schematic of CPR timer  10  is illustrated. In this implementation, a processor U 1  may direct the various operations of CPR timer  10 . Processor U 1  may be a microcontroller or microprocessor, for example, a PIC16F872 processor manufactured by MICROCHIP or a MC9508AW16CF6E processor manufactured by Freescale, however other suitable processors are contemplated. 
         [0049]    As shown, Input J 1  may be electrically coupled to processor U 1  through resistors R 17  and R 18  and capacitors C 1 , C 6  and C 7  and may enable programming of processor U 1  by providing a data input. A crystal oscillator may be electrically coupled with processor U 1 . In this embodiment, Crystal oscillator acts as an internal clock to generate a timing signal to be used by processor U 1 . It should be appreciated that a crystal oscillator may not be required in implementations where processor U 1  has an internal clock. 
         [0050]    A series of light emitting diodes (“LEDs”) D 1 -D 5  may be electrically coupled to processor U 1  through resistors R 7 -R 16  to provide CPR timer  10  with the necessary electronics for start indicator  20  and timing indicators  22 ,  24 ,  26 ,  28 . 
         [0051]    A non-visual indicator BZ 1  may be electrically coupled to processor U 1  through an amplifier Q 1  and a resistor R 21  to provide CPR timer  10  with a non-visual indicator. For example, amplifier Q 1  may be a BC847AE6327 amplifier manufactured by FAIRCHILD SEMICONDUCTOR. In one embodiment, non-visual indicator BZ 1  may be a noise generator such as a buzzer, while in another embodiment non-visual indicator BZ 1  can be a vibratory component. 
         [0052]    A selector S 2  may be electrically coupled to processor U 1 . In addition, the mode change selector  30  may include selector S 2  operatively associated with resistor R 4 . In addition, selector S 3  may be electrically coupled to processor U 1  and a resistor R 5  to provide the electronics for patient mode selector  36 . Diode pair D 6  and D 7  as well as diode pair D 8  and D 9  may be alternately illuminated in different order or in sequence to provide CPR indicator  32 , rescue breathing indicator  34 , patient selector  36 , and child patient indicator  38 , respectively. 
         [0053]    A pressure sensor  21  may be operatively coupled to processor U 1  in order to monitor pressure detected through flexible tubing  7  which is in fluid flow communication with valve assembly  3  through outlet port  15  in order to provide a means for the CPR timer  10  to determine whether the resuscitation bag  4  is being actuated and a sufficient breath is being delivered to the patient in order to initiate the pace setting operation. In one embodiment, pressure sensor  21  may continually monitor air pressure at a designated number of times per second, such as every 1/20 of a second, to determine if the monitored air pressure exceeds a predetermined threshold in order to initiate a pace setting operation. Pressure sensor  21  may be an integrated pressure sensor MPXV4006 manufactured by FREESCALE. Pressure sensor  21  may be capable of measuring air pressure in a range from 0-60 cm H 2 0 above atmospheric pressure. A capacitor C 4  may be electrically coupled to pressure sensor  21  and may be a 470 picofarad 25 v capacitor manufactured by SURGE. 
         [0054]    Power may be provided to CPR timer  10  from a power source V 1  when selector S 1  is actuated. In one embodiment, power source V 1  may be a 9 volt battery, however other suitable power sources are also contemplated. Selector S 1  may be electrically coupled with resistors R 2  and R 3  to provide the electronics for ON/OFF switch  14  in order to either initiate or terminate operation of CPR timer  10 . 
         [0055]    Three seven-segment displays L 1 , L 2  and L 3  may be electrically coupled with drivers U 3  and U 4  to provide a numerical display for displaying the various values for inspiratory time indicator  16 , BPM indicator  18  and airway pressure indicator  19 . For example, drivers U 3  and U 4  may be an LED MC14489B driver made by MOTOROLLA. 
         [0056]    Referring to  FIG. 4 , an implementation of a method of operation for CPR timer  10  is illustrated. In this implementation, the default settings of CPR timer  10  may be loaded or the previous mode settings may be recalled at step  200 . The default settings may be loaded when CPR timer  10  is turned on by actuation of ON/OFF switch  14 . 
         [0057]    In one embodiment, the mode settings of CPR timer  10  may be the settings for the operation mode or patient mode last used with CPR timer  10 , however other embodiments such as having the predetermined mode settings set by the manufacturer or distributor are also contemplated. The default settings may be that non-visual indicator BZ 1  is actuated rather than illuminating the timing indicators  22 ,  24 ,  26 ,  28 . 
         [0058]    At step  202 , CPR timer  10  may sample a power source V 1 . An implementation of sampling a power source is described in greater detail below. CPR timer  10  may then sample pressure sensor SEN 1  at step  204  in order to determine whether the resuscitation bag  4  has been actuated by the user. An implementation of sampling pressure sensor SEN 1  is described in greater detail below. 
         [0059]    At step  206 , CPR timer  10  tracks the time once sufficient pressure has been detected. Thereafter, CPR timer  10  at step  207  may update the displays and indicators. For example, updating the settings may be checking for a change in operation mode or patient mode. 
         [0060]    In one embodiment, when the CPR timer  10  is placed in the CPR operation mode the user provides life saving support by alternating between providing a breath to the patient by actuation of resuscitation bag  4  within a range of 1-1.4 seconds and then providing an appropriate number of chest compressions to the patient. 
         [0061]    When in the rescue breathing operation mode, CPR timer  10  may be set to pace the user to provide 8 to 12 breaths a minute by having the user to maintain an inspiratory time of 1 to 1.4 seconds and an expiratory time of about 3.5 seconds when the patient is an adult, while a greater number of breaths per minute may be applied to a child by actuating the patient selector  36 . In one embodiment, inspiratory time may indicate inhale time, while expiratory time may indicate the combination of exhale time and wait time. 
         [0062]    In one embodiment, non-visual indicator BZ 1  may be in ON or OFF mode by actuating mode change selector  30  for a predetermined period of time, such as two seconds, in order to provide an audio pace setting operation either alone or in combination with the visual pace setting operations discussed above. Non-visual indicator BZ 1  may provide an audio indication, such as two beeps to indicate that non-visual indicator BZ 1  has been turned ON or OFF. 
         [0063]    CPR timer  10  at decision point  208  determines whether the OFF mode has been selected. In one embodiment, OFF mode may be selected when ON/OFF selector  14  is actuated by the user, however other embodiments such as holding down mode change selector  30  or patient selector  36  for a prescribed period of time are also contemplated. 
         [0064]    If the OFF mode has not been selected by the user, CPR timer  10  returns to step  202 . If OFF mode has been selected, an implementation of the foregoing method is complete. 
         [0065]    Referring to  FIG. 5 , an implementation of a method for sampling power source V 1  is illustrated. In this implementation, CPR timer  10  at step  210  first determines the power remaining for operating CPR timer  12  at step  210 . CPR timer  10  at decision point  212  may determine whether the remaining power of power source V 1  is less than a predetermined power threshold. In one embodiment, the predetermined power threshold may be 6.7 volts, however other values may also be contemplated. 
         [0066]    If the remaining power source V 1  is less than the predetermined power threshold, CPR timer  10  may be placed in low power mode at step  214  for conserving power. In one embodiment, low power mode may not provide sufficient power to inspiratory time indicator  16  and BPM indicator  18 , while continuing to power start indicator  20  and timing indicators  22 ,  24 ,  26 ,  28 , however other low power arrangements are also contemplated. 
         [0067]    In one embodiment, low power mode may be indicated by flashing one or more visual indicators, such as CPR indicator  32  and/or rescue breathing indicator  34 . If the remaining power of power source V 1  is not less than the predetermined power threshold, an implementation of the foregoing method is complete. 
         [0068]    Referring to  FIG. 6 , an implementation of a method for sampling a sensor is illustrated. In this implementation, CPR timer  10  monitors pressure by pressure sensor  21  at step  220 . At decision point  222 , CPR timer  10  determines whether the current pressure is greater than the predetermined start pressure. If the current pressure is not greater than the predetermined start pressure, CPR timer  10  returns to step  220 . If the current pressure is greater than the predetermined start pressure, CPR timer  12  may start tracking inspiratory time and proceed to step  224 . 
         [0069]    When the current pressure is greater than the predetermined start pressure CPR timer  10  may have detected the start of a breath to the patient by the bag mask resuscitor  2 . In one embodiment, the predetermined start pressure may be 5 cm H 2 O above atmospheric pressure, however other predetermined start pressures above and below 5 cm H 2 0 atmospheric pressure are also contemplated. 
         [0070]    CPR timer  10  may activate non-visual indicator BZ 1  when the end of an X time  occurs. The activation of non-visual indicator BZ 1  may provide a “chirp” sound to indicate that the care giver should start a new breath and a “beep” sound to indicate that a new breath has started and detected by the CPR timer  10 . In addition, non-visual indicator BZ 1  may be activated for a predetermined period of time corresponding to the desired inspiratory time, such as one second. 
         [0071]    At step  224 , CPR timer  10  may sequentially activate timing indicators  22 ,  24 ,  26   28  in series to provide a visual pace setting indicator to guide the user for delivering a breath to the patient using resuscitation bag  4 . In one embodiment, timing indicators  22 ,  24 ,  26   28  are sequentially illuminated so as to visually show elapsed time for pacing a properly timed breath to the patient such that all four timing indicators  22 ,  24 ,  26 ,  28  are all illuminated. 
         [0072]    Alternatively, a properly timed breath may be delivered when indicators  20 ,  22 ,  24 , and  26  are sequentially illuminated, but timing indicator  28  is not yet illuminated. In one embodiment, the timing indicators  22 ,  24 ,  26 ,  28  may be illuminated in an inspiratory color such as green, however other colors and/or color combinations are also contemplated. 
         [0073]    At the end of desired inspiratory time, CPR timer  10  may calculate and display the breaths per minute being provided to the patient at step  226 . In one embodiment, breaths per minute may be calculated by measuring the time between the start of the last two breaths and then dividing 60 by that number. 
         [0074]    At step  228 , CPR timer  10  may determine and display the updated inspiratory time on inspiratory time indicator  16 . Thereafter, CPR timer  10  may read the current pressure detected by pressure sensor  21  at step  229 . 
         [0075]    CPR timer  10  at decision point  230  may determine whether the current detected pressure is greater than peak pressure previously detected by pressure sensor  21 . If the current detected pressure is greater than peak pressure previously detected, CPR timer  10  returns to step  228  to display the updated inspiratory time. In one embodiment, CPR timer  10  may sample the current detected pressure twenty times a second, however other embodiments with different sampling rates are also contemplated. If the current detected pressure is not greater than peak pressure, CPR timer  10  proceeds to decision point  232 . 
         [0076]    CPR timer  10  may determine at decision point  232  whether the current detected pressure is less than the peak pressure minus a first predetermined delta pressure value, ΔP 1 . The first predetermined delta pressure value is a predetermined value for pressure that prevents inadvertent pressure surges in the bag mask resuscitator  2  from providing a false pressure reading. If the current detected pressure is not less than the peak pressure minus the first predetermined delta pressure value, CPR timer  10  updates and displays the inspiratory time at step  234  and then reads the current pressure at step  235 . After the current pressure is read, the CPR timer  10  returns to decision point  232 . If the current detected pressure is less than the peak pressure minus the first predetermined delta pressure value, CPR timer  10  proceeds to step  236 . 
         [0077]    CPR timer  10  at step  236  may sequentially deactivate timing indicators  22 ,  24 ,  26 ,  28  in reverse sequence to illustrate the expiratory phase when the patient is exhaling. In one embodiment, timing indicators  22 ,  24 ,  26 ,  28  may be deactivated sequentially in one second intervals when CPR timer  10  is in adult mode and in 4/10 of a second intervals when CPR timer  10  is in child mode, however other timing intervals are also contemplated. A unique expiratory color, for example yellow, may be activated for each timing indicator  22 ,  24 ,  26 ,  28  instead of deactivating timing indicators  22 ,  24 ,  26 ,  28  in reverse sequence. After completion of step  236 , an implementation of the foregoing method is complete. 
         [0078]    In one embodiment, after step  236  start indicator  20  may be illuminated and non-visual indicator BZ 1  activated in order to provide a short audio notification to signify the start of a next breath by actuation of bag mask resuscitator  2 . 
         [0079]    A bad breath flag may be activated with the foregoing method to indicate that a particular breath applied to the patient was not within an acceptable breath range when detected by the pressure sensor  21 . For example, an acceptable breath range may be 1.0 to 1.4 seconds of inspiratory time. CPR timer  10  may monitor whether the bad breath flag has been activated and may provide the user of CPR timer  10  with a bad breath alert. For example, the bad breath alert may be activated by changing start indicator  20  and/or one or more of timing indicators  22 ,  24 ,  26 ,  28  to a bad breath color for the duration of the breath and/or providing an audio notification. For example, bad breath color may be red, however the use of other colors and color combinations are also contemplated. 
         [0080]    In one embodiment, a BPM flag may be used with the foregoing method to indicate that the breaths per minute is not within the predetermined acceptable BPM range. For example, the acceptable breaths per minute range may be 8-10 breaths per minute when the CPR timer  10  is in adult mode and 16-20 breaths per minute when the CPR timer  10  is in the child mode, however other acceptable BPM ranges are also contemplated. 
         [0081]    Referring to  FIG. 7 , a timing diagram illustrates a breath being provided to a patient using bag mask resuscitator  2  for the purpose of determining inspiratory and expiratory times for each breath given to a patient, while also determining the breaths per minute provided to the patient. In this implementation, the start of a breath may be shown to be provided by bag mask resuscitator  2  at a “Inspiratory Time Start” when pressure is set at Base Pressure+ΔP 1 , wherein Base Pressure is the lowest pressure achieved by the bag mask resuscitator  2  during operation and ΔP 1  is the first predetermined delta pressure value. As the breath is begun to be provided to the patient by the actuation of the resuscitation bag  4 , the current detected pressure will rise until the current detected pressure reaches the value of the Peak Pressure. The current detected pressure falls from the Peak Pressure as the a breath is continue to be provided to the patient until the current detected pressure reaches a value of Peak Pressure minus a second predetermined delta pressure value, ΔP 2   
         [0082]    In one embodiment, the first and second predetermined delta pressure values are 5 cm/H20, although other predetermined delta pressure values are contemplated. Once the current detected pressure reaches a value of Peak Pressure minus the second predetermined delta pressure value an “Inspiratory Time Finish” is established. Thereafter, the current detected pressure continues to fall until this pressure reaches the Base Pressure. Once current detected pressure falls to the Base Pressure, a delay may occur before the next breath is started by the actuation of the resuscitation bag  4 . At the end of the delay, the current detected pressure may be seen to rise again from Base Pressure to Base Pressure+ΔP 1  such that the next Peak Pressure may be determined. 
         [0083]    As illustrated in  FIG. 7 , the time between the Inspiratory Time Start and Inspiratory Time Finish establishes the inspiratory time for that particular breath, while the time between the Inspiratory Time Finish and the next Inspiratory Time Start establishes the expiratory time for that particular breath. Accordingly, the inspiratory and expiratory times may be determined for each breath. 
         [0084]    It should be understood from the foregoing that, while particular implementations have been illustrated and described, various modifications can be made thereto and are contemplated herein. It is also not intended that the invention be limited by the specific examples provided within the specification.