Abstract:
A method and system for providing emergency medical counselling to a rescuer is disclosed. The method comprises transmitting a first data set comprising first temporal data, first positional data and first medical data from a first position to a central server and transmitting a second data set comprising second temporal data, second positional data and medical data from a second position to the central server ( 150 ). The central server ( 150 ) matches ( 380 ) in the first temporal data ( 32   a ) and the first positional data ( 34   a ) with the second temporal data ( 32   b ) and the second positional data ( 34   b ) to associate the first set of data ( 30   a ) with the second set of data ( 30   b ) to thereby obtain a medical history dataset ( 195 ) comprising at least the first medical data ( 36   a ) and the second medical data ( 36   b ).

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    None 
       FIELD OF THE INVENTION 
       [0002]    The field of the invention relates to a method and a system as well as a mobile station for providing emergency medical counselling to a rescuer who is aiding a patient. 
       BACKGROUND OF THE INVENTION 
       [0003]    The concept of a “chain of survival” refers to a series of actions that, when put into motion, substantially reduce the mortality associated with a cardiac arrest of a patient. The chain of survival is, however, only as strong as its weakest link. The four inter-dependent links in the chain of survival are: i) early access to the patient, ii) early cardio pulmonary resuscitation (CPR) on the patient, ii) early defibrillation and iv) early advanced cardiac life support. Each of these links needs to be supported if the chance of survival of the patient is to be increased. 
         [0004]    Ideally, a bystander recognising an impending cardiac arrest should contact an emergency services centre as soon as possible and, in order to be most affective, CPR should be provided immediately after collapse of the patient. It is known that properly performed CPR can keep the heart, brain and other vital organs alive for ten to twelve minutes longer, which can substantially increase the chance of survival. Studies have shown that about half of the bystanders or rescuers have some degree of CPR training and would therefore be capable of providing early CPR. However, only about one third of those trained in CPR actually performed CPR on the patient suffering the cardiac arrest. The reasons for this are multi-fold. The bystanders may have panicked, are afraid of doing harm, or do not understand that the patient was in cardiac arrest. There is therefore a need to encourage these bystanders to perform CPR correctly. 
         [0005]    One method for supporting bystanders as rescuers is to use assistance from a dispatcher. A method and system for giving remote emergency medical counsel to potential rescuers of patients is known from U.S. Pat. No. 6,053,864 (Clawson), which uses a series of flash cards to enable a dispatcher in an emergency medical services centre to guide the rescuer through the steps of a procedure for giving remote emergency medical counsel, such as CPR, to the patient. This system has been implemented in some emergency medical services centres, but currently does not provide any feedback to the dispatcher on the progress of the CPR, other than voice communication with the rescuer or another bystander. 
         [0006]    U.S. Pat. No. 6,459,933 (Lurie et al.) teaches a method for providing medical treatment to a patient at a location, which is away from a medical facility. The method provides that at least one physical parameter of the patient is monitored with a monitoring device and the physical parameter, such as a heartbeat, is subsequently transmitted to a central controller that is located within the medical facility. A control signal is transmitted from the controller to operate a treatment device that is coupled to the patient. This patent does not, however, disclose a system in which a rescuer is supported in providing emergency medical care to the patient. 
       SUMMARY OF THE INVENTION 
       [0007]    This disclosure teaches a method for providing emergency medical counselling to a rescuer which comprises transmitting a first set of data relating to the patient and comprising first temporal data, first positional data and first medical data from a first position to a central position. A second set of data relating to the same patient and comprising temporal data, positional data and medical data from a second position is also provided to the central server. The central server can match the first temporal data and the first positional data with the second temporal data and the second positional data to associate the first set of data with the second set of data and thereby obtain a medical history data set for the patient, comprising at least the first medical data and the second medical data. The match occurs because at at least one point in time, the first position and the second position will be substantially the same and the central server will be able to determine this match. 
         [0008]    The first positional data indicates the position of the patient on collapse. The first medical data will then relate to data from treatment by a rescuer on the spot. The second positional data relates to the position of an emergency services vehicle on arrival at the scene or the position of medical equipment carried from the vehicle to the patient. The second medical data will be medical data that has been obtained from a paramedic at the scene of the patient. The central server is able to take the first and second data sets, gathered independently from each other, and combine the two data sets in order to provide a complete record of the process of the emergency medical treatment. This can then be made available to the paramedics in the emergency services vehicle or to a doctor at a hospital or other medical facility on arrival of the patient. The complete record can be used to improve system of care by better training, better procedures, better equipment, increase motivation and understanding of the mechanism of resuscitation. 
         [0009]    This disclosure also teaches a system for providing an automated emergency medical record of a patient treatment, which comprises a data receiver for receiving the first data set and the second data set as well as a processor for matching the first temporal data and the first positional data with the second temporal data and the second positional data. This then allows the association of the first data set with the second data set to obtain a complete medical history data set, as explained above. 
         [0010]    In one aspect of this invention the first medical data is obtained from a CPR card placed on the chest of the patient in order to measure the depth and rate of compression. This first medical data is provided through to the central server for access by the dispatcher. The first medical data can be transferred by means of a mobile station, such as a smartphone, which has a data receiver and a data transmitter. The dispatcher can also communicate with the rescuer through the loudspeaker and/or the microphone detached to the mobile station. 
     
    
     
       DESCRIPTION OF THE FIGURES 
         [0011]      FIG. 1  shows an overview of the system of this disclosure. 
           [0012]      FIG. 2  shows an example of the data sets. 
           [0013]      FIG. 3  shows an outline of the method of this disclosure. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0014]    The invention will now be described on the basis of the drawings. It will be understood that the embodiments and aspects of the invention described herein are only examples and do not limit the protective scope of the claims in any way. The invention is defined by the claims and their equivalents. It will be understood that features of one aspect or embodiment of the invention can be combined with a feature of a different aspect or aspects and/or embodiments of the invention. 
         [0015]      FIG. 1  shows a first aspect of the system of the current disclosure. In this aspect of the disclosure, it is assumed that a patient  100  has already collapsed and is being attended by a rescuer  50 . It will be assume that the rescuer  50  has been trained in cardiopulmonary resuscitation (CPR) and has a smartphone  60 . This is, however, not limiting of the invention and it is possible that the rescuer  50  has not been trained in CPR but has some basic knowledge of first aid. It is also possible that the rescuer  50  uses a device other than a smartphone  60 . For example, the rescuer  50  may use a dedicated emergency service radio device or other data transmission device, such as a tablet or mobile computer. These devices will be commonly termed a mobile station  60 . The mobile station  60  includes a local memory  62  for storing applications programs, also called apps, and data. The mobile station  60  includes further a GPS receiver or similar positioning means  64  for generating positional data from a GPS signal and a clock  66  for maintaining real time and producing temporal data. It will be known that the temporal data can also be obtained from the GPS signal and thus the clock  66  may also be part of the GPS receiver  64 . The clock  66  may also be arranged in a central server that connects to the mobile station  60 . A receiver  67  is present which receives data over a number of protocols, including but not limited to the Bluetooth protocol. A transmitter  69  can transfer data, including the temporal data and the positional data. 
         [0016]    The rescuer may be equipped with a so-called CPR card  22 . The CPR card  22  is produced, for example, by the Laerdal Medical Company and is able to measure and record the rate and depth of chest compressions (pushing up and down on the chest performed by the rescuer  50  on the patent  100 ). It is also possible that other devices, like the CPR Meter, are used to record this information. 
         [0017]    The smartphone  60  will be provided an application program in the local memory  62 , which has already been downloaded from a central repository  155 , such as from Google Play or iTunes, and installed on the smartphone  60 . The CPR card  22  transmits continuously or regularly first medical data  36   a  relating to the rate and depth of the chest compression to the smartphone  60  for example by means of a Bluetooth or similar protocol and is received by the receiver  67 . The smartphone  60  transmits continuously or regularly using the transmitter  69  as a first data set  30  the received first medical data  36   a  from the CPR card  22 , together with first temporal data  32   a,  obtained either from the GPS signal received by the smartphone  60  or from an internal clock  66 , as well as first positional data  34   a  obtained from the GPS system or other positional device. In addition and without limitation, voice data, video data, acceleration data, temperature data, light data may also be recorded by the smartphone  60  and communicated as part of the first medical data  36   a.    
         [0018]    This first data set  30   a  is transmitted to a central server  150  and received at a data receiver  160 . It will be understood that the transmission between the smartphone  60  and the data receiver  160  is carried out using a mobile telecommunications system in this aspect of the invention. It would be possible to use a number of different protocols, such as UMTS (3G), LTE (4G) or even EDGE (2G) data transfer protocols. Alternatively a Wi-Fi protocol could be used if this is available locally. The central server  150  stores the first data set  30   a  in a database as medical history data set  195 . The medical history data set  195  is a collocation of the received first data sets  30   a.    
         [0019]    The medical history data set  195  can be accessed by trained medical personal. In one aspect of the disclosure the trained medical personal could include a dispatcher located, for example, in an emergency services centre, such as a hospital  180  or other medical facility. Access is made via a communications link  190 . The dispatcher is able to receive the medical history data set  195  on a continuous basis from the central server  150 . 
         [0020]    In one aspect of the invention the dispatcher is also able to communicate with the rescuer  50  by means of a loud speaker  63  at the smartphone  60 . Communication is via a mobile telecommunications system. A microphone  65  is provided at the smartphone  60  and can be accessed by the app in the smartphone  60  to enable the rescuer  50  to communicate with the dispatcher. In one further aspect, the dispatcher is able to send a control signal to the smartphone  60 , which enables the use of the loudspeaker  63 , video camera, accelerometer or other sensors found on a smartphone such that the information from the sensor is communicated to the dispatcher and made useful to the dispatcher as for instance live video displayed on a monitor in front of the dispatcher. 
         [0021]    The application program stored in the smartphone  60  can provide additional features. For example, the application program can access a Bluetooth interface on the smartphone  60  to pair the CPR card  22  (or other devices) with the smartphone  60 . Other protocols, such as the IEEE 802.x protocol, can also be used for this communication. The application program can also call the appropriate emergency medical phone number, and can determine this from the location of the smartphone  60 . The application program also has a function to activate the loudspeaker  63  when connection has been established as well as setting the loudspeaker volume to a high level and the illumination of the display of the smartphone  60  to bright. 
         [0022]    The dispatcher calls an emergency services vehicle  65  to the location of the patient  100 . The dispatcher is able to obtain the exact coordinates of the patent  100  from the first positional data  34   a  received from the smartphone  60 . This enables the emergency services vehicle  65  to arrive promptly at the location of the patent  100 . It is also possible for the app on the smartphone  60  to automatically call the emergency services vehicle  65  by sending the first positional data  34   a  of the smart phone  60  together with an emergency signal or other indication that the patient  100  is requiring emergency medical counselling. 
         [0023]    The emergency services vehicle  65  has a number of medical devices in the vehicle, which are shown schematically as block  80  in the emergency services vehicle  65 . The emergency services vehicle  65  is also able to communicate a second data set  30   b  with the data receiver  160  over a mobile telecommunications link. The second data set  30   b  comprises second medical data  36   b  from the second set of medical devices  80  and is transmitted across the telecommunications link, together with second temporal data  32   b  and second positional data  34   b  from the location of the emergency services vehicle  60 . 
         [0024]    The central server  150  is able to match the first temporal data  32   a  and the first positional data  34   a  from the smartphone  60  with the second temporal data  32   b  and the second positional data  34   b  from the emergency vehicle  65 . The central server  150  will therefore identify that the first medical data  36   a  from the smartphone is associated with the same patient  100  as the second medical data  36   b  received from the emergency services vehicle  60 . The central server  150  can therefore match the first data set  30   a  and the second data set  30   b  with each other to create the combined medical history data set  195 . 
         [0025]    The combined medical history data set  195  is supplied to the dispatcher (as noted above), but can also be supplied to the paramedics while at scene, to a doctor/medical director or at the hospital  180  or other medical facility. Non-limiting examples of the other medical facilities include a national or international cardiac arrest registry, like CARES or EUREKA. It will be appreciated that a hospital  180  could also be a clinic or similar. 
         [0026]      FIG. 2  shows an example of the first data set  30   a  and the second data set  30   b.  The data sets  30   a  and  30   b  comprise at least three data fields including temporal data  32   a  and  32   b,  position data  34   a  and  34   b  and at least one item of medical data  36   a  and  36   b  per data set  30   a  and  30   b.  It will be appreciated that the medical data  36   a  and  36   b  will at least relate to the rate and depth of chest compression on the patient  100 . It is equally possible that the medical data  36   a  and  36   b  relates to other medical parameters, such as the heart rate. For example the emergency services vehicle  65  can include other devices such as a defibrillator or a respiratory profile motor, which monitors standard parameters, like tidal CO 2 , O 2  saturation, inspiratory and expiratory tidal volume and similar, as well as the patient temperature, shock delivery and other medical events. The data relating to these other medical parameters from these devices is provided as the second medical data  36   b  in additional data fields, which are not shown on  FIG. 2 . It is equally possible that the smartphone  60  transmits some or similar data and could receive the first medical data  36   a  from portable medical devices in addition to the CPR card  22 . 
         [0027]      FIG. 3  shows an outline of the method for providing emergency medical counselling, according to one aspect of this invention. The procedure starts in step  300 . It is assumed that the patient  100  collapses or otherwise shows signs of medical distress. The rescuer  50  will call in step  310  the emergency telephone number for the emergency services centre, such as 911 in the United States, 000 in Australia or 112 in Europe. It will be assumed for purposes of this disclosure that the rescuer  50  is a trained rescuer and has already downloaded the app onto his or her smartphone  60 , but the app could also be downloaded in real-time. This app can be used to automatically call the emergency services number (911, 000, 112) and also to turn on the smartphone&#39;s  60  microphone and loudspeaker, as noted above. A connection is made in step  315  to the dispatcher who is then able to aid the rescuer  50 . 
         [0028]    The rescuer  50  has the CPR card  22  and places this CPR card  22  on a patient&#39;s  100  chest in a suitable position. The CPR card  22  connects through a communications link to the smartphone  60  in step  320 . The rescuer  50  then starts CPR in step  330  and the CPR card  22  measures the rate and depth of the chest impressions in step  340  and transmits this data to the smartphone  60 . The rescuer  50  is encouraged by the dispatcher to change the rate and depth of chest compression if the dispatcher receives the medical data  36   a  indicating that the rescuer  50  is not performing the CPR in an optimal manner. The CPR card  22  can also include an indication that the CPR is being performed correctly, but encouragement from a dispatcher is advantageous. In one aspect of the disclosure, the smartphone  60  may also provide direct feedback to the rescuer regarding his/her CPR performance. This feedback may be visible on the display of the smartphone  60 , audible through the loudspeaker  63  or both. 
         [0029]    The dispatcher will notify in step  345  a paramedical service that arrives in the emergency services vehicle  65  in step  350 . The emergency services vehicle  65  is connected to the central server  150  and notifies the central server of the arrival of the emergency services vehicle  65  in a location, which is proximate to the patient  100 . The paramedics from the emergency service vehicle  65  provide relief the rescuer  50  in step  360 . The paramedics can provide additional medical treatment and attach additional medical devices  80  to the patient and the further medical devices  80  transmit the second data set  30   b  in  370  to the central server  150 . The central server  150  can identify that this second data set  30   b  comes from the same location and is concurrent to the data received from the first data set  30   a.  The central server  150  will conclude from the matching of the first temporal data  32   a  and the second temporal data  32   b  as well as the first positional data  34   a  and the second positional data  34   b  that the paramedics are dealing with the same patient  100 . The central server  150  has a processor  170  which access the stored first data set  30   a  and the second data set  30   b  and creates the combined medical data set in  195  in step  390 . The medical history data set  195  can then be either supplied to the paramedics and/or to a hospital to allow treatment of the patient  100  on arrival in the hospital.