Patent Publication Number: US-7214203-B2

Title: Cardiopulmonary resuscitation apparatus

Description:
FIELD OF THE INVENTION 
   The present invention relates to a cardiopulmonary resuscitation (CPR) apparatus, and more particularly, to a cardiopulmonary resuscitation apparatus adapted to artificially trigger the circulation of blood flow of a patient whose heartbeats are stopped. 
   BRIEF DESCRIPTION OF THE PRIOR ART 
   Generally, the method of cardiopulmonary resuscitation serves to provide blood flow to the entire human body in lieu of functions of heart and lung, which includes external chest compression and artificial respiration. 
   In order to restore spontaneous circulation, coronary perfusion pressure needs to be maintained above 20 mmHg during cardiopulmonary resuscitation. Standard CPR can usually generate only 15–20% of normal cardiac output, which is inadequate to restore spontaneous circulation in the majority of patients. Therefore, a variety of CPR techniques and/or apparatuses have been disclosed to enhance blood flow. 
   One of the CPR apparatuses was filed by the present applicant and registered as Korean Patent No. 270596. 
   The aforementioned Korean Patent No. 270596 is a CPR apparatus provided with sternal compression and thoracic constriction means that simultaneously functions as a cardiac pump for compressing the sternum and as a thoracic pump for constricting the thorax, thereby supplying a large amount of blood flow. 
   As illustrated in  FIG. 1 , the sternal compression and thoracic constriction means  1  includes a piston  6  for compressing sternum  4  of a patient  2 , and a chest band  10 , both ends of which are wound on a plurality of rollers  8  to be coupled to both lateral surfaces of the piston  6 , for encompassing, constricting or relaxing the chest of the patient  2  in response to movement of the piston  6 . 
   In the apparatus thus described in the Patent No. 270596, when the piston  6  descends, the piston  6  compresses the sternum to function as a cardiac pump and, at the same time, the chest band  10  secured at both ends thereof to the piston  6  fastens the chest, which additionally enhances a rise of intrathoracic pressure, thereby increasing the amount of the blood flow and promoting the effect of CPR. 
   However, there is a problem in the patent No. 270596 in that the length of the chest band not easy adjustable and it takes a long period of time to adjust the chest band such that CPR cannot be performed within a short period of time, resulting in the fear of losing a patient&#39;s life, because the chest band should be adjusted according to a patient&#39;s physique to allow the thoracic pump to properly function. 
   There is another problem in that the chest band moves, potentially causing damage to the patient&#39;s body when the piston moves vertically to compress the patient&#39;s sternum and the chest band constricts the thorax. 
   SUMMARY OF THE INVENTION 
   The present invention provides a cardiopulmonary resuscitation apparatus adapted to easily adjust a chest band according to the patient&#39;s physique to maintain effective sternal compression and chest constriction simultaneously. 
   The present invention further provides a cardiopulmonary resuscitation apparatus adapted to protect the chest from the chest band when a patient&#39;s chest is constricted. 
   In accordance with an embodiment of the present invention, a cardiopulmonary resuscitation apparatus comprises sternal compression means having a piston for compressing a patient&#39;s sternum; thoracic constriction means having a chest band for fastening and constricting the chest when the compression means compresses the sternum; and length adjusting means for adjusting the length of the chest band according to the size of the patient&#39;s chest. The length adjusting means includes: a bobbin for getting the chest band wound on; a first ratchet wheel inserted and fixed at a bobbin axle; a first stopper meshed to the first ratchet wheel for preventing reverse rotation of the bobbin; a handle bracket inserted at the bobbin axle for free rotation, coupled with the first stopper to be guided and with a second ratchet wheel coupled at one side thereof; a second stopper meshed to the second ratchet wheel for restricting the rotation of the handle bracket; and a spiral spring for giving rotational force to the bobbin. 
   The thoracic constricting means further includes a protection pad to be attached to the chest when the chest band is tightened. 
   The sternal compressing means further includes: a stopper having a plurality of restricting grooves for adjusting a dropping level of the piston; and a restricting member hitched at the restricting groove in descending along with the dropping piston. 
   In accordance with another embodiment of the present invention, the cardiopulmonary resuscitation apparatus comprises sternal compression means having a piston for compressing a patient&#39;s chest; and thoracic constriction means having a chest band for fastening and constricting the chest when the compression means compresses the chest, wherein the chest band includes: left and right chest bands divided for respectively winding around the left and right parts of the chest, a main body having a support side for securely placing and supporting a patient&#39;s back and length adjusting means assembled at the main body for adjusting the length of the chest band according the size of the patient&#39;s chest, the length adjusting means further including; left and right bobbins for getting the left and right chest bands wound on after insertion through the center of the support side; a spiral spring for giving restoring force to the left and right bobbins; a plurality of electric gears mounted to the left and right bobbins for rotating the left and right bobbins; and driving means for driving the electric gears and locking means for restricting the rotation of the electric gears. 
   The driving means includes a driving gear meshed to the electric gears for rotation, a driving axle coupled with the driving gear, a handle axle spline-fastened at the driving axle for attachment and detachment and a handle fastened at the handle axle. 
   The driving means may include a driving gear meshed to the electric gears for rotation, a driving axle coupled with the driving gear, and a motor for being controlled by control means to rotate the driving axle. 
   The driving means may include a center gear meshed to the electric gears for rotations, a driving axle coupled with the center gear, a driving gear inserted at the driving axle and a cylinder having a rack gear for rotating the driving gear. 
   The thoracic constriction means includes a protection pad for being attached to the chest when the chest band is fastened and an elastic skin protection band attached at the internal side of the chest band for protecting the patient&#39;s skin. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The objects and aspects of the invention will become more apparent from the following description of preferred embodiments with reference to the accompanying drawings in which: 
       FIG. 1  is an elevation view for illustrating a conventional cardiopulmonary resuscitation apparatus; 
       FIG. 2  is a plane for illustrating the cardiopulmonary resuscitation apparatus in accordance with the first embodiment of the present invention; 
       FIG. 3  is a cross-sectional view cut along arrow line I—I shown in  FIG.2 ; 
       FIG. 4  is a cross-sectional view cut along arrow line II—II shown in  FIG. 3 ; 
       FIG. 5  is a cross-sectional view cut along arrow line III—III shown in  FIG. 3 ; 
       FIG. 6  is a perspective view for illustrating a first guide roller mounted on a connection plate shown in  FIG. 3 ; 
       FIG. 7  is a perspective view for illustrating a first stopper and a handle bracket shown in  FIG. 3 ; 
       FIG. 8  is a perspective view for illustrating a stopper and a restricting member shown in  FIG. 5 ; 
       FIG. 9  is an elevation view for illustrating the cardiopulmonary resuscitation apparatus in accordance with the second embodiment of the present invention; 
       FIG. 10  is a plane of the main body shown in  FIG. 9 ; 
       FIG. 11  is a lateral view of the main body shown in  FIG. 9 ; 
       FIG. 12  is a plane for illustrating the sternal compression means and thoracic constriction means shown in  FIG. 9 ; 
       FIG. 13  is a cross-sectional view of the attachable and detachable connection unit shown in  FIG. 2  as seen along arrow line A—A; 
       FIG. 14  is an analytical perspective view for illustrating the parts shown in  FIG. 12 ; 
       FIG. 15  is an analytical, perspective view for illustrating the locking means of the cardiopulmonary resuscitation apparatus in accordance with the second embodiment of the present invention; 
       FIG. 16  is an assembling plane view of the locking means shown in  FIG. 15 ; 
       FIGS. 17 and 18  illustrate operational states of the locking means shown in  FIG. 15 ; 
       FIG. 19  illustrates a patient lying on the cardiopulmonary resuscitation apparatus of the present invention; 
       FIG. 20  illustrates an elevation view for illustrating the cardiopulmonary resuscitation apparatus in accordance with the third embodiment of the present invention; 
       FIG. 21  is a plane view of the main body shown in  FIG. 20 ; 
       FIG. 22  is a lateral view of the main body shown in  FIG. 20 ; 
       FIG. 23  is an analytical, perspective view for illustrating the parts of the sternal compression means and thoracic constriction means shown in  FIG. 20 ; 
       FIG. 24  is a perspective view for illustrating the connection unit shown in  FIG. 20 ; and 
       FIG. 25  is a cross-sectional view for illustrating the assembly of the connection unit shown in  FIG. 24 . 
   

   DETAILED DESCRIPTION OF THE INVENTION 
     FIG. 1  illustrates a conventional cardiopulmonary resuscitation apparatus, discussed above in the Description of the Prior Art. 
   As shown in  FIGS. 2 and 3 , two vertical, lateral plates  12 ,  12 ′ are connected by a horizontal center plate  14 , so that a frame  16  is constructed with a predetermined gap between the two vertical lateral plates  12 ,  12 ′. The frame  16  includes: first compression means  18  for compressing the sternum, second compression means  22  having a chest band  20  for fastening and constricting the chest when the first compression means compresses the sternum and length adjusting means for adjusting the length of the chest band  20  according to the size of the patient&#39;s chest. 
   The first compression means  18  includes a compression pad  30  coupled with a piston  26  protruded downward at the horizontal center plate  14  via a medium member  28 . The piston  26  is embedded in a cylinder  32  and is operated by air pressure. The compression pad  30  may be coupled directly with the piston  26 . 
   The piston  26  may have a spring inserted at the internal side of the cylinder  32  for being operated by air pressure when it goes forward (drops) and operated by the restoring force when it goes backward (rises). On the other hand, the piston  26 , as disclosed in Patent No. 270,596, includes a rack at one side thereof and can be operated by a motor that rotates a pinion toothed with the rack. 
   The medium member  28  is fixed at a connection plate where a guide roller, which will be described below, is coupled, and a hitching block  34  is mounted at an end of the protruder  28   a  extended down to the medium member  28  for being inserted and hitched to the compression pad  30 . 
   The compression pad  30  includes a groove  30   a  where the hitching block  34  is inserted, and the hitching block  34  is hitched by a cover  36  that covers a partial upper portion of the groove  30   a.    
   The second compression means  22  includes a connection plate  38  fixed at the medium member  28 , a plurality of rollers at both sides of the connection plate  38  and at both lower sides of the vertical lateral plate. When the chest band  20  guided by the rollers is wrapped around a patient&#39;s chest and fastened, protection pads  40 ,  40 ′ are closely related to the patient&#39;s chest. 
   At this time, the rollers guiding the chest band  20  are classified into first guide rollers  42 ,  42 ′ coupled at both sides of the connection plate  38 , second guide rollers  44 ,  44 ′ coupled at both lower sides of the vertical lateral plates  12 ,  12 ′ and idle rollers  46 ,  46 ′ coupled between the first and second guide rollers. 
   As shown in  FIG. 6 , a fixing groove  38   a  is formed at the center of the connection plate  38  for insertion and fixation of the medium member  28 . Both ends of the connection plate  38  are sunken for assembly of the first guide rollers  42 ,  42 ′. The connection plate  38  is fixed at the medium member  28  to rise or fall along with the operation of the piston  26 . However, it may also be raised or dropped by a separate power source in relation to the operation of the sternal compression means  18 . 
   As shown in  FIGS. 3 and 4 , the protection pads  40 ,  40 ′ are fitted at both ends of an axle of the second guide rollers  44 ,  44 ′ and fixed at the vertical lateral plates  12 ,  12 ′. The lower surfaces  40   a ,  40   a ′ of the protection pads  40 ,  40 ′ have curves having a predetermined degree of curvature. The protection pads  40 ,  40 ′ are respectively attached to lower and upper sides of a patient&#39;s chest when the patient stands up. The upper protection pad  40 ′ is wider than the lower protection pad  40 . It is preferable that the protection pads  40 ,  40 ′ are made of flexible material such as rubber, soft urethane or textile material. 
   The lower, external edges of the protection pads  40 ,  40 ′ are bent for attachment of the vertical lateral plates  12 ;  12 ′, while the internal sides of the protection pads  40 ,  40 ′ are sunken for smooth rise and fall of both sides (front and back sides in  FIG. 6 ) of the connection plate  38 . 
   It is preferable that the chest band  20  is made of one of various materials such as woven fabric, non-woven cloth, leather and the like, and the width of the chest band  20  is about 10 cm. Then, the chest band  20  is wound around the bobbin of the length adjusting means  24 , subsequently passed through the first guide roller  42 , idle roller  46 , second guide roller  44 , second guide roller  44 ′ and idle roller  46 ′, and then is fixed at the first guide roller  42 ′. The chest band  20  is divided into two parts under the second guide roller  44 ′ and connected by the hitching loops  20   a ,  20   b . However, the chest band  20  may also be held at the first guide roller  42 ′ for easy attachment and detachment. 
   As shown in  FIGS. 2 through 4 , the length adjusting means  24  is fastened above the idle roller  46  between the vertical lateral plates  12 ,  12 ′. The length adjusting means  24  comprises a bobbin  48  for getting the chest band  20  wound onto, a first ratchet wheel  52  inserted and fixed at an axle  50  of the bobbin  48 , a first stopper  54  meshed with the first ratchet wheel  52  for preventing reverse rotation of the bobbin  48 , a handle bracket  58  with the first stopper  54  coupled for guides and the second ratchet wheel  56  inserted at the axle of the bobbin  48  for free rotation, a second stopper  60  meshed to the second ratchet wheel  56  for restricting rotation of the handle bracket  58  and a spiral spring  62  for applying rotational force to the bobbin  48 . 
   The first and second ratchet wheels  52 ,  56  and the spiral spring  62  are respectively fastened at both sides of the axle  50 . 
   As shown in  FIG. 7 , the first stopper  54  includes a horizontal plate  54   b  having wings  54   a ,  54   a ′ to be inserted into guide slots of the handle bracket and a vertical flange  54   c  bent upward at one edge (wing side) of the horizontal plate  54   b  for being held by a hand and a hitching unit  54   d  horizontally protruded at the horizontal plate  54   b  opposite to the vertical flange  54   c  for insertion of a spring. 
   The handle bracket  58  is constructed with two ratchet plates  58   a  having second ratchet wheels  56  which are integrated by a connection plate  58   b . The first ratchet wheel  52  is shaped in a circular plate and positioned at the internal side of the ratchet plate  58   a.    
   The second ratchet wheel  56  having a serrate arc is positioned at one side of the ratchet plate  58   a , and a guide slot  58   c  is formed at the center of the ratchet plate  58   a  for insertion of the wings  54   a ,  54   a ′. The guide slot  58   c  has the shape of a letter X which includes a first groove where the wing  54   a  is hitched by the saw tooth of the first ratchet wheel  52  and a second groove where the wing  54   a  is not hitched to the saw tooth of the first ratchet wheel  52 . A cylindrical rod ( 64 : shown in  FIG. 2 ) is coupled opposite to the second ratchet wheel  56  for convenient handling by a user. 
   At the right, center of the connection plate  58   b  and at the upper portion of the bent flange  58   d , a hitching unit  58   e  is protruded to face the hitching unit  54   d . A spring ( 66 : shown in  FIG. 2 ) is inserted between the hitching units  54   d ,  58   e  for pushing the first stopper  54 . 
   The second stopper  60  is vertically erected in the shape of a reverse T. The vertical lateral plates  12 ,  12 ′ have slots for guiding both ends of the second stopper  60 . An upper plate  68  is coupled at the upper sides of the vertical, lateral plates  12 ,  12 ′with slots that guide the upper center ends of the second stopper  60 . A spring  69  is integrated between the second stopper  60  and the upper plate  68  for elasticity. 
   On the other hand, propping rods  70 ,  70 ′ are inserted between the vertical lateral plates  12 ,  12 ′ with a predetermined level of gap, for support and strength. Furthermore, a groove ( 12   a ′: shown in  FIG. 5 ) is formed at the center of the vertical lateral plate  12  for preventing a stopper from being hitched in rotation. 
   As shown in  FIG. 5 , an axle member  74  is vertically fixed and coupled at an edge of a medium plate  72  fixed at the piston  26  of the compression means  18 . In the horizontal center plate  14 , a stopper  76  having a plurality of restricting grooves  80   a ,  80   b ,  80   c  (shown in  FIG. 8 ) is rotatively inserted at the axle member  74 . A restricting member  78  is inserted and fixed at the axle member  74  over the stopper  76  for being hitched at the restricting grooves  80   a ,  80   b ,  80   c  as the piston is lowered. 
   As shown in  FIG. 8 , there is an accommodating unit  80  for accommodating the restricting member over a flange  79  formed in the middle of the stopper  76  and an insertion unit  82  for being inserted into the horizontal center plate  14  under the flange  79 . 
   Grooves  79  are formed at the flange  79  for having balls hitched at the lower side thereof. A plurality of restricting grooves  80   a ,  80   b ,  80   c  are formed around the circumference of the stopper  76  with different levels of depth at the accommodating unit  80 . Meanwhile, a center hole  80   d  is formed larger than the axle member  74  for insertion of the boss unit of the restricting member, which will be described below. The restricting grooves  80   a ,  80   b ,  80   c  and a hole  79   a  are spaced evenly apart at 120 degree angles. The respective grooves are formed symmetrically around the center hole  80   d  along the circumference of the stopper  76  at 60 degrees. 
   As shown in  FIG. 8 , the restricting member  78  includes a boss unit  78   a  for being inserted into the center hole  80   d  of the accommodating unit  80 , and two flanges  78   b ,  78   b ′ at the external surface of the boss unit  78   a  at 180 degrees for insertion into the restricting grooves  80   a ,  80   b ,  80   c . The thickness of the flanges  78 ,  78 ′ is smaller than the width of the restricting grooves  80   a ,  80   b ,  80   c . A chamfer  78   c  is formed at the lower end of the flanges  78   b ,  78   b ′ for smooth insertion. 
   On the other hand, a ball  86  is elastically supported by a spring  84  at the horizontal, center plate  14 . 
   Hereinafter, the operation of the CPR apparatus thus constructed will be described in accordance with the first embodiment of the present invention. 
   One end of the chest band  20  is wound around the bobbin  48  of the length adjusting means  24 , rolled around the first guide roller  42 , the idle roller  46  and the second guide roller  44  and hitched with a hitching loop  20   a  at a hitching unit (not shown), and the other end of the chest band  20  is wound around the first guide roller  42 ′, the idle roller  46 ′ and the second guide roller  44 ′ and hitched with a hitching loop  20   b  at the other hitching unit. Then the chest band  20  is kept at the state described above. 
   When the CPR apparatus is used, the horizontal flange unit  54   c  of the first stopper  54  is held and pulled back to move the wing  54   a  from the first groove to the second groove of the guide slot  58   c  to make the first ratchet wheel  52  free for rotation. Then the hitching loop  20   a  of the chest band  20  is pulled and wrapped around a patient&#39;s chest, and then the hitching loops  20   a ,  20   b  are connected. The wing  54   a  of the first stopper  54  is moved to the first groove of the guide slot  58   c  again and hitched at the saw tooth of the first ratchet wheel  52 , and the second stopper  60  is hitched at the saw tooth of the second ratchet wheel  56 . Therefore, the chest band  20  is adequately unwound to wrap around the patient&#39;s chest. 
   When a cylinder is operated by control means (not shown) to lower the piston  26 , the compression pad  30  presses down the patient&#39;s chest and functions as a cardiac pump. At the same time, the connection plate  38  is lowered to fasten the chest band  20  wrapped around the patient&#39;s chest, thereby functioning as a thoracic pump. While the piston  26  is in operation, the first stopper  54  prevents the chest band  20  from being released from the bobbin  48 , and the second stopper  60  prevents the handle bracket  58  from rotating and the chest band  20  from becoming loose. 
   On the other hand, when the piston  26  is in operation, it is necessary to control the height of the dropping compression pad  30 . At this time, the stopper  76  rotates and stops by the ball  86  at a predetermined level of angle. Accordingly, one of the restricting grooves  80   a ,  80   b ,  80   c  is aligned at the flanges  78   b ,  78   b ′ of the restricting member  78 . When the piston  26  is lowered, the flanges  78   b ,  78   b ′ are inserted into the restricting groove to restrict the dropping length of the piston. 
   The piston  26  is controlled by control means and a pneumatic circuit to keep the ratio of compression and relaxation at 50:50 and the compression speed at 80–100 times per minute according to the characteristics of the patient. The pneumatic circuit operates the piston  26 . Oxygen is separately but simultaneously supplied to the patient&#39;s lungs. At this time, oxygen is subsequently supplied to the operation of the piston  26 . 
     FIGS. 9 through 19  illustrate a cardiopulmonary resuscitation apparatus in accordance with the second embodiment of the present invention. 
   As shown in  FIGS. 9 through 11 , above a main body  112  where the patient lies, there are compression means  116  having a piston  114  that compresses the patient&#39;s chest and thoracic constriction means  120  having a chest band  118  for fastening and constricting the chest when the compression means  116  presses down the patient&#39;s chest. 
   The chest band  118  is divided into left and right chest bands  122 ,  124  for respectively wrapping around the left and right chests of a patient. Length adjusting means  126  is installed at the main body for controlling the length of the chest band  118  according to the size of the patient&#39;s chest. 
   The upper external surface of the main body  112  has protruded left and right sides and a support side  128  shaped with a lengthwise opening to hold around the patient when the patient is lying down. A lowered recess unit  129  is formed in the middle of a lengthwise support side  128  along the direction that the patient is lying down. The recess unit  129  is often horizontally formed with the same width as that of the chest band. The long hole  129   a  is formed in the middle of the recess unit  129 , and the lower ends of the left and right chest bands  122 ,  124  are inserted into the main body  112  and wound onto the left and right bobbins. 
   The length adjusting means  126  includes a base bracket  130  at the internal side of the main body  112 , propping brackets  132 ,  134 , respectively at both sides of the base bracket  130  (left and right sides in  FIG. 11 ) and left and right axle members  136 ,  138  between the prop brackets  132 ,  134 . The left and right axle members  136 ,  138  further include left and right bobbins  140 ,  142  to get the left and right chest bands  122 ,  124  wound around, electric gears  144 ,  146  made of spur gears meshing each other. An electric gear  150  made of a bevel gear is mounted at an end of the right axle member  138  to be driven by driving means  148 . 
   Furthermore, the driving means  148  includes a driving axle  154  via propping bracket  152  at the internal side of the main body  112 . A driving gear  156 , a bevel gear meshed to the electric gear  150  is fixed at one end of the driving axle  154 , and a spline is fastened at the other end of the driving axle  154  for attachment and detachment of a handle axle  158 . A handle  160  is fixed at the handle axle  158 . 
   At this time, the driving means may be constructed with a driving gear meshed to the electric gear for rotation, a driving axle fastened to the driving gear and a motor to be controlled by the control means for rotation of the driving axle. 
   A head support unit  162  is protruded at the front side of the main body  112  for supporting a patient&#39;s head, and a hole  162   a  is formed at the head support unit  162  for convenient handling by a user. A curve surface  162   b  is formed over the hole  162   a  for the easy support of the patient&#39;s head. The head support unit  162  is positioned lower than the support side  128 . Furthermore, guide rollers  164 ,  164 ′ are coupled around the long hole  129   a  for guiding the left and right chest bands  122 ,  124  and are covered by a protection cover  166 , both sides of which are fixed at the support side  128 . 
   As shown in  FIGS. 9 ,  12 ,  14 , in the compression means  116 , a compression pad  170  is installed at the piston  114  protruded down from the support bracket  168  via a connection bracket  169 . The piston  114  is embedded at the cylinder  172  and operated by air pressure. The compression pad  170  may be directly coupled with the piston  114 . 
   The support bracket  168  is fixed at a frame (not shown) and shaped in the cross-section of having bent flanges  168   a ,  1689   a ′ at both sides as shown in  FIG. 14 . A hole  168   c  and a cylinder fixing hole  168   d  are fixed at the upper surface of the wave  168   b  for passage of the piston  114 . A plurality of holes  168   e ,  168   f  are formed at the flanges  168   a ,  168   a ′ for insertion of the axles of the guide and idle rollers. 
   The piston  114  is constructed in the same structure as that of the first embodiment of the present invention. The cylinder  172  is fixed on the support bracket  168 . 
   The connection bracket  169  is fixed at the cross-section of the piston  114  by a bolt  174 , and a hitching block  176  which will be inserted and hitched to the compression pad  170  is fixed on the lower surface of the connection bracket  169 . 
   The thoracic constriction means  120  includes the connection bracket  169 , a plurality of rollers at both sides of the support brackets  168  for guiding the chest band  118  to wrap around the patient&#39;s chest and a protection pad  178  to be attached to the chest as the chest band  118  is fastened. 
   The rollers guiding the chest band  118  includes fixation rollers  180 ,  180 ′ fastened at both sides of the connection bracket  169  for fixation of the left and right chest bands  122 ,  124 , guide rollers  182 ,  182 ′ fastened at both lower sides of the support bracket  168  for guiding the left and right chest bands  182 ,  182 ′ and simultaneously fastening the protection pad and idle rollers  184 ,  184 ′ mounted between the guide and fixation rollers  182 ,  182 ′,  180 ,  180 ′. 
   As shown in  FIG. 14 , the connection bracket  169  includes a protruder  169   b  protruded at the center of the base plate  169   a  and holes  169   c  formed at both sides of the base plate  169   a  for insertion of an axle that fastens a fixation roller  180  accommodated at a carved portion made for fixation of the fixation rollers  180 ,  180 ′. At this time, a hole is formed at the protruder  169   b  for insertion of the bolt  174 . The connection bracket  169  is fixed at the piston  114  to be raised or dropped by the motion of the piston  126 . However, the connection bracket  169  may be constructed to move up or down in relation to the compression means  118  with a separate power source. 
   As shown in  FIG. 14 , the protection pad  178  includes a curved bottom surface  178   a  having a predetermined degree of curvature around a patient&#39;s chest and a rectangular hole  178   b  in the middle for passage of the connection bracket  169  and compression pad  170 , four protruders  186 ,  186 ′ protruding out of the rectangular hole. In addition, auxiliary pads  188 ,  188 ′ are respectively inserted into the protruders  186 ,  186 ′. 
   Furthermore, holes  186   a ,  186   a ′ are formed at one side of the protruders  186 ,  186 ′ for inserting the axle of the guide rollers  182 ,  182 ′, and hitching grooves are formed at the other side of the protruders  186 ,  186 ′ for insertion of the hitching protruders  188   a ,  188   a ′ of the auxiliary pads  188 ,  188 ′. 
   The auxiliary pads  188 ,  188 ′ are extended from the hitching protruders  188   a ,  188   a ′ in the lengthwise direction of the protection pad  178 , and both of the extended ends are connected to the connection units  188   b ,  188   b ′. The lower surface of the connection parts  188   b ,  188   b ′ is made of a curve connected with the bottom surface  178   a  of the protraction pad. 
   It is preferable that the protection pad  178  and auxiliary pads  188 ,  188 ′ are made of rubber, soft urethane or the like. 
   On the other hand, as shown in  FIGS. 12 and 13 , the left and right chest bands  122 ,  124  are divided into fixed chest bands  122   a ,  124   a , and flexible chest bands  122   b ,  124   b  by the connection units  190 ,  190 ′ over the auxiliary is pads  188 ,  188 ′ for attachment and detachment. In the connection units  190 ,  190 ′ one side of the female and male connection units  192 ,  194  are hinged, and rods  192   a ,  194   a  are formed at the other side of the female and male connection units  192 ,  194  for fixation of the fixed chest bands  122   a ,  124   a  and the flexible chest bands  122   b ,  124   b.    
   The material and width of the chest band  118  are the same as those described in the first embodiment of the present invention. The fixed chest bands  122   a ,  124   a  are fixed at the fixation rollers  180 ,  180 ′, passed through idle rollers  184 ,  184 ′ and guide rollers  182 ,  182 ′, and finally fixed at the rod  192 . The flexible chest bands  122   b ,  124   b  are fixed at the rod  194   a , passed through guide rollers  164 ,  164 ′ coupled with the main body  112  and through the long hole  129   a  and finally wound onto the left and right bobbins. 
   As shown in  FIG. 9 , skin protection bands  196 ,  196 ′ having elasticity are coupled at the internal surface of the chest band  118  (only the exposed portion of the main body) for protecting the patient&#39;s skin. The skin protection bands  196 ,  196 ′ are fixed at the lower surface of the connection units  188   b ,  188   b ′ of the auxiliary pads  188 ,  188 ′ and connected to the lower side of the protection cover  166  surrounding the guide rollers  164 ,  164 ′ coupled with the main body  112  for wrapping around the patient&#39;s body. The skin protection bands  196 ,  196 ′ are elastically fastened or relaxed for keeping it tightly attached to the body at all times. 
   In addition, a spiral spring  198  is included in the left and right axle members  136 ,  138  of the length adjusting means  126  for providing the recovering force to the left and right bobbins  140 ,  142 . 
   Furthermore, a handle axle  158  of the driving means  148  is fastened to a housing via a ring-shaped slider  200  that moves only along the axle. The housing  202  is fixed at the lateral wall of the main body  112 . The slider  200  and housing  202  are coupled by well-known stopping means  204  consisting of a ball, a spring and a set screw for stopping the left and right direction of the slider  200 . The locking means  210  is fastened at the handle axle  158  for preventing rotation of the handle. 
   On the other hand, as shown in  FIGS. 15 ,  16 , the locking means  210  includes a gear  212  fixed at the handle axle  158 , an internal housing  214  installed at the external side of the handle axle  158  for accommodating the gear  212 , left and right stoppers  215 ,  216  having protruders  215   a ,  216   a  on the both sides of the gear  212  for being hitched with the tooth of the gear and a switch  222  fastened over the left and right stoppers  215 ,  216  with left and right spring plates  218 ,  220  that selectively press the stoppers  215 ,  216 . 
   One side of the internal housing  214  is left open for installation of the left and right stoppers  215 ,  216  and the switch  222  while a hitching jaw is included for hitching the left and right stoppers  215 ,  216 . The switch  222  is constructed with the left and right spring plates  218 ,  220  under a knob  224 . 
   Hereinafter, the operation of the cardiopulmonary resuscitation apparatus constructed by the second embodiment of the present invention will be described below. 
   First, the female connection unit  192  is separated from the male connection unit  194  of the connection units  190 ,  190 ′ for taking the flexible chest bands  122   b ,  124   b  off from the fixed chest bands  122   a ,  124   a . At this time, if there are no skin protection bands  196 ,  196 ′ in the structure, the male connection unit  194  may be simply separated from the female connection unit  192 . 
   In the state described above, a patient M lays on the support side  128  of the main body  112  on the back with his head supported by the head support unit  162 . Then, in reverse sequence to the aforementioned separation steps, the flexible chest bands  122   b ,  124   b  are connected to the fixed chest bands  122   a ,  124   a  and the auxiliary pads  188 ,  188 ′ to the protection pad  178 . At this time, the flexible chest bands  122   b ,  124   b  are released properly from the left and right bobbins  140 ,  142  after overcoming the recovering force of the spiral spring  198 , to wrap around the patient&#39;s chest.  FIG. 19  illustrates a patient (M) lying on the CPR apparatus with his chest wrapped by the chest bands. 
   Next, if the handle  160  is pushed to move the slider  200 , spline-fasten the handle axle  158  to the driving axle  154  and fix the handle axle  158  with the locking means  210 , the left and right bobbins  140 ,  142  do not rotate due to the fixation of the length of the released chest bands. The stopping means  204  prevents the handle axle  158  from being separated from the driving axle  154 . 
   When the knob  224  of the locking means  210  is moved to the right as shown in  FIG. 17 , a right spring plate  220  presses down the right stopper  216  to release the protruder  216   a  of the right stopper  216  from the teeth of the gear  212  and keep the protruder  215   a  of the left stopper  215  from being hitched at the teeth of the gear  212 , thereby causing the left stopper  215  to be hitched at the housing  214  and restrict counter-clockwise (CCW) rotation of the handle. 
   Furthermore, when the handle  224  of the locking means  210  is moved to the left as shown in  FIG. 18 , the left spring plate  218  presses the left stopper  215  to release the protruder  215   a  of a left stopper  215  from the teeth of the gear  212  and keep the protruder  216   a  of the right stopper  216  hitched at the teeth of the gear  212 , thereby causing the right stopper  216  to be hitched at the housing  214  and restrict clockwise (CW) rotation of the handle. 
   When the cylinder  172  is operated by control means (not shown) to lower the piston  114 , the compression pad  170  presses down the patient&#39;s chest to function as a cardiac pump. At the same time, the connection bracket  169  descends to allow the chest band  118  wrapped around the patient&#39;s chest to fasten and function as a thoracic pump. At this time, the protection pad  178  and auxiliary pads  188 ,  188 ′ are tightly attached to the chest for protection of the patient&#39;s chest, and the skin protection bands  196 ,  196 ′ are attached to the patient&#39;s body with elasticity. 
   Meanwhile, when the chest band  118  is initially wound onto the left and right bobbins  140 ,  142 , and when the locking means  210  is released for rotation of the handle  160 , the left and right bobbins  140 ,  142  are rotated by the driving and electric gears to wind the chest band  118 . 
   The operation of the piston  114  in the CPR apparatus thus constructed is described for the first embodiment of the present invention. 
     FIGS. 20 through 25  illustrate a cardiopulmonary resuscitation apparatus constructed in accordance with the third embodiment of the present invention. 
   As shown in  FIGS. 20 through 22 , there is compression means  316  having a piston  314  that compresses down on a patient&#39;s chest when the patient is lying down, and chest constriction means  320  having a chest band  318  that fastens and constricts the chest, when the compression means  316  presses down the chest, above the main body  312 . 
   At this time, the chest band  318  is divided into left and right chest bands  322 ,  324  for respectively winding around left and right sides of the patient with length adjusting means  326  installed at the main body for adjusting the length of the chest band  318 . 
   The main body  312  has left and right protruders and remains open in the lengthwise direction of the support side for wrapping around a patient when the patient is lying in a flat, horizontal position. The support side  328  also has a recess  329  in the middle portion of the lengthwise direction. The width of the recess  329  is identical to the width of the chest band. A cover  331  is formed at the center of the recess  329  with a long hole  331   a . The lower ends of the left and right chest bands  322 ,  324  are inserted through the long hole  331   a  into the inside of the main body  312  and then wound onto the left and right bobbins. 
   The length adjusting means  326  includes a base bracket  330  installed at the internal part of the main body  312 , support brackets  332 ,  324  at both sides of the base bracket  330  (at the left and right sides in  FIG. 22 ), left and right axle members  336 ,  338  between the support brackets  332 ,  334 , left and right bobbins  340 ,  432  where the left and right chest bands  322 ,  324  are wound, electric gears  344 ,  346  made of spur gears for being meshed together, and an electric gear made of a bevel gear at the end of the right axle member  338  for being driven by the driving means  348 . 
   The driving means  348  includes a driving axle  354  installed at the internal side of the main body  312  via a support bracket  352 , a center gear  356 , a bevel gear fixed at one end of the driving axle  354  for being meshed to the electric gear  350 , locking means spline-fastened at the other end of the driving axle  354  for attachment and detachment, a driving gear  357  inserted at the center of the driving axle  354  for being driven by the driving cylinder  355  and a moving member  361  formed at the piston of the driving cylinder  355  with a rack gear  361   a  for being meshed to the driving gear  357 . The moving member  361  is included to be guided by the guide rod  363 , fixed at the end of the piston and bent and extended toward the cylinder with a rack gear  361   a  at an extended part. 
   A head supporter  362  protrudes at the front portion of the main body  312  for supporting the patient&#39;s head. The hole  362   a  and curved surface  362   b  are shaped in the same way as the second embodiment of the present invention. 
   Guide rollers  364 ,  364 ′ are coupled at the place where the long hole  331   a  of the cover  331  is formed for guiding the left and right chest bands  322 ,  324 . 
   As shown in  FIGS. 20 and 23 , the compression means  316  has a compression pad  370  fastened at the piston  314  protruding downward from a support bracket  368  via a connection bracket  369 . The piston  314  is embedded in the cylinder  372  and operated by pressurized air or oxygen. The compression pad  370  is directly coupled with the piston  314 . The piston  314 , support bracket  368 , connection bracket  369 , compression pad  370 , cylinder  372  and hitching block  376  are the same as those in the second embodiment of the present invention. 
   The chest constriction means  320  includes a plurality of rollers at both sides of the connection bracket  369  and support bracket  368  for getting the chest band  318  wound around the patient&#39;s chest and pads  378 ,  378 ′ for being attached to the patient&#39;s chest when the chest band  318  is fastened. The fixed rollers  380 ,  380 ′, idle rollers  384 ,  384 ′ and guide rollers  382 ,  382 ′ are constructed in the same way as those constructed in the second embodiment of the present invention. 
   It is preferable that the pad  378  is fastened at the external portion of both ends of the flange of the support bracket  368  by the guide rollers  382 ,  382 ′ with a curved lower surface having a predetermined curvature in the direction of the patient&#39;s chest. It is also preferable that the pad  378  is made of rubber, soft urethane or the like. 
   On the other hand, after being wound around the left and right bobbins  340 ,  342 , the left and right chest bands  322 ,  324  are respectively moved in the left and right directions, passed through the guide and idle rollers  382 ,  382 ′,  384 ,  384 ′ and fixed at the fixed rollers  380 ,  380 ′. As shown in  FIGS. 24 and 25 , the left and right chest bands  322 ,  324  are separated at the center of one of the left and right chest bands by a connection unit  390  into flexible and fixed chest bands  324   a ,  324   b  for attachment and detachment. 
   The connection unit  390  is constructed with female and male connection units  392 ,  394  at both upper portions of the flexible base plate  391 . A predetermined length of two long guide holes  391   a ,  391   b  are adjacently formed at the base plate surface of a place, which includes the female connection unit  392 , for insertion and guide of the flexible chest band  324   a.    
   The female connection unit  392  is a bracket  393  constructed with a rod  393   a  for hitching and fixing the flexible chest band  324   a  and a hitching plate  393   b  protruded toward the male connection unit  394  at the top portion of the bracket  393 . The flexible chest band  324   a  is inserted and hitched at the guide long holes  391   a ,  391   b  and then sewn at the rod  393   a  for fixation. The bracket  393  is pulled and fastened at the fixed chest band  324   b . There is a hitching hole  393   c  in the hitching plate  393   b.    
   The male connection unit  394  includes a bracket  395  fixed at the base plate  391  with a rod  395   a  for hitching and fixing the fixed chest band  324   b , a case  397  fixed over the bracket  395  for accommodation of the protruded plate  393   b , a hitching plate  399  fixed at one end of the case  397  with a hitching plate  399   a  at the other end of the case  397  for insertion into the hitching hole  393   c  and a pressing plate  401  fastened over the hitching plate  399  via a spring  407  for releasing the locked state when the hitching plate  399  is pressed down. One end of the pressing plate  401  is hinged at the case  397 . 
   An elastic skin protection band  396  is mounted on the internal surface of the chest band  318  to protect the patient&#39;s skin. The skin protection band  396  is wound onto the rollers and the left and right bobbins in the same way as the chest band  318 . 
   A spiral spring  398  is mounted on the left and right axle members  336 ,  338  of the length adjusting means  326  with restoring force. 
   Furthermore, a locking axle  358  is spline-fastened at the other end of the driving axle  354  of the driving means  348  for attachment and detachment of the locking axle  358 . The locking axle  358  is fixed at a piston  405 , which moves according to the operation of the locking cylinder  403 , for locking or unlocking with the driving axle  354 . The locking axle  358  is fastened to a housing  402  via a ring-shaped slider  400  that moves only in the direction of the locking axle  358 . The housing  402  is fixed at the lateral wall of the main body  312 . 
   Hereinafter, a description will be made regarding the operation of the CPR apparatus thus constructed in accordance with the third embodiment of the present invention. 
   First, the pressing plate  401  of the connection unit  390  is pressed down to separate the hitching plate  399  from the protruded plate  393   b  of the female unit  392 . In this state, the patient is lying in a flat, horizontal position with his back touching the support side  328  of the main body  312  and with his head supported by the head support unit  362 . The female connection unit  392  is pulled in reverse order of the above separation process for connecting onto the male connection unit  394 . At this time, the flexible chest band  324   a  is released from the left and right bobbins  340 ,  342 , overcoming the restoring force of the spiral spring  398 , and is adequately wound around the patient&#39;s chest. 
   The chest band  318  is attached to the patient&#39;s body by simple adjustments with the driving cylinder  355  of the driving means  348 . The driving axle  354  is simply locked or unlocked via the locking cylinder  403 . 
   When the cylinder  372  is operated by the control means (not shown) to lower the piston  314 , the compression pad  370  compresses down the patient&#39;s chest to function as a cardiac pump. At the same time, the connection bracket  369  is lowered to fasten the patient&#39;s chest with the chest band  318 , thereby functioning as a thoracic pump. The skin protection band  396  is elastic for attachment to the patient&#39;s body. 
   On the other hand, when the chest band  318  is wound onto the left and right bobbins  340 ,  342 , the locked state of the locking cylinder  403  is released to drive the driving cylinder  350 , the left and right bobbins  340 ,  342  are rotated by the driving gear  357 , center gear  356  and electric gear  350  to wind the chest band  318 . The operations of the piston  314  are the same as those described in accordance with the first embodiment of the present invention. 
   The CPR apparatus of the present invention may additionally include a tension control unit for checking and displaying a proper degree of tension when the chest band is wound around the patient, a unit for keeping the tension of the chest band constant, an auxiliary unit for protecting the woman&#39;s breasts, a control unit for adjusting the ratio between chest compression and artificial respiration, a pressure control unit for controlling the pressure of inhaled oxygen to prevent possible damage to the lungs when the artificial respiration is performed and a breathing amount control unit for controlling the amount of oxygen to be inhaled for keeping the amount of inhaled oxygen constant. 
   The present invention is not restricted to the preferred embodiments described above, but can be practiced with wide variations. 
   As described above, there are advantages in the CPR apparatus of the present invention in that the length of the chest band can be adjusted according to the size of the patient&#39;s chest, the patient&#39;s chest can be protected from excessive compression and the depth of the compression pad can be easily controlled.