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  Method and system for responding to non-perfusing and non-shockable heart rhythmsUSPTO Application #: 20080103538Title: Method and system for responding to non-perfusing and non-shockable heart rhythms Abstract: A system and method are disclosed for prompting emergency medical personnel who are attending to a patient. When the patient presents a heart rhythm that is a non-perfusing and non-shockable rhythm or perfusing but unstable, the attending personnel are prompted to administer therapy, such as reestablishing perfusion by performing CPR. The attending personnel may also be urged to defer taking the pulse of the patient. (end of abstract) Agent: Mary Y. Redman Medtronic, Inc. - Minneapolis, MN, US Inventors: Robert G. Walker, James M. Owen USPTO Applicaton #: 20080103538 - Class: 607 3 (USPTO) The Patent Description & Claims data below is from USPTO Patent Application 20080103538. Brief Patent Description - Full Patent Description - Patent Application Claims
TECHNICAL FIELD [0001]The invention relates to emergency medical devices, and more particularly, to medical devices or methods for treating cardiac conditions based on electrocardiogram analysis. BACKGROUND [0002]When a patient experiences a medical emergency, trained medical personnel may be summoned to provide emergency care. The medical personnel evaluate the condition of the patient and provide emergency treatment to restore a life sustaining condition and attempt to stabilize the patient. [0003]When the patient has abruptly lost consciousness, the medical personnel check the patient's ECG and check for other vital signs such as the patient's pulse to determine whether the heart is perfusing, i.e., whether the heart is effectively pumping blood in a manner that will sustain the vital organs. The heart's stroke volume and rate are among the factors, which determine whether perfusion is adequate. Medical conditions such as ventricular fibrillation (VF), Ventricular Tachycardia (VT), or organized rhythms such as pulseless electrical activity (PEA) might be responsible for a failure of perfusion, which in turn might be responsible for the loss of consciousness. When the heart is not perfusing, the time required to determine and deliver the appropriate treatment is of great importance to the patient's chance of survival. The patient could die or suffer serious brain injury due to lack of oxygen unless perfusion is established promptly. Accordingly, it is important for the medical personnel to assess the condition of the patient promptly and take action that would benefit the patient. [0004]Medical personnel typically bring an external defibrillator to the site of the emergency. The defibrillator may employ two or more electrodes to record an electrocardiogram (ECG). In addition, the defibrillator may prompt an operator, i.e., a person using the device and attending to the patient, to deliver a therapy to the patient based upon analysis of the physiological conditions of the patient. [0005]When the heart of the patient is not perfusing, the cause of the non-perfusing rhythm could be VF, which may be responsive to defibrillation shock therapy. When shock therapy is to be applied, the medical personnel refrain from touching the patient, to avoid receiving an electric shock. When the heart of the patient is not perfusing for other reasons, however, the best course may be to reestablish perfusion by cardiopulmonary resuscitation (CPR) or other therapy that involves physical contact with the patient. SUMMARY [0006]Systems, methods and devices that expeditiously and efficiently prompts personnel attending to the patient to institute therapy to maintain perfusion when the patient presents an ECG rhythm that is unstable and that is non-shockable, or to reestablish perfusion when the patient presents an ECG rhythm that is not indicative of an organized perfusing rhythm and that is non-shockable are disclosed. A "non-perfusing" rhythm encompasses any rhythm that is not adequately perfusing, i.e., not adequate to sustain vital organs. Examples of non-perfusing rhythms include, but are not limited to, asystole, PEA, profound bradycardia, in which the patient exhibits a heart rate below a threshold capable of sustaining the vital organs, and a rhythm in which atrial electrical activity is present in the ECG, but ventricular electrical activity is not. [0007]In some instances, the patient's heart rhythm upon analysis can be determined not to be a shockable rhythm. A "shockable rhythm" is a non-perfusing heart rhythm that can potentially be converted to a perfusing rhythm by administration of a therapeutic shock such as a defibrillation or cardioversion shock, and a "non-shockable rhythm" is a heart rhythm that cannot be converted to a perfusing rhythm by administration of a shock. [0008]Conventional practice, such as decisions made by emergency medical personnel based on ALS, BLS AHA /ILCOR or other guidelines, may be to take the patient's pulse as the next stage of medical care. Such guidelines do not always address the specific physiologic condition of the patient and the decision making process can add delays to providing appropriate treatment that can adversely effect the patient's chances of survival. When the patient presents a rhythm that is non-perfusing and non-shockable, trying to find a pulse and obtain a pulse rate delays delivery of therapies that are of extreme importance to reestablishing perfusion. Such therapies may include, for example, CPR or administration of drugs to stimulate cardiac activity. Accordingly, when a non-shockable heart rhythm that is not indicative of a perfusing rhythm is identified, the disclosed system, method and device provide for prompting the personnel to begin applying therapy such as CPR immediately without first prompting to check the patient's pulse. [0009]In an embodiment, a medical device such as an external defibrillator includes a processor that analyzes physiological signals, such as ECG signals, sensed via the defibrillation electrodes or other sensing devices. When the processor detects a non-shockable heart rhythm that is not indicative of a perfusing rhythm, the processor prompts the operator to begin CPR or other therapy based upon the physiological signals. The disclosed systems, methods and devices further support selection of a health care protocol as a function of the detected non-perfusing non-shockable heart rhythm. In general, health care protocols encompass plans, procedures and rules for treating patients, and depend upon the conditions of the patient. [0010]One embodiment is directed to a method which includes detecting in a patient a heart rhythm and determining that the detected rhythm is a non-perfusing and a non-shockable rhythm. The method further includes prompting an operator to administer therapy, in response to the determination. The therapy can be, for example, CPR or drug therapy. The method can also include prompting the operator to defer taking a pulse of the patient. Another embodiment is directed to a computer-readable medium comprising instructions for causing a programmable processor to carry out such a method. Another embodiment is directed to a system that includes a sensor that detects electrical activity in a patient's heart; a user interface including an output device configured to deliver prompts to a user of the device; and a processor that is capable of receiving a signal indicative of the sensed electrical activity; analyzing the signal to determine if the heart rhythm is one of (a) a non-perfusing and-non-shockable rhythm and (b) a perfusing and unstable rhythm; and controlling the output device to prompt an operator to administer therapy in response to the determination. [0011]Various of the disclosed embodiments may result in one or more advantages. When the processor determines that the patient is exhibiting a non-perfusing, non-shockable rhythm that could benefit from prompt administration of CPR or other non-shock therapy, the processor prompts the attending personnel to administer the therapy. Deferring a pulse check can result in a quicker administration of drugs or CPR or other therapy, and consequently a quicker reestablishment of perfusion, thereby reducing risks of injury due to oxygen deprivation. Medical personnel can save significant time and potentially make a substantial difference in the patient's survival or quality of life by administering the therapy immediately, and deferring taking the pulse until a later time. [0012]Other advantages of the disclosed systems, methods and devices include enhancement of the ability to determine the best course of treatment for a patient who exhibits a shockable rhythm that follows a non-shockable rhythm, or vice-versa. [0013]The details of one or more embodiments are set forth in the accompanying drawings and the description below. Other features, objects, and advantages will be apparent from the description and drawings, and from the claims. BRIEF DESCRIPTION OF DRAWINGS [0014]FIG. 1 is a schematic diagram of a defibrillator that may be used to practice techniques for responding to a non-perfusing, non-shockable heart rhythm according to an embodiment. [0015]FIG. 2 is a flow diagram illustrating a procedure for responding to a non-perfusing, non-shockable heart rhythm. DETAILED DESCRIPTION [0016]FIG. 1 is a block diagram illustrating a system according to an illustrative embodiment. A patient 10 is coupled to an external defibrillator 12. Although the embodiment will be described in the context of external defibrillator 12, external defibrillator 12 is one example of an emergency medical device that may be used to practice the disclosed systems, methods and devices. External defibrillator 12 can be an automated, semi-automated, or manual defibrillator. Other medical devices that can be used to practice the disclosed systems, methods and devices include, but are not limited to, a vital signs monitor, a patient care recorder, and a mechanical cardiopulmonary resuscitation (CPR) assist device. [0017]Defibrillator 12 is configured to administer defibrillation therapy to patient 10 via electrodes 14 and 16, which may be hand-held electrode paddles or adhesive electrode pads placed externally on the skin of patient 10. The body of patient 10 provides an electrical path between electrodes 14 and 16. [0018]Electrodes 14 and 16 are coupled to defibrillator 12 via conductors 18 and 20 and interface 22. In a typical application, interface 22 includes a receptacle, and connectors 18, 20 plug into the receptacle. Electrical impulses or signals may be sensed by defibrillator 12 via electrodes 14 and 16 and interface 22. Electrical impulses or signals may also be delivered from defibrillator 12 to patient 10 via electrodes 14 and 16 and interface 22, e.g., in the form of defibrillation shocks or pacing or cardioversion pulses. [0019]Therapy delivery element 24 includes one or more modules configured to provide defibrillation therapy. Energy stored in therapy delivery element 24 can be delivered to patient 10 as a defibrillation shock, under the control of a processor 26, via electrodes 14 and 16. Interface 22, which operates under the control of processor 26, regulates when current may flow to patient 10, and may also regulate the direction of current flow. Continue reading... Full patent description for Method and system for responding to non-perfusing and non-shockable heart rhythms Brief Patent Description - Full Patent Description - Patent Application Claims Click on the above for other options relating to this Method and system for responding to non-perfusing and non-shockable heart rhythms patent application. Patent Applications in related categories: 20080161869 - Method and apparatus for electrolytic hydrotherapy - A device and method for increasing the number and type of ions in a hydrotherapy treatment to assist in removing unwanted chemicals from the body. A battery-powered array is submerged into a liquid foot bath to generate ions through electrolysis. The array has at least two electrodes, one containing copper ... ###  How KEYWORD MONITOR works... a FREE service from FreshPatents1. Sign up (takes 30 seconds). 2. Fill in the keywords to be monitored. 3. Each week you receive an email with patent applications related to your keywords. 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