# US 12,109,169 B2 · Synchronization of repetitive therapeutic interventions

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- Number: US 12,109,169 B2
- Document ID: US12109169B2
- Status: Granted
- Kind: B2
- Application number: 17/650,866
- Filed: 2022-02-14
- Published: 2022-07-21
- Granted: 2024-10-08
- Earliest claimed: 2005-09-14
- Assignees: ZOLL Medical Corporation
- Applicants: ZOLL Medical Corporation
- Inventors: Gary A Freeman; Daniel M Lisogurski
- Web page: https://patentgrep.com/patent/US12109169B2

## CPC

- A61H 31/005: {with feedback for the user}
- A61H 31/00: Artificial respiration by a force applied to the chest; Heart stimulation, e.g. heart massage (applying electric currents by contact electrodes for stimulation, e.g. heart pace-makers, A61N1/36 {; teaching or training models, demonstration models for medical purposes G09B23/288})
- A61H 31/006: {Power driven}
- A61H 31/007: {Manual driven}
- A61M 5/142: Pressure infusion, e.g. using pumps
- A61N 1/3625: {External stimulators}
- A61N 1/3628: {using sub-threshold or non-excitatory signals}
- A61N 7/00: Ultrasound therapy (lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 {; using ultrasound for introducing media into the body A61M37/0092})
- G16H 20/10: relating to drugs or medications, e.g. for ensuring correct administration to patients
- G16H 20/30: relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
- G16H 20/40: relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
- G16H 40/63: for local operation
- G16H 50/20: for computer-aided diagnosis, e.g. based on medical expert systems
- A61B 5/318: Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61H 2201/5007: computer controlled
- A61H 2201/501: connected to external computer devices or networks
- A61H 2201/5043: Displays
- A61H 2201/5048: Audio interfaces, e.g. voice or music controlled
- A61H 2201/5084: Acceleration sensors
- A61H 2201/5097: wireless
- A61H 2230/04: Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
- A61H 2230/205: partial CO2-value
- A61H 2230/207: partial O2-value
- A61H 2230/25: Blood flowrate, e.g. by Doppler effect
- A61H 2230/42: Rate
- A61N 1/39044: {in combination with cardiopulmonary resuscitation [CPR] therapy}
- A61H: PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY (electrotherapy, magnetotherapy, radiation therapy or ultrasound therapy A61N)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

An external defibrillator system for assisting manual delivery of chest compressions and ventilations to a patient by a rescuer as cardiopulmonary resuscitation (CPR) includes a speaker, and a processor, memory, and associated circuitry coupled to the speaker. The processor is configured to initiate prompting for the chest compressions and the ventilations manually delivered to the patient by the rescuer as CPR, control the speaker to generate first auditory cues for the chest compressions, and control the speaker to generate second auditory cues for the ventilations with a different sound than the first auditory cues for the chest compressions. The first auditory cues and the second auditory cues assist the rescuer in timing the delivery of the chest compressions and the ventilations.

## Claims

### Claim 1

An external defibrillator system for assisting manual delivery of chest compressions and ventilations to a patient by a rescuer as cardiopulmonary resuscitation (CPR), the external defibrillator system comprising:
at least one speaker;
at least one chest compression sensor configured to detect motion during the delivery of chest compressions to the patient; and
a processor, memory, and associated circuitry coupled to the at least one speaker and the at least one chest compression sensor, the processor configured to:
initiate prompting for the chest compressions and the ventilations manually delivered to the patient by the rescuer as CPR,
receive and process signals from the at least one chest compression sensor,
control the at least one speaker to generate first non-verbal auditory cues for the delivery of chest compressions to the patient by the rescuer, and
control the at least one speaker to generate second non-verbal auditory cues comprising a gradually changing sound for the delivery of ventilations to the patient by the rescuer with a different sound than the first non-verbal auditory cues for the delivery of chest compressions,
wherein the first non-verbal auditory cues for the delivery of chest compressions are of substantially shorter duration than the second non-verbal auditory cues for the delivery of ventilations, and wherein the first non-verbal auditory cues and the second non-verbal auditory cues assist the rescuer in timing the delivery of the chest compressions and the ventilations.

### Claim 2 (depends on 1)

The external defibrillator system of claim 1, wherein the processor is configured to determine cue times at which the first and second non-verbal auditory cues are generated by the at least one speaker.

### Claim 3 (depends on 1)

The external defibrillator system of claim 1, wherein a difference in tone causes the different sound for the second non-verbal auditory cues than for the first non-verbal auditory cues.

### Claim 4 (depends on 3)

The external defibrillator system of claim 3, wherein the difference in tone is a difference in waveshape and harmonics.

### Claim 5 (depends on 1)

The external defibrillator system of claim 1, wherein the second non-verbal auditory cues for the delivery of ventilations to the patient by the rescuer are a biphasic audio tone.

### Claim 6 (depends on 1)

The external defibrillator system of claim 1, wherein at least one of the first and second non-verbal auditory cues comprise feedback cues.

### Claim 7 (depends on 1)

The external defibrillator system of claim 1, comprising an automated external defibrillator.

### Claim 8 (depends on 1)

The external defibrillator system of claim 1, wherein the at least one chest compression sensor comprises an accelerometer.

### Claim 9 (depends on 1)

The external defibrillator system of claim 1, comprising a display configured to provide visual feedback for one or more chest compression parameters determined based on signals from the at least one chest compression sensor.

### Claim 10 (depends on 9)

The external defibrillator system of claim 9, wherein one or more chest compression parameters comprise compression depth and compression rate.

### Claim 11 (depends on 1)

The external defibrillator system of claim 1, comprising a defibrillation pulse generator for energy output.

### Claim 12 (depends on 11)

The external defibrillator system of claim 11, comprising electrocardiogram (ECG) leads configured to attach to the patient.

### Claim 13 (depends on 12)

The external defibrillator system of claim 12, comprising a signal processing module coupled to the processor and configured to:
receive ECG signals via the ECG leads, and analyze the ECG signals.

### Claim 14 (depends on 13)

The external defibrillator system of claim 13, wherein the processor is configured to:
detect a heart rhythm based on the ECG signals,
determine that defibrillation of the patient is advised based on the heart rhythm, and
cause the defibrillation pulse generator to deliver a shock for defibrillating the patient's heart.

### Claim 15 (depends on 14)

The external defibrillator system of claim 14, wherein the processor is configured to:
prompt the rescuer to request the delivery of the shock via a rescuer input to the external defibrillator system, and
cause the defibrillation pulse generator to deliver the shock for defibrillating the patient's heart in response to the rescuer input.

### Claim 16 (depends on 1)

The external defibrillator system of claim 1, wherein the processor is configured to control the at least one speaker to generate and provide the first non-verbal auditory cues for the delivery of chest compressions on a compression-by-compression basis.

### Claim 17 (depends on 1)

The external defibrillator system of claim 1, wherein the processor configured to control the at least one speaker to generate and provide the second non-verbal auditory cues for the delivery of ventilations during a ventilation cycle of the CPR.

### Claim 18 (depends on 1)

The external defibrillator system of claim 1, wherein the processor is configured to monitor the received and processed signals to determine chest compression depth, and
wherein controlling the at least one speaker to generate the first non-verbal auditory cues for the delivery of chest compressions comprises causing the at least one speaker to emit a downstroke cue until a chest compression reaches a target depth and then causing the at least one speaker to emit an upstroke cue.

### Claim 19 (depends on 18)

The external defibrillator system of claim 18, wherein a frequency or volume of the upstroke cue is different than a frequency or volume of the downstroke cue.

### Claim 20 (depends on 19)

The external defibrillator system of claim 19, wherein controlling the at least one speaker to generate the downstroke cue comprises varying the frequency or volume of the downstroke cue as the chest compression approaches the target chest compression depth.

### Claim 21 (depends on 1)

The external defibrillator system of claim 1, wherein the processor is further configured to:
calculate a latency between actual times that chest compressions are performed determined based on the received signals from the at least one chest compression sensor and desired delivery times for the chest compression, and
adjust a pattern for generating the first non-verbal auditory cues based on the calculated latency.

### Claim 22 (depends on 1)

The external defibrillator system of claim 1, wherein one or more of the first non-verbal auditory cues overlap with a single one of the second non-verbal auditory cues.