System for cardiac resuscitation

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• (3) a second input device, responsive to a medical professional, for producing a defibrillation command signal, for initiating the automatic application of a defibrillation pulse to said victim;
• and
• (4) a first transmitting/receiving (T/R) device, coupled to said display device and to said first and second input devices, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a logic device for automatic control of the portable unit, coupled to the second T/R device, for automatically producing a second defibrillation control signal for controlling the application of a defibrillation pulse to said victim, upon receipt of a defibrillation command signal from said central station, in response to electrocardiogram (ECG) signals received from said victim;
• (3) a defibrillator circuit, having a control input coupled to said second T/R device and to said logic device, for generating a defibrillation pulse at a defibrillator circuit output in response to a either a first or a second defibrillation control signal received at said defibrillator circuit control input;
• (4) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device and to said logic device, and having an ECG electrode input;
• (5) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (6) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim;
• and wherein, upon transmission of a defibrillation command signal from said central station to said logic device at said remote site, said defibrillator circuit is responsive to said second defibrillation control signal generated by said logic device to generate said defibrillation pulse for application to said at least one contact electrode for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) at least one input device, responsive to said medical professional, for producing a defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to defibrillation control signal received at said defibrillator circuit control input;
• (3) a signaling device, coupled to said second T/R device and to said defibrillator circuit for producing a confirmation signal for transmission to said central station when said defibrillation pulse is generated;
• (4) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device, and an ECG electrode input;
• (5) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (6) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit, (3), in response thereto, said defibrillation pulse may be transmitted from said defibrillator output to selected ones of said contact electrodes for resuscitation of said victim, and (4) said signaling device may transmit said confirmation signal to said central station.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) at least one input device, responsive to said medical professional, for producing a defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and to said input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (4) a first signaling device, coupled to said first T/R device, for producing a handshake signal for transmission to a remote site in response to receipt of a telemetry signal;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a second signaling device, coupled to said second T/R device, for producing a telemetry signal for transmission to said central station and for receiving said handshake signal from said first signaling device at central station in response thereto;
• (3) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to defibrillation control signal received at said defibrillator circuit control input;
• (4) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device, and an ECG electrode input;
• (5) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (6) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said second signaling device may send a telemetry signal to said central station and, if said handshake signal is received from said first signaling device in response thereto, then (2) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (3) said defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit, and (4), in response thereto, said defibrillation pulse may be transmitted from said defibrillator output to selected ones of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) at least one input device, responsive to said medical professional, for producing a defibrillation control signal for controlling the application of a defibrillation pulse to said victim and for producing an electrode selection control signal for controlling the selection of electrodes from which ECG signals may be received and to which said defibrillation pulse may be applied;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and to said input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device, and an ECG electrode input;
• (4) a plurality of contact electrodes adapted to be placed by a nearby enabler upon a chest wall of said victim, at spaced apart locations thereon, said plurality of contact electrodes being adapted for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (6) an electrode selection device, responsive to said electrode selection control signal, for connecting selected ones of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said ECG signals may be transmitted from said selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit, and (3), in response thereto, said defibrillation pulse may be transmitted from said defibrillator output to said selected ones of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) at least one input device, responsive to said medical professional, for producing a defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and to said input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (4) a first signaling device, coupled to said first T/R device, for producing a telemetry signal for transmission to a remote site and for receipt of a handshake signal in response thereto;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a second signaling device, coupled to said second T/R device, for producing a handshake signal for transmission to said central station in response to receipt of said telemetry signal from said first signaling device at central station;
• (3) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to defibrillation control signal received at said defibrillator circuit control input;
• (4) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device, and an ECG electrode input;
• (5) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (6) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said first signaling device may send a telemetry signal to said portable unit and, if said handshake signal is received from said second signaling device in response thereto, then (2) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (3) said defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit, and (4), in response thereto, said defibrillation pulse may be transmitted from said defibrillator output to selected ones of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a defibrillation control signal for controlling the timing and the parameters of a defibrillation pulse for application to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output, with the timing and the parameters of said defibrillation pulse being determined by the defibrillation control signal received at said control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device and to said automatic control device, and having an ECG electrode input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim.

An automated cardiac monitoring and external defibrillation system which allows an untrained human enabler to treat a victim of cardiac arrest by applying a defibrillation pulse to said victim, said system comprising, in combination:

• (a) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a first transmitting/receiving (T/R) device for duplex electronic communication with a first T/R device at a central station;
• (2) an automatic external defibrillator circuit, having an electrocardiogram (ECG) input, for generating a defibrillation pulse at a defibrillator circuit output in response to ECG signals received at said ECG input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said ECG input of said defibrillator circuit, and having an ECG electrode input;
• (4) a plurality of contact electrodes adapted to be placed by a nearby enabler upon a chest wall of said victim of cardiac arrest at spaced apart locations thereon, said plurality of contact electrodes being adapted for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• (5) a voice communication device including a microphone and a speaker coupled to said first T/R device;
• and
• (6) a releasable lock mechanically connecting said portable unit to a stationary fixture;
• and
• (b) a central station comprising:
• (1) a second transmitting/receiving device for duplex electronic communication with said first T/R device in one or more of said portable units;
• and
• (2) a voice communication device including a microphone and speaker, coupled to said second T/R device;
• whereby an enabler at any one of said portable units may engage in voice communication with a person at said central station and request release of said portable unit for use in a medical emergency.

A cardiac monitoring and external defibrillation and cardiac pacing system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said-medical professional;
• (2) at least one first input device, responsive to said medical professional, for producing a defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• (3) at least one second input device, responsive to said medical professional, for producing a cardiac pacing control signal for controlling the application of a cardiac pacing pulses to said victim;
• and
• (4) a first transmitting/receiving (T/R) device, coupled to said display device and to said first and said second input devices, for electronic communication with emergency cardiac monitoring, defibrillation and cardiac pacing apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation and cardiac pacing apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a defibrillation control input coupled to said second T/R device, for producing defibrillation pulses at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillation control input;
• (3) a cardiac pacing circuit, having a pacing control input coupled to said second T/R device, for producing cardiac pacing pulses at a pacing circuit output in response to a cardiac pacing control signal received at said pacing control input;
• (4) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device, and an ECG electrode input;
• (5) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for (1) the receipt of ECG signals from said victim;
• (2) for application of said defibrillation pulses to said victim and (3) for application of said pacing pulses to said victim;
• and
• (6) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input;
• (ii) said defibrillator output and (iii) said cardiac pacing output;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional;
• (2) said defibrillation control signal and said cardiac pacing control signal may be transmitted from said central station to said defillibration control input of and said pacing control input, respectively;
• and (3) in response thereto, said defibrillation pulse may be transmitted from said defibrillator output or said cardiac pacing pulses may be transmitted from said cardiac pacing output to selected ones of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites, said first T/R device having means for decrypting information received from one or more of said remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station, said second T/R device including an encryption device for encrypting information transmitted to said first T/R device;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device, and having an ECG electrode input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said ECG signals may be transmitted from said contact electrodes via said connecting cable and said ECG circuit and from thence in encrypted form from said second to said first T/R device, respectively, where it is decrypted for evaluation by said medical professional at said central station, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim.

A multiple-pin electrical connector capable of sensing when and which connector elements are connected together, said connector comprising, in combination:

• (a) a first connector element having a plurality of first pins each adapted to be electrically connected to an electric circuit element;
• and
• (b) a second connector element having a plurality of second pins, each adapted to be electrically connected to an electric circuit element,
• wherein each of said first pins is adapted to be electrically connected to a corresponding one of said second pins when said first and said second connector elements are coupled together,
• the improvement comprising an electrical low resistance connection between two pins of said first connector element and means, electrically connected to a plurality of pins of said second connector element, for sensing said low resistance connection between said two pins of said first connector element when said two connector elements are coupled together, thereby to sense the connection between said first and second connector elements and to sense the presence of a particular first connector element from among a plurality of first connector elements that may be coupled to said second connector element.

A flexible, semi-rigid pad having a substantially flat surface adapted to be placed upon the chest wall of a patient for establishing an electrical connection with a plurality of points on said chest wall, said pad comprising, in combination:

• (a) a pad substrate of flexible, semi-rigid material, said substrate having a substantially flat surface which is substantially conformable to the chest of a human patient;
• (b) a plurality of contact electrodes disposed in spaced relation on said surface, said contact electrodes being electrically insulated from each other and adapted to make contact with the chest wall of a patient;
• (c) a flexible film made of electrically insulating material having one side thereof adhesively but removably attached to said surface and covering said contact electrodes;
• and
• (d) at least one electrically connecting element disposed on said one side of said film, and removable from said surface together with said film, said connecting element providing an electrical connection between at least two of said contact electrodes,
• whereby the removal of said film may be sensed by sensing the electrical resistance between said at least two contact electrodes.

A video system comprising:

• (a) a video camera, arranged at a first location, for producing a video signal representing a video image;
• (b) a video camera supporting device, arranged at said first location, having means for aiming said video camera in a plurality of desired directions in response to a control signal, said video supporting device including:
• (1) a housing, adapted to house at least a portion of said video camera when said camera is in a retracted position;
• (2) a video aiming device, attached to said housing and supporting said video camera, for moving said video camera in response to the receipt of said control signal, said aiming device being operative to move said camera between said retracted position and an extended position away from said housing and to aim said video camera in a direction away from said housing and, when said camera is in said extended position, in a direction toward said housing;
• (c) a video monitor, arranged at a second location remote from said first location, for producing a video image in response to a video signal;
• (d) a control device, arranged at said second location, for producing said control signal in response to a manual control input by a human operator;
• and
• (e) telecommunication system for transmitting said video signal from said video camera at said first location to said video monitor at said second location and for transmitting said control signal from said control device at said second location to said camera supporting device at said first location,
• whereby a human operator may test said video camera, said supporting device and said telecommunication system by viewing said monitor while providing a manual control input to said control device to cause said video camera to point in the direction toward said housing, thereby to determine the condition of said housing.

An audio system comprising:

• (a) a microphone, arranged at a first location, for producing a first audio signal representing received sound;
• (b) a sound producing device, arranged at said first location, having a loudspeaker and means, electrically connected to said loudspeaker, for causing said loudspeaker to produce a sound in response to a control signal;
• (c) a sound transducer, arranged at a second location remote from said first location, for producing a sound in response to, and represented by, an audio signal;
• (d) a control device, arranged at said second location, for producing a control signal in response to a manual control input by a human operator;
• and
• (e) telecommunication system for transmitting said control signal from said control device at said second location to said sound producing device at said first location and for transmitting said first audio signal from said microphone at said first location to said sound transducer at said second location,
• whereby a human operator may remotely test said audio system by listening to said sound transducer at said second location while providing a manual control input to said control device.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising a plurality of work stations, one for each of a plurality of medical professionals, each work station comprising:
• (1) a display device for displaying cardiac information from at least one victim for evaluation by the medical professional assigned to such work station;
• and
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said at least one victim;
• said central station further comprising a first transmitting/receiving (T/R) device, coupled to said display device and said first input device of each work station, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device, and having an ECG electrode input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said ECG signals may be transmitted from said contact electrodes via said connecting cable and said ECG circuit and from thence from said second to said first T/R device, respectively, for evaluation by a medical professional at one of said work stations at said central station, (2) said first defibrillation control signal may be transmitted from said one work station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim, thereby to allow the services of one or more medical professionals to be provided to a plurality of victims simultaneously.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• (3) a second input device, responsive to said medical professional, for producing a voice prompt control signal;
• (4) a first microphone, responsive to said medical professional, for producing a first audio signal representing the voice of said medical professional;
• (5) a first sound transducer for producing a sound in response to a second audio signal;
• (6) a first transmitting/receiving (T/R) device, coupled to said display device, said first and said second input device, said first microphone and said first sound transducer, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device and to said automatic control device, and having an ECG electrode input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• (6) a second sound transducer, coupled to said second T/R device, for producing a sound in response to receipt of said first audio signal;
• (7) a voice prompt producing device, coupled to said second sound transducer and to said second T/R device, for causing said second sound transducer to produce a selected voice prompt in response to receipt of a voice prompt control signal;
• and
• (8) a second microphone, coupled to said second T/R device and responsive to said enabler, for producing a second audio signal representative of the voice of said enabler which may be transmitted to said central station;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim;
• and wherein said medical professional may attempt to establish voice communication with said enabler and, in the absence of proper voice communication, may transmit said voice prompt control signal to said portable unit for producing a selected voice prompt.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• (3) a second input device, responsive to said medical professional, for producing a signal for controlling the operation of the system;
• (4) a first microphone, responsive to said medical professional, for producing a first audio signal representing the voice of said medical professional;
• (5) a first sound transducer for producing a sound in response to a second audio signal;
• (6) a first transmitting/receiving (T/R) device, coupled to said display device, said first and said second input device, said first microphone and said first sound transducer, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device and to said automatic control device, and having an ECG electrode input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• (6) a second sound transducer, coupled to said second T/R device, for producing a sound in response to receipt of said first audio signal;
• and
• (7) a second microphone, coupled to said second T/R device and responsive to said enabler, for producing a second audio signal representative of the voice of said enabler which may be transmitted to said central station;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim;
• and wherein said medical professional may control the operation of the system by means of said second input device.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device, and having an ECG electrode input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• and
• (c) means, disposed in said central station and each of said remote sites, for repeatedly automatically checking the operation of the system for faults;
• whereby (1) said ECG signals may be transmitted from said contact electrodes via said connecting cable and said ECG circuit and from thence from said second to said first T/R device, respectively, for evaluation by said medical professional at said central station, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• (4) a mass storage device, coupled to said first T/R device, for storing ECG information received from the emergency cardiac monitoring and defibrillation apparatus disposed at each of said plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of said plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device, and having an ECG electrode input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said ECG signals may be transmitted from said contact electrodes via said connecting cable and said ECG circuit and from thence from said second to said first T/R device, respectively, for evaluation by said medical professional at said central station, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and internal defibrillation system which allows a patient with an implanted cardiac defibrillator device immediate access to a medical professional who can and will remotely monitor, diagnose and treat a medical emergency, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a patient for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said patient;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and internal defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a unit implanted in a patient and including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) a logic device for automatic control of the implanted unit, coupled to the second T/R device and to the control input of said defibrillator circuit, for automatically producing a second defibrillation control signal for controlling the application of said defibrillation pulse to said patient in the absence of proper and timely communication between said first T/R device and said second T/R device, in response to electrogram (EGM) signals received from said patient;
• (4) an electrogram (EGM) circuit, having an EGM circuit output, coupled to said second T/R device and to said logic device, and having one or more EGM electrode inputs;
• (5) a plurality of electrodes, adapted to be coupled at separate locations to internal tissue of said patient, for the receipt of EGM signals from said patient and for application of said defibrillation pulse to said patient;
• and
• (6) a means for connecting each of said electrodes to at least one of (i) said EGM electrode inputs and (ii) said defibrillator output;
• whereby (1) said EGM signals may be transmitted from selected ones of said electrodes via said EGM circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said electrodes for resuscitation of said patient;
• and wherein, in the absence of proper and timely communication between said first T/R device and said second T/R device, said defibrillator circuit is responsive to said second defibrillation control signal received from said logic device to generate said defibrillation pulse-for application to said at least one electrode for resuscitation of said patient.

A cardiac monitoring and internal defibrillation system which allows a patient with an implanted cardiac defibrillator device immediate access to a medical professional who can and will remotely monitor, diagnose and treat a medical emergency, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a patient for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said patient;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and internal defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a unit implanted in a patient and including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) a logic device for automatic control of the implanted unit, coupled to the second T/R device and to the control input of said defibrillator circuit, for automatically producing a second defibrillation control signal for controlling the application of said defibrillation pulse to said patient in response to electrogram (EGM) signals received from said patient;
• (4) an electrogram (EGM) circuit, having an EGM circuit output, coupled to said second T/R device and to said logic device, and having an EGM electrode input;
• (5) a plurality of electrodes, adapted to be coupled at separate locations to internal tissue of said patient, for the receipt of EGM signals from said patient and for application of said defibrillation pulse to said patient;
• and
• (6) a means for connecting each of said electrodes to at least one of (i) said EGM electrode input and (ii) said defibrillator output;
• whereby (1) said EGM signals may be transmitted from selected ones of said electrodes via said EGM circuit to said central station for evaluation by said medical professional;
• (2) wherein said defibrillator circuit is responsive to said second defibrillation control signal received from said logic device to generate said defibrillation pulse for application to said at least one electrode for resuscitation of said patient;
• (3) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (4), in response to receipt of a defibrillation control signal from said central station, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said electrodes for resuscitation of said patient.

A flexible, semi-rigid pad having a substantially flat surface adapted to be placed upon the chest wall of a patient for establishing an electrical connection with a plurality of points on said chest wall, said pad comprising, in combination:

• (a) a pad substrate of flexible, semi-rigid material, said substrate having a substantially flat surface which is substantially conformable to the chest of a human patient;
• (b) a plurality of contact electrodes disposed in spaced relation on said surface, said contact electrodes being electrically insulated from each other and adapted to make contact with the chest wall of a patient;
• and
• (c) a detection device, connected to said contact electrodes, for determining the resistance between respective ones of said electrodes when such electrodes are attached to said chest wall of said patient, and for determining whether the resistance between said chest wall and at least one of said electrodes is sufficiently low for the transmission of electric current.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• (3) a second input device for producing an ECG control signal;
• and
• (4) a first transmitting/receiving (T/R) device, coupled to said display device and said first and said second input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output and a control input, both coupled to said second T/R device, and an ECG electrode input, said electrocardiogram circuit being operative to receive said ECG control signal at said control input and to responsively adjust the accuracy of reproduction of ECG signals received at said ECG input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim;
• and wherein said medical professional may adjust the accuracy of reproduction of said ECG signals by means of said second input, as required to review and understand said ECG signals, within the bandwidth available for transmission between second and said first T/R device.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac and respiratory information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first and said second input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output coupled to said second T/R device, and an ECG electrode input, said electrocardiogram circuit being operative to receive ECG signals received at said ECG input and to transmit ECG signals at said ECG circuit output;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• and
• (6) a mask for providing air under pressure to the victim's respiratory system, said mask having a resilient member adapted to fit snugly on the face, over the mouth and nose, of the victim to prevent air from escaping between the victim's face and the mask, said mask further comprising an air pressure sensor disposed therein and an electric circuit, connected to said sensor and to said second T/R device, for determining the air pressure in the mask which delivered to said victim and for transmitting a signal to said central station, via said second and first T/R device, respectively, which represents information about said pressure;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac and respiratory information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first and said second input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output coupled to said second T/R device, and an ECG electrode input, said electrocardiogram circuit being operative to receive ECG signals received at said ECG input and to transmit ECG signals at said ECG circuit output, said ECG circuit further comprising a ventilation detection circuit, connected to said ECG input, for monitoring the impedance between two electrodes, thereby to monitoring and producing a signal at said ECG output, for transmission to said central station, containing information concerning the impedance across the patient's chest and permit evaluation of the patient.'s respiration;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• (3) a second input device for producing an ECG bandwidth control signal;
• and
• (4) a first transmitting/receiving (T/R) device, coupled to said display device and said first and said second input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output and a control input, both coupled to said second T/R device, and an ECG electrode input, said electrocardiogram circuit being operative to receive said ECG bandwidth control signal at said control input and to responsively adjust the bandwidth of ECG signals received at said ECG input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim;
• and wherein said medical professional may adjust the bandwidth of transmission of said ECG signals by means of said second input, as required to review and understand said ECG signals, within the bandwidth available for transmission between second and said first T/R device.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac and respiratory information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first and said second input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output coupled to said second T/R device, and an ECG electrode input, said electrocardiogram circuit being operative to receive ECG signals received at said ECG input and to transmit ECG signals at said ECG circuit output;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• and
• (6) a mask for providing air under pressure to the victim's respiratory system, said mask having a resilient member adapted to fit snugly on the face, over the mouth and nose, of the victim to prevent air from escaping between the victim's face and the mask, said mask further comprising an air flow sensor disposed therein and an electric circuit, connected to said flow sensor and to said second T/R device, for determining the air flow in the mask which delivered to said victim and for transmitting a signal to said central station, via said second and first T/R device, respectively, which represents information about said air flow;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information and medical information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first and said second input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output coupled to said second T/R device and an ECG electrode input, said electrocardiogram circuit being operative to receive ECG signals at said ECG input and supply ECG information at said ECG circuit output;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• (6) a portable unit input device, connected to said second T/R device, for receiving and storing medical information about said victim and for transferring said medical information to said central station via said second T/R device;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim.

A video system comprising:

• (a) a video camera, arranged at a first location, for producing a video signal representing a video image;
• (b) a video camera supporting device, arranged at said first location, having means for aiming said video camera in a plurality of desired directions in response to a control signal, said video supporting device including:
• (1) a housing, adapted to house at least a portion of said video camera;
• (2) a video aiming device, attached to said housing and supporting said video camera, for moving said video camera in response to the receipt of said control signal to aim said video camera in a direction away from said housing;
• and
• (3) a mirror, arranged at a distance from said video camera and facing said video camera;
• (c) a video monitor, arranged at a second location remote from said first location, for producing a video image in response to a video signal;
• (d) a control device, arranged at said second location, for producing said control signal in response to a manual control input by a human operator;
• and
• (e) telecommunication system for transmitting said video signal from said video camera at said first location to said video monitor at said second location and for transmitting said control signal from said control device at said second location to said camera supporting device at said first location,
• whereby a human operator may test said video camera, said supporting device and said telecommunication system by viewing said monitor while providing a manual control input to said control device to cause said video camera to point in a direction toward said mirror, thereby to determine the condition of said housing and said camera.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first and said second input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output coupled to said second T/R device, and an ECG electrode input, said electrocardiogram circuit being operative to transmit ECG signals received at said ECG input to said second T/R device;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• (6) a display device, coupled to said second T/R device, for displaying information received at said second T/R device;
• and
• (7) a first input device coupled to said control input of said defibrillator circuit, enabling local control of said defibrillator circuit;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first and said second input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output coupled to said second T/R device, and an ECG electrode input, said electrocardiogram circuit being operative to transmit to said second T/R device ECG signals received at said ECG input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least:one of (i) said ECG electrode input and (ii) said defibrillator output;
• and
• (6) a local transmitting and receiving (T/R) device, coupled to said second T/R device, for communicating with the local T/R device of another portable unit;
• whereby (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim;
• and wherein each of said portable units can serve as a relay in the communication link between the second T/R device of the portable unit associated with a victim and said first T/R device at said central station.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) computer logic for controlling the operations and communications of the central station in response to actions taken by said medical professional;
• (2) a display device, coupled to said computer logic, for displaying cardiac information from a victim for evaluation by said medical professional;
• (3) a first input device, coupled to said computer logic and responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (4) a first transmitting/receiving (T/R) device, coupled to said display device and said first input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device and having an ECG electrode input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• wherein (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim;
• and wherein said computer logic causes said display device to display a warning if said medical professional attempts to take an action which may be considered medically unreasonable.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (a) a central station comprising:
• (1) a display device for displaying cardiac information from a victim for evaluation by said medical professional;
• (2) a first input device, responsive to said medical professional, for producing a first and a second defibrillation control signal for controlling the application of a defibrillation pulses to said victim;
• and
• (3) a first transmitting/receiving (T/R) device, coupled to said display device and said first input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a first defibrillator circuit, having a first control input coupled to said second T/R device, for generating a first controllable defibrillation pulse at a first defibrillator circuit output in response to a first defibrillation control signal received at said first control input;
• (3) a second defibrillator circuit, having a second control input coupled to said second T/R device, for generating a second controllable defibrillation pulse at a second defibrillator circuit output in response to a second defibrillation control signal received at said second control input;
• (4) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device and having an ECG electrode input;
• (5) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (6) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said first and second defibrillator circuit output;
• wherein (1) said ECG signals may be transmitted from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first and second defibrillation control signals may be transmitted from said central station to said first and second control inputs of said first and second defibrillator circuits, respectively, and (3), in response thereto, said defibrillator circuits may generate said defibrillation pulses for application between at least two of said contact electrodes for resuscitation of said victim.

A cardiac monitoring and external defibrillation system which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said system comprising, in combination:

• (b) a central station comprising:
• (1) computer logic for controlling the operations and communications of the central station in response to actions taken by said medical professional;
• (2) a display device, coupled to said computer logic, for displaying cardiac information from a victim for evaluation by said medical professional;
• (3) a first input device, coupled to said computer logic and responsive to said medical professional, for producing a first defibrillation control signal for controlling the application of a defibrillation pulse to said victim;
• and
• (4) a first transmitting/receiving (T/R) device, coupled to said display device and said first input device, for electronic communication with emergency cardiac monitoring and defibrillation apparatus disposed at each of a plurality of remote sites;
• and
• (b) emergency cardiac monitoring and external defibrillation apparatus disposed at each of a plurality of remote sites, each said apparatus comprising a portable unit including:
• (1) a second transmitting/receiving (T/R) device for electronic communication with said first T/R device of said central station;
• (2) a defibrillator circuit, having a control input coupled to said second T/R device, for generating a defibrillation pulse at a defibrillator circuit output in response to a defibrillation control signal received at said defibrillator circuit control input;
• (3) an electrocardiogram (ECG) circuit, having an ECG circuit output, coupled to said second T/R device and having an ECG electrode input;
• (4) a plurality of contact electrodes, adapted to be placed by a nearby enabler upon a chest wall of said victim, said plurality of contact electrodes being adapted to be arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of said defibrillation pulse to said victim;
• and
• (5) a connecting cable having a plurality of electric wires for connecting each of said contact electrodes to at least one of (i) said ECG electrode input and (ii) said defibrillator output;
• wherein (1) said ECG signals may be transmitted:from selected ones of said contact electrodes via said ECG circuit to said central station for evaluation by said medical professional, (2) said first defibrillation control signal may be transmitted from said central station to said control input of said defibrillator circuit and (3), in response thereto, said defibrillator circuit may generate said defibrillation pulse for application to at least one of said contact electrodes for resuscitation of said victim;
• and wherein said computer logic causes said display device to display legal information, in response to a prompt by the medical professional, relating to the duties and responsibilities of the medical professional.

A method of monitoring and external defibrillation which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said method comprising the steps of:

• (1) placing a plurality of contact electrodes on a chest wall of a victim at a remote site, said plurality of contact electrodes being arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of a defibrillation pulse to said victim;
• (2) receiving said ECG signals at a central station and displaying said signals for review by and consideration of a medical professional;
• (3) transmitting instructions of said medical professional at said central station to said remote site for applying a defibrillation pulse to said victim between at least two of said contact electrodes;
• (4) repeating steps (2) and (3) until said victim is defibrillated;
• and
• (5) terminating the application of defibrillation pulses if, in the judgment of said medical professional, the resuscitation of the victim is not possible.

A method of monitoring and external defibrillation which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said method comprising the steps of:

• (1) placing a plurality of contact electrodes on a chest wall of a victim at a remote site, said plurality of contact electrodes being arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of an electrical pulse to said victim;
• (2) transmitting said ECG signals from said remote site to said central station;
• (3) receiving said ECG signals at a central station and displaying said signals for review by and consideration of a medical professional;
• (4) said medical professional manually selecting, at said central station, from a menu of defibrillation pulses and pacing pulses for application to said victim at said remote site;
• (5) transmitting the results of said selection by said medical professional at said central station to said remote site;
• and
• (6) receiving the results of said selection at said remote site and applying the selected pulse to said victim between at least two of said contact electrodes.

A method of monitoring and external defibrillation which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said method comprising the steps of:

• (1) placing a plurality of contact electrodes on a chest wall of a victim at a remote site, said plurality of contact electrodes being arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of an electrical pulse to said victim;
• (2) transmitting said ECG signals from said remote site to said central station;
• (3) receiving said ECG signals at a central station and displaying said signals for review by and consideration of a medical professional;
• (4) said medical professional manually selecting, at said central station, from a menu of defibrillation pulses for application to said victim at said remote site;
• (5) transmitting the results of said selection by said medical professional at said central station to said remote site;
• and
• (6) receiving the results of said selection at said remote site and applying the selected defibrillation pulse to said victim between at least two of said contact electrodes.

A method of monitoring and external defibrillation which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said method comprising the steps of:

• (1) placing a plurality of contact electrodes on a chest wall of a victim at a remote site, said plurality of contact electrodes being arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of an electrical pulse to said victim;
• (2) transmitting said ECG signals from said remote site to said central station;
• (3) receiving said ECG signals at a central station and displaying said signals for review by and consideration of a medical professional;
• (4) said medical professional manually selecting, at said central station, from a menu of pacing pulses for application to said victim at said remote site;
• (5) transmitting the results of said selection by said medical professional at said central station to said remote site;
• and
• (6) receiving the results of said selection at said remote site and applying the selected pacing pulses to said victim between at least two of said contact electrodes.

A method of monitoring and internal defibrillation which allows a cardiac patient immediate access to a medical professional who can and will remotely monitor, diagnose and treat the patient's heart at a remote site, said method comprising the steps of:

• (1) implanting an implantable cardioverter defibrillator (ICD), having at least one extending lead, in the patient's body and connecting said lead to the patient's heart for the receipt of ECG signals from said heart and for application of an electrical pulse to said heart;
• (2) said ICD automatically determining when said patient experiences at least one of tachycardia and fibrillation;
• (3) said ICD transmitting said ECG signals from said remote site to said central station;
• (4) receiving said ECG signals at a central station and displaying said signals for review by and consideration of a medical professional;
• (5) said medical professional manually selecting, at said central station, from a menu of defibrillation pulses for application to said victim at said remote site;
• (6) transmitting the results of said selection by said medical professional at said central station to said ICD at said remote site;
• and
• (7) said ICD receiving the results of said selection at said remote site and applying the selected defibrillation pulse to said patient's heart via said at least one lead.

A method of monitoring and internal defibrillation which allows a cardiac patient immediate access to a medical professional who can and will remotely monitor, diagnose and treat the patient's heart at a remote site, said method comprising the steps of:

• (1) implanting an implantable cardioverter defibrillator (ICD), having at least one extending lead, in the patient's body and connecting said lead to the patient's heart for the receipt of ECG signals from said heart and for application of an electrical pulse to said heart;
• (2) said ICD automatically determining when said patient experiences at least one of tachycardia and fibrillation;
• (3) said ICD transmitting said ECG signals from said remote site to said central station;
• (4) receiving said ECG signals at a central station and displaying said signals for review by and consideration of a medical professional;
• (5) said medical professional manually selecting, at said central station, from a menu of pacing pulses for application to said victim at said remote site;
• (6) transmitting the results of said selection by said medical professional at said central station to said ICD at said remote site;
• and
• (7) said ICD receiving the results of said selection at said remote site and applying one or more of the selected pacing pulses to said patient's heart via said at least one lead.

A method of monitoring and internal defibrillation which allows a cardiac patient immediate access to a medical professional who can and will remotely monitor, diagnose and treat the patient's heart at a remote site, said method comprising the steps of:

• (1) implanting an implantable cardioverter defibrillator (ICD), having at least one extending lead, in the patient's body and connecting said lead to the patient's heart for the receipt of ECG signals from said heart and for application of an electrical pulse to said heart;
• (2) said ICD automatically determining when said patient experiences at least one of tachycardia and fibrillation;
• (3) said ICD transmitting said ECG signals from said remote site to said central station;
• (4) receiving said ECG signals at a central station and displaying said signals for review by and consideration of a medical professional;
• (5) said medical professional manually selecting, at said central station, from a menu of defibrillation and pacing pulses for application to said victim at said remote site;
• (6) transmitting the results of said selection by said medical professional at said central station to said ICD at said remote site;
• and
• (7) said ICD receiving the results of said selection at said remote site and applying at least one of the selected pulses to said patient's heart via said at least one lead.

A method of monitoring and external defibrillation which allows an untrained human enabler immediate access to a medical professional who can and will remotely monitor, diagnose and treat a victim of medical emergency at one of a plurality of remote sites, said method comprising the steps of:

• (1) establishing two-way voice communication between the human enabler and the medical professional, such that the medical professional can instruct the enabler to carry out the necessary procedures for resuscitation of the victim;
• (2) said human enabler placing a plurality of contact electrodes on a chest wall of a victim at a remote site, said plurality of contact electrodes being arranged at separate locations on said chest wall for the receipt of ECG signals from said victim and for application of an electrical pulse to said victim;
• (3) automatically transmitting said ECG signals from said remote site to said central station;
• (4) receiving said ECG signals at a central station and displaying said signals for review by and consideration of a medical professional;
• (5) said medical professional manually selecting, at said central station, the application of a defibrillation pulse to said victim at said remote site;
• (6) automatically transmitting the results of said selection by said medical professional at said central station to said remote site;
• (7) receiving said selection at said remote site and automatically applying the selected defibrillation pulse to said victim between at least two of said contact electrodes;
• and
• (8) if said selection is not received at the remote site within a reasonable time, automatically applying a default defibrillation pulse to said victim between at least two of said contact electrodes.