U.S. patent application number 10/675156 was filed with the patent office on 2005-03-31 for automated external defibrillator (aed) with context-sensitive help.
Invention is credited to Fischer, Kurt, Froman, James, Hansen, Kim, Ohta, Seiya.
Application Number | 20050070964 10/675156 |
Document ID | / |
Family ID | 34377071 |
Filed Date | 2005-03-31 |
United States Patent
Application |
20050070964 |
Kind Code |
A1 |
Hansen, Kim ; et
al. |
March 31, 2005 |
Automated external defibrillator (AED) with context-sensitive
help
Abstract
A defibrillator system is disclosed including an operational
state input, a user-operated information request input, and a user
guidance output. The defibrillator system can be implemented as an
AED, a manual defibrillator, or as a defibrillator trainer. The
defibrillator system further utilizes the state and request inputs
to determine a context-sensitive rescue information which is
provided to the output.
Inventors: |
Hansen, Kim; (Renton,
WA) ; Fischer, Kurt; (Lynnwood, WA) ; Froman,
James; (Issaquah, WA) ; Ohta, Seiya;
(Issaquah, WA) |
Correspondence
Address: |
PHILIPS INTELLECTUAL PROPERTY & STANDARDS
P.O. BOX 3001
BRIARCLIFF MANOR
NY
10510
US
|
Family ID: |
34377071 |
Appl. No.: |
10/675156 |
Filed: |
September 30, 2003 |
Current U.S.
Class: |
607/5 |
Current CPC
Class: |
A61N 1/39044 20170801;
A61N 1/3904 20170801; A61N 1/3993 20130101 |
Class at
Publication: |
607/005 |
International
Class: |
A61N 001/39 |
Claims
What is claimed is:
1. An automated external defibrillator comprising; An information
request input; a state input indicative of an operational state of
the defibrillator; an output; and a controller which provides
context-sensitive rescue information to the output in response to
the nformation request input and the operational state of the
defibrillator.
2. The automated external defibrillator of claim 1 further
comprising a second state input indicating the defibrillator
electrode status, wherein said controller further provides said
context-sensitive rescue information based on said second
input.
3. The automated external defibrillator of claim 2, wherein said
defibrillator electrode status comprises a rescue electrode status,
training electrode status or electrode not installed status.
4. The automated external defibrillator of claim 3 wherein said
rescue electrode status further comprises an adult electrode status
or pediatric electrode status.
5. The automated external defibrillator of claim 1 wherein said
state input comprises an impedance between electrodes which is
indicative of said operational condition of the defibrillator.
6. The automated external defibrillator of claim 1 wherein said
context-sensitive rescue information comprises a CPR
instruction.
7. The automated external defibrillator of claim 1 wherein said
output is a speaker.
8. The automated external defibrillator of claim 1 wherein the
information request input is a button.
9. The automated external defibrillator of claim 1, wherein said
button is selectively activated by said state input, and wherein
said activation is indicated by the automated external
defibrillator. The automated external defibrillator of claim 1,
wherein said rescue information further comprises defibrillator
condition, defibrillation procedure guidance, user reassurance
comments, enhanced CPR guidance, and defibrillator administrative
guidance.
10. A method for providing context-sensitive rescue information to
the user of an automated external defibrillator, the method
comprising the steps of: requesting help through a information
request input; determining an operational state of the
defibrillator; and conveying through an output rescue information
based on said requesting step and determining step.
11. The method of claim 11, further comprising the step of
detecting a defibrillator electrode status, and wherein said rescue
information is further based on said detecting step.
12. The method of claim 12, wherein said defibrillator electrode
status comprises a rescue electrode status, training electrode
status or electrode not installed status.
13. The method of claim 13 wherein said rescue electrode status
further comprises an adult electrode status or pediatric electrode
status.
14. The method of claim 11, further comprising the step of
measuring an impedance between electrodes, and wherein said output
rescue information is further based on said measuring step.
15. The method of claim 11, wherein said rescue information
comprises a CPR instruction.
16. The method of claim 11, wherein said output is a speaker.
17. The method of claim 11, wherein said information request input
is a button.
18. The method of claim 18, further comprising the steps of;
selectively activating said button based on said operational state;
and illuminating said button in response to said activating
step.
19. The method of claim 11, wherein said rescue information
comprises defibrillator condition, defibrillation procedure
guidance, user reassurance comments, enhanced CPR guidance, and
defibrillator administrative guidance.
Description
BACKGROUND OF THE INVENTION
[0001] Automated External Defibrillators (AEDs) have been available
for public use for several years, and have proven effective at
treating Sudden Cardiac Arrest (SCA). SCA kills about 250,000
Americans a year and is the leading cause of death in the U.S.
Untreated SCA usually results in death in a very short time, and
survival rates for SCA decline by about 10% for every minute
defibrillation treatment is delayed. Because most EMS or other
medical response cannot reach the scene of SCA within a very few
minutes, it is important for witnesses or bystanders to be able to
apply defibrillation treatment as quickly as possible, whenever a
defibrillator is available.
[0002] Cardiopulmonary resuscitation (CPR) is often performed
concurrent with AED use. CPR is a combination of artificial
respiration and artificial circulation that keeps oxygenated blood
flowing to the brain during cardiac arrest. The effectiveness of
CPR is highly dependent on the proficiency of the rescuer's
application, and as such, the AHA and American Red Cross have
established detailed step-by-step CPR procedures. Many people
receive CPR training each year, but most, even emergency
responders, have not maintained their proficiency. Rescuers may
find it difficult to recall these procedures, especially during
high stress rescue situations and as standards evolve.
[0003] Similarly, successful defibrillation requires the rescuer to
perform a specific sequence of steps in order for the AED to
function properly. The rescuer must activate the AED, remove
interfering clothing from the victim's torso, successfully apply
the defibrillation electrode pads in their proper locations on the
torso, and cause the defibrillation shock to be delivered in order
to defibrillate the heart. The victim's chance of survival improves
greatly the faster these steps are completed.
[0004] AEDs are increasingly being deployed into environments where
a minimally-trained or untrained user is likely to be the first
responder. AEDs now appear in businesses, schools, public venues
and homes in addition to the more traditional emergency responder,
ambulance and rescue squad environments.
[0005] The problems of minimal training, high levels of stress
accompanied by noise and confusion, and a very limited time in
which to effect a rescue negatively affects the chances of a
successful rescue. The rescue of an SCA victim is a high stress
event. In order to keep the rescuer on track during the stress of a
rescue, many AEDs guide the user through the defibrillation process
with audible or visual prompts. These prompting features are very
useful to a user who is unfamiliar with the defibrillation
procedure or with CPR protocol. An example of a defibrillator with
automatic CPR prompting features is described in U.S. Pat. No.
6,356,785 by Snyder et al., titled "External Defibrillator with CPR
Prompts and ACLS Prompts and Methods of Use", which is incorporated
herein.
[0006] On the other hand, the same prompting features can delay a
proficient rescuer who is able to work faster than the prompts, or
can complicate the already chaotic rescue situation with extraneous
and distracting information. In some cases, the continuing
prompting noise may tempt a rescuer to turn the AED off when a
perceived "safe" time in the rescue is reached. If the SCA recurs,
the AED then would not have the ability to sense or respond to the
recurring emergency.
[0007] Thus, there is a need for an AED which provides appropriate
information only when it is needed, with minimal action by the
user. Specifically, what is needed is an improved AED which
selectively provides rescue information to the user in order to
reduce confusion and improve the guidance for successful cardiac
rescue. Further, an improved AED which can dynamically alter the
guidance provided to the rescuer based on both the state of the
rescue and on whether or not the rescuer has requested guidance
during that rescue state could improve the chances of a successful
SCA treatment.
SUMMARY OF THE INVENTION
[0008] The apparatus and methods of the present invention are the
result of the inventors' discovery that the interaction between
defibrillator and user is significantly enhanced by dynamically
modifying the sestet of rescue information based on the progress of
the rescue. The present inventors have further discovered that a
user improves the likelihood of performing a successful rescue if
the user retains some control over the delivery of the guidance;
i.e. the help prompting should be optional and not completely
automatic. With appropriate optional guidance, the user eliminates
the stress associated with extraneous noise and distraction, while
simultaneously retaining the ability to quickly obtain assistance
if the user becomes confused during the rescue. In addition,
optional guidance reduces the likelihood that the AED is turned off
mid-rescue in an attempt to reduce stress and distraction. The AED
of the present invention will remain quiet unless conditions or a
request actually warrant a prompt.
[0009] It was further discovered that defibrillator users prefer an
information request input that is dedicated and distinct from other
elements in the AED user interface. This discovery was not obvious
to those skilled in the AED art because it was previously assumed
that an AED should minimize the number of knobs and switches in
order to simplify use. The result of this discovery was that the
addition of another button for information request, preferably a
flashing button, enhances the likelihood of successful use, even
for minimally trained users, and is worth any additional "clutter"
that may be caused by the additional button. Still, it is important
to design the information request button such that distraction of
the operator is minimized, particularly when there is no additional
information to be gained by pressing the button.
[0010] In accordance with these discoveries, the present invention
is directed to an improved defibrillator system comprising an
operational state input, a user-operated information request input,
and a user guidance output. The defibrillator system can be
implemented as an AED, a manual defibrillator, or as a
defibrillator trainer. The defibrillator system further utilizes
the state and request inputs to determine a context-sensitive
rescue information which is provided to the output. The preferred
embodiment of the request input is a button on the AED. The button
may be illuminated when active to further assist the user in
locating it. Output rescue information may be provided through a
speaker with verbal instructions or audible signals without
requiring a display screen. Optionally, the rescue information may
be provided visually through a display screen or other dynamic
visual indicators such as LEDs, pictograms, or iconic
representations.
[0011] Another embodiment of the present invention is directed to
the above-described defibrillator system with an additional
electrode interface input indicating the presence of a patient
electrode, and if present, the type of electrode. Exemplary
electrode types include rescue electrodes, training electrodes,
pacing electrodes, monitoring electrodes and cardioversion
electrodes. Rescue electrodes may further be distinguished as adult
or pediatric electrodes. Electrodes of all configurations may also
be hereafter referred to as "electrode pads" or "pads".
[0012] Yet another embodiment of the present invention is a method
of providing context-sensitive rescue information to the user of a
defibrillator system which depends upon both the operational state
of the system and an information request input. Examples of
context-sensitive rescue information are: defibrillator condition
(including whether pediatric electrodes are installed);
defibrillation procedure guidance; user reassurance comments;
enhanced CPR guidance; defibrillator training scenario guidance;
and defibrillator administrative guidance. The method may further
comprise the step of sensing the presence and type of patient
electrode attached to the defibrillator, and wherein the
context-sensitive rescue information is selected based on the
electrode presence/type input.
[0013] Other features, attainments, and advantages will become
apparent to those skilled in the art upon a reading of the
following description when taken in conjunction with the
accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] FIG. 1. is a diagram of a prior art AED being used during
the rescue of a cardiac victim.
[0015] FIG. 2 illustrates an AED of the present invention, with a
button embodiment of the user request input.
[0016] FIG. 3 is a block diagram of one embodiment of the inventive
AED apparatus.
DETAILED DESCRIPTION OF THE INVENTION
[0017] The defibrillation of a SCA victim using an automatic
external defibrillator of the prior art is illustrated in FIG. 1.
The rescuer 12 begins the process by connecting an AED 10 to the
victim 14 via a set of AED electrodes 16 which are attached to the
victim as shown. The rescuer 12 activates the AED 10, which in turn
analyzes the patient 14 cardiac parameters through the AED
electrodes 16. If the cardiac parameters indicate that the victim
is in ventricular fibrillation (VF), the AED 10 will prompt the
rescuer 12 to remain clear of the patient and press the triangular
shock button to initiate a patient shock through the electrodes 16.
The cardiac parameters and prompts may be displayed visually on the
AED screen as shown.
[0018] If the defibrillation shock is successful at restoring
normal cardiac rhythm, the AED 10 will so indicate and will further
prompt the rescuer 12 to perform other first aid actions. If the
shock is unsuccessful, the AED 10 may repeat the cardiac analysis
and shock sequence, or may prompt the user 12 to begin CPR. The
prompting sequence in the prior art AED 10 follows a pre-programmed
script, which in very basic AEDs, advances based upon elapsed time.
In later generation devices, the script advances based on a
detected status of the patient, as detected by signals from the
patient electrodes. In addition, AED 10 may provide generic CPR
instructions during the CPR period. The prompts are generally
provided audibly, or can optionally be provided by text messages on
an electronic display.
[0019] FIG. 2 shows one embodiment of the present invention. AED 20
comprises a set of patient electrodes that are stored inside
cartridge 22. Activation of AED 20 may be through an on/off button
24 or by removing the protective electrode cartridge cover 22. The
electrodes are removed from cartridge 22 and applied to the
patient's bare torso, the detection of which automatically begins
the analysis of the patient's condition. When indicated, a shock
button 28 is pressed to deliver a defibrillation shock. AED 20
lacks the visual display of the prior art AED 10 in order to reduce
cost, size, weight and complexity in the device.
[0020] FIG. 2 further illustrates the dedicated user information
request button 26 on AED 20. The information request button 26
serves as the primary interface between rescuer 12 and AED 20.
Information request button 26 may be selectively activated by the
AED 20 and illuminated to indicate that information is available
during that particular operational state. The illumination feature
thus serves to draw the user's attention to the information request
button 26 only during appropriate situations. By keeping the
information request button dark when it is not appropriate to press
it, user distraction is minimized.
[0021] When the rescuer 12 presses the information request button
26, AED 20 issues help information based on the operational state
of the device. By coupling the delivered information based to the
operational state of the device, the device is able to provide
information that is appropriate to the context in which it was
requested. Thus, the provided information is "context-sensitive".
In the preferred embodiment, the context-sensitive help is audibly
conveyed through speaker 30 or through buzzer 32. Visual help may
optionally be displayed (not shown). One exemplary type of
context-sensitive help is a detailed set of CPR instructions,
provided only if the information button is pressed during a CPR
period.
[0022] FIG. 3 is a schematic block diagram of a defibrillator
system 110 according to a preferred embodiment of this invention.
The defibrillator system 110 comprises an energy source 112 to
provide a defibrillating shock to the patient 14 via electrode
interface 114 and electrodes 16. Defibrillator system 110 may be
implemented as a manual defibrillator, an AED, or a defibrillator
trainer that simulates the behavior of a manual defibrillator or
AED in use.
[0023] A controller 120 operates electrode interface 114 to
selectively connect and disconnect energy source 112 to electrodes
16 in order to provide electrotherapy to the patient 14. Controller
120 also controls the information flow from an instruction
generator 122 to the user via a sound generator 126 or visual
indicator or image generator 124. Instruction generator 122 may
also activate protocol changes being performed by the defibrillator
110 based on information received from the controller 120. For
example, controller 120 may sense how the AED 110 has been
activated, either with on/off button 24 or by removing the
electrode cartridge cover 22, to determine which protocol to
follow. Output of the selected instruction protocol is then
accomplished through sound generator 126 and speaker 30 or buzzer
32. Audible commands may include verbal commands directing the
rescuer in the proper sequence and timing for administering CPR or
ACLS, or audible timing tones, such as those generated by a
metronome, for timing the administration of CPR. Optionally, output
may be passed through visual image generator 124 to an LCD display
(not shown) for displaying or highlighting textual and graphical
instructions.
[0024] Controller 120 controls the information flow to the sound
generator 126 or visual image generator 124 based on parameters
that indicate the operational state of the defibrillator.
Controller 120 further comprises an internal memory for storing
operational state information and a timing circuit for determining
the elapsed time between successive operational states or between
successive user inputs. Operational state parameters are provided
from electrode interface 114. Parameters passed from electrode
interface 114 to controller 120 comprise patient ECG signals and
electrode-to-electrode impedance measurements. Optionally,
electrode interface 114 detects and passes to controller 120
information on whether an electrode cartridge 22 is installed and
if so, what type of electrode cartridge 22 is installed. Exemplary
electrode cartridge types are: ADULT, PEDIATRIC, and TRAINING
cartridges.
[0025] Controller 120 further controls user information flow based
on the state of a user-operated information request button 128.
Information request button 128 states may be as simple as PRESSED
or NOT PRESSED. In an alternate embodiment, information request
button 128 states comprise: PRESSED FOR <2 SECONDS, PRESSED FOR
>2 SECONDS, PRESSED FOR >4 SECONDS.
[0026] Other embodiments of the invention are contemplated in which
controller 120 controls the state of the information request button
128 itself through an input indicator 132. To indicate that
information request button 128 is active, indicator 132 causes the
information request button 128 to illuminate, alerting the user
that information is available at that particular operational state
by pressing the button 128. The illumination feature thus enhances
the usefulness of the AED 110, as well as realizing additional
information request button 128 states of NOT PRESSED, PRESSED WHEN
ILLUMINATED, and PRESSED WHEN NOT ILLUMINATED. If button press time
states are used, as outlined above, illumination of information
request button 128 will generally occur only if a "PRESSED <2
SECONDS" state has a corresponding message available.
[0027] Table 1 illustrates an exemplary set of context-sensitive
user instructions which are issued in response to specific
combinations of operational state and information request button
states of "PRESSED <2 SECONDS", "PRESSED 2-TO-4 SECONDS", and
"PRESSED >4 SECONDS". In this case, a cartridge containing
rescue electrodes is installed in the AED 110. Exemplary
operational states which are sensed by controller 120 with input
from electrode interface 114 are "On, Pads Off", "On, Placing
Pads", "On, Pads On, Analyzing", "On, Pads On, CPR Pause, CPR
sensed", "On, Pads On, CPR Pause, CPR not sensed", "Standby,
Self-Test OK", and "Standby, Self-Test Not OK". A brief description
of the user information available at each state combination
follows.
[0028] "On, Pads Off"--AED 110 activated with no user manipulation
of stored electrode pads. In this operational state, a rescue has
generally begun, and it is undesirable to distract the
first-response user with information beyond the first tier voice
prompting protocol. However, a second responder rescuer, presumably
with a higher level of lifesaving skill, would have access to a
"handoff" message which indicates the progress of the rescue. An
exemplary handoff message is, "<number> shocks,
<number> minutes" of operation, and might be available only
if the information request button 128 is intentionally held down
for 2 seconds or more. In this instance, and to avoid distracting
the first-response user, the information request button would
remain unilluminated, yet would still respond to the request of an
operator who had received more extensive and advanced training and
knows that this "hidden" information is available if needed.
[0029] "On, Placing Pads"--AED 110 activated with concurrent
manipulation of electrode pads, but both pads are not affixed to
the patient. Like the "On, Pads Off" operational state, it is
undesirable to distract the first-response user with information
beyond the first tier voice prompting protocol during this
especially critical step in the rescue. A second responder rescuer,
presumably with a higher level of lifesaving skill, again would
have access to the "handoff" message which indicates the progress
of the rescue prior to her arrival.
[0030] "On, Pads On, Analyzing"--AED 110 activated with both
electrode pads affixed to the patient. AED 110 is analyzing the
patient ECG and delivering defibrillation therapy if so determined.
No detailed level of user information is necessary during this
operational state.
[0031] "On, Pads On, CPR Pause, Initiate CPR"--AED 110 operational
state is a CPR period as defined by a CPR treatment protocol,
generally following the "On, Pads On, Analyzing" operational state,
and when conditions indicate that CPR may be initiated. During the
CPR pause, the rescuer is expected to provide CPR to the victim if
the victim's condition warrants. Many rescuers are not proficient
in the correct CPR protocols, including airway management, where to
place hands, and the sequence and cadence of chest compressions and
rescue breaths. Thus, during this period, a momentary press of the
user information request button 128 will initiate instructions that
will guide the user through the proper CPR procedure. Input
indicator 132 may further prompt the user that this information is
available by illuminating the button 128 accompanied by a standard
voice protocol message saying "For help with CPR, press the
illuminated button". Because this CPR information can be relatively
extensive, it is made optionally available through the second-tier
request. Likewise, if CPR is not indicated, the rescuer is not
bombarded by CPR instructions that are distracting and introduce
confusion as to whether or not CPR should be performed or withheld.
A more proficient rescuer can thus be spared the distraction of
extraneous CPR instructions and proceed with the rescue faster.
Also, as in operational states 1 and 2 above, the second responder
rescuer has access to the "handoff" message by holding the
illuminated information request button down for 2 seconds or
more.
[0032] "On, Pads On, CPR Pause, do not initiate CPR"--AED 110
operational state is a protocol-defined CPR period and when
conditions indicate that CPR should not be initiated. In this case,
the rescuer has perhaps panicked, or has not heard a post-analysis
prompt saying that "It is safe to touch the patient" and has waited
a significant period of time before requesting CPR assistance. When
the information request button 128, again preferably illuminated,
is pressed momentarily, the controller 120 delivers a message
intended to reassure the user, such as "It is safe to touch the
patient", but will not provide CPR instruction. A reason for
withholding instruction is that the cumulative elapsed time from
the start of the CPR pause to the press of the information request
button 128 and then to the conclusion of the round of "instructed"
CPR may exceed the recommendations of CPR treatment protocols. For
example, if CPR protocol dictates a ninety second maximum CPR pause
and the AED CPR prompting sequence consumes sixty seconds, then the
"On, Pads On, CPR Pause, do not initiate CPR" operational state
would begin 30 seconds after the beginning of the CPR pause, and
last until the end of the CPR pause. Thus, an operator who delays
requesting assistance for a significant period of time is not
confused by abbreviated or interrupted CPR prompts. As in previous
operational states, the second responder rescuer also has access to
the "handoff" message by holding the illuminated information
request button down for 2 seconds or more.
[0033] "Standby, Self-Test OK"--AED 110 is in standby or has been
inadvertently turned off during rescue, and the most recent AED
self-test indicates "OKAY". Assuming the more severe case of the
AED 110 being inadvertently deactivated during a rescue, the
information request button 128 when pressed, prompts the user to
"In case of emergency, press the on/off button". This operational
state also provides the handoff instruction for button 128 presses
of 2 seconds or more, again for second tier responder purposes.
[0034] "Standby, Self-Test Not OK"--AED 110 is in standby or has
been inadvertently turned off during rescue, and the most recent
AED self-test indicates "NOT OKAY". Anytime the AED 110 is inactive
and in a non-operational state, the buzzer 32 makes a periodic
audible signal and concurrently the information request button 128
illuminates. When pressed, AED 110 prompts the user with the
self-test failure corrective action. This gives the user the
opportunity to quickly address the situation and resume the rescue.
Exemplary self-test corrective action messages are: "Replace
battery immediately" and "Pads not usable, insert new pads
cartridge". This operational state also provides the handoff
instruction for button 128 presses of 2 seconds or more, again for
second tier responder purposes.
1TABLE 1 Rescue Cartridge Installed Operational State I-Button On,
On, On, Pads On, Pads On, Pads Standby, Standby, Self- State Pads
Placing On, On, CPR On, CPR Self- Test Not OK Off Pads Analyzing
Pause, Pause, Do Test OK Initiate Not CPR Initiate CPR Pressed
<2 Sec. None None None Detailed Assure Initiate Fail CPR User
Type Pressed 2-4 Sec. Handoff Handoff None Handoff Handoff Handoff
Handoff Pressed >4 Sec. None None None None None Handoff
Handoff
[0035] If controller 120 is disposed to detect the cartridge
installed in AED 110 through electrode interface 114, additional
instruction sets which depend upon operational state, button state,
and cartridge type are contemplated. One apparatus for detecting a
cartridge type is disclosed in the co-pending application Ser. No.
______ titled "YYYY", Philips Invention Disclosure 704238, "Four
Contact Identification System for Defibrillator Electrode Package,
by Jonsen. In a first example, a rescue cartridge can be either an
ADULT or PEDIATRIC rescue cartridge. Because CPR protocols differ
substantially between adults and infants, controller 120 causes
instruction generator 122 to select the appropriate CPR protocol
depending on detected cartridge type. The "On, Pads On, CPR Pause,
Initiate CPR" operational state accompanied by a momentary press of
the information request button 128 would then prompt the
appropriate ADULT or PEDIATRIC set of detailed CPR
instructions.
[0036] The electrode cartridge detection feature of the present
invention has additional utility by discerning when the AED is used
in a non-rescue operational state. If the AED has a built-in
training operational state, the training electrode cartridge should
be disposed such that it cannot deliver a shock to a trainee or
training mannequin. In the training operational state, the
information request button 128 pressed momentarily would provide a
means to select among a plurality of training scenario settings, or
might optionally be used to select an alternate training scenario
declaration. Such a feature is especially useful in an AED without
a visual display.
[0037] The electrode cartridge detection feature of the present
invention has additional utility by discerning when no cartridge is
present in the AED. Table 2 illustrates an exemplary set of user
instructions which are issued in response to specific combinations
of operational state and information request button states of
"PRESSED <2 SECONDS", "PRESSED 2-TO-4 SECONDS", and "PRESSED
>4 SECONDS" with no cartridge installed. Applicable operational
states with no cartridge installed are: "On, Pads Off", "Standby,
Self-Test OK", and "Standby, Self-Test Not OK". A brief description
of the user information available at each state combination
follows.
[0038] "On, Pads Off"--AED 110 activated with no electrode
cartridge installed. If a rescue is intended in this operational
state, a first-tier voice message automatically informs the user to
install a cartridge, without requiring the push of the information
request button. In this state, it is undesirable to distract the
first-response user with information beyond that pertaining to
cartridge installation since proceeding further with the rescue
process is irrelevant without an installed electrode pads
cartridge. Then, when a cartridge is installed per the automatic
instruction, AED 110 reverts to the Table 1 information protocol.
Absence of a cartridge in AED 110 can also signal controller 120 to
operate in an administrational mode, said signal confirmed by
pressing the information request button for more than 4 seconds.
The sequence of removing the cartridge, activating AED 110, and
then holding the information request button 128 would be well known
to a routine user. Entry into the administration mode is
accompanied by an "Administration" or equivalent voice prompt. The
information request button 128 can then be manipulated to further
advance through the various administration mode features, with
additional voice prompting as appropriate.
[0039] "Standby, Self-Test OK"--The cartridge is absent AED 110
while in standby, and the most recent AED self-test indicates
"OKAY". If the AED 110 is inactivated during the rescue and the
cartridge is concurrently removed from AED 110, buzzer 32 makes a
periodic audible signal and the information request button 128
simultaneously illuminates. When the information button is pressed
momentarily, the AED 110 prompts the user to "In case of emergency,
press the on/off button", followed closely by a prompt to insert a
cartridge. This instruction is especially important in an AED with
no graphical or text display, because it may not be apparent to the
user that the AED has been inactivated and that the cartridge is
not installed. The presence of a single illuminated information
request button 128 will attract the user's attention and get the
rescue back on track. In the more likely case of the cartridge
removal occurring during the routine standby mode, AED 110
automatically indicates by some means, such as illuminated LED or
audible beep sounds, that the AED 110 is not ready for use and that
an operator or other maintenance individual needs to provide it
with service. This feature spares battery life and environmental
noise clutter by making more detailed cartridge insertion prompting
dependent on the press of the information request button 128. This
operational state also provides the handoff instruction for button
128 presses of 2 seconds or more, assuming that second responders
have arrived, have inactivated the AED 110 and removed the
cartridge, but still need pre-arrival rescue information. For
button presses of 4 seconds or longer AED 110 will begin the
administration mode as described in the previous paragraph.
[0040] "Standby, Self-Test Not OK"--The cartridge is absent AED 110
while in standby, and the most recent AED self-test indicates "NOT
OKAY". Assumptions and response of the AED 110 to operational state
and information request button 128 states are the same as for
"Standby, Self-Test OK" operational state.
[0041] It should be appreciated that the scope of the invention is
not limited to the embodiments described above. The above-described
AED provides a second, more detailed layer of help information that
is appropriate to both the operational, i.e. rescue, state and to
an explicit user request. Such an AED can be modified and altered
by those skilled in the art without departing from the spirit and
scope of the present invention.
2TABLE 2 No Cartridge Installed Operational State I-Button State On
Pads On Pads On, On Pads On Pads Standby Standby Off Placing
Analyzing On CPR, On CPR, OK Self- Failed Self- Pads Initiate Do
Not Test Test CPR Initiate CPR Pressed <2 Sec. None NA NA NA NA
Insert Insert Cartridge Cartridge Pressed 2-4 Sec. None NA NA NA NA
Handoff Handoff Pressed >4 Sec. Admin NA NA NA NA Admin
Admin
* * * * *