U.S. patent application number 13/538031 was filed with the patent office on 2014-01-02 for rescue scene video transmission.
This patent application is currently assigned to ZOLL MEDICAL CORPORATION. The applicant listed for this patent is Ziad F. Elghazzawi. Invention is credited to Ziad F. Elghazzawi.
Application Number | 20140005506 13/538031 |
Document ID | / |
Family ID | 49778818 |
Filed Date | 2014-01-02 |
United States Patent
Application |
20140005506 |
Kind Code |
A1 |
Elghazzawi; Ziad F. |
January 2, 2014 |
RESCUE SCENE VIDEO TRANSMISSION
Abstract
A defibrillator or monitoring system may comprise a
defibrillator, at least one video camera configured to acquire a
video of a subject being treated by the defibrillator, a data
collection unit configured to collect data associated with the
subject, a communications unit configured to establish a
communication channel between the defibrillator system and an
emergency response center; and a processing unit configured to
cause transmission to the emergency response center of at least one
of the video of the subject and the data associated with the
subject.
Inventors: |
Elghazzawi; Ziad F.;
(Newton, MA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Elghazzawi; Ziad F. |
Newton |
MA |
US |
|
|
Assignee: |
ZOLL MEDICAL CORPORATION
Chelmsford
MA
|
Family ID: |
49778818 |
Appl. No.: |
13/538031 |
Filed: |
June 29, 2012 |
Current U.S.
Class: |
600/324 ; 348/77;
348/E7.085 |
Current CPC
Class: |
A61N 1/3993 20130101;
H04N 7/181 20130101; A61B 5/0013 20130101; A61B 5/0006 20130101;
A61B 5/0205 20130101; H04W 4/90 20180201; H04W 4/70 20180201; A61B
5/0022 20130101 |
Class at
Publication: |
600/324 ; 348/77;
348/E07.085 |
International
Class: |
H04N 7/18 20060101
H04N007/18; A61B 5/0205 20060101 A61B005/0205 |
Claims
1. A defibrillator system comprising; a defibrillator; a video
camera configured to acquire a video of a subject being treated by
the defibrillator; a data collection unit configured to collect
data associated with the subject; a communications unit configured
to establish a communication channel between the defibrillator
system and an emergency response center; and a processing unit
configured to cause transmission to the emergency response center
of at least one of the video of the subject and the data associated
with the subject.
2. The defibrillator system of claim 1, wherein the processing unit
is further configured to: compare available bandwidth of the
communication channel to a threshold bandwidth; if the available
bandwidth exceeds the threshold bandwidth, cause transmission of
both the video of the subject and the data associated with the
subject; and if the available bandwidth is less than the threshold
bandwidth, cause transmission of at least one of (1) only the data
associated with the subject and (2) the data associated with the
subject and the video at a lower frame rate than an original frame
rate of the video.
3. The defibrillator system of claim 1, wherein the processing unit
is configured to cause transmission of only the data associated
with the subject when the available bandwidth is below a threshold
bandwidth.
4. The defibrillator system of claim 3, wherein the threshold
bandwidth is at least about 750 kbps.
5. The defibrillator system of claim 1, wherein the processing unit
is configured to transmit the video at a lower frame rate than an
original frame rate of the video when the available bandwidth is
below a threshold bandwidth.
6. The defibrillator system of claim 5, wherein a ratio of the
lower frame rate to the original frame rate is at least about
2:1.
7. The defibrillator system of claim 1, wherein the processing unit
is configured to determine the available bandwidth of the
communication channel.
8. The defibrillator system of claim 1, wherein the processing unit
is configured to receive an input indicative of the available
bandwidth of the communication channel.
9. The defibrillator system of claim 1, wherein the video camera is
coupled with the defibrillator or at least one electrode.
10. The defibrillator system of claim 1, wherein the video camera
is configured to be worn by a person treating the subject.
11. The defibrillator system of claim 1, wherein the data include
at least one of an electrocardiogram signal, an SpO.sub.2 level, a
blood pressure, a measure of cardiac output, and a compression
parameter.
12. The defibrillator system of claim 1, further comprising an
audio unit configured to receive audio signals, the processing unit
further configured to cause transmission of the audio signals based
on the available bandwidth.
13. The defibrillator system of claim 1, wherein the communication
channel is a wireless communication channel.
14. The defibrillator system of claim 1, wherein the defibrillator
is an automated external defibrillator (AED).
15. A method comprising: acquiring a video of a patient being
treated by a defibrillator, the defibrillator forming part of a
defibrillator system; collecting data associated with the subject;
establishing a communication channel between the defibrillator
system and an emergency response center; and based on an available
bandwidth of the communication channel, causing transmission to the
emergency response center of at least one of the video of the
subject and the data associated with the subject.
16. The method of claim 15, wherein causing transmission includes:
comparing the available bandwidth of the communication channel to a
threshold bandwidth; if the available bandwidth exceeds the
threshold bandwidth, causing transmission of both the video of the
subject and the data associated with the subject; and if the
available bandwidth is less than the threshold bandwidth, causing
transmission of at least one of (1) only the data associated with
the subject and (2) the data associated with the subject and the
video at a lower frame rate than an original frame rate of the
video.
17. The method of claim 15, wherein causing transmission includes
causing transmission of only the data associated with the subject
when the available bandwidth is below a threshold bandwidth.
18. The method of claim 15, wherein causing transmission includes
causing transmission of the video at a lower frame rate than an
original frame rate of the video when the available bandwidth is
below a threshold bandwidth.
19. The method of claim 15, wherein causing transmission further
includes causing transmission of audio data.
20. The method of claim 15, further comprising determining the
available bandwidth of the communication channel.
21. The method of claim 15, further comprising receiving an input
indicative of the available bandwidth of the communication
channel.
22. The method of claim 15, wherein the defibrillator is an
automated external defibrillator (AED).
23. A defibrillator system comprising: a defibrillator; a plurality
of video cameras each configured to acquire a video of a subject
being treated by the defibrillator; a communications unit
configured to establish a communication channel between the
defibrillator system and an emergency response center; and a
processing unit configured to: cause transmission to the emergency
response center of a plurality of images, each image acquired by
one of the plurality of video cameras, receive, from the emergency
response center, a selection of one of the plurality of video
cameras, and cause transmission to the emergency response center of
the video acquired by the selected one of the plurality of video
cameras.
24. The defibrillator system of claim 23, wherein the processing
unit is further configured to cause transmission to the emergency
response center of data sufficient to enable a user at the
emergency response center to select one of the plurality of images;
and wherein the selection of one of the plurality of video cameras
is based on a selection by the user of a corresponding one of the
plurality of images.
25. The defibrillator system of claim 23, wherein the images are
still images.
26. The defibrillator system of claim 23, wherein one of the
plurality of video cameras is configured to be mounted on the
defibrillator.
27. The defibrillator system of claim 23, wherein one of the
plurality of video cameras is configured to be worn by a person
treating the subject.
28. The defibrillator system of claim 23, further comprising a data
collection unit configured to collect a plurality of types of data
associated with the subject.
29. The defibrillator system of claim 28, wherein the processing
unit is further configured to: receive, from the emergency response
center, a selection of one of the plurality of types of data; and
cause transmission to the emergency response center of the selected
type of data.
30. The defibrillator system of claim 28, wherein the processing
unit is further configured to cause transmission to the emergency
response center of identifiers of the plurality of types of
data.
31. The defibrillator system of claim 28, wherein the plurality of
types of data include at least some of an electrocardiogram signal,
an SpO.sub.2 level, a blood pressure, a measure of cardiac output,
and a compression parameter.
32. The defibrillator system of claim 23, wherein the communication
channel is a wireless communication channel.
33. The defibrillator system of claim 23, wherein the defibrillator
is an automated external defibrillator (AED).
34. A method comprising: using a plurality of video cameras,
acquiring a corresponding plurality of videos of a subject being
treated by a defibrillator, the defibrillator forming part of a
defibrillator system; establishing a communication channel between
the defibrillator system and an emergency response center; causing
transmission to the emergency response center of a plurality of
images, each image acquired by one of the plurality of video
cameras; receiving, from the emergency response center, a selection
of one of the plurality of video cameras; and causing transmission
to the emergency response center of the video acquired by the
selected one of the plurality of video cameras.
35. The method of claim 34, wherein causing transmission of the
plurality of images includes causing transmission of data
sufficient to enable a user at the emergency response center to
select one of the plurality of images; and wherein the selection of
one of the plurality of video cameras is based on a selection by
the user of a corresponding one of the plurality of images.
36. The method of claim 34, wherein the images are still
images.
37. The method of claim 34, further comprising collecting a
plurality of types of data associated with the subject.
38. The method of claim 37, further comprising: receiving, from the
emergency response center, a selection of one of the plurality of
types of data; and causing transmission to the emergency response
center of the selected type of data.
39. The method of claim 37, further comprising causing transmission
to the emergency response center of identifiers of the plurality of
types of data.
40. The method of claim 34, wherein the defibrillator is an
automated external defibrillator (AED).
Description
TECHNICAL FIELD
[0001] This disclosure relates to systems and techniques for rescue
scene video communication, e.g., for a rescue scene in which a
defibrillating device is used to treat a subject.
BACKGROUND
[0002] Sudden health problems such as sudden cardiac arrest and
injuries caused by accidents kill thousands of people and cause
permanent injury every year. Fast and competent care to resuscitate
such subjects of these problems can be essential to positive
outcomes in such situations. For example, it is said that the
chance of surviving a sudden cardiac arrest falls by ten percent
for every minute of delay in providing effective treatment.
[0003] Resuscitation treatments for patients suffering from cardiac
arrest generally include clearing and opening the patient's airway,
providing rescue breathing for the patient, and applying chest
compressions to provide blood flow to the subject's heart, brain,
and other vital organs. If the patient has a shockable heart rhythm
(ventricular fibrillation or pulseless ventricular tachycardia),
resuscitation also may include defibrillation therapy. Along with
such action, an electrocardiogram (ECG) signal for the patient may
be electronically captured, displayed, and monitored, so that
rescuers can determine when the patient's heart has returned to
normal or near-normal operation, and determine when the heart
exhibits a shockable rhythm. About half of patients who suffer
ventricular fibrillation (VF) have a recurrence of VF within
minutes of successful VF conversion, which may then require
reconversion. Patient odds of survival fall with repeated VF
recurrence during resuscitation.
SUMMARY
[0004] Described herein are systems and techniques for transmitting
and/or receiving video and/or audio communication between a rescue
scene and an emergency response center. More particularly, one or
more video cameras are included with a defibrillator, such as an
automated external defibrillator (AED). When a subject (e.g., a
victim of cardiac arrest) receives treatment from a caregiver with
the assistance of the AED, the cameras acquire still and/or video
images of the subject, the caregiver, and/or the rescue scene.
[0005] In some examples, a responder can select one or more cameras
and/or microphones from which to receive video/audio transmission.
For example, a still image acquired by each of the cameras is
transmitted to the emergency response center, where a responder
(e.g., a dispatcher) selects one or more of the images as
representing a view for which he would like to receive a streaming
video transmission. Video and/or audio from the
camera(s)/microphones corresponding to the selected image(s) is
transmitted in real-time to the emergency response center, enabling
the responder to assess the situation at the rescue scene and/or
provide guidance and instructions to the caregiver.
[0006] In some additional examples, if the bandwidth of the
communication channel between the rescue scene and the emergency
response center is limited, the transmission of the video and/or
audio may be limited or stopped in order to allow preferential
transmission of other information, such as subject monitoring data
and/or audio conversations.
[0007] The systems and techniques described herein have a number of
advantages. For instance, providing real-time video/audio of a
rescue scene and/or a subject receiving treatment to a responder at
an emergency response center enables the responder to assess the
urgency of the situation at the rescue scene and react accordingly,
e.g., by dispatching the appropriate first responders. In addition,
by receiving the video and/or audio transmission, the responder may
be able to guide a caregiver in the treatment of the subject and/or
the operation of equipment (e.g., an automated external
defibrillator (AED)) used to treat the subject. Furthermore, with
multiple cameras and/or microphones associated with rescue
equipment, there is a reasonable likelihood that at least one of
the cameras and/or microphones will be positioned so as to capture
the rescue scene, thus allowing the rescuer to focus on treatment
of the subject without having to spend time setting up or adjusting
a camera.
[0008] The details of one or more embodiments are set forth in the
accompanying drawings and the description below. Other features and
advantages will be apparent from the description and drawings, and
from the claims.
BRIEF DESCRIPTION OF THE FIGURES
[0009] FIG. 1 is a schematic diagram of a rescue scene and an
emergency response center.
[0010] FIG. 2 is a block diagram of an example defibrillating
system.
[0011] FIG. 3 is a flow chart of an example process for camera
selection.
[0012] FIG. 4 is a schematic diagram of an example user
interface.
[0013] FIG. 5 is a flow chart of an example process for video and
data transmission.
DETAILED DESCRIPTION
[0014] Described herein are systems and techniques for video and/or
audio bidirectional communication between a rescue scene and an
emergency response center. More particularly, one or more video
cameras and/or microphones are included with a defibrillator, such
as an automated external defibrillator (AED). When a subject (e.g.,
a victim of cardiac arrest) receives treatment from a caregiver
with the assistance of the AED, the cameras acquire still and/or
video images of the subject, the caregiver, and/or the rescue
scene. A still image acquired by each of the cameras is transmitted
to the emergency response center, where a responder (e.g., a
dispatcher) selects one or more of the images as representing a
view for which he would like to receive a streaming video
transmission. Video from the camera(s) corresponding to the
selected image(s) and/or audio is communicated in real-time between
emergency response center and the rescue scene, enabling the
responder to assess the situation at the rescue scene and/or
provide guidance and instructions to the caregiver. If the
bandwidth of the communication channel between the rescue scene and
the emergency response center is limited, the transmission of the
video and/or audio may be limited or stopped in order to allow
preferential transmission of other information, such as subject
monitoring data and/or audio conversations.
[0015] Referring to FIG. 1, at a rescue scene 100, a caregiver 104
performs cardiopulmonary resuscitation (CPR) on a subject 102. An
electronic defibrillating and/or monitoring system 106 including a
defibrillator, such as an automated external defibrillator (AED)
108, a professional defibrillator, or another type of
defibrillating apparatus, instructs the caregiver 104 in performing
CPR and provides defibrillation as needed via external electrode
pads 110. The subject may be, for instance, an individual who has
apparently undergone sudden cardiac arrest. The caregiver may be,
for instance, a civilian responder with limited or no training in
lifesaving techniques; a first responder, such as an emergency
medical technician (EMT), police officer, or firefighter; or a
medical professional, such as a physician or nurse. The caregiver
104 may be acting alone or may be acting with assistance from one
or more other caregivers, such as a partner EMT.
[0016] One or more video cameras, such as video cameras 105 and
107, are provided with the defibrillating system 106. The cameras
105, 107 are positioned to acquire still images and/or video images
of various portions of the rescue scene 100, such as an image of a
large part of the rescue scene 100, an image of the subject 102, an
image of the caregiver's treatment of the subject, or another view.
For instance, a camera (in this example, camera 105) may be mounted
on a headpiece 109 or other wearable item that is to be worn by the
caregiver 104, e.g., to provide a view of the caregiver's treatment
of the subject. Another camera (in this example, camera 107) may be
mounted on the AED 108, e.g., to provide a broad view of a large
part of the rescue scene 100. Further, one or more cameras may be
coupled or embedded with one or more electrodes such as electrode
110. Additional cameras may also be provided for positioning in
other locations. For instance, a mobile (e.g., handheld) camera may
be provided that can be held and operated by another caregiver or a
bystander. A camera such as cameras 105 and 107 may include an
embedded microphone configured to receive audio emanating from the
rescue scene.
[0017] The defibrillating system 106 is connected via a
communication channel 112 to an emergency response center 116, such
as a 911 call center, a police dispatch, an ambulance dispatch, a
fire department, or another emergency response center. In the
illustrated example, the communication channel 112 is a long-range
wireless communication channel (e.g., a 3G or 4 G communication
channel) supported by a wireless transmission tower 114, such as a
cellular telephone tower. In other embodiments, the communication
channel 112 may be a short-range wireless communication channel,
such as a Bluetooth or WiFi connection, that is connected to a
hardwired communication channel.
[0018] Images and/or video and audio from one or more of the
cameras and/or microphones 105, 107 are communicated via the
communication channel 112 between the emergency response center 116
and the rescue scene 100. The images and/or video are displayed on
a display 118 (e.g., a computer monitor, television, mobile
communication device, or other display) at the emergency response
center 116, enabling a responder 120 (e.g., a dispatcher) to view
the rescue scene 100 in real time. In some embodiments, the
responder 120 may choose to receive video and/or audio from fewer
than all of the cameras and/or microphones 105, 107 (e.g., from
only one camera). For instance, the responder 120 may choose to
view video from the camera that provides a desired view, such as a
view of the subject 102 or a broad view of a large portion of the
rescue scene 100.
[0019] In an embodiment, the defibrillating system 106 also
monitors the subject 102 during treatment and collects real-time
subject monitoring data. For instance, signals such as an ECG
waveform, an SpO2 level, a blood pressure, a measure of cardiac
output, or a measure of heart rate may be monitored. Alternatively
or additionally, compression parameters, such as a sternal motion
signal, a compression rate, a compression depth, or another
measurement of compression, may be monitored. Some or all of these
types of subject monitoring data may be transmitted to the
emergency response center 116 via the communication channel 112. In
some embodiments, the responder 120 may choose to view only some of
the types of subject monitoring data.
[0020] In an embodiment, audio communication is also provided
between the rescue scene 100 and the emergency response center 116.
For instance, the defibrillating system 106 may include an audio
device 122 including a microphone and speakers, which may be
integrated into one or more of the cameras 105, 107, or may be a
separate device (as shown in the illustrated example). Audio
detected by the microphone in the audio device 122 (e.g., a
conversion between the caregiver 104 and the subject 102 or between
the caregiver 104 and another caregiver or bystander, or questions
or comments from a caregiver to the responder 120) is transmitted
to the emergency response center via the communication channel 112.
Audio from the emergency response center 116 (e.g., questions or
instructions by the responder 120) is transmitted to the
defibrillating system 106 via the communication channel and played
on the speakers in the audio device 122. For instance, while
watching the streaming video, the responder 120 may be able to
instruct the caregiver 104 in treatment of the subject 102, such as
how to open a pouch containing electrodes, how to place electrodes
and/or sensors on the subject, and how to perform CPR and/or other
rescue operations. In addition, the responder 120 may be able to
guide the caregiver in operation of the AED system 106, such as
switching the language of the AED system, switching the AED system
to or from adult or pediatric mode, and/or other system operations.
In some instances, the responder 120 may be able to perform some
AED system operations remotely on behalf of the caregiver.
[0021] FIG. 2 is a block diagram of an example defibrillating
system 200 for providing CPR and defibrillation assistance to a
caregiver 204 administering care to a subject 202 and for
communicating with an emergency response center 206. In general,
the system 200 includes a number of medical devices that may be
used to provide life-saving care to subject 202. The devices may be
part of a single unit or multiple units, and may be used to monitor
various real-time physical parameters of the subject 202, to
communicate between the components and with remote systems such as
central caregivers and emergency services, and to provide care to
the subject 202 or provide instructions to caregivers, such as
caregiver 204, in providing care to the subject 202.
[0022] The subject 202 is positioned to receive therapy from the
caregiver 204 with the assistance of a Main Processing Unit (MPU)
212. For example, a set of defibrillator electrodes 210 has been
applied to the subject's torso in a typical manner and is in wired
connection to a portable external defibrillator 208 in the MPU 212.
The defibrillator 208 may be, for example, a typical automated
external defibrillator (AED), a professional defibrillator, or
another similar type of defibrillating apparatus. A ventilation bag
provides forced air into the subject's lungs to assist in rescue
breathing for the subject. The defibrillator 208 and ventilation
bag may be operated in familiar manners and in coordination by one
or more caregivers. The ventilation bag may be fitted with various
sensors and transmitters so as to collect data and to communicate
electronically with the defibrillator 208. For example, a
volumetric flow sensor provided with the ventilation bag may
collect data about the volume of airflow to and from the subject,
which data is transmitted to the defibrillator 208. The
defibrillator 208 may relay these data, e.g., to the caregiver 204
and/or to the emergency response center 206; and/or may use the
data to affect the manner in which defibrillation is provided to
the subject 202.
[0023] A computer tablet 214 is provided in communication with the
other devices of the system 200 and can be manipulated by the
caregiver 204. The tablet 214 may serve as a general electronic
command post for the caregiver 204 to receive information, e.g.,
about the subject 202, to communicate with other caregivers, and to
provide input for controlling the operation of the components of
the system 200. The tablet 214 may be provided with short range
and/or long range wireless communication capabilities, such as
Bluetooth, Wi-Fi, and/or cellular 3G or 4G capabilities. The tablet
214 may also be in data communication with sensors that sense
real-time information about the subject 202, such as the subject's
blood pressure, pulse, or other real-time subject monitoring data
(discussed in more detail below). The caregiver 204 may input
information into the tablet 214, such as information describing the
condition of the subject 202 or other information that is to be
recognized and recorded by the caregiver 204. The caregiver may
also input information into tablet 214 so as to control one or more
of the medical devices being used with the subject 202. For
example, the caregiver may adjust the type, intensity, speed, or
coordination of treatment that is provided to the subject 202.
[0024] The defibrillator unit 212 includes a communication module
237, which includes a transmitter and a receiver for providing a
communication link between the defibrillator unit 212 and the
emergency response center 206. The communication module 237 may
include short range and/or long range wireless communication
capabilities, such as Bluetooth, Wi-Fi, and/or cellular 3G or 4G
capabilities. During operation, the communication module 237 sends
a signal to a cellular tower 241, which in turn relays the signal
to the emergency response center 206, thus establishing
communication between the defibrillator unit 212 and the emergency
response center 206. While shown in FIG. 2 as being included in the
defibrillator unit 212, the communication module 237 could
additionally or alternatively be included in the tablet 214.
[0025] Communication module 237 may enable the caregiver 204 to
talk with a responder at the emergency response center 206, for
instance to share information about the status of the subject 202,
to request instructions, or to request assistance. Similarly, the
responder may, for instance, provide instructions or support to the
caregiver 204 or ask questions of the caregiver. In some cases, the
communications module transmits some or all of the real-time
patient monitoring data sensed by any of various sensors to the
emergency response center 206 for viewing and/or analysis.
[0026] A video module 210 controls the operation of one or more
cameras 204, which are positioned to acquire still and/or video
images of the subject 202. For instance, one camera may be attached
to the defibrillator 208 such that when the defibrillator is in
operation, the camera is able to acquire an image of the subject.
Another camera may be attached to a headpiece to be worn by the
caregiver 204 so as to provide a close-up image of the subject 202
as the subject undergoes treatment. The videos acquired by one or
more of the cameras may be sent to the emergency response center by
the communications module. In some embodiments, a still image
acquired by each of the cameras 204 is sent to the emergency
response center so that a responder (e.g., a dispatcher, first
responder, or other professional) can select the camera that
presents a desired image. Once the responder selects a camera,
video acquired by the selected camera is streamed to the emergency
services center via the communications module.
[0027] In some cases, both subject data and video may be sent to
the emergency response center. Depending on the communication link
between the communication module and the emergency response center,
there may not be sufficient bandwidth to support transmission of
both subject data and video and/or audio. In this case, the video
and/or transmission may be temporarily halted to allow for
preferential transmission of the subject data to the emergency
response center. Alternatively, the video may be transmitted at a
lower frame rate than the frame rate at which the video was
acquired by the camera (e.g., a ratio of the frame rate of the
acquired video to the transmitted video can be at least 2:1, at
least 3:1, or at least 4:1).
[0028] One or more sensors, such as sensors applied to the subject
202, provide input signals to MPU 212 that characterize the current
real-time condition or physical parameters of the subject 202. The
signals may be used by the MPU 212 to determine an appropriate
treatment for the subject 202, such as a timing and/or force for
chest compressions 218 delivered to the subject. For example, an
ECG signal 222, obtained from leads connected to defibrillator 208,
may represent the current and real-time ECG waveforms for the
subject 202. An SpO.sub.2 (oxygen saturation) signal 223 or another
physiologically derived signal that is a direct or indirect measure
of circulatory flow or perfusion, is obtained from a corresponding
sensor. Other input signals may include physiological signals such
as measures of cardiac output, measures of heart rate, blood
pressure(s), ECG, oxygen saturation (SpO.sub.2), heart sounds
(e.g., phonocardiography), heart imaging (e.g., ultrasound), and/or
impedance cardiography.
[0029] A signal processing unit 228 in the MPU 212 filters inputs,
such as ECG inputs, for further analysis by a microprocessor 230.
For example, the signal processing unit 228 may filter noise from
input signals. In the case of ECG data, the signal processing unit
228 may filter artifacts created by chest compression motion of the
subject 202 in order to remove such artifacts. Such preparation of
ECG signals may be termed SEE-THRU CPR.RTM., and can be performed
as discussed in U.S. Pat. No. 7,220,235, the contents of which are
incorporated herein by reference in their entirety.
[0030] The microprocessor 230 receives input information associated
with the real-time parameters of the subject 202, including ECG
waveform data. The microprocessor 230 also performs analysis on
such data to determine whether defibrillation is needed and/or to
modify the feedback prompts provided by the display 224 and/or a
speaker 236a controlled by an audio processing unit 236b.
[0031] Based on either retrospective data analysis of clinical
datasets that include simultaneous recording of sternal motion
signals and ECGs as well as patient outcome data, or of
pre-clinical testing in animal models, a statistical model may have
been developed that can predict the risk of fibrillation induction.
The statistical model may in turn be used to determine an
appropriate compression profile to be provided to a patient, and to
be aligned in time with ECG data of the patient. The statistical
model may be in the form of either a linear or non-linear
regression equation, using such techniques as multiple logistic
regression, for example.
[0032] The chest compression actions and/or other actions
undertaken with respect to the subject 202 may be performed
manually and may be prompted by various devices, including the MPU
212. Changes in compression profile may also be prompted via a
manual process. For example, coordinated chest compression times
and rates may be computed by the microprocessor 230 and verbally
announced by the speaker 236a. For example, a metronome of beeping
sounds may be played during CPR to indicate to the caregiver 204
when to press down on the subject's chest so as to avoid
compressions or decompressions during a vulnerable period.
Furthermore, the display 224 may provide coordinated visual
feedback, such as a display of an ECG waveform, a graph of
compression depth, or other similar data that may be helpful to the
caregiver in providing care to the subject 202.
[0033] Referring to FIG. 3, in an example process for camera
selection, an AED is associated with multiple video cameras. The
cameras may be positioned to acquire still images and/or video
images of various portions of the rescue scene, such as broad view
of much of the rescue scene, an image of the subject, an image of
the caregiver's treatment of the subject, or another view. For
instance, a camera may be mounted on a headpiece or other wearable
item that is to be worn by the caregiver, e.g., to provide a view
of the caregiver's treatment of the subject. Another camera may be
mounted on the AED, e.g., to provide a broad view of a large part
of the rescue scene. Additional cameras may also be provided for
positioning in other locations. For instance, a mobile (e.g.,
handheld) camera may be provided that can be held and operated by
another caregiver or a bystander.
[0034] When a subject needs assistance (e.g., the subject appears
to be experiencing sudden cardiac arrest), a caregiver initializes
an AED (step 300). The cameras associated with the AED are also
initialized (step 302). In some examples, the cameras are
initialized automatically upon initialization of the AED. In other
examples, one or more of the cameras are initialized manually, for
example, when the caregiver turns on the camera or puts on a
headpiece on which the camera is mounted. One or more of the
cameras may be in a position to acquire a video image of the
subject.
[0035] The subject is monitored (step 304) by one or more sensors
during treatment, as discussed above, and real-time subject
monitoring data is collected. For instance, signals such as an ECG
waveform, an SpO.sub.2 level, a blood pressure, a measure of
cardiac output, or a measure of heart rate may be monitored.
Alternatively or additionally, compression parameters may be
monitored. Compression parameters may include, for instance, a
sternal motion signal, compression velocity; compression depth;
duty cycle; velocity of down stroke and/or upstroke; introthoracic
pressure(s) during compressions; pleural pressure(s) during
compressions; sternal position, velocity, and/or acceleration;
chest wall or sternal strain or deformation; force applied to the
chest; and/or pressure used to compress the chest by a mechanical
chest compressor.
[0036] A video and data transmission channel is established (step
306) between the AED system and the emergency response center. For
instance, the transmission channel may be a long-range wireless
communication channel, such as a cellular 3G or 4G channel; or the
transmission channel may be a short-range wireless communication
channel, such as a Bluetooth or Wi-Fi connection, that is connected
to a hardwired communication channel.
[0037] A still image from each of the cameras is transmitted to the
emergency response center (step 308) and displayed to a responder,
e.g., on a display interface such as a computer monitor, television
screen, mobile communications device, or other display interface.
The responder is prompted to select one of the images. For
instance, the responder may select the image that provides a view
of the subject, a view of a large part of the rescue scene, a view
of the caregiver's treatment of the subject, or another view.
[0038] The responder's selection is transmitted via the
transmission channel and received by the AED system (step 310).
Video from the camera associated with the selected image is
transmitted to the emergency response center (step 312).
[0039] The video from the selected camera may be transmitted along
with the subject monitoring data. In some embodiments, a listing of
some or all of the available types of subject monitoring data is
also presented to the responder on the display interface such that
the responder may select one or more types of data for
transmission. For instance, an ECG waveform, an SpO.sub.2 level, a
compression rate, and a compression depth may be available, from
which the responder is prompted to select one or more for
transmission. In some cases, the transmission of video and subject
monitoring data may be controlled based on the available bandwidth
of the communication channel, as described in greater detail
below.
[0040] Referring to FIG. 4, an example user interface 400 displayed
on a display interface at the emergency response center allows a
responder at the emergency response center to select an image
corresponding to a desired camera view and which types of subject
monitoring data to be transmitted.
[0041] In the illustrated example, a camera selection window 400
displays images 404 and 406 corresponding to cameras A and B,
respectively. As can be seen from image 404, camera A is positioned
to provide a view of a subject 408. As can be seen from image 406,
camera B is positioned to provide a view of a caregiver 410
treating subject 408. The responder selects the image corresponding
to the camera from which he would like to view video by selecting
(e.g., clicking on) the appropriate selection button 412a,
412b.
[0042] The user interface 400 also includes a data selection window
414 that allows the responder to select one or more types of
subject monitoring data to be transmitted. In the illustrated
example, an ECG waveform, compression rate and depth data, and
SpO.sub.2 data are available for transmission. The responder
selects one or more of the types of data that he would like to
receive by selecting (e.g., clicking on) one or more of the
appropriate selection buttons 416a, 416b, 416c, 416d.
[0043] The responder's image and data selections are transmitted
back to the AED system at the rescue scene. Video from the camera
corresponding to the selected image is streamed to the emergency
response center. In addition, the selected type(s) of data are
transmitted to the emergency response center. In some embodiments,
the transmission of video and subject monitoring data may be
controlled based on the available bandwidth of the communication
channel, as discussed below.
[0044] In an alternative embodiment, video from all of the cameras
is initially displayed on the user interface, and the responder is
given the option to select one or more cameras for which to cease
video transmission.
[0045] In another alternative embodiment, the user interface is
provided at the rescue scene, e.g., on the tablet computer or
another screen associated with the AED. The rescuer selects one or
more cameras and/or types of subject monitoring data to be
transmitted to the emergency response center.
[0046] Referring to FIG. 5, in an example process, an AED provides
the capability to control the transmission of subject monitoring
data and/or video to the emergency response center based on the
available bandwidth of the transmission channel.
[0047] When a subject needs assistance (e.g., the subject appears
to be experiencing sudden cardiac arrest), a caregiver initializes
an AED (step 500). One or more cameras associated with the AED are
also initialized (step 502). In some examples, the cameras are
initialized automatically upon initialization of the AED. In other
examples, the cameras are initialized manually, for example, when
the caregiver turns on a camera or puts on a headpiece on which a
camera is mounted. The cameras may be in a position to acquire a
video image of the subject. In some examples, one or more cameras
previously selected by a responder at the emergency response center
(e.g., as described above) are initialized.
[0048] The subject is monitored (step 504) by one or more sensors
during treatment, as discussed above, and real-time subject
monitoring data is collected. For instance, signals such as an ECG
waveform, a SpO.sub.2 level, a blood pressure, a measure of cardiac
output, or a measure of heart rate may be monitored. Alternatively
or additionally, compression parameters, such as a sternal motion
signal or another measurement of compression, may be monitored.
[0049] A video and data transmission channel is established (step
506) between the AED system and the emergency response center. For
instance, the transmission channel may be a long-range wireless
communication channel, such as a cellular 3G or 4G channel; or the
transmission channel may be a short-range wireless communication
channel, such as a Bluetooth or Wi-Fi connection, that is connected
to a hardwired communication channel.
[0050] The available bandwidth on the transmission channel is
monitored (step 508) and a determination is made as to whether the
available bandwidth is below a predetermined threshold (step 510).
The threshold may be determined, for instance, based on an expected
quantity of data to be sent via the transmission channel and/or a
desired data transmission speed. In some examples, the threshold
may be, e.g., 750 kbps, 1 Mbps, 1.5 Mbps, or another threshold.
[0051] If the available bandwidth is above the threshold, then the
subject monitoring data and the video are both transmitted to the
emergency response center via the transmission channel (step 512).
If, however, the available bandwidth is below the threshold, the
subject monitoring data may be preferentially transmitted to the
emergency response center while the video is not transmitted (step
514). Alternatively, the subject monitoring data and the video may
both be transmitted, but with the video at a lower frame rate than
the frame rate at which the video was originally acquired (step
514). For instance, a ratio of the frame rate of the acquired video
to the frame rate of the transmitted video may be at least 2:1, at
least 3:1, or at least 4:1. In some embodiments, audio data may
also be preferentially transmitted, e.g., when the available
bandwidth is above a threshold for data-only transmission but below
a threshold for full transmission of data, audio, and video.
[0052] The available bandwidth is monitored during the transmission
of data and/or video to the emergency response center and
adjustments are made as appropriate. For instance, if the bandwidth
of the channel suddenly falls below the threshold, the video
transmission may be stopped or the frame rate of the transmitted
video may be reduced. Alternatively, if the bandwidth of the
channel had been below the threshold but rises above the threshold,
transmission of the video may be started.
[0053] The features described can be implemented in digital
electronic circuitry, or in computer hardware, firmware, software,
or in combinations of them. The apparatus can be implemented in a
computer program product tangibly embodied in an information
carrier, e.g., in a machine-readable storage device, for execution
by a programmable processor; and method steps can be performed by a
programmable processor executing a program of instructions to
perform functions of the described implementations by operating on
input data and generating output. The described features can be
implemented advantageously in one or more computer programs that
are executable on a programmable system including at least one
programmable processor coupled to receive data and instructions
from, and to transmit data and instructions to, a data storage
system, at least one input device, and at least one output device.
A computer program is a set of instructions that can be used,
directly or indirectly, in a computer to perform a certain activity
or bring about a certain result. A computer program can be written
in any form of programming language, including compiled or
interpreted languages, and it can be deployed in any form,
including as a stand-alone program or as a module, component,
subroutine, or other unit suitable for use in a computing
environment.
[0054] Suitable processors for the execution of a program of
instructions include, by way of example, both general and special
purpose microprocessors, and the sole processor or one of multiple
processors of any kind of computer. Generally, a processor will
receive instructions and data from a read-only memory or a random
access memory or both. The essential elements of a computer are a
processor for executing instructions and one or more memories for
storing instructions and data. Generally, a computer will also
include, or be operatively coupled to communicate with, one or more
mass storage devices for storing data files; such devices include
magnetic disks, such as internal hard disks and removable disks;
magneto-optical disks; and optical disks. Storage devices suitable
for tangibly embodying computer program instructions and data
include all forms of non-volatile memory, including by way of
example semiconductor memory devices, such as EPROM, EEPROM, and
flash memory devices; magnetic disks such as internal hard disks
and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM
disks. The processor and the memory can be supplemented by, or
incorporated in, ASICs (application-specific integrated
circuits).
[0055] To provide for interaction with a user, the features can be
implemented on a computer having a display device such as a CRT
(cathode ray tube) or LCD (liquid crystal display) monitor for
displaying information to the user and a keyboard and a pointing
device such as a mouse or a trackball by which the user can provide
input to the computer.
[0056] The features can be implemented in a computer system that
includes a back-end component, such as a data server, or that
includes a middleware component, such as an application server or
an Internet server, or that includes a front-end component, such as
a client computer having a graphical user interface or an Internet
browser, or any combination of them. The components of the system
can be connected by any form or medium of digital data
communication such as a communication network. Examples of
communication networks include, e.g., a LAN, a WAN, and the
computers and networks forming the Internet.
[0057] The computer system can include clients and servers. A
client and server are generally remote from each other and
typically interact through a network, such as the described one.
The relationship of client and server arises by virtue of computer
programs running on the respective computers and having a
client-server relationship to each other.
[0058] The computer system may include software for implementing an
electronic patient care record, for example the ePCR software of
ZOLL Data Systems (Broomfield Colo.). The software provides the
ability to enter, store and transmit patient information as well as
therapeutic interactions. The computer is often a so-called
"tablet" computer system that has been ruggedized for pre-hospital
use, but may also take the form of an IPHONE or IPAD. Data is
preferably transmitted in real time between the portable "tablet"
computer to an MPU 212, such as data that indicates the delivery of
epinephrine to a subject. As epinephrine may increase risk of VF
induction, notification of its delivery may be used by the MPU to
adjust the compression parameters to further minimize risk of VF
induction. Other separate treatments provided to the patient, or
parameters of the patient condition sensed by the various sensors
may also be provided to the tablet, and may factor into the rate,
timing, force, or speed with which compressions and decompressions
are performed on the patient.
[0059] A number of embodiments have been described. Nevertheless,
it will be understood that various modifications may be made
without departing from the spirit and scope of the invention.
Accordingly, other embodiments are within the scope of the
following claims.
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