CN110721408B - Program control instrument and emergency treatment triggering system - Google Patents

Program control instrument and emergency treatment triggering system Download PDF

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CN110721408B
CN110721408B CN201911187968.9A CN201911187968A CN110721408B CN 110721408 B CN110721408 B CN 110721408B CN 201911187968 A CN201911187968 A CN 201911187968A CN 110721408 B CN110721408 B CN 110721408B
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treatment
control
emergency treatment
program
triggered
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CN110721408A (en
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井铁军
刘光辉
张瑛
洪峰
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Suzhou Wushuang Medical Equipment Co ltd
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Suzhou Wushuang Medical Equipment Co ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient ; user input means
    • A61B5/742—Details of notification to user or communication with user or patient ; user input means using visual displays
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/37211—Means for communicating with stimulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/375—Constructional arrangements, e.g. casings
    • A61N1/37512—Pacemakers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
    • A61N1/3962—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
    • A61N1/39622—Pacing therapy

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Abstract

The invention discloses a program control instrument with an emergency treatment function, which can prevent false triggering of emergency treatment. And displaying a treatment triggering control in a display of the program control instrument, and providing an emergency treatment confirmation device outside the display of the program control instrument. After the on-screen control is triggered, the program control instrument displays an emergency treatment triggering warning, and the emergency treatment confirmation device is in a triggerable state, and at the moment, the program control instrument can send a treatment message to the ICD only when a doctor triggers the emergency treatment confirmation device. By the double confirmation mode, the doctor can be prevented from triggering the emergency treatment function by mistake, and the danger of triggering the emergency treatment function by mistake is prevented.

Description

Program control instrument and emergency treatment triggering system
Technical Field
The application belongs to the field of medical equipment, and more particularly relates to an improvement on an implantable cardiac defibrillator and a program control instrument.
Background
Implantable Cardiac Defibrillators (ICDs) are an active medical device that is small in size and can be implanted in the chest or abdominal cavity of a patient. ICDs can complete cardiac rhythm diagnosis and release therapy within seconds once an arrhythmia occurs.
After the ICD is implanted into a human body, a doctor uses a program control instrument to check an electrocardiogram and program parameters of the ICD. The program control instrument and the ICD transmit communication data through the built-in wireless communication modules.
In the diagnosis and treatment or test process of a doctor on a patient by using a program controlled instrument, the patient possibly bursts arrhythmia conditions such as ventricular tachycardia or ventricular fibrillation, and the like, and then the patient needs to be treated immediately by using the ICD.
Thus, emergency treatment triggering is a necessary function of the programmer. When the patient suddenly shakes or the ventricular rate is increased in the diagnosis and treatment or test process, the doctor can control the ICD to carry out emergency treatment on the patient by controlling the operation program control instrument and starting the emergency treatment triggering mechanism.
In the prior art, three mechanical keys are arranged on a program control instrument for defibrillation, emergency pacing and stopping treatment respectively. When the treatment is needed, the doctor presses the corresponding treatment button to trigger the corresponding treatment control. The mechanism has good responsiveness, but has higher requirements on mechanical design, and the mechanism is not easy to press down to prevent the false triggering of the treatment function.
Disclosure of Invention
The invention aims to provide a program control instrument with an emergency treatment function, which can prevent false triggering of emergency treatment. And displaying a treatment triggering control in a display of the program control instrument, and providing an emergency treatment confirmation device outside the display of the program control instrument.
The program control instrument comprises a treatment triggering control displayed in a screen and an emergency treatment confirmation device arranged outside the screen. After the on-screen control is triggered, the program control instrument displays an emergency treatment triggering warning, and the emergency treatment confirmation device is in a triggerable state, and at the moment, the program control instrument can send a treatment message to the ICD only when a doctor triggers the emergency treatment confirmation device. By the double confirmation mode, the doctor can be prevented from triggering the emergency treatment function by mistake, and the danger of triggering the emergency treatment function by mistake is prevented.
The programmer includes a communication module for communicating with the ICD:
a display for displaying medical information;
an execution unit for executing a program control program of the program control instrument;
a storage unit for storing the control program of the program control instrument;
emergency treatment confirmation means;
the program control device control program comprises a method capable of triggering emergency treatment:
displaying at least one triggerable treatment trigger control on the display;
after the trigger control is triggered, an emergency treatment warning is generated;
after the emergency treatment confirmation device is triggered, the communication module sends a treatment message to the ICD, and the emergency treatment warning is eliminated.
In a preferred scheme, the triggering control controls comprise a defibrillation control, a pacing control and a termination control, wherein the termination control is set to be in a non-triggerable state when the defibrillation control or the pacing control is not triggered;
the termination control is set to a triggerable state when the defibrillation control or pacing control is triggered. The control device has the advantages that the control device in the non-triggerable state can be used by a doctor, a clear use prompt can be given, namely, the non-triggerable control device is not required to be operated, and the time waste caused by invalid operation is avoided. Meanwhile, the triggerable control can reflect the existing available state of the program control instrument.
In a preferred embodiment, the method of triggering an emergency treatment includes a method of monitoring whether the treatment trigger control is triggered.
In a preferred embodiment, the method for triggering the emergency treatment includes generating an emergency treatment alert after the control is triggered.
In a preferred embodiment, the method for triggering the emergency treatment includes monitoring whether the emergency treatment confirmation device is triggered, as described after the emergency treatment alert is generated, and the communication module sends a treatment message to the ICD after the emergency treatment confirmation device is triggered.
The confirmation message can contain the treatment parameters configured at the program control instrument end, the confirmed message is sent to the treatment parameters of the ICD end, and the ICD further executes treatment operation according to the content of the treatment parameters.
In a preferred embodiment, the method for triggering the emergency treatment includes setting the treatment triggering control to an unactivatable state after the emergency treatment confirmation device is triggered. This non-triggerable state may prevent the physician from repeatedly operating the emergency treatment function after having been triggered.
In a preferred embodiment, the method for triggering the emergency treatment includes issuing an emergency treatment alert after the emergency treatment confirmation device is triggered.
In a preferred embodiment, the method of triggering the emergency treatment includes monitoring whether the emergency treatment function is switched if the emergency treatment confirmation device is not triggered.
In a preferred embodiment, the method of triggering the emergency treatment includes continuing to monitor the non-triggered treatment trigger control by the programmer control program when the treatment trigger control has been triggered but the emergency treatment confirmation device has not been triggered; if the doctor triggers a different treatment trigger control again, the triggered treatment trigger control is modified to be in an un-triggered state, and the currently triggered treatment trigger control is modified to be in a state which can not be triggered.
In a preferred embodiment, the method for triggering the emergency treatment includes, if the monitoring treatment triggering control is not triggered, monitoring whether the termination control is triggered.
In a preferred embodiment, the method for triggering the emergency treatment includes setting a state of the treatment triggering control to an untriggered state after triggering the termination control.
In a preferred embodiment, the method of triggering an emergency treatment comprises continuing to monitor whether the emergency treatment confirmation device is triggered if a treatment trigger control is triggered or if the termination control is not triggered.
In a preferred scheme, a display is used for displaying a virtual touch control which can be triggered, the display is a touch display, the treatment triggering control can be triggered by a doctor touch action, and the treatment triggering control is confirmed by an emergency treatment confirmation device after being triggered.
In a preferred embodiment, the emergency treatment confirmation device is a mechanical button outside the display.
In a preferred scheme, the mechanical key comprises a luminous alarm, the emergency treatment alarm is configured to flash after the treatment trigger control is triggered, the luminous alarm is normally on after the mechanical key is pressed to indicate that the treatment state is entered, and the luminous alarm is extinguished after the treatment is completed.
In a preferred scheme, the mechanical key is arranged on a program control head of the program control instrument, and the flashing or normally-bright light color of the alarm is the same as the color of the triggered control. The control displays a specific color, the color of the alarm is kept the same as that of the control, and a doctor can quickly identify the working state of the current program control instrument in the use process.
The second object of the present invention is to provide an emergency treatment triggering system comprising a program control device and an ICD, wherein the program control device is used for preventing false triggering, the program control device is used for sending a confirmation message to the corresponding ICD after triggering a treatment triggering control, and the ICD is used for executing treatment operation according to message parameters sent by the program control device.
An emergency treatment triggering system comprising
An ICD for performing a therapy procedure, the ICD comprising:
a lead for connection to heart tissue;
a treatment unit for generating treatment pulses;
an execution unit for executing an ICD control program;
a storage unit for storing the control program;
a communication module for communicating with the programmable controller;
a programmable device for triggering emergency treatment by a doctor, the programmable device comprising:
a display for displaying medical information;
an execution unit for executing a program control program of the program control instrument;
a storage unit for storing the control program of the program control instrument;
emergency treatment confirmation means;
the method is characterized in that the program control program of the program control instrument comprises the following steps of triggering an emergency treatment execution method:
displaying at least one treatment trigger control on the display that is triggerable by a medical person;
after the treatment triggering control is triggered, an emergency treatment warning is generated;
after the emergency treatment confirmation device is triggered, the communication module sends a treatment message to the ICD, and the emergency treatment warning is eliminated;
the ICD control program includes a method of performing emergency treatment:
receiving a treatment message sent by the program control instrument and starting a treatment program;
and after the treatment program is finished, sending a treatment finishing message to the program control instrument.
In a preferred embodiment, the treatment program comprises controlling the charging and discharging process of the treatment unit according to treatment parameters.
In a preferred embodiment, the treatment parameters are received from a treatment message sent by the programmer or stored in a memory unit of the ICD.
In a preferred embodiment, the method of performing emergency treatment includes receiving a termination message from the programmer and ending an ongoing treatment program.
In a preferred embodiment, the method for performing emergency treatment includes the programmable controller sending the termination message after the emergency treatment confirmation device is continuously triggered during the emergency treatment.
It is a further object of the present invention to provide an ICD, comprising
A lead for connection to heart tissue;
a treatment unit for generating treatment pulses, the output port of the treatment unit being connected to a lead;
an execution unit for executing an ICD control program;
a storage unit for storing the control program;
a communication module for communicating with the programmable controller;
the ICD control program includes a method of performing emergency treatment:
receiving a confirmation message sent by the program control instrument and starting a treatment program;
and after the treatment program is finished, sending a treatment finishing message to the program control instrument.
In a preferred embodiment, the confirmation message includes a treatment parameter, and the treatment program includes a treatment unit charged according to the treatment parameter and discharged according to the treatment parameter.
In summary, the invention has at least the following advantages in triggering ICD emergency treatment by the program control instrument: 1. the false triggering can be prevented through the double verification of the screen display control and the emergency treatment confirmation device, and compared with the existing single-button program control instrument on the market, the false triggering prevention effect is better. 2. Because of the double confirmation of the screen display control and the emergency treatment confirmation device, the requirement on the mechanical characteristics of the emergency treatment confirmation device can be reduced under the condition that the emergency treatment confirmation device is a physical button, namely the emergency treatment confirmation device is not required to be pressed as the existing product so as to prevent false triggering, and compared with the existing product, the design requirement of the mechanical button for confirming treatment of the program control instrument is lower, and the design and manufacturing cost of the mechanical button for confirming treatment of the program control instrument are lower. 3. In a preferred scheme, the confirmation treatment device is a mechanical button arranged on the program control head, so that a doctor can conveniently operate when the doctor is far away from the program control instrument in the operation process. 4. In the preferred scheme, the luminous warning device is arranged on the program control head, the color of the treatment triggering control part can be displayed on the display of the program control device, the color of the warning device is the same as the color of the control part when the program control device triggers treatment, and a doctor can quickly know the current state of the program control device when the doctor is far away from the program control device and operates the emergency treatment confirmation device.
Drawings
Fig. 1 is a schematic diagram of the operating states of the programmer and ICD.
Fig. 2 is a schematic diagram of the hardware architecture of the programmable controller.
Fig. 3 is a general flow diagram.
Fig. 4 is a schematic flow diagram of an emergency treatment triggering system.
Fig. 5 is a schematic diagram of ICD hardware architecture and implantation state.
Fig. 6 is a sequence diagram of triggering an emergency treatment system of the programmable control instrument.
Detailed Description
Referring to fig. 1, the sequencer is a sequencer 118 for cardiac rhythm management, comprising a sequencer 118 body and a sequencer head 108 electrically connected to the body. Its function is to assist the physician in performing medical procedures on patients 110 who have Implanted Cardiac Defibrillators (ICDs) 104 (see fig. 5), implantable cardiac pacemakers, and implantable cardiac detectors (ICMs). Taking the ICD as an example, the programming head 108 may read and store historical internal electrocardiograms within the ICD, view real-time internal electrocardiograms of the ICD, and the programmer provides a physician interface through which the physician may set prescription parameters within the programmer and send them to the ICD device 104 within the patient via the programmer. The ICD104, upon receiving the new parameters, performs a diagnostic job with the new parameters, including but not limited to: heart rate partition threshold, cardiac event perception threshold, cardiac event discriminator type, cardiac event discriminator threshold, treatment energy, treatment pulse width, etc. The programmable control device is usually used in the sitting position of a patient in an outpatient service, or in a lying position in an operation or in a follow-up process. The emergency treatment triggering mechanism is applied to the situations of sudden atrial fibrillation, atrial speed and the like of patients in the occasions.
In order to realize the emergency treatment triggering function, the program control instrument and the ICD software and hardware structure are respectively described below.
Program control instrument
The programmer generally includes an execution unit (CPU), 204 Random Access Memory (RAM) 208, read Only Memory (ROM) 206, external memory (HARDDrive) 210, display 120, touch screen 214, RF wireless communication subsystem 226, body surface electrocardiogram subsystem (ECG subsystem) 233, and emergency treatment confirmation device 234 interconnected by a system BUS (BUS) 202.
Execution unit
The execution unit 204 described with reference to fig. 2 is configured to execute a program control program 236 stored in the external memory 210. After the programmable controller is started, the programmable controller control program 236 is loaded to the random storage unit 208, the CPU directly reads the control instruction of the programmable controller from the random storage unit 208, and the execution unit reads the instruction, executes the operation, returns the data and other processes from the random storage unit 208 through the system bus 202.
Wireless communication subsystem
The RF wireless communication subsystem 226 is configured to communicate with the ICD104, send the prescription parameters described above to the ICD104, and receive diagnostic data, real-time electrocardiographic data, etc. returned by the ICD 104. The RF wireless communication subsystem 226 includes wireless communication circuitry (not shown) capable of converting data into radio signals, optical signals, acoustic signals that may be received by the ICD. The RF radio frequency subsystem is preferably adopted to complete the communication function in the application, and data can be communicated and transmitted to the ICD through Bluetooth communication protocol (Bluetooth), wireless local area network 802.11 (Wi-Fi), zigBee or the like. The communication antenna of the wireless communication subsystem is arranged in the program control head 108 of the program control instrument, the emergency treatment confirmation device 234 of the program control instrument is arranged in the program control head 108, the emergency treatment confirmation device comprises a mechanical key 232 and a key driving module 230 connected with the key, the key driving module 230 is used for responding to the event that the key is pressed and sending the event that the mechanical key is pressed to an emergency treatment module 240, the emergency treatment confirmation device 234 also comprises an LED lamp 228 connected with the wireless communication module, and the LED lamp 228 is used as an alarm of the emergency treatment device.
It should be noted that the emergency treatment warning indicator may also be a virtual display control in the display, or a graphical interface or a change in display content generated in the display during emergency treatment, which can prompt an emergency treatment state.
Emergency treatment confirmation device
With continued reference to fig. 2, in a preferred embodiment, the emergency treatment confirmation device is a mechanical button 232 outside the display 120, such as disposed in a location where the body is not easily touched. The mechanical key may be located at the position of the mechanical key 116 shown in fig. 1, or at the position of the mechanical key 106 shown in fig. 1. The mechanical key may be provided with one or more.
In fig. 2, the mechanical key 232 corresponds to the mechanical key 106 in the drawing, and the mechanical key 222 corresponds to the mechanical key 116 in fig. 1, in a preferred scheme, an LED lamp 228 is built in the mechanical key 232 and is used as a luminous emergency treatment alarm, the LED lamp 228 is configured to flash after the treatment triggering control is triggered, the luminous alarm is normally on after the mechanical key is pressed to indicate that the ICD enters a treatment state, and the luminous alarm is extinguished after the treatment is completed.
In a preferred embodiment, the light emitting warning device is preferably a led lamp, which may also be connected to the bus 202 (reference numeral 220 in the figure), and the led lamp emits a warning light signal through a transparent or semitransparent mechanical key.
In a preferred embodiment, referring to fig. 1, the mechanical button 106 is disposed on a programming head 108 of the programming instrument, and the led warning device blinks or lights with a color that is the same as the color of the activated control 122. The control displays a specific color, the color of the alarm is the same as that of the control 122, and a doctor can quickly identify the current working state of the program control 118 in the use process.
Display device
Referring to fig. 1 and 2, the programmer includes a display 120 for displaying medical information, and an emergency treatment interface call-out control 112 is also displayed within the display 120. The display is a touch display, which can monitor the touch operation of the doctor so that the doctor can call out the control 112 through the touch emergency treatment interface, jump out of the emergency treatment interface 114, and the emergency treatment interface 114 can be displayed in the form of a graphic dialogue window. The emergency treatment interface includes a defibrillation control 122 that may be triggered, a pacing control 126, and a termination control 124.
The displayed medical information comprises the diagnosis and treatment parameters, and further comprises an internal electrocardiogram received from the ICD and diagnostic mark information of the ICD on the internal electrocardiogram. It should be noted in particular that. The display content can be scattered at different positions by providing paging, scrolling and the like for an interactive interface, so that management and searching are convenient. Patient information including the sex, age, weight diagnosis, etc. of the patient can also be displayed in the display of the program control instrument.
A memory.
The memory 210 of the programmer is used to store programmer control programs 236, including a programmer operating system and underlying drivers and application layer software, and patient data. It will be apparent to those skilled in the art that dedicated control programs may also be developed to achieve a more hardware resource efficient system. The operating system is well known to those skilled in the art and will not be described in detail herein.
Program controlled instrument control program
The programmer control program 236 includes a GUI module 242 for displaying the emergency treatment call control 112 and the emergency treatment interface 114 on a display, the communication module 238 implements a data transceiver protocol for the programmer and ICD communication module, and the emergency treatment module 240 is for controlling the triggering logic of emergency treatment. The doctor triggers the treatment trigger control 122, 124 or 126 in fig. 1 through the GUI module 242, the emergency treatment module 240 knows that the treatment trigger control is triggered to control the emergency treatment alarm to generate an alarm, and the emergency treatment module 240 sends an emergency treatment message to the communication module 238 after the emergency treatment confirmation device 234 is triggered. Meanwhile, the emergency treatment module 240 can acquire the treatment state of the ICD through the communication module, and control the LED lamp 228 to display different warnings through the treatment state of the ICD. Meanwhile, the ICD treatment control module can feed back to the GUI control module according to different treatment states of the ICD, so that the GUI updates display contents.
The emergency treatment module 240, referring to fig. 3, includes a method for triggering emergency treatment, including three steps, numbered 302-306. The steps are respectively as follows: at least one triggerable treatment trigger control is displayed on the display, step 302, after which the programmer generates an emergency treatment alert, step 304, after which the emergency treatment confirmation device is triggered, the communication module sends a treatment message to the ICD, the emergency treatment alert is extinguished 306. Finally the ICD receives the treatment message sent by the programmer and initiates the treatment procedure step 308.
The GUI module of the programmer control program displays controls on the programmer's display that can be triggered by the physician in step 302.
In the triggering step 304, the program control device generates an emergency treatment warning after the emergency treatment control is triggered by the doctor.
In the process of sending the treatment information, after the emergency treatment device is triggered, a communication module of the program control instrument sends a treatment message to the ICD, and the emergency treatment warning is eliminated.
The programmer 118 first displays the virtual trigger control as a first trigger mechanism on the screen and the emergency treatment confirmation device on the programmer as a second trigger mechanism. The program control instrument firstly displays a virtual trigger control in a screen to a doctor for a first trigger mechanism, then generates an emergency treatment warning after the virtual trigger control is triggered, and only when an emergency treatment confirmation device on the program control instrument is triggered by the doctor, the program control instrument sends a treatment message to the ICD, so that the problem of false triggering caused by false operation of the program control instrument is solved.
Fig. 4 is a further detailed implementation step of the triggering method of emergency treatment on the basis of fig. 3.
Referring to fig. 4, step 302 in fig. 3 includes a turn-off annunciator step 402, which returns to an initial state.
Further included in step 304 are steps 404-418, where the process control waits for the physician to trigger the acute treatment interface call out control 112 to enable the treatment trigger controls 122-126 to be displayed in step 404 so that the setup saves display space on the display. The acute treatment interface call-out control 112 may also be a mechanical button disposed outside the display.
In a preferred embodiment, in step 112, the emergency treatment trigger control controls include a defibrillation control 122, a pacing control 126, and a termination control 124.
The GUI control monitors in step 408 whether the treatment trigger control is triggered, i.e. whether it is touched by the physician, and if not triggered all the time, the step of displaying the treatment trigger control 406 is repeated. Logic for repeated monitoring of treatment trigger controls can be implemented by those skilled in the art through software and hardware interrupts.
Preferably, the termination control is set to a non-triggerable state when either the defibrillation control 122 or the pacing control 126 is not triggered.
When it is detected in step 408 that the treatment trigger control is triggered, step 410 is performed, wherein the LED warning light continues to flash.
Preferably, the termination control 124 is set to a triggerable state when either the defibrillation control 122 or the pacing control 126 is triggered. The advantage of the above arrangement is that the control in the non-triggerable state can give a clear use prompt when the doctor uses the programmer 118, i.e. the non-triggerable control is not required to be operated, thus avoiding time waste due to ineffective operation. Meanwhile, the triggerable control can reflect the existing available state of the program control instrument.
In step 410, the treatment trigger control is triggered, and an emergency treatment warning is generated, and the warning is displayed in a flashing manner by the led warning lamp, and the warning can also be displayed on the screen through a special prompt displayed on the GUI module.
Preferably, the color of the LED alert lights is the same as the color of the control, for example, the trigger control 122 for the emergency defibrillation therapy is red, and the alert lights continuously flash to red. The doctor can quickly know the upcoming treatment through the alarm.
In step 412, after the emergency treatment alert is generated, it is monitored whether the emergency treatment confirmation device 234 is triggered.
Step 306 in fig. 3 includes step 418, where the emergency treatment confirmation device is triggered and the communication module sends a treatment message to the ICD in step 418. Meanwhile, the flickering state of the emergency treatment LED warning device is changed into a normally-on state. The normally-on state is used for indicating that the ICD is in a treatment state, and the LED lamp of the alarm is extinguished after the ICD treatment is completed
Preferably, the confirmation message may include the ICD treatment parameters, the treatment parameters are configured at the programmable controller, the confirmed message is sent to the treatment parameters at the ICD, and the ICD further performs the treatment operation according to the content of the treatment parameters. These treatment parameters include, but are not limited to: therapeutic energy, discharge pulse width, defibrillation or pacing modes, etc. The confirmation message may also be a therapy code agreed upon via the communication protocol, with different therapy codes corresponding to different therapy parameters in the ICD.
Preferably, the treatment trigger control is set to a non-triggerable state after the emergency treatment confirmation device 234 is triggered. This non-triggerable state may prevent the physician from repeatedly operating the emergency treatment function after having been triggered.
If the emergency treatment confirmation device 234 is not triggered in step 412, step 414 is performed to monitor whether the emergency treatment function is switched. The purpose of step 414 is to be set because, prior to triggering the emergency treatment confirmation device 234, it is possible for the physician to modify the emergency treatment regimen, i.e., to switch the emergency treatment function by re-triggering the corresponding treatment trigger control.
For example, before the doctor presses the mechanical button 106, clicking the defibrillation therapy control 122 on the touch screen changes the therapy mode from the pacing mode to the defibrillation mode, and after the defibrillation control 122 is triggered, the therapy parameters of the pacing therapy message are modified to the therapy parameters corresponding to the defibrillation therapy.
Preferably, when the treatment trigger control has been triggered but the emergency treatment confirmation device 234 has not been triggered, continuing to monitor the non-triggered treatment trigger control changes the previously triggered treatment trigger control state to a triggerable state if the doctor triggers a different treatment trigger control again. The current triggered therapy trigger control state is modified to a state that cannot be triggered.
In step 416, if the monitoring therapy trigger control is not triggered, it is monitored whether the termination control 124 is in a triggered state. If the termination control 124 is not triggered, the process returns to step 410 to continue monitoring the trigger state of the treatment trigger control.
In a preferred embodiment, after the termination control is triggered, the state of the emergency treatment button is set to a triggerable state, and the alarm is turned off at the same time as returning to the initializing step. At the same time, the program control instrument sends a message for terminating the treatment to the ICD.
In a preferred approach, the display 120 is used to display virtual touch controls that can be triggered, and the touch screen 214 is used to monitor the physician's touch. The display and the touch screen are integrated and assembled together.
In the touch display, the GUI module reacts to the clicking control operation of the doctor, so that the key can be triggered, and conversely, the GUI module does not react to the clicking operation, so that the key cannot be triggered. The GUI module may represent the triggerable state of the control using normal color drawing controls and the non-triggerable state of the control using gray.
Emergency treatment system
With continued reference to fig. 4, the present invention further provides an emergency treatment system comprising a programmable controller and an ICD, wherein the step 420 is performed in the ICD, and the ICD performs confirmation through an emergency treatment confirmation device after the programmable controller has been triggered by a screen control before the ICD receives the confirmation message according to the confirmation treatment message sent by the programmable controller, so that the ICD does not perform erroneous treatment.
Referring to fig. 5, the ICD includes: an ICD body portion 502 and a lead 504 connected to the ICD, the ICD body including a connector 506 for connecting the lead and a hybrid 508 encased within the housing.
The hybrid circuit 508 includes a cardiac event sensing unit 510, a therapy unit 512 for generating therapy pulses, an execution unit 514 for executing an ICD control program, and a communication unit 526 for communicating with the ICD.
The execution unit 514 may be an MCU unit having a memory unit, optionally storing an ICD control program for controlling the ICD.
The lead 504 is adapted for connection to a connective machine of cardiac tissue and an ICD, the lead comprising a proximal end 520 connected to a connector, a distal end 518 connected to cardiac tissue 516, and at least one sensing electrode 524 and a therapy electrode 522 on the distal end of the lead, the sensing electrode 524 being connected to a sensing unit 510 inside the ICD via the lead 504 and the connector for sensing cardiac events.
The therapy electrode 522 is connected to the therapy unit 512 of the hybrid circuit 508 by a lead 504, and the therapy pulses generated by the therapy unit 512 are capable of discharging the heart tissue 516 through the therapy electrode 522 on the lead. Treatment can be divided into: defibrillation, anti-tachycardia pacing, etc.
The ICD control program includes a method of performing emergency treatment:
receiving a treatment message sent by the program control instrument and starting a treatment program;
and after the treatment program is finished, sending a treatment finishing message to the program control instrument.
Preferably, the treatment procedure comprises controlling the charging and discharging process of the treatment unit according to treatment parameters.
Preferably, the treatment parameters are received from a treatment message sent by the programmer or stored in a memory unit of the ICD.
Preferably, the program control program includes a method of canceling treatment: and receiving a termination message sent by the program control instrument and ending the ongoing treatment program. The method of therapy cancellation includes monitoring whether the mechanical button is continuously pressed or monitored.
Referring to fig. 4, during cancellation of an ongoing treatment in steps 422-426, the programmer GUI control module monitors whether the termination control 124 is triggered, and the programmer simultaneously monitors whether the mechanical key 106 is continuously pressed, and stops treatment if the mechanical key 232 is continuously pressed or the termination button is triggered.
Emergency treatment system interaction process
Referring to fig. 6, the interaction process during emergency treatment of doctor J, programmer and ICD in the system of the present application will be described.
The physician finds that emergency treatment is needed in step 602, it triggers a treatment trigger control in the programmer, the programmer monitors that after the triggering action in step 604, the GUI control module sets the triggered treatment trigger control to a non-triggerable state, and the termination control 124 to an available state.
At step 606, the program control instrument sends out an emergency treatment warning, which is a flashing light of the emergency treatment mechanical button 106 on the program control head, and the color of the light is the same as that of the treatment triggering control.
Other trigger controls may be touch-controlled to switch treatment modes at step 608
The physician confirms the treatment by triggering the emergency treatment mechanism button 106 at step 610. After the programmer monitors the confirmation message in step 612, the led annunciator is activated to flash in step 614, and then the programmer sends a therapy message to the ICD in step 616, which performs the therapy process in step 618. The emergency treatment mechanism button 106 is transitioned to a normally-lit light indication at step 620 that is the same color as the treatment trigger control of the programmer.
During the treatment, the doctor may cancel the ongoing treatment by double clicking the emergency treatment button or clicking the cancel button at 622, the programmer monitors at 624 whether termination is triggered, if so, a cancel treatment message is sent at 626, after the treatment is terminated or the treatment is over, the ICD sends a complete treatment or an end of termination treatment message to the programmer at 628, and the programmer turns off the warning light at 630.
In summary, the present invention provides an emergency treatment triggering mechanism utilizing an emergency treatment triggering and confirmation mechanism, as well as a false triggering mechanism that reduces the requirements for mechanically designed keys over the prior art.

Claims (18)

1. A programmed instrument comprising a communication module for communicating with an ICD:
a display for displaying medical information;
an execution unit for executing a program control program of the program control instrument;
a storage unit for storing the control program of the program control instrument;
the device is characterized by also comprising an emergency treatment confirmation device;
the method for providing the program controlled control program for triggering the emergency treatment comprises the following steps:
displaying at least one operable treatment trigger control on the display;
after the treatment triggering control is triggered, an emergency treatment warning is generated;
after the emergency treatment confirmation device is triggered, the communication module sends a treatment message to the ICD;
the emergency treatment confirmation device is a mechanical button outside the display, the mechanical button comprises a luminous warning device, the emergency treatment warning device is configured to flash after a treatment triggering control is triggered, the luminous warning device is normally on after the mechanical button is pressed to indicate that the emergency treatment confirmation device enters a treatment state, and the luminous warning device is extinguished after treatment is completed.
2. The sequencer of claim 1, wherein the therapy trigger controls include a defibrillation control and a pacing control and a termination control, the termination control being set to a non-triggerable state when either the defibrillation control or the pacing control is not triggered; the termination control is set to a triggerable state when the defibrillation control or pacing control is triggered.
3. The program control instrument of claim 2, wherein the method of triggering emergency treatment includes a method of monitoring whether the treatment trigger control is triggered.
4. A program control apparatus as claimed in claim 3, wherein the means for triggering emergency treatment comprises means for generating an emergency treatment alert upon detection of the control being triggered.
5. A program control instrument as claimed in claim 4, wherein the method of triggering emergency treatment comprises monitoring whether the emergency treatment confirmation device is triggered after an emergency treatment alert is generated, the post-trigger communication module sending a treatment message to the ICD.
6. The program control apparatus of claim 5, wherein the method of triggering emergency treatment comprises the emergency treatment confirmation device being triggered with the treatment trigger control set to a non-triggerable state.
7. The apparatus of claim 5, wherein the means for triggering the emergency treatment comprises means for alerting the user of the status of the treatment after the emergency treatment confirmation means is triggered.
8. The program control apparatus of claim 4, wherein the method of triggering the emergency treatment includes monitoring whether an emergency treatment function is switched if the emergency treatment confirmation device is not triggered.
9. The program control instrument of claim 8, wherein the method of triggering emergency treatment comprises monitoring whether a treatment trigger control is not triggered and monitoring whether the termination control is triggered.
10. The program control apparatus of claim 8, wherein the method of triggering emergency treatment comprises setting a state of the treatment trigger control to an un-triggered state after the termination control is triggered.
11. The program control apparatus of claim 8 or 9, wherein the method of triggering emergency treatment comprises continuing to monitor whether the emergency treatment confirmation button is triggered if the treatment trigger control is triggered or if the termination control is not triggered.
12. The program control device of any one of claims 1-10, wherein the display is a touch display and the treatment trigger control is triggerable by a physician touch action.
13. The program control instrument of claim 1, wherein the mechanical key is provided on a program control head of the program control instrument, and the alarm blinks or normally shines in the same color as the activated control.
14. An emergency treatment triggering system comprising
An ICD for performing a therapy procedure, the ICD comprising:
a lead for connection to heart tissue;
a treatment unit for generating treatment pulses;
an execution unit for executing an ICD control program;
a storage unit for storing the control program;
a communication module for communicating with the programmable controller;
a programmable device for triggering emergency treatment by a doctor, the programmable device comprising:
a display for displaying medical information;
an execution unit for executing a program control program of the program control instrument;
a storage unit for storing the control program of the program control instrument;
emergency treatment confirmation means;
the method is characterized in that the program control instrument control program is provided for triggering the emergency treatment:
displaying at least one triggerable treatment trigger control on the display;
after the treatment triggering control is triggered, an emergency treatment warning is generated;
after the emergency treatment confirmation device is triggered, the communication module sends a treatment message to the ICD, and the emergency treatment warning is eliminated;
the ICD control program includes a method of performing emergency treatment:
receiving a treatment message sent by the program control instrument and starting a treatment program;
after the treatment program is finished, sending a treatment completion message to a program control instrument;
the emergency treatment confirmation device is a mechanical button outside the display, the mechanical button comprises a luminous warning device, the emergency treatment warning device is configured to flash after a treatment triggering control is triggered, the luminous warning device is normally on after the mechanical button is pressed to indicate that the emergency treatment confirmation device enters a treatment state, and the luminous warning device is extinguished after treatment is completed.
15. An emergency treatment triggering system as recited in claim 14 wherein the method of performing emergency treatment includes controlling a charging and discharging process of the treatment unit in accordance with treatment parameters.
16. An emergency treatment triggering system according to claim 15, wherein the treatment parameters are received from a treatment message sent by the programmer or stored in a memory unit of the ICD.
17. An emergency treatment triggering system as recited in claim 14 wherein said method of performing emergency treatment includes receiving a termination message from said programmer and terminating an ongoing treatment program.
18. An emergency treatment triggering system as in claim 17 wherein the method of performing emergency treatment includes the programmable logic device sending the termination message after the emergency treatment confirmation device is continuously triggered during the emergency treatment.
CN201911187968.9A 2019-11-28 2019-11-28 Program control instrument and emergency treatment triggering system Active CN110721408B (en)

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