(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT)

(19) World Intellectual Property

Organization
International Bureau
(10) International Publication Number
(43) International Publication Date WO 2015/082318 Al
11 June 2015 (11.06.2015) W P O PCT

(51) International Patent Classification:
A61H 31/00 (2006.01)
(21) International Application Number:
PCT/EP2014/075880
(22) International Filing Date:
28 November 2014 (28.1 1.2014)
(25) Filing Language:
(26) Publication Language:
(30) Priority Data:
13 195433. 1 3 December 2013 (03. 12.2013)
(71) Applicant: KONINKLIJKE PHILIPS N.V. [NL/NL];
High Tech Campus 5, NL-5656 AE Eindhoven (NL).
(72) Inventors: PAULUSSEN, Igor Wilhelmus Franciscus;
c/o High Tech Campus 5, NL-5656 AE Eindhoven (NL).
VAN ROOIJ, Willem-Jan; c/o High Tech Campus 5, NL-
5656AE Eindhoven (NL). WOERLEE, Pierre Her-
manus; c/o High Tech Campus 5, NL-5656AE Eindhoven
(NL). NOORDERGRAAF, Gerrit Jan; c/o High Tech Published:
Campus 5, NL-5656AE Eindhoven (NL).
(74) Agents: VAN IERSEL, Hannie Cornelia Patricia Maria
et al; Philips IP&S, High Tech Campus 5, NL-5656 AE
Eindhoven (NL).
(81) Designated States (unless otherwise indicated, for every
kind of national protection available): AE, AG, AL, AM,
AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY,
BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM,
DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT,
HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR,
KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, MG,
MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM,
English PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, SC,
English SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN,
TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW.
(84) Designated States (unless otherwise indicated, for every
EP
kind of regional protection available): ARIPO (BW, GH,
GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, ST, SZ,
TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU,
TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE,
DK, EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU,
LV, MC, MK, MT, NL, NO, PL, PT, RO, RS, SE, SI, SK,
SM, TR), OAPI (BF, BJ, CF, CG, CI, CM, GA, GN, GQ,
GW, KM, ML, MR, NE, SN, TD, TG).
— with international search report (Art. 21(3))

(54) Title: MOVING BOX AUTOMATED CARDIO PULMONARY RESUSCITATION DEVICE

CB

LI

CL2
f/ /
CP
/

CL1 CB CL1
/ CL2
CP'
\

FIG. 2

(57) Abstract: A Cardiac Pulmonary Resuscitation (CPR) device (CPD) for performing CPR on a patient (PT). A supporting struc -
00 ture (LI, L2, F) with two legs (LI, L2) shaped to accommodate space for the patient's (PT) thorax between them. The legs (LI, L2)
have clamp mechanisms (CL1, CL2) to allow clamping onto a backboard (BB). A compression box (CB) with a plunger mechanism
(PM) with a contact pad (CP) projecting downwards from the enclosure (CS), and a processor (P) for controlling the plunger mech
∞ anism (PM) to perform CPR on the patient (PT) in an automatic manner. A height adjustment mechanism (H) is used to fix a height
© (h) of the compression box (CB) relative to the supporting structure (LI, L2, F). The height adjustment mechanism (H) can allow the
compression box (CB) to move in relation to the supporting structure (LI, L2, F) in a first operating state, by help of gravity.
o Hereby, the compression box (CB) can enter a height (H) where the contact pad is in contact with the patient's (PT) chest, preferably
within a predetermined contact force range, upon clamping of the supporting structure (LI, L2, F) onto the backboard (BB). Hereby,
o the height and contact force parameters are inherently set automatically by the device, when the operator has clamped the CPR
device (CPD) onto the backboard (BB). This setup task is easy for the operator, time without CPR can be saved, and CPR can be mi -
tiated with a correct contact force.
Moving box automated cardio pulmonary resuscitation device

FIELD OF THE INVENTION

The present invention relates to the field of medical devices, more specifically
to the field of automated cardio pulmonary resuscitation (ACPR) devices.

BACKGROUND OF THE INVENTION

Manual Cardio Pulmonary Resuscitation (CPR) is difficult to perform in a
consistent high-quality manner. However, consistent high quality chest compressions, is key
for survival, and thus there is a strong drive to have a mechanical automated CPR device (A-
CPR) to replace less reliable, frequently interrupted, difficult to control, and sometimes
lengthy in duration manual CPR. Examples of A-CPR devices are disclosed in US
2012/0238922 A l and EP 1 913 924 Al, wherein US 2012/0238922 Aldiscloses an A-CPR
device that includes a plunger driven by a drive to perform a compressive massage on a
patient's body, a position measuring device that measures the respective position of the
plunger during its compressive massaging motion, and a holding device for the drive and the
plunger. EP 1 913 924 A l discloses a support for an A-CPR device comprising a back plate,
a front part, and a side part, wherein the front part comprises a seat for a compression
member and that the side part is adapted to provide adjustable spacing between the seat and
the back plate.
A number of A-CPR devices exist, and the market is rapidly growing as
caregivers come to realize their essence. Typically, such devices are mounted on a backboard
on which the patient rests. However, important issues with current A-CPR devices include
long set-up times, low stability during operation of the device, as well as suggestions and
clinical evidence that insufficient force is being applied for optimal performance.
To adjust the height during initial setup, the operator needs to adjust height of
the legs of the device, or to adjust a position of adjusting the length of the plunger mechanism.
However, such setup requires time before CPR can be activated, and often results in a not
optimal starting height, therefore resulting in a not optimal force on the patient's chest, and
hence a not optimal CPR treatment, once the CPR is activated.
SUMMARY OF THE INVENTION
It would be advantageous to provide an A-CPR device and a method for using
such device which allows a fast setup time, and at the same time ensures that a sufficient
contact force is applied during the automatic CPR procedure.
In a first aspect, the invention provides a CPR device arranged to perform
CPR on a patient, the CPR device comprising: the device comprising:
a supporting structure comprising first and second legs shaped to
accommodate space for the patient's thorax between the first and second legs, wherein the
first and second legs each has a clamp mechanism arranged for engagement with
corresponding clamp mechanisms on each side of an associated backboard, so as to allow an
operator to clamp the supporting structure onto the associated backboard,
a compression box comprising an enclosure containing:
a plunger mechanism with a contact pad projecting downwards from
the enclosure, and arranged to provide a chest compression force to the patient's chest, and
a processor arranged to control the plunger mechanism to perform
Cardiac Pulmonary Resuscitation on the patient, and
the device further comprising:
a height adjustment mechanism arranged to fix a height of the compression
box relative to the supporting structure, wherein in a first operating state of the device, upon
clamping of the supporting structure onto the associated backboard, the height adjustment
mechanism is arranged to allow the compression box to slide by gravity in relation to the
supporting structure, so as to press the contact pad against the patient's chest with a force
determined by the mass of the compression box, and
a spring mechanism arranged to force the compression box downwards, so as
to press the contact pad against the patient's chest with a predetermined force.
Such CPR device is advantageous for an easy and fast initial setup, thus
enabling a quick initiation of automated CPR treatment of a patient. At the same time, a
sufficient force on the patient's chest is also ensured by the CPR device. This is obtained,
since, in the first operating state, i.e. an initial state of the CPR during setup, the compression
box is allowed to move. Hereby, the contact pad is allowed to be in contact with the patient's
chest, while an operator clamps the supporting structure onto the associated backboard. Thus,
after the operator has clamped the CPR device onto the associated backboard, a suitable
height of the compression box is automatically obtained without the need for any further
adjustment by the operator, or by the device itself. An advantage is that it is possible to use a
plunger mechanism, where the plunger has a fixed position relative to the compression box,
in contrast to prior art device with moving plunger principles, e.g. a telescopic type plunger
that can be retracted relative to the compression box.
The height can then be manually or automatically fixed by means of the height
adjustment mechanism, whereafter a CPR sequence can immediately be activated. Hereby,
time is saved, and still the weight of the compression box can be matched to provide a
suitable force of the contact pad against the patient's chest by gravity acting on the
compression box. If the patient's chest sink during CPR, a force sensor in the device may be
able to detect that insufficient force is applied, and in response, the height adjustment
mechanism can be automatically released, and the compression box will then be allowed to
move downwards by gravity, and again to press against the patient's chest by a suitable force.
After this, the height adjustment mechanism can again be used to fix the height of the
compression box, and a CPR sequence can be re-activated.
The compression box preferably comprises all necessary electronics and drive
train to be able to perform a CPR sequence on a patient. The CPR device is arranged for the
initial setup of an operator when it is in the first operating state, e.g. an "off state or "stand
by" state, i.e. where the operator is expected to clamp the supporting structure onto an
associated backboard, where the patient rests. Thus, the first and second legs are placed on
each side of the patient's thorax. Activation of a CPR sequence is initiated after the height
adjustment mechanism has fixed the height of the compression box. This height fixation can
be initiated automatically, e.g. in response to sensors in the clamps of the first and second
legs arranged to detect when the supporting structure has been correctly clamped onto the
associated backboard. When this is detected, the height can be fixed, e.g. automatically by
means of an electrical locking mechanism, e.g. by an electrically actuated pin-in-hole
arrangement. The height could also be fixed by the operator by means of a tightening handle,
or another locking mechanism. After the height has been fixed, the processor can be arranged
to automatically activate a CPR sequence, i.e. an "on" state of the device.
Thus, the CPR device is easy to operate, since the operator can be relieved
from the difficult and time consuming task of initially adjusting the height of the contact pad.
Especially, the inexperienced operator may spend a significant amount of time on such task,
and still arrive at a contact pad height which does not provide sufficient force onto the
patient's chest during the CPR. Further, in fully automated versions of the CPR device, i.e.
where the CPR sequence is automatically started after the device has detected correct
clamping of the supporting structure onto the associated backboard, the initial setup
procedure can be completed in a very short time, even by an inexperienced operator, and thus
important non-CPR time can be saved.
Still further, the CPR device is advantageous, since it can be produced in
version where the supporting structure is one rigid structure with fixed legs, because the
compression box is the one that provides the height adjustment. Thus, the overall height of
the device during storage can be limited, since the compression box will can then be in its
lower position. Yet further, with the possibility of a CPR device with a fixed (rigid)
supporting structure, the CPR device may be even easier to setup, since the legs can be
shaped to precisely fit to the backboard clamps, without requiring any initial adjustment or
unfolding of the legs. Even further, the moving compression box allows the legs to be shaped,
e.g. curved, to accommodate good space for the patient's thorax, and still the compression
box can be made compact to provide good visibility of the patient's thorax for the operator
during setup. E.g. a width of the compression box is smaller than a distance between the
clamps on the sides of associated backboard, e.g. smaller than 80% of said width, such as
smaller than 60% of said width, such as smaller than 40%> of said width, thus providing a
good visibility for the operator. In other embodiments, the first and second legs may be
straight, or substantially straight.
The height adjustment mechanism is arranged to allow the
compression box to slide by gravity, so as to press the contact pad against the patient's chest
with a force determined by the mass of the compression box, in the first operating state.
Additionally, a spring mechanism is arranged to force the compression box downwards, so as
to press the contact pad against the patient's chest with a predetermined force, in the first
operating state. Thus, the compression box may be suspended such that it can freely move by
gravity, and thus by selecting the mass of the compression box within a suitable range, it is
possible to control the initial force of the contact pad against the patient's chest. This gravity
principle is combined with an additional spring mechanism to either reduce or increase the
force which the contact pad presses against the patient's chest, in the first operating state.
This allows e.g. a reduction of the mass of the compression box, and still a spring mechanism
can increase the pressing force to a desired value, and thereby enabling a CPR device which
is easy to handle for the operator, and still provides the above-mentioned advantages of
providing enough initial pressing force. Alternatively, means for providing friction force
and/or a spring force may be used to reduce the resulting force of the compression box, in
case the free weight of the compression box will provide a too large contact force.
 The height adjustment mechanism may be arranged to fix a height of the
compression box relative to the supporting structure, in a second operating state. Especially,
the processor may be arranged to enter the second operating state in response to one of: an
input from the operator, and an input from a sensor informing the processor that the
supporting structure has been clamped onto the associated backboard. Thus, the second
operating state, e.g. an "on" state, may be initiated manually by the operator when he/she has
finished clamping the supporting structure onto the associated backboard, or it may be
initiated automatically by the CPR device itself.
The processor may be arranged to initiate a CPR sequence, after the height
adjustment mechanism has fixed the height of the compression box relative to the supporting
structure. Such start of the CPR treatment may be initiated automatically by the processor,
e.g. after it has detected that the height mechanism has fixed, e.g. locked, the height of the
compression box. In case the height adjustment mechanism is to be operated by the operator,
e.g. by tightening a knob, inserting a pint or the like, the CPR sequence may be initiated
either automatically by the processor, or by the operator activating the CPR sequence by
pressing a "start" button. Since there is no need for a manual height adjustment, after the
CPR device has been clamped onto the associated backboard, valuable time may be saved by
an automated detection of correct clamping onto the backboard, an automated initiation of
fixation of the height, and finally an automated initiation of a CPR sequence. Hereby, the
operator is relieved from potentially stressful operations, and unnecessary delays of the CPR
sequence start can be eliminated.
Preferably, the height adjustment mechanism may be arranged to fix a height
of the compression box relative to the supporting structure in one of a plurality of possible
height positions, e.g. a limited number of fixed positions between an upper position and a
lower position, e.g. by means of holes in the compression box structure or a structure rigidly
connected to the compression box, and an electrically operated pin-arrangement fastened to
the supporting structure, serving to engage with one of said holes, so as to fix a height
position of the compression box, and thus provide a rigid connection between the
compression box, and the associated backboard, when the supporting structure has been
clamped onto the backboard. Other methods including applying friction, rack and pinions etc.
may be used additionally or alternatively.
The height adjustment mechanism may be arranged to fix a height of the
compression box relative to the supporting structure in a position corresponding to an actual
height position of the compression box, upon activation of the CPR device. This is
advantageous, since during the initial clamping onto the associated backboard, the
compression box will automatically be in the correct height position, and thus can be fixed in
this position as soon as the manual clamping procedure has been performed. As already
mentioned, the activation of the CPR device may be in response to a manual activation by the
operator, or the processor may activate the CPR device in response to detection that a correct
clamping onto the associated backboard has been obtained.
The height adjustment mechanism may comprise a locking pin arrangement
arranged to fix a height of the compression box relative to the supporting structure, in one of
a limited number of height positions. Such locking pin arrangement can be formed in
different ways, and be automatically controlled by the processor in response to various inputs,
or it can be manually operated by the operator.
The height adjustment mechanism may be arranged to fix a height of the
compression box relative to the supporting structure, in response to an output from the
processor. Hereby, enabling an automatic fixation of the height e.g. in response to the
processor receiving an input from a sensor, e.g. a sensor integrated in one or both clamping
mechanisms of the first and second legs arranged to sense that correct clamping has been
achieved. This may help to eliminate time required for the operator to take the decision and
perform a manual activation of the CPR device after the initial clamping of the supporting
structure onto the associated backboard. However, it is to be understood that it may be
implemented that the contact force may be controlled or adjusted after the height adjustment
procedure has been performed.
The height adjustment mechanism may be arranged to release the compression
box from a fixed height position relative to the supporting structure, in response to an output
from the processor. Hereby, a self-adjustment height mechanism can be obtained without the
need for a motorized height adjustment, since the release of the compression box will allow
the compression box to fall down, e.g. by gravity, to press the contact pad against the
patient's chest with a predetermined force. It is to be understood that this movement of the
compression box may be controlled by introducing friction and/or a spring effect or other
opposing force, in case it is considered that a free falling compression box will provide a too
violent fall of the compression box, and thus a too large force on the patient's chest. Hereby,
the CPR device can adapt to the patient's chest sinking during a CPR sequence, and thus the
CPR device can automatically adapt to this by lowering the compression box, and r e
activating CPR quickly after the height adjustment mechanism has fixed the compression box
in the new, lower position. Especially, the processor may generate said output causing the
release of the compression box in response to a detected force applied to the patient's chest
being below a predetermined threshold value. Thus, during CPR, the CPR device may
monitor the applied force by means of a force sensor, and if the detected force falls below a
predetermined threshold value, CPR can be aborted, and the processor can control the height
adjustment mechanism to release the compression box, which can then fall to a lower height
and thus press against the patient's chest in the same way as during initial setup.
The supporting structure may comprise a frame structure rigidly connected to
the first and second legs, so as to form a rigid supporting structure, and wherein the
compression box is arranged to slide inside the frame. Alternatively, the height adjustment
mechanism may be positioned at least partly inside structures forming the first and second
legs.
In a second aspect, the invention provides a method for initial setup of a
device for performing CPR on a patient. The CPR device comprises a supporting structure
comprising first and second legs shaped to accommodate space for the patient's thorax
between the first and second legs, a compression box comprising an enclosure containing: a
plunger mechanism with a contact pad projecting downwards from the enclosure, and
arranged to provide a chest compression force to the patient's chest, and a processor arranged
to control the plunger mechanism to perform Cardiac Pulmonary Resuscitation on the patient,
a height adjustment mechanism, and a spring mechanism, the method comprising
- entering a first operating state of the device, wherein the height adjustment
mechanism is arranged to allow the compression box to slide by gravity in relation to the
supporting structure with a force determined by the mass of the compression box, and the
spring mechanism is arranged to force the compression box downwards so as to press the
contact pad against the patient's chest with a predetermined force,
- manually clamping the supporting structure onto an associated backboard, and
fixing a height of the compression box by means of the height adjustment
mechanism and the spring mechanism after the supporting structure has been clamped onto
the associated backboard.
As already explained, this method allows elimination of a manual height
adjustment step, thus allowing initial setup to be speeded up, and thus reducing non-active
CPR time. The manual step of clamping the supporting structure onto the associated
backboard is the only manual task for the operator to perform, which can be made an easy
task with a rigid supporting structure with fixed legs that fit to the size of the associated
backboard and which may be fitted with clamps that allow the operator to have an audible
click as feedback of the CPR device being correctly clamped onto the associated backboard.
The CPR device may then automatically fix the height and initiate a CPR sequence without
any further involvement of the operator.
It is appreciated that the same advantages and embodiments of the first aspect
apply as well for the second aspect. In general the first and second aspects may be combined
and coupled in any way possible within the scope of the invention. These and other aspects,
features and/or advantages of the invention will be apparent from and elucidated with
reference to the embodiments described hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the invention will be described, by way of example only,
with reference to the drawings, in which
FIG. 1 illustrates a sketch of an embodiment seen from above,
FIG. 2 illustrates side view sketches of an embodiment with the compression
box in lower and upper position,
FIG. 3 illustrates side view sketches of another embodiment with the
compression box in lower and upper position,
FIG. 4 illustrates two steps of a method for mounting a CPR device onto a
backboard with a patient lying thereon,
FIG. 5 illustrates two steps of another method for mounting a CPR device onto
a backboard with a patient lying thereon,
FIG. 6 illustrates a block diagram of an example of elements contained in a
compression box of a CPR device embodiment, and
FIG. 7 illustrates a diagram of steps of a method embodiment.

DESCRIPTION OF EMBODIMENTS
FIG. 1 illustrates a CPR device embodiment seen from above. The CPR device
comprises a supporting structure with two legs LI, L2 shaped to accommodate space for the
patient's thorax between the two legs LI, L2. The two legs LI, L2 are rigidly connected to a
frame F. The two legs LI, L2 each has a clamp mechanism CL1, CL2 arranged for
engagement with corresponding clamp mechanisms on each side of an associated backboard.
Hereby, an operator can clamp the supporting structure onto a backboard, such that the
supporting structure is locked in position onto the backboard. Preferably, the legs LI, L2 and
the frame F are rigidly connected and shaped such that the clamp mechanisms CL1, CL2 fit
onto the clamp mechanisms on the backboard. Hereby, the operator can easily position the
CPR device and clamp it onto the backboard.
A compression box CB is arranged within the frame F, and the compression
box CB comprises an enclosure containing a plunger mechanism, and a processor arranged to
control the plunger mechanism. A contact pad projects downwards from the enclosure, and
the contact pad is arranged to provide a chest compression force to the patient's chest by
moving up and down, and thus perform CPR on a patient. The plunger mechanism is
preferably fixed in relation to the enclosure of the compression box.
The compression box CB is mounted to a height adjustment mechanism H
which is arranged to fix a height of the compression box CB relative to the supporting
structure LI, L2, F. To perform CPR, the compression box CB needs to be fixed to the
supporting structure LI, L2, F so as to be able to provide the necessary plunging forces onto
the patient's chest. However, during setup, i.e. in an initial state or mode of the CPR device,
the height adjustment mechanism H is arranged to allow the compression box CB to move in
relation to the supporting structure LI, L2, F, so as to allow the compression box CB to enter
a height where the contact pad is in contact with the patient's chest, upon clamping of the
supporting structure LI, L2, F to the backboard.
Especially, the height adjustment mechanism H may comprise a suspension
mechanism that controls horizontal movements of the compression box CB, e.g. in each side
as shown, but allows the compression box CB to move by gravity in vertical direction (i.e. in
and out of the paper plane on FIG. 1), to allow adjust a height of the compression box CB
between an upper and a lower limit. Thus, during clamping of the CPR device onto the
backboard, the contact pad will by gravity on the compression box CB be forced in contact
with the patient's chest with a predetermined force. When clamped onto the backboard, the
vertical position of the compression box CB is thus automatically set to a proper height to
start a CPR sequence after the height adjustment mechanism has fixed the height of the
compression box relative to the supporting structure LI, L2, F, e.g. by an electrically actuated
locking mechanism controlled by the processor, e.g. in response to sensors positioned to
sense that the clamps CLl, CL2 are properly locked to the backboard. Hereby, the processor
can automatically initiate fixing of the height, and immediately afterwards control the
plunger mechanism to initiate a CPR sequence. Hereby, the role of the operator is limited to
perform the clamping of the CPR device onto the backboard. The CPR device can then
automatically initiate a CPR sequence without any delaying factors, and without the operator
having to perform any complicated adjustment of the height that influences the compression
force of the CPR, and therefore also the effectiveness of the CPR treatment.
It is to be understood that there are several other methods to implement a
height locking mechanism for fixing the height of the compression box CB. Such methods
may either be automatically operated by the CPR device itself, or manually operated by the
operator of the CPR device.
During storage, the CPR device is preferably in the initial non-activated state,
where the compression box CB can freely move by gravity to its lower position, and thus
occupy only a limited storage space. Further, the operator does not need to activate the device
to perform the initial step of clamping it onto the backboard.
Alternative to the fully automated version, the operator may press a "start"
button to activate the height fixation and the subsequent automatic initiation of a CPR
sequence.
FIG. 2 shows a sketch of a CPR device embodiment with a supporting
structure formed by a rigid connection of curved legs LI, L2 and a frame F in which a
compression box CB is suspended. In principle the embodiment on FIG. 2 is structurally
similar to the embodiment shown from above in FIG. 1. The legs are curved to provide space
for the patient's thorax, and the rather narrow compression box CB provides a good view to
the patient for the operator, during the setup procedure. Each leg LI, L2 has a clamp
mechanism CL1, CL2 on its lower end to enable clamping onto a backboard. The height
adjustment mechanism is not visible, but arranged within the frame F, see e.g. FIG. 1.

As seen, the contact pad CP of the plunger mechanism is visible, since it

projects downwards from the enclosure or casing of the compression box CB. In the
illustration to the left, the compression box is in its lower position, thus providing the contact
pad CP to be in the smallest possible height h . In the illustration to the right, the compression
box is shown in its upper position, i.e. where the contact pad is in the position providing the
largest possible height h .
FIG. 3 shows a side view of another embodiment, where the height adjustment
mechanism is arranged within the structure of the straight vertically extending legs LI, L2,
thus allowing the compression box CB to slide to its lower position, shown to the left, and to
its upper position, shown to the right. In this embodiment, the compression box CB fills the
space between the legs LI, L2, however in such embodiment it may be possible to reduce the
thickness of the compression box CB, thus still to provide a good visibility for the operator.
The structures of the two legs LI, L2 are not structurally linked in this embodiment. Thus, it
may be preferred to provide synchronization means to link a position of the two legs LI, L2
such that both legs have always equal position with respect to the compression box CB. This
may be achieved by a mechanical link, and/or by an electric motor being controlled by
electronic synchronization means.
FIG. 4 shows, for the CPR device embodiment of FIG. 2, one possible way of
clamping the CPR device CPD onto a backboard BB, where the thorax of the patient PT is
positioned, to show the principle of the moving compression box during initial setup of the
CPR device CPD. To the left, the an operator (not shown) has lifted the CPR device CPD
above the patient PT, and as seen the compression box is here in its lower position. To the
right, the operator (not shown) has now moved the CPR device CPD vertically downwards to
make the clamps of the CPR device CPR engage with the corresponding clamp mechanisms
on both side of the backboard BB at the same time. During this procedure, the contact pad is
forced into contact with the patient's PT chest, due to gravity acting on the vertically free
moving compression box, and thus the compression box rests on the patient's PT chest
during the clamping procedure. When clamped onto the backboard BB, the compression box
is thus in correct height position for start of CPR, and the operator can push a "start" button,
or the CPR device may automatically start by fixing the height of the compression box, and
subsequently start CPR treatment.
FIG. 5 shows a variant of the initial setup method in FIG. 4 . Here, the operator
(not shown) has lifted the CPR device CPD over the patient PT and clamped the CPR device
CPD onto one side of the backboard BB. Then the operator (not shown) tilts the CPR device
to bring the opposite side clamp into engagement with the backboard, and during this tilting
operation, the freely moving compression box will force the contact pad into contact with the
patient's PT chest, and thus finally, when clamped onto both sides of the backboard, the
compression box will provide the correct pressure force of the contact pad onto the patient's
PT chest.
It is to be understood that the plunger mechanism, contact pad, the processor
and the CPR sequence referred to above can be selected such as known by the skilled person.
The function related to the setup of the CPR device according to the invention, as explained
above, may be program code forming part of the control program executed by the processor.
The compression box may contain a battery to power the processor and the plunger
mechanism, however the processor and plunger mechanism may alternatively be powered by
an external power supply. Further, the CPR device may comprise an interface with indicators
indicating the state or mode of the CPR device to the operator, and possibly one or more
operator input means for the operator to control the function of the CRP device. Preferably,
the compression box is suspended to provide a height between contact pad and backboard
surface of such as 16 cm to 34 cm.
It is further to be understood that the force on the patient's chest referred to
will also be known by the skilled person. Thus, the weight of the compression box, or its
weight in combination with any spring mechanism acting on the compression box, can be
selected so as to be within a suitable range for initial force on the patient's chest when
starting CPR with an active CPR device.
FIG. 6 shows a block diagram of elements contained inside an embodiment of
a compression box for a CPR device. A casing CS forms an enclosure around a plunger
mechanism PM controlled by a processor P. A rechargeable battery BT serves to deliver
power to the processor and the plunger mechanism PM. The processor P can receive an input
CL P indicative of clamping of the backboard has been performed. In response, the
processor can control the height adjustment mechanism H to fix the height of the
compression box, e.g. by activating a locking mechanism. The processor P can then start
controlling the plunger mechanism PM to run a CPR sequence. The plunger mechanism PM
is connected to a contact pad CP which projects downward from the compression box to
allow contact with the patient's chest. The CPR is performed by the plunger mechanism PM
moving the contact pad CP up and down (see double arrow), so as to provide compressions
of the patient's chest.
The processor P can receive an optional force censor input FC input from a
force sensor arranged to sense the compression force on the patient's chest. When the
processor detects an insufficiently low force during a CPR sequence, the processor can be
programmed to stop the CPR sequence, to release the fixation of the compression box height
in the height adjustment mechanism H . This allows the compression box to slide downwards,
thus entering a new, lower height position. The processor P can then activate fixation in this
new, lower height position, where the contact pad CP is again forced towards the patient's
chest with the force provided by gravity acting on the compression box. The processor may
also be capable of detecting a force censor input FC from a force sensor, and in case the
sensed force is above a predetermined threshold, the processor P may be arranged to cause
the plunger mechanism PM to retract, so as to reduce the applied contact force.
FIG. 7 illustrates steps of a method embodiment for initial setup of a CPR
device for performing CPR on a patient. The device has a supporting structure with two legs
shaped to accommodate space for the patient's thorax between them. A compression box has
an enclosure containing: a plunger mechanism with a contact pad projecting downwards from
the enclosure, and arranged to provide a chest compression force to the patient's chest, and a
processor arranged to control the plunger mechanism to perform CPR on the patient, and a
height adjustment mechanism. First step is to enter an initial operating state CB M of the
CPR device, which is preferably an in-active state, or an "off state, which the CPR device is
already in during normal storage. In this state CB M, the compression box is allowed to
move freely in relation to the supporting structure between a lower and upper position, so as
to allow the compression box to enter a height where the contact pad is in contact with the
patient's chest. Next, the operator manually clamps M CL the supporting structure onto the
backboard. During this step, the compression box will be in its lower position, when the
operator lifts the CPR device, and during the step of manually clamping the supporting
structure of the CPR device onto the backboard, the contact pad will be forced into contact
with the patient's chest, and thus apply a force on the patient's chest, when the CPR device is
clamped onto the backboard. Then, the height of the compression box is fixed F_H by means
of the height adjustment mechanism after the supporting structure has been clamped onto the
associated backboard. This is possible immediately after the clamping procedure, since the
compression box will automatically be at the correct height position for starting of a CPR
sequence. Thus, after fixing the height of the compression box relative to the supporting
structure, the compression box is in fixed connection with the backboard, and then finally,
CPR can be initiated I CPR.
As already explained, the various steps expect the manual clamping M CL
onto the backboard, can be performed automatically by the CPR device, or it can involve the
operator starting the CPR device, and it can even involve the operator manually fixing the
height F_H after the clamping procedure M CL.
The invention allows a CPR device with a fast device setup and initial setup
workflow. Interruptions are important to minimize. With the use of the moving compression
box principle, device setup can be executed faster, which is a key aspect in minimizing no
CPR compression time on a patient. The setup can be faster because the application of the
CPR device on the backboard and the height adjustment of the compression box including the
contact pad can be performed as one single fluent step. This allows saving of a critical step in
the setup procedure over the prior art concepts. The preferred setup solution only consists of
the application of the backboard under the patient, and applying the CPR device onto the
correct spot on the sternum of the patient without the operator having to take the hands of the
CPR device at any time, requiring a total of two steps.
 It is difficult to place the contact pad with the correct force on the thorax so
that the contact pad is not leaning on the chest. Another challenge is adapting to molding of
the patient's chest during ongoing CPR compressions. Molding means that due to the
resuscitation the distance between the back and the sternum of the patient becomes less
because the sternum does not return to its starting position. With the CPR device according to
the invention, setup of the CPR device can automatically adjust for too much and to less
force on the contact pad. When there is too much force on the contact pad the pad, the contact
pad can be pulled back a bit by the compression box so that the pad is keeping contact with
the chest with less force. When there is too less force on the chest, e.g. due to molding, the
CPR device can release the fixing of the height, and let the moving box move down by
gravity. The CPR device can the again fix or lock the height of the compression box and
continue CPR. If the moving box was lowered too much so that the pad is with too much
force on the chest, the compression pad can be pulled back a bit so that the pad is with less
force on the chest and then continue CPR.
It is important to have a good view on the chest surface for an operator. With
the CPR device according to the invention, the compression box is always as close as
possible to the patient's chest, due to gravity during setup, and the view on the chest surface
is thus optimal. It is also an advantage when the device is used in a cathlab. In a cathlab a C-
arm X-ray device moves around the patient. Thus, more free space above the patient
facilitates free movement of the X-ray device around the patient.
Shift of compression point position is unacceptable. A key requirement is to
have a stable CPR device. Position of the contact pad during operation is very important and
could be disturbed by e.g. vibration /mechanical shock during transport in ambulances or
helicopters. Furthermore, rocking of the CPR device due to the complex chest deformation is
reduced. With the use of the moving compression box principle, CPR device according to the
invention has a low center of mass compared to moving plunger CPR devices. Thus, the low
center of mass results in a more stable device which is less vulnerable for disturbances which
lead to incorrect compressions and safety issues for the patient and caregiver in case of rapid
speed changes of the vehicle in which CPR is being performed. Further, because the plunger
mechanism can be made with a short arm (because the compression box is near the patient,
the plunger can be short), disturbances at the top of the plunger will not translate to large
movements at the patient.
With the use of a the moving compression box, the total device height is as
low as possible for a specific patient. This is important for patients with chest sizes and
thicknesses smaller than the maximum device limit. In contrast, a moving plunger device has
total device height being fixed, and thus always maximum. Keeping the device low can be an
advantage for accessing the patient, for fitting the device in an ambulance/helicopter or for
possible (CT-) scans that require a certain proximity or angle with respect to the patient. Still
further, the CPR device can be packaged in a compact way, and thus fits in ambulances etc.
with small storage spaces.
To sum up, the invention provides a CPR device CPD for performing CPR on
a patient PT. A supporting structure LI, L2, F with two legs LI, L2 shaped to accommodate
space for the patient's PT thorax between them. The legs LI, L2 have clamp mechanisms
CL1, CL2 to allow clamping onto a backboard BB. A compression box CB with a plunger
mechanism PM with a contact pad CP projecting downwards from the enclosure CS, and a
processor P for controlling the plunger mechanism PM to perform CPR on the patient PT in
an automatic manner. A height adjustment mechanism H is used to fix a height h of the
compression box CB relative to the supporting structure LI, L2, F. The height adjustment
mechanism H can allow the compression box CB to move in relation to the supporting
structure LI, L2, F in a first operating state, by help of gravity. Hereby, the compression box
CB can enter a height H where the contact pad is in contact with the patient's PT chest,
preferably within a predetermined contact force range, upon clamping of the supporting
structure LI, L2, F onto the backboard BB. Hereby, the height and contact force parameters
are inherently set automatically by the device, when the operator has clamped the CPR
device CPD onto the backboard BB. This setup task is easy for the operator, time without
CPR can be saved, and CPR can be initiated with a correct contact force.
While the invention has been illustrated and described in detail in the drawings
and foregoing description, such illustration and description are to be considered illustrative or
exemplary and not restrictive; the invention is not limited to the disclosed embodiments.
Other variations to the disclosed embodiments can be understood and effected by those
skilled in the art in practicing the claimed invention, from a study of the drawings, the
disclosure, and the appended claims. In the claims, the word "comprising" does not exclude
other elements or steps, and the indefinite article "a" or "an" does not exclude a plurality. A
single processor or other unit may fulfill the functions of several items recited in the claims.
The mere fact that certain measures are recited in mutually different dependent claims does
not indicate that a combination of these measured cannot be used to advantage. A computer
program may be stored/distributed on a suitable medium, such as an optical storage medium
or a solid-state medium supplied together with or as part of other hardware, but may also be
distributed in other forms, such as via the Internet or other wired or wireless
telecommunication systems. Any reference signs in the claims should not be construed as
limiting the scope.
CLAIMS:

1. A Cardiac Pulmonary Resuscitation device (CPD) arranged to perform

Cardiac Pulmonary Resuscitation on a patient (PT), the device (CPD) comprising:
a supporting structure (LI, L2, F) comprising first and second legs (LI, L2)
shaped to accommodate space for the patient's (PT) thorax between the first and second legs
(LI, L2), wherein the first and second legs (LI, L2) each has a clamp mechanism (CL1, CL2)
arranged for engagement with corresponding clamp mechanisms on each side of an
associated backboard (BB), so as to allow an operator to clamp the supporting structure (LI,
L2, F) onto the associated backboard (BB),
a compression box (CB) comprising an enclosure (CS) containing:
a plunger mechanism (PM) with a contact pad (CP) projecting
downwards from the enclosure (CS), and arranged to provide a chest compression force to
the patient's (PT) chest, and
a processor (P) arranged to control the plunger mechanism (PM) to
perform Cardiac Pulmonary Resuscitation on the patient (PT), and
the device further comprising:
a height adjustment mechanism (H) arranged to fix a height (h) of the
compression box (CB) relative to the supporting structure (LI, L2, F), wherein
in a first operating state of the device (CPD), upon clamping of the supporting structure (LI,
L2, F) onto the associated backboard (BB), the height adjustment mechanism (H) is arranged
to allow the compression box (CB) to slide by gravity in relation to the supporting structure
(LI, L2, F), so as to press the contact pad (CP) against the patient's (PT) chest with a force
determined by the mass of the compression box (CB), and
a spring mechanism arranged to force the compression box (CB) downwards,
so as to press the contact pad (CP) against the patient's (PT) chest with a predetermined force.

2. Device according to claim 1, wherein the height adjustment mechanism (H) is

arranged to fix a height (h) of the compression box (CB) relative to the supporting structure
(LI, L2, F), in a second operating state.
3. Device according to claim 2, wherein the processor (P) is arranged to enter the
second operating state in response to one of: an input from the operator, and an input (CL P)
from a sensor informing the processor (P) that the supporting structure (LI, L2, F) has been
clamped onto the associated backboard (BB).

4. Device according to claim 1, wherein the processor (P) is arranged to

automatically initiate a Cardiac Pulmonary Resuscitation sequence after the height
adjustment mechanism (H) has fixed the height (h) of the compression box (CB) relative to
the supporting structure (LI, L2, F).

5. Device according to claim 1, wherein the height adjustment mechanism (H) is

arranged to fix a height (h) of the compression box (CB) relative to the supporting structure
(LI, L2, F) in one of a plurality of possible height positions.

6. Device according to claim 1, wherein the height adjustment mechanism (H) is

arranged to fix a height (h) of the compression box (CB) relative to the supporting structure
(LI, L2, F) in a position corresponding to an actual height position of the compression box
(CB), upon activation of the device.

7. Device according to claim 1, wherein the height adjustment mechanism (H)

comprises a locking pin arrangement arranged to fix a height (h) of the compression box (CB)
relative to the supporting structure (LI, L2, F), in one of a limited number of height positions.

8. Device according to claim 1, wherein the height adjustment mechanism (H) is

arranged to fix a height (h) of the compression box (CB) relative to the supporting structure
(LI, L2, F), in response to an output from the processor (P).

9. Device according to claim 1, wherein the height adjustment mechanism (H) is

arranged to release the compression box (CB) from a fixed height position relative to the
supporting structure (LI, L2, F), in response to an output from the processor (P).

10. Device according to claim 9, wherein the processor (P) generates said output
in response to a detected force (FC) applied to the patient's (PT) chest being below a
predetermined threshold value.
11. Device according to claim 1, wherein the supporting structure (L 1, L2, F)
comprises a frame structure (F) rigidly connected to the first and second legs (LI, L2), so as
to form a rigid supporting structure (LI, L2, F), and wherein the compression box (CB) is
arranged to slide inside the frame (F).

12. Device according to claim 1, wherein the height adjustment mechanism (H) is
positioned at least partly inside structures forming the first and second legs (LI, L2).

13. A method for initial setup of a device (CPD) for performing Cardiac
Pulmonary Resuscitation on a patient (PT), the device comprising a supporting structure (LI,
L2, F) comprising first and second legs (LI, L2) shaped to accommodate space for the
patient's (PT) thorax between the first and second legs (LI, L2), a compression box (CB)
comprising an enclosure containing: a plunger mechanism (PM) with a contact pad (CP)
projecting downwards from the enclosure (CS), and arranged to provide a chest compression
force to the patient's (PT) chest, and a processor (P) arranged to control the plunger
mechanism (PM) to perform Cardiac Pulmonary Resuscitation on the patient (PT), a height
adjustment mechanism (H), and a spring mechanism
entering (CB_M) a first operating state of the device, wherein the height
adjustment mechanism (H) is arranged to allow the compression box (CB) to slide by gravity
in relation to the supporting structure (LI, L2, F) with a force determined by the mass of the
compression box (CB), and the spring mechanism is arranged to force the compression box
(CB) downwards so as to press the contact pad (CP) against the patient's (PT) chest with a
predetermined force,
- manually clamping (M CL) the supporting structure (LI, L2, F) onto an
associated backboard (BB), and
fixing a height (F_H) of the compression box (CB) by means of the height
adjustment mechanism (H) and the spring mechanism after the supporting structure (LI, L2,
F) has been clamped onto the associated backboard (BB).
 INTERNATIONAL SEARCH REPORT

Box No. II Observations where certain claims were found unsearchable (Continuation of item 2 of first sheet)

This international search report has not been established in respect of certain claims under Article 17(2)(a) for the following reasons:

Claims Nos.: 3
because they relate to subject matter not required to be searched by this Authority, namely:

see FURTHER INFORMATION sheet PCT/ISA/210

□ Claims Nos.:
because they relate to parts of the international application that do not comply with the prescribed requirements to such
an extent that no meaningful international search can be carried out, specifically:

3. □
I I Claims Nos.:
because they are dependent claims and are not drafted in accordance with the second and third sentences of Rule 6.4(a).

Box No. Ill Observations where unity of invention is lacking (Continuation of item 3 of first sheet)

This International Searching Authority found multiple inventions in this international application, as follows:

□ As all required additional search fees were timely paid by the applicant, this international search report covers all searchable
claims.

□ As all searchable claims could be searched without effort justifying an additional fees, this Authority did not invite payment of
additional fees.

As only some of the required additional search fees were timely paid by the applicant, this international search report covers
only those claims for which fees were paid, specifically claims Nos. :

4. I I No required additional search fees were timely paid by the applicant. Consequently, this international search report is
restricted to the invention first mentioned in the claims; it is covered by claims Nos. :

Remark o n Protest The additional search fees were accompanied by the applicant's protest and, where applicable, the
' ' payment of a protest fee.
The additional search fees were accompanied by the applicant's protest but the applicable protest
' ' fee was not paid within the time limit specified in the invitation.

I INo protest accompanied the payment of additional search fees.

Form PCT/ISA/21 0 (continuation of first sheet (2)) (April 2005)

A . CLASSIFICATION O F SUBJECT MATTER
INV. A61H31/00
ADD.

According to International Patent Classification (IPC) o r t o both national classification and IPC

B . FIELDS SEARCHED
Minimum documentation searched (classification system followed by classification symbols)
A61H

Documentation searched other than minimum documentation to the extent that such documents are included in the fields searched

Electronic data base consulted during the international search (name of data base and, where practicable, search terms used)

EPO-Internal , WPI Data

C . DOCUMENTS CONSIDERED TO B E RELEVANT

Category* Citation of document, with indication, where appropriate, of the relevant passages Relevant to claim No.

US 2012/238922 Al (STEMPLE GUENTER [DE] ET 1-12

AL) 20 September 2012 (2012-09-20)
paragraphs [0040] , [0043] , [0069] ;
f i gures 1-3

F R 1 331 573 A (G0DEL E. ) 1-12

5 July 1963 (1963-07-05)
page 1, r i ght-hand col umn , l i nes 11-33 ;
f i gure 1

EP 1 913 924 Al ( LAERDAL MEDICAL AS [NO] ) 1-12

23 Apri l 2008 (2008-04-23)
paragraphs [0021] , [0022] , [0027] ,
[0042] ; f i gure 8

US 2010/113990 Al (CHANG TI -LI [T ] ) 1-12

6 May 2010 (2010-05-06)
the whol e document

-/-
X| Further documents are listed in the continuation of Box C . XI See patent family annex.

* Special categories of cited documents :

"T" later document published after the international filing date o r priority
date and not in conflict with the application but cited to understand
"A" document defining the general state of the art which is not considered
the principle o r theory underlying the invention
to be of particular relevance
"E" earlier application o r patent but published o n o r after the international
"X" document of particular relevance; the claimed invention cannot be
filing date considered novel o r cannot b e considered to involve a n inventive
"L" documentwhich may throw doubts o n priority claim(s) orwhich is step when the document is taken alone
cited to establish the publication date of another citation o r other
"Y" document of particular relevance; the claimed invention cannot be
special reason (as specified)
considered to involve a n inventive step when the document is
"O" document referring to a n oral disclosure, use, exhibition o r other combined with one o r more other such documents, such combination
means being obvious to a person skilled in the art
"P" document published prior to the international filing date but later than
the priority date claimed "&" document member of the same patent family

Date of the actual completion of the international search Date of mailing of the international search report

2 February 2015 10/02/2015

Name and mailing address of the ISA/ Authorized officer
European Patent Office, P.B. 5818 Patentlaan 2
NL - 2280 HV Rijswijk
Tel. (+31-70) 340-2040,
Fax: (+31-70) 340-3016 Fi scher, Elmar

page 1 of 2
C(Continuation). DOCUMENTS CONSIDERED TO BE RELEVANT

Category* Citation of document, with indication, where appropriate, of the relevant passages Relevant to claim No.

WO 2008/097153 A l (JOLIFE AB [SE] ; KING 1-12

BEN [NZ]) 14 August 2008 (2008-08-14)
page 11, lines 2-12; figures 3a, 3b

US 2010/198118 A l (ITNATI MICHAEL ITAI 1-12

[IL]) 5 August 2010 (2010-08-05)
paragraph [0252]; figure 7B

page 2 of 2
 Patent document Publication Patent family Publication
cited in search report date member(s) date

US 2012238922 Al 20-09-2012 D E 102011014304 A l 20-09-2012

EP 2500008 A2 19- 09-2012
JP 2012192190 A 11-10-2012
US 2012238922 A l 20- 09-2012

FR 1331573 A 05 -07 -1963 NONE

EP 1913924 Al 23 -04 -2008 AT 483440 T 1 5 -10 -2010

AU 2007229410 Al 08 -05 -2008
EP 1913924 Al 23 -04 -2008
P 5073445 B2 1 4 -11 -2012
P 2008119460 A 29 -05 -2008

US 2010113990 Al 06 -05 -2010 NONE

O 2008097153 Al 14 -08 -2008 EP 2114343 A l 1 1 -11 -2009

US 2010004572 A l 07 -01 -2010
O 2008097153 A l 1 4 -08 -2008

US 2010198118 Al 05 -08 -2010 NONE

 International Application No. PCT/ EP2Q14/ Q7588Q

FURTHER INFORMATION CONTINUED FROM PCT/ISA/ 210

Conti nuati on of Box I I . l

Cl aims Nos . : 13

Rul e 39 . 1( ) PCT - Method for treatment of the human or animal body by

therapy. I n parti cul ar, i ndependent cl aim 13 i s di rected t o method
encompassi ng cardi o pulmonary resusci tati on , si nce accordi ng t o the
descri pti on (see al so cl aim 4) , after the hei ght has been f i xed, the
processor can be arranged t o automati cal l y acti vate a CPR sequence.