US-12616843-B2 - Techniques for managing inconclusive or disagreeing results in analyses of physiological parameters

US12616843B2US 12616843 B2US12616843 B2US 12616843B2US-12616843-B2

Abstract

An example method includes generating first filtered data by applying a first filter to physiological parameter data representing the physiological parameter; generating second filtered data by applying a second filter to the physiological parameter data; and determining a first index by analyzing the first filtered data. The example method further includes determining that the first index is greater than a first threshold and lower than a second threshold; and in response to determining that the first index is greater than the first threshold and lower than the second threshold, displaying the second filtered data. Upon expiration of a time period after outputting the second filtered data, the method further includes determining a second index by analyzing the first filtered data; generating a first treatment recommendation by analyzing the second index; and displaying the first treatment recommendation.

Inventors

Tyson G. Taylor
Doan Huu Dinh

Assignees

STRYKER CORPORATION

Dates

Publication Date: 20260505
Application Date: 20230928

Claims (20)

1 . A monitor-defibrillator, comprising: a detection circuit configured to detect an ECG of a subject; a discharge circuit configured to output an electrical shock to the subject; an input device; a display; and a processor configured to: determine that first data indicating the ECG of the subject during a pre-charge time period is indicative of ventricular fibrillation (VF) or ventricular tachycardia (VT); in response to determining that the first data is indicative of VF or VT, cause the display to output a recommendation to administer the electrical shock to the subject; in response to causing the display to output the recommendation, determine that the input device has received an input signal indicating a request to administer the electrical shock to the subject; in response to determining that the input device has received the input signal, cause the discharge circuit to charge during a CPR period, the subject receiving chest compressions during the CPR period; determine that second data indicating the ECG of the subject during the CPR period is indicative of QRS complexes; and in response to determining that the second data is indicative of QRS complexes, cause the discharge circuit to refrain from outputting the electrical shock to the subject.
2 . The monitor-defibrillator of claim 1 , wherein the processor is configured to determine that the first data is indicative of VF or VT by: determining a shock index by analyzing the first data; and determining that the shock index is above an upper threshold or below a lower threshold.
3 . The monitor-defibrillator of claim 2 , the shock index being a first shock index, wherein the processor is configured to determine that the second data is indicative of QRS complexes by: determining a second shock index by analyzing the second data; and determining that the second shock index is below the lower threshold or above the upper threshold.
4 . A medical device, comprising: a detection circuit configured to detect a physiological parameter of a subject; a treatment component configured to output a treatment to the subject; an input device; a display; and a processor configured to: determine an index by analyzing first data indicating the physiological parameter of the subject during a first time period; determine that the index is below a first threshold or above a second threshold; in response to determining that the index is below the first threshold or above the second threshold, cause the display to output a recommendation to administer the treatment to the subject; in response to causing the display to output the recommendation, determine that the input device has received an input signal indicating a request to administer the treatment to the subject; in response to determining that the input device has received the input signal, cause the treatment component to prepare the treatment during a second time period; determine that second data indicating the physiological parameter of the subject during the second time period is indicative of a non-pathologic condition; and in response to determining that the second data is indicative of the non-pathologic condition, cause the treatment component to refrain from outputting the treatment to the subject.
5 . The medical device of claim 4 , wherein the processor is configured to determine that the index is below the first threshold or above the second threshold by determining that the physiological parameter is indicative of VF or VT.
6 . The medical device of claim 4 , the index being a first index, wherein the processor is configured to determine that the second data is indicative of the non-pathologic condition by: determining a second index by analyzing the second data; and determining that the second index is below the first threshold or above the second threshold.
7 . The medical device of claim 4 , wherein the subject is receiving chest compressions during the second time period.
8 . The medical device of claim 4 , wherein the processor is further configured to cause the display to present an alert upon determining that the second data is indicative of the non-pathologic condition.
9 . The medical device of claim 4 , further comprising: a speaker configured to audibly present an alert, wherein the processor is further configured to cause the speaker to output the alert upon determining that the second data is indicative of the non-pathologic condition.
10 . The medical device of claim 4 , wherein the processor is further configured to: in response to causing the treatment component to refrain from outputting the treatment to the subject, cause the display to output a selectable option to discharge a voltage stored in the treatment component.
11 . The medical device of claim 4 , the index being a first index, the recommendation being a first recommendation, the input signal being a first input signal, wherein the processor is further configured to: in response to causing the treatment component to refrain from outputting the treatment to the subject, determine a second index by analyzing third data indicating the physiological parameter of the subject; determine that the second index is below the first threshold or above the second threshold; in response to determining that the second index is below the first threshold or above the second threshold, cause the display to output a second recommendation to administer the treatment to the subject; in response to causing the display to output the second recommendation, determine that the input device has received a second input signal indicating a request to administer the treatment to the subject; in response to determining that the input device has received the second input signal, cause the treatment component to charge during a fourth time period, wherein the subject is receiving chest compressions during the fourth time period; determine a third index by analyzing the physiological parameter of the subject during the fourth time period; determine that the third index is below the first threshold or above the second threshold; and in response to determining that the third index is below the first threshold or above the second threshold, cause the treatment component to output the treatment to the subject.
12 . The medical device of claim 4 , wherein the physiological parameter comprises an ECG, a transthoracic impedance, an airway parameter, a blood oxygenation, or a blood pressure; and wherein the treatment comprises an electrical shock, chest compressions, or ventilation.
13 . A method performed by a medical device comprising a treatment component configured to output a treatment to a subject, the method comprising: determining an index by analyzing first data indicating a physiological parameter of the subject during a first time period; determining that the index is below a first threshold or above a second threshold; in response to determining that the index is below a first threshold or above a second threshold, displaying a recommendation to administer the treatment to the subject; in response to displaying the recommendation, determining that an input device has received an input signal indicating a request to administer the treatment to the subject; in response to determining that the input device has received the input signal, causing the treatment component to prepare the treatment during a second time period; determining that second data indicating the physiological parameter of the subject during the second time period is indicative of a non-pathologic condition; and in response to determining that the second data is indicative of the non-pathologic condition, causing the treatment component to refrain from outputting the treatment to the subject.
14 . The method of claim 13 , wherein determining that the index is below the first threshold or above the second threshold comprises determining that the physiological parameter is indicative of VF or VT.
15 . The method of claim 13 , the index being a first index, the method further comprising: determining that the second data is indicative of the non-pathologic condition by: determining a second index by analyzing the second data; and determining that the second index is below the first threshold or above the second threshold.
16 . The method of claim 13 , wherein the subject is receiving chest compressions during the second time period.
17 . The method of claim 13 , further comprising: outputting an alert upon determining that the second data is indicative of the non-pathologic condition, wherein the alert is a visual alert or an audible alert.
18 . The method of claim 13 , further comprising: in response to causing the treatment component to refrain from outputting the treatment to the subject, displaying a selectable option to discharge a voltage stored in the treatment component.
19 . The method of claim 13 , the index being a first index, the recommendation being a first recommendation, the input signal being a first input signal, the method further comprising: in response to causing the treatment component to refrain from outputting the treatment to the subject, determining a second index by analyzing third data indicating the physiological parameter of the subject; determining that the second index is below the first threshold or above the second threshold; in response to determining that the second index is below the first threshold or above the second threshold, displaying a second recommendation to administer the treatment to the subject; in response to displaying the second recommendation, determining that the input device has received a second input signal indicating a request to administer the treatment to the subject; in response to determining that the input device has received the second input signal, causing the treatment component to charge during a fourth time period, wherein the subject is receiving chest compression during the fourth time period; determining a third index by analyzing the physiological parameter of the subject during the fourth time period; determine that the third index is below the first threshold or above the second threshold; and in response to determining the third index is below the first threshold or above the second threshold, causing the treatment component to output the treatment to the subject.
20 . The method of claim 13 , wherein the physiological parameter comprises an ECG, a transthoracic impedance, an airway parameter, a blood oxygenation, or a blood pressure; and wherein the treatment comprises an electrical shock, chest compressions, or ventilation.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application is a U.S. National Phase Application based on International Patent Application No. PCT/US2023/034057, filed on Sep. 28, 2023, which claims the priority of U.S. Provisional App. No. 63/412,255, filed on Sep. 30, 2022, and each of which is incorporated by reference herein in its entirety. BACKGROUND Medical devices are configured to detect various physiological parameters. In some cases, they analyze data representing physiological parameters to determine whether a patient has a physiological condition. However, sometimes, the results of those analyses are inconclusive. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 illustrates an example environment for selectively outputting processed data to a user and controlling delivery of treatment based on multiple instruction inputs. FIGS. 2A and 2B illustrate an example defibrillator with display screens that are visually presented at different times. FIG. 3 illustrates example signaling for facilitating communication between medical devices. FIG. 4 illustrates an example process for managing inconclusive results in analysis of a physiological parameter. FIG. 5 illustrates an example process for managing treatment output based on multiple instruction inputs. FIG. 6 illustrates an example process for identifying a shockable arrhythmia in ECG data that includes a chest compression artifact. FIG. 7 is a diagram illustrating examples of possible shock index and threshold adjustments. FIG. 8 illustrates an example of an external defibrillator configured to perform various functions described herein. FIG. 9 illustrates a chest compression device configured to perform various functions described herein. DETAILED DESCRIPTION Various implementations described herein relate to managing inconclusive or disagreeing results in analysis of a physiological parameter of a subject detected by a monitoring device. In particular cases, data representing the physiological parameter includes an artifact caused by a treatment administered to the subject, such as chest compressions or cardiopulmonary resuscitation (CPR). In various cases, a monitoring device is configured to remove the artifact and/or filter the data in order to determine if the subject is in need of an additional treatment. For example, a monitor-defibrillator removes a chest compression artifact from an electrocardiogram (ECG) of a patient receiving chest compressions to determine if the subject is exhibiting a shockable arrhythmia that is treatable by an electrical shock. The term “shockable arrhythmia” refers to a rhythm treatable by defibrillation, such as ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). However, in some examples, the monitoring device is unable to determine whether the subject is in need of the additional treatment. For instance, an analysis performed by the monitoring device produces an inconclusive result. In some examples, the monitoring device may be able to identify whether the subject has the shockable arrhythmia in data that lacks the artifact. For instance, this problem could be addressed by pausing the ongoing treatment (e.g., CPR) and analyzing the data without the artifact present. However, pausing CPR has been shown to result in decreased chances of survival in cardiac arrest patients. Thus, it would be advantageous to accurately assess the subject's condition without pausing CPR. Various implementations of the present disclosure address these and other problems by selectively outputting filtered physiological parameter data when the monitoring device is unable to automatically determine whether a treatment is indicated. For instance, the monitoring device generates first filtered data by removing an artifact from unfiltered physiological parameter data using a first filter (e.g., a non-comb filter). The monitoring device performs an analysis on the first filtered data to determine whether the first filter data indicates that a treatment is warranted. However, if the monitoring device is unable to conclude whether the treatment is or is not warranted, the monitoring device outputs second filtered data to the user for manual review. In various cases, the monitoring device generates the second filtered data by removing the artifact from the unfiltered physiological parameter data using a second filter (e.g., a comb filter) that is different than the first filter. The first filtered data, for instance, is suitable for analysis by the monitoring device but is unsuitable for manual review by the user. In contrast, the second filtered data may be inferior for analysis by the monitoring device but is suitable for manual review by the user. Accordingly, in examples where the monitoring device is unable to conclude whether the treatment is indicated, the monitoring device enables the user to manually assess the condition of the patient, even when the artifact is present in the unfiltered physiological parameter data. For i