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Sudden cardiac death case study
Automated external defibrillator
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Sudden Cardiac Deaths - Engineering Solutions Abdallah El-Falou
I. INTRODUCTION
UDDEN Cardiac Arrest (SCA) is one of the greatest causes Sof death and can strike an individual at any time or place, whether or not they have a diagnosed heart condition. SCA occurs because of Ventricular Fibrillation (VF) [1], a type of Cardiovascular Disease (CVD). CVD is caused by disorders of the heart and blood vessels and mainly affects people of age greater than 65 [2][3]. CVD is mainly diagnosed using the electrocardiogram (ECG) to measure and record electrical activity of the heart from the body surface. However, since ECG recording sessions are usually brief, rare symptoms are
easily and often missed [3].
II. SURVEY OF THE LITERATURE
Defibrillators have developed greatly since the 1950s, when defibrillation of the heart was performed as a major open chest surgery. In time to come, defibrillation technology was greatly improved. Manual External Defibrillators (MED) used by medical practitioners could be used in a less invasive manner, eliminating the need for open chest surgery. However, due to the nature of CVD, chances of treating CVD successfully fall greatly by the minute, and therefore a quicker, easier tool was needed to treat patients immediately, before any medical practitioner can reach the site [1].
Automated External Defibrillators (AED) were the solution to such problems. AED simplified the treatment by providing a basic portable defibrillator that can be used by untrained non-medical personnel such as policemen, security guards, flight attendants and the general public. Audible and/or visible instructions guide the operator through the process, while a microprocessor inside the defibrillator automatically analyzes the patie...
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...Cited
[1] W. L. Lim, C. C. Hang and K. B. Neo, “Discontinuous innovations framework: A review of automatic external defibrillators in the healthcare industry,” in Management of Innovation and Technology, 2008. ICMIT 2008. 4th IEEE International Conference on, 2008, pp. 356-361.
[2] E. Villalba, M. T. Arrendondo, S. Guillen and E. Hoyo-Barbolla, “A new solution for a heart failure monitoring system based on wearable and information technologies,” in Wearable and Implantable Body Sensor Networks, 2006. BSN 2006. International Workshop on, 2006, pp. 4 pp.-153.
[3] Zhanpeng Jin, Yuwen Sun and A. C. Cheng, "Predicting cardiovascular disease from real-time electrocardiographic monitoring: An adaptive machine learning approach on a cell phone," in Engineering in Medicine and Biology Society, 2009. EMBC 2009. Annual International Conference of the IEEE, 2009, pp. 6889-6892.
Also, while the sensors have little competition and has proven to achieve gross margins of 40%, the low-end defibrillator market is full of competitors and has a limit of 25%. Even though switching to manufacturing high-end defibrillators could bring a gross margins of 40%, the market is limited by saturation and it will be too late to switch from low-end to high-end right
Stephanie Lee MS in Medical Device Innovation Personal Statement This past January, I had the most enriching opportunity to dissect and study the thoracic cavity of a human cadaver through the Advanced Cardiac Anatomy course held by the UMN. For the first time, I held a human heart within my hands, studied its anatomy, and was also able to closely examine the placement of a dual-chamber defibrillator. My company, Heraeus Medical Components, specializes in products for cardiac rhythm/heart failure management, so this was extra meaningful for me to not only see the leads, but also follow them to the sites of therapy within the heart. In a room of twenty-four cadavers, could I have somehow impacted any one of these patients’ lives?
There is high risk of death and poor neurological function with unconscious survivors in out of hospital cardiac arrest. Trails were undertaken with the patients after awakening from cardiac arrest, which was compared with Ther...
It occurs because of repetitive electrical activity. This can occur in a patient with early or late heart failure, because there is damage to the heart tissue and the heart beats faster to try to supply the body with blood. Recommended treatment is elective cardioversion. Drugs used include an antidysrhythmic such as Mexitil or Sotalol (Ignatavicius &Workman, p. 728-729).
A total of 22 patients were admitted for the study, with 11 on the BiPAP side and the other half on the BiPAP using the AVAPS. Every patient had to be in a select range of APACHE II score within 4, age within 10, pH within.04, Glasgow Coma Scale within 2, and BMI within 2 points; also referred by a doctor who did not know about the study. Both of the groups received the same parameters for their BiPAP machines, including an IPAP of 12 cmH2O, EPAP as 6 cmH2O, a tidal volume 8-12 ml/kg of ideal body weight, respiratory rate of 15 bpm, rise time 300-400 ms, and finally Helsinki-based inspiration time at a minimum of.6 seconds. Arterial blood gases, maximum tidal volumes and IPAP, EVT, leaks, respiratory and heart rates, and blood pressure were all assessed every 1, 3, 12, and then every 24 hours.... ... middle of paper ... ...
These programmers communicate with the pacemaker via wireless radio frequency as well as telemetry to make device adjustments and monitor device functions. Physician programmers require no authentication to program pacemaker devices [15]. This is true for all pacemakers. The lack of required authentication is a point of concern because of the potential for risk. As was mentioned, pacemaker manufacturers warn of prolonged exposure to cellphones, metal detection systems, and other electrical devices for risk of misinterpretation by the pacemaker. The electrical impulses these devices emit could be read by the pacemaker as a heartbeat which could cause the device to malfunction or fail [17]. Deliberate attacks on pacemakers have been tested and provide troubling results. Within a 50-foot proximity, an attacker can deliver a lethal 830v jolt to a user’s heart from a laptop [13]. On the hard drives of two pacemaker devices both encrypted and unencrypted data was found by researchers for the technology research company WhiteScope. The researchers found that one unnamed pacemaker device stores unencrypted PHI such as patient and physician names, treatment data, and, most concerning, patient social security number [15]. This information can be collected and sold through black market
Basic life support (BLS) is a skill that many people in the community are lacking. Nearly 400,000 out-of-hospital cardiac arrests occur annually in the United States (American Heart Association, 2012), and of this 89% of the people die because they did not receive immediate CPR by a bystander (American Heart Association, 2012).
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
According to the American Heart Association (AHA), over 350,000 people experience cardiac arrest outside of hospitals every year. Every second that a heart doesn’t beat dramatically decreases a person’s survival rate. CPR is a simple way to keep blood pumping through the body until medical personnel arrive. Only 46 percent of cardiac arrest victims receive CPR, primarily because most bystanders don’t have the proper training. Fortunately, schools are in a unique position to greatly improve that statistic.
will deliver an electric shock to the heart to try to get it to stop the ventricular fibrillation which is when your heart rate increases and does not produce enough blood to the brian or other organs. A defibrillator was used in the case of Wes Leonard, but unfortunately it was not enough. As of right now I do not believe that there is a clear answer that would prevent the sudden cardiac arrests that athletes are suffering.
Lidwell and Edgar H. Booth invented the first pacemaker. It was a portable device that consisting of two poles, one of which included a needle that would be plunged into a cardiac chamber. It was very crude, but it succeeded in reviving a stillborn baby at a Sydney hospital in 1928. The decades that followed, inventors came up with increasingly sophisticated versions of the pacemaker. However, these devices; which relied upon vacuum tubes; remained heavy and bulky, affording little or no mobility for patients. Colombian electrical engineer Jorge Reynolds Pombo developed a pacemaker in 1958 weighed 99 lbs and was powered by a 12-volt auto battery. Surgeons at the Karolinska Institute in Sweden were the first to place a fully implantable device into a patient in 1958. Rune Elmqvist and surgeon Ake Senning invented this pacemaker, which was implanted in the chest of Arne Larsson. The first device failed after three hours, the second after two days. Larsson would have 26 different pacemakers implanted in him. He died at the age of 86 in 2001, outliving both Elmqvist and Senning. In the world there are many heart attacks and as people grow they can get abnormalities in there heart(Medlineplus). When someone 's heart stops working it can be fixed with a pacemaker, it makes the heart beat properly. The artificial pacemaker is a wonder of modern science. A small, implantable device that regulates a human heartbeat through electrical impulses have saved millions of lives. The development of this vital medical device owes much to the advances in electronics and communications brought about by the Space Age.Pacemakers may be used for people who have heart problems that cause their heart to beat too slowly. A slow heartbeat is called Bradycardia two common problems that cause a slow heartbeat are sinus node disease and heart block. When your heart
Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis, and those that require immediate attention. Atrial fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnose a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play a major role in the nursing world, allowing the nurse and other trained medical professionals to interpret what the heart is doing.
With this newer technology Physicians, nurses, and other approved medical staff have the option to monitor their patient’s heart functionality, and fix pacemaker electrical signals to fit patients need from a mobile device, without ever bringing the patient into the Physicians’ office. Cardiac remote patient monitoring uses smart phones, and specific designed (secured) e-mails to deliver information sent from the device implanted within the patient’s heart. This allows medical staff to receive pertinent up-to date- information on the condition of the patient’s pacemaker, and heart. This can help create profound patient care, early critical heart failure, or heart defibrillation detection; while adding to medical staff’s proficiency, and cutting costly emergency room visits with prevention detection ("Remote Monitoring Technology Improves Pacemaker Performance", 2012).
...& Hamilton, G. A. (2010). The long-term lived experience of patients with implantable cardioverter defibrillators. MEDSURG Nursing, 19(2), 113-119.
...de first aid to a person having an attack. Though there are risk factors that cannot be changed that are many things a person can do to improve their chances of preventing an attack and living through one. With such a high rate of heart attacks in the United States it is also extremely important to know how to provide first aid to a person who is having an attack.