- 學位論文
自動心臟按摩與行動遠距醫療之系統整合
The Integration of Automated CPR and Mobile Telemedicine Systems
摘要
到院前心臟停止 (out-of-hospital cardiac arrest, OHCA)患者若有心肺復甦術之協助，病患到院後獲救以及復原之機率都可提升，雖是如此，OHCA患者到院前其生命重要訊息的先前獲得，爭取到院前救治之時效性也關係到急救的成效。本研究課題的目的是整合電動心臟按摩器和生理訊息即時監測平台成為一套功能性系統，以持續按壓，並將OHCA患者的生命重要訊息透過無線行動網路傳達至急診室，使醫護人員事前準備，達到院內與院前零距離為目標。本課題所發展的系統包含三部分: (一)電動心臟按摩系統、(二)即時生理監測平台與(三)遠端監控系統。電動心臟按摩系統由電動心臟按摩器與訊號擷取系統組成，其中訊號擷取系統包含雙極式ECG、光脈動體積描述圖與荷重元感測模組；所擷取得之訊號由藍芽傳輸至即時生理監測平台，顯示心電圖、光脈動體積描述圖與按壓訊號，其中心率、脈搏數、按壓數與血氧濃度亦一併顯示，並將患者之即時視訊與生理訊號經行動無線網路傳遞至遠端監測系統。所發展之系統驗證是在靜止和移動二種狀態進行人體量測，以之相較於市售生理監測器。在心率、脈搏與血氧濃度穩定度方面，靜止狀態可達80%以上的正確率，在移動狀態則下降至70%。在即時視訊傳輸探討方面，使用TCP (transmission control protocol) 傳輸之影像接收率近乎100%，但視訊的影像畫面更新速度較慢，實際獲偵數平均僅能達到3到4 fps (frames per second)，而使用UDP (user datagram protocol) 傳輸之影像遺失雖高達17%，但實際獲偵數最低可達12 fps，最高可達24 fps。綜言之，本課題已完成電動心臟按摩器與生命重要訊息傳遞之系統整合發展，具有到院前對OHCA患者搶救黃金時間之潛能。
並列摘要
It is well known that out-of-hospital cardiac arrest (OHCA) patients being rushed to emergency rooms (ER) administered with cardiopulmonary resuscitation (CPR) intervention have better chance to be rescued and fully recovered after the life save. Nonetheless, pre-delivery of the patient vital signs to ER, so as the personnel having advanced preparation, is also heavily related to the rescue efficacy. This study integrated an electric-based automated CPR, a bio-signal acquisition device, a 7-inch flat panel computer and a real-time bio-signal tele-monitoring system into a functional unit. In addition to load cell graph attained during chest compression, the electrocardiogram (ECG) and photoplethysmogram (PPG) of the patient are acquired in the device and displayed in the flat panel monitor via a blue-tooth connection. The acquired ECG and PPG are calculated so that heart rate and saturation of peripheral oxygen (SpO2) are available to show on the panel monitor. Except for ECG and text data of heart rate and SpO2, via 3G (WiFi) technology the video frames of patient face are also sent to the tele-monitoring system located in a remote ER. This integrated unit was evaluated by comparison with a market device in two modes: steady and motion. In the steady mode, the delivery accuracy of heart rate and SpO2 by the unit reached to 80%. However, the accuracy was down to 70% when the measurement was performed within a car. The video frames with transmission control protocol (TCP) in both steady and motion modes were perfectly transmitted between the panel computer and the tele-monitoring system. However, the actual transmission rates of 3~4 fps (frames per second) were achieved even though 15, 24 and 30 fps were initiated. The video frame transmission rates for UDP (user datagram protocol) reached 12~24 fps. Unfortunately, the frame missing rate with this transmission protocol was about 17%. In conclusion, this study completed a combination system of an automated CPR and a bio-signal tele-medicine system, which performs chest compression and transmits vital signs of OHCA patients at the same time. It is believed that such an integrated unit has a great potential for the use in saving the patient lives.
參考文獻
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