WO2013140087A1

WO2013140087A1 - Device for manual insufflator, and insufflator comprising said device

Info

Publication number: WO2013140087A1
Application number: PCT/FR2013/050584
Authority: WO
Inventors: Abdo KHOURY; Philippe VALERO; Gilles CAPELLIER; Benoit Gresset; Jean-François Vinchant
Original assignee: Polycaptil; Schrader; Centre Hospitalier Regional Universitaire De Besancon
Priority date: 2012-03-19
Filing date: 2013-03-19
Publication date: 2013-09-26
Also published as: FR2988004B1; FR2988004A1

Abstract

The invention relates to a device for a manual insufflator, for assisting a distressed person with breathing. Said device comprises timing means which indicate to a user when insufflations should be performed, the timing means comprising input means for indicating the size of the individual, the times at which insufflations should be performed being timed according to the size. The invention also relates to an insufflator comprising said device.

Description

Device for manual insufflator and insufflator comprising this device.

FIELD OF THE INVENTION

The invention relates to a device for a manual resuscitator for the respiratory assistance of a person in distress. It also relates to an insufflator integrating this device.

PRIOR ART

When a person is in respiratory distress, it is important to be able to assist in breathing, whatever the surrounding conditions. In particular, for emergency medicine or for transfers to hospitals, manual resuscitators are used. Such an insufflator comprises a self-inflating balloon, interface means for connecting the insufflator to the distressed person and an exhalation valve placed between the balloon and the interface means to let out the exhaled air by the person in question. distress and direct air from the balloon to the interface means. The interface means is either a mask that is applied to the mouth and nose of the distressed person, or a tube to be inserted into the trachea of the distressed person. The flask was further equipped with an anti return valve ^¬ which opens to the open air and which is conductive in the direction from the atmosphere into the balloon.

An operator cyclically crushes the balloon to expel air from the balloon. The check valve closes ^¬ back and the air is expelled through the exhalation valve to the interface means to be blown to the person. The operator releases the pressure on the balloon so that it resumes its shape and draws air through the non-return valve. At the same time, the person expires through the means interface. The exhalation valve directs exhaled air outwardly in a manner known per se.

Although these devices have been used for a long time, they are not without problems. Mainly, the operating parameters are left to the full discretion of the operator who also has no direct feedback on the effectiveness of its action.

A first problem that arises is the rate of insufflation. Indeed, it must be located in a suitable range. If the flow rate is too low, the ventilation of the person in distress will be insufficient. On the other hand, if it is too strong, the air does not have the time to distribute itself correctly in the lungs and one is likely to create a trauma by too much induced pressure.

WO 02/15968 shows an insufflator equipped with a device for reducing the flow rate. A valve is driven by the flow of air against a spring and closes variably the passage of air during insufflation if the flow is too important. Such a system, even if it avoids having a too high flow rate, blocks the passage of air during an excess pressure on the balloon which is not acceptable from a medical point of view. Another problem is that even with a low flow rate, too much pressure can be generated in the lungs. Such pressure also creates trauma to the lungs, especially for young children. It also causes a passage of air towards the stomach of the person, which is harmful.

We also note that the operators do not always follow a rhythm of insufflation adapted for the patients. In fact, the optimal blown volume and rate of insufflation depends on the size of the person. Operators can impose a pace too important that leads to hyperventilation, or on the contrary a too slow pace. These risks are reinforced by the stressful situations often encountered in these circumstances and by the lack of training of operators. The operator may have to carry out too frequent insufflations for fear that the person lacks air, or on the contrary be distracted by another problem and reduce the frequency of insufflation.

Document US 2008/0053445-A1 shows a manual insufflator equipped with a timing device which provides the operator with a series of sound signals at a predetermined rate to clock the breaths. At the same time, a sensor measures the insufflation pressure which makes it possible to detect the insufflation and rest phases, and to deduce information on the rate of insufflation which is displayed, in respiration per minute. The pace imposed does not allow to adapt to the real situation of a person in distress. In addition, the pressure sensor is in direct contact with the air exhaled by the person. The hygiene conditions are thus difficult to maintain at a good level, the sensor being difficult to sterilize at high temperature and can not be considered as disposable material.

As already mentioned, air can pass into the stomach of the person in distress. It is also possible that the air leaks at the interface means. The operator does not currently benefit from any help to detect such problems to which it could provide a solution.

OBJECTIVES OF THE INVENTION

The invention aims to provide a device for manual insufflator with means allowing the operator who uses it to avoid a too high flow rate and a too small or too large volume insufflated. It is Another objective is to allow the user to follow a good rhythm of insufflation and to have information on the progress of the operation and the parameters related to breathing. The invention also aims to provide an insufflator comprising these characteristics.

STATEMENT OF THE INVENTION

With these objectives in view, the invention relates to a device for a manual resuscitator, for the respiratory assistance of a person in distress, including timing means for signaling to a user the instants conducive to insufflation, the device being intended to be mounted between interface means for connecting the insufflator to the distressed person and an expiration valve arranged to let out the exhaled air by the person and direct blown air supplied by a balloon to the interface means, characterized in that it comprises air flow detection means arranged to identify the passage from an insufflation phase to an expiration phase and vice versa, and input means for indicate the size of the person, the timing means being arranged to give a new signal after at least the flow of a predetermined time depending on the size since the transmission of the previous signal edent and after the detection of the end of the expiry phase of the person in distress.

The user thus has a guide to perform breaths at a good pace, adapted to the person in distress, thanks to the timing means that are self-adaptive. In fact, it has been found that people's respiration rate is related to age. Therefore, from the measured size, a child and an adult age class can be defined to determine the appropriate ventilatory frequency. The indication of the size can be provided by through the input means. The end of the expiration is detected when the flow is zero. The timing indicated by the insufflator is not rigid, but it thus adapts to the conditions actually encountered, in particular by avoiding re-infusing air while the person in distress has not finished. expire.

According to one improvement, the duration of the timing signal is a function of the size of the person in distress. Thus, the user of the insufflator can be given indications on the recommended duration of insufflation. The longer the duration is important, the more the blown volume will be important. By modulating the duration of insufflation to the size of the person in distress, it is possible to adapt the volume insufflated to the needs of the latter. Indeed, we can estimate the lung volume of the person, this allows to differentiate for example a child from an adult.

The timing signal is for example sound and / or light, but it could also be tactile.

According to another characteristic, the flow detection means are means for measuring air flow. By applying thresholds on flow measurement, it is possible to determine when the expiration and insufflation phases end. In addition, the measurement means make it possible to restore important information to the user concerning the progress of the operations. The means for measuring the flow rate pass the flow of air blown and the flow of exhaled air by the person in distress. One can therefore display on the one hand the instantaneous intensity of this flow, but also, by integration over time, the total volume that has passed in one direction and the other.

According to an improvement, the timing means deliver an alarm signal when after the duration of the predetermined timing signal the volume insufflated measured by the flow measurement means does not reach a predetermined volume depending on the size of the person in distress. The user thus has a quick indication that the insufflation is insufficient for the person. It can react directly by being more active on the handling of the ball.

According to other characteristics, the timing means give additional indications among the following:

- Indication "Faster" if the time between the end of the expiration and the beginning of the insufflation is greater than a predetermined threshold;

- "Slow" indication if the cumulative duration of a successive expiration and insufflation phase is less than the interval determined according to the size of the patient between two successive insufflation phases;

- "Stronger" indication if the blown volume is below a predetermined threshold depending on the size of the patient;

- Indication "Less loud" if the volume delivered is greater than a predetermined threshold depending on the size of the patient.

According to an embodiment characteristic, the flow measurement means comprise a movable element in a guide and second elastic means connecting the movable element to the guide, the mobile element carrying a second restriction, the measuring means indicating the flow through a conversion of the displacement of the captured mobile element. The air flow induces a force on the second restriction, which causes the displacement of the movable element against the second elastic means. The measurement of this displacement gives a direct access to the quantization of the flux, with an indication of the flow direction, according to the displacement in a direction or in the other of the movable element from a position of equilibrium when the flow is zero. The inertia of this system is low, and the mobile element quickly finds a position corresponding to a new value of air flow.

In particular, the displacement of the movable element is measured by optical or magnetic means fixed on the guide and interacting with a series of marks materialized on the movable element. Such optical or magnetic means allow access without contact to the position of the movable element. It is thus possible to separate the measuring means of the mobile element by a wall, which is transparent in the case of the optical means. The electronic measuring means are thus not exposed to contamination and do not need to be sterilized. The technique of measurement by the marks on the moving element is already applied in many fields, for example in incremental encoders, and will not be detailed here. It is simply stated that by using two offset measuring cells, the direction of movement is accessed in a manner known per se.

According to an improvement, the measuring means calculate and display a ratio between the volume of air blown and the volume of air expelled. The value is for example expressed as a percentage or in milliliters. This information allows the user to realize a problem of leakage or a problem of insufflation of air in the stomach of the person or trapping. In addition to the display, it is also possible to provide an alert message if the report is moving away from the target value.

In a complementary manner, the timing means and those of measurement are stopped if the measured flow rate does not vary for a predetermined duration. The shutdown makes it possible to preserve the power supply of the device, without this stopping occurs during active use of the insufflator.

The invention also relates to an insufflator comprising a device as described above and further means for regulating the flow rate of air blown to a constant function beyond a predetermined threshold of the pressure supplied by the balloon. Thus, the flow limitation is achieved by the insufflator and does not depend on the user. Whatever the stress of it, the flow is limited and regulated to a predetermined constant value. Furthermore, the rate is not abruptly reduced to exceeding a threshold, unlike the device of WO 02/15968. In combination with the timing means which modulate the duration of the signals, it can be considered that the blown volume will be the product of the duration of insufflation by the flow rate as limited. It is not necessary then to enslave the duration of the signal to the measurement of the flow.

According to one embodiment, the flow control means comprise a slide movable in a slide according to the flow and passages for the air whose section is modulated by the position of the slide. If the flow tends to increase beyond a control threshold, due to an increase in excessive pressure on the balloon or an inspiration from the distressed person, the slide moves and reduces the section of the passages. The flow is reduced and a new equilibrium is established with the same flow rate.

In particular, the slide has first resilient means for connecting with the slide and a first restriction capable of generating a pressure drop in the air flow, the pressure drop generating a force driving the slide against the first elastic means. If the pressure provided by the balloon decreases, the flow begins to decrease. The airflow drives the drawer with less force at the level of the first restriction and the drawer is recalled by the first elastic means. It thus increases the section of the passages, which allows more air to pass. The flow is thus restored. Below a certain limit, the pressure on the balloon is no longer sufficient to ensure the flow and it decreases.

According to an embodiment characteristic, the passages comprise at least one drawer opening at the periphery of the drawer and a sliding opening at the periphery of the slide, the drawer and slide openings fully communicate with each other when no flow of The air passes through the regulating means and staggered to reduce the section of the passage as the drawer moves. The first elastic means determine the equilibrium position of the drawer and align the openings when the flow is zero. The section of the passages is then maximum. The movement of the drawer shifts the openings which, therefore, decreases the passage section.

According to an improvement, the regulating means comprise an adjusting ring acting on the first elastic means for modifying the predetermined threshold of flow. The displacement of the equilibrium position of the drawer by acting on the first elastic means modifies the equilibrium position of the drawer and therefore the equilibrium flow.

In particular, the first restriction is a diaphragm. The diaphragm is a disc-shaped wall open at its center. It could also be a venturi or another form decreasing the passage section.

According to another characteristic, the insufflator comprises a pressure relief valve for limiting the insufflation pressure downstream of the flow control means. Such a pressure relief valve lets out air when the pressure exceeds a threshold predetermined. Even if the flow rate is limited, particular conditions of flow of the air flow can cause an increase in pressure. This overpressure can be harmful for the person in distress. Also, thanks to the pressure relief valve, this risk is avoided.

According to one embodiment, the pressure relief valve has a spring acting on a valve to hold it against a seat against the insufflation pressure, and an adjusting knob for adjusting the spring resting force on the seat. valve. The operator can thus adjust the predetermined threshold of opening of the pressure relief valve, for example depending on the pathology and the nature of the person in distress. This feature is optional, and an insufflator could be provided without the possibility of adjustment, with a fixed predetermined threshold, according to rules of good medical practice. For security reasons the valve can also be made to prohibit a disablement by the operator.

According to another characteristic, the device described above comprises a carbon dioxide rate sensor. The display of this measurement allows the operator to better follow the state of the person in distress.

Complementarily, the sensor has a second display and displays the carbon dioxide content only of the expelled air. The displayed value is more stable and only contains interesting information for tracking the person.

The sensor comprises for example an infrared-sensitive cell, the measurement being based on the absorption of infrared radiation. In this case and in the case of flow measurement means by a mobile element, to measure the carbon dioxide content only expelled air, the cell is masked by the mobile element during the insufflation phases. The direction of the air flow conditions the direction of movement of the movable element. It is therefore possible to place the infrared-sensitive cell such that the mobile element occludes the cell during insufflation and allows it to observe the flow of air during expiration.

According to an advantageous arrangement, the flow measurement means and / or the sensor are housed in a casing removably placed on the guide. Thus, as the measuring means are not exposed to contamination or are likely to contaminate the air passing through the guide, it is not necessary to sterilize them. The guide, not including electronic means, can be treated to be sterilized or to constitute a part of single use.

BRIEF DESCRIPTION OF THE FIGURES

The invention will be better understood and other features and advantages will appear on reading the description which follows, the description referring to the appended drawings among which:

Figure 1 is a schematic view of an insufflator according to one embodiment of the invention;

FIG. 2 is a sectional view of the flow control and pressure control means of the insufflator of FIG. 1;

Figure 3 is a partial sectional view of the measuring means parts of the insufflator of Figure 1; - Figure 4 is a sectional view along the line IV-IV of Figure 3;

Figure 5 is a sectional view along the line V-V of Figure 4;

Figure 6 is a detail view of an outer cylindrical surface of a movable member. DETAILED DESCRIPTION

A manual insufflator, according to an embodiment of the invention shown in Figure 1, comprises a self-inflating balloon 1, interface means 5 for connecting the insufflator to a distressed person and an exhalation valve 3 placed between the balloon 1 and the interface means 5 to let out the exhaled air by the person in distress and direct the air from the balloon 1 to the interface means 5. The interface means is a mask 5 which is intended to be applied to the mouth and nose of the person in distress. The balloon 1 is also equipped with a non-return valve 10 which opens in the open air and which passes in the direction of the atmosphere towards the balloon 1.

The insufflator further comprises means 2 for regulating the flow rate of blown air placed between an outlet 11 of the balloon 1 and an inlet 30 of the expiration valve 3. The flow control means 2 incorporate an overpressure valve 6 to limit the insufflation pressure.

The insufflator also comprises a device comprising air flow measurement means 4 and a carbon dioxide rate sensor 7 between the exhalation valve 3 and the interface means 5.

The elements 1, 2, 3, 4, 5 of the insufflator are assembled together removably, typically by interlocking, in a manner known per se which is not detailed here.

Referring to FIG. 2, the regulation means 2 of the flow comprise a slider 20 of tubular shape and closed by a bottom 201 in the form of a solid disc. On the side of the bottom 201, a sleeve 21 of tubular shape surrounds the slide 20 by providing a space 22 between them to a shoulder 202 in which the sleeve 21 fits. Before the shoulder 202, the slide 20 has sliding openings 203 distributed over the periphery of the slide 20. The slide openings 203 are, for example, oblong and open into the interior of the slide. The sleeve 21 is also connected to the outlet 10 of the balloon 1.

A drawer 23 is movably mounted in the slide 20.

The drawer 23 is also tubular. It comprises a first aperture disk-shaped diaphragm 230 calibrated at its center extending perpendicular to the axis of the slide B to form a first restriction. The drawer 23 comprises first elastic means 231 which rest on a ring 24 mounted screwed into the slide 20. The ring 24 is also open at its center to let a flow of air. The first elastic means are formed by a coil spring 231 which bears on the ring 24 to be connected to the slide 20 and the slide 23 at the first diaphragm 230 to push the slide 23 towards the bottom 201. drawer 23 further comprises slit-shaped drawer openings 232 extending on the periphery of the drawer 23 just beside the first diaphragm 230 on the bottom side 201, thus opposite the support of the drawer spring 231 The slide openings 232 are opposite the slide openings 20 when the slide 23 is in abutment against the bottom 201 by the action of the slide spring 231.

The slide 20 further comprises the pressure relief valve 6. The pressure relief valve 6 comprises a body 60 of tubular shape and formed integrally with the slide 20. It extends perpendicularly to the axis of the slide 20. The slide 20 is pierced by a conduit 61 opening at a seat 62 and on which a valve 63 is held in abutment by a valve spring 64 against the insufflation pressure. An adjusting knob 65 is provided screwed on the body 60 to adjust the bearing force of the valve spring 64 on the valve 63. The adjustment knob 65 is pierced to let air.

The flow measurement means 4, as shown in FIGS. 3 to 5, comprise a cylindrical tubular guide 40 and a movable element 41 in the guide 40. The guide 40 is made of transparent synthetic material, for example polycarbonate . The movable member 41 is of cylindrical tubular shape and has inside a second restriction 410 also having the shape of a second diaphragm. Second resilient means, formed by a guide spring 42, bear on the one hand on an inner shoulder 401 of the guide 40 and on the other hand on the second diaphragm 410, being fixed to the guide 40 and the movable member 41 by snapping. Thus, the movable member 41 can act on the guide spring 42 in tension and in compression.

The guide 40 further comprises a series of three annular abutments 402 delimiting between them two receiving zones 403, 404 for the flow measurement means 4 and the carbon dioxide rate sensor 7. At rest, the movable element 41 extends entirely facing the first zone 403, intended to accommodate the flow measurement means 4, and partially facing the second zone 404 intended to accommodate the sensor 7. The cylindrical surface outer member 411 of movable member 41 includes a series of dark colored annular shape markers 4111 alternating with light color separations 4112, as shown in FIG.

The flow measurement means 4 comprise a first housing 43 and a fork 44 which surrounds the guide 40 for more than half a turn. The fork 44 by its elasticity makes it possible to fix the first housing 43 on the first zone 403 between two stops 402. A pivoting around the axis of the guide A is thus allowed.

The sensor 7 comprises a second housing 70 and is fixed on the second zone 404 in the same manner as the first housing 43.

The measuring means 4 comprise two optical cells 45 offset in the direction of the axis of the guide A and placed to target the marks 4111. Whatever the angular position of the housing, the optical cells 45 see the marks 4111 scrolling in front of them during the axial displacement of the movable element, because they are annular. They also comprise a first electronic card 46 comprising a microcontroller 460, a battery 461 and a sounder 462. The first housing 43 also comprises a first display 431 which is electrically connected to the first electronic card 46 and which has a visible face 430 of the outside to display information.

The carbon dioxide rate sensor 7 comprises an infrared-sensitive cell 75, the measurement being based on the absorption of infrared radiation. It further comprises a second electronic card 76 powered by a battery 761 and a microcontroller 760. A second display 702 is fixed on the second housing 70 and is electrically connected to the second electronic card 76. The infrared-sensitive cell 75 is placed such that it is masked by the movable element 41 during the insufflation phases.

The first display 431 has a graph area 4311 to symbolize the flow of air by increasing bars. It also includes a display area 4312 of the size selected for the distressed person, and a balance area 4313, detailed below. The first housing 43 further comprises control buttons, not shown, to turn on the flow measurement means 4 and select the size of the person in distress, in a manner not detailed here. Similarly, the second housing 70 includes a start button and automatic stop means, no detailed here.

Operation

During the use of the manual insufflator, after starting the flow measuring means 4 and the sensor 7, an operator cyclically crushes the balloon 1 so as to expel air from the balloon 1. The return 10 closes and the air is expelled through the regulating means 2 of the flow, the exhalation valve 3, the flow measurement means 4 to the interface means 5 to be blown into the person in distress. The operator releases the pressure on the balloon 1 so that the balloon 1 resumes its shape and draws air through the non-return valve 10. At the same time, the person expires through the interface means 5 The exhaled air passes through the flow measurement means 4 and then the exhalation valve 3 which directs it outwards, in a manner known per se.

At the level of the regulating means 2, the air which arrives through the sleeve 21, as represented by the arrows Fl, bypasses the slide 20 and passes through the slide openings 203 and the slide openings 232. It then passes through the first diaphragm 230 and is directed to the exhalation valve 3 by the ring 24. When passing through the first diaphragm 230, a differential pressure is exerted thereon, which causes the slide 23 against the slide spring 231. The drawer openings 232 are then offset relative to the slider openings 203 toward the exhalation valve 3 by decreasing their overlap, thereby reducing the passage section for air. Once the pressure has reached a sufficient level, the flow is limited to a substantially constant value, even if the user exerts a strong pressure on the balloon 1.

By pivoting the adjusting ring 24, the first elastic means 231 is actuated to modify the equilibrium position of the slide 23 and thus the predetermined threshold of flow limitation.

If, despite the limited flow rate, the flow of air to the person's lungs is impeded, the insufflation pressure may increase. It is at this moment that the pressure relief valve 6 intervenes. Under the effect of the pressure downstream of the slide valve 23, the valve 63 of the valve is lifted from the seat 62 and the air escapes, so as to to limit the pressure thanks to this leak. The pressure level can be adjusted by acting on the adjusting knob 65 to more or less compress the valve spring 64.

The air passing through the flow measurement means 4 passes through the movable element 41, and in particular the second restriction 410. A force is then exerted on the mobile element 41 so that it moves to the against the second elastic means 42, in the direction of the arrow F2 in case of insufflation, and the opposite of the arrow F2 in case of expiration.

The optical cells 45 deliver digital signals according to the presence of a reference 4111 or a separation 4112 opposite them. The offset between the signals of the two cells makes it possible to know the direction of movement of the mobile element 41. The first electronic card 46 analyzes these signals, extracts a position from the mobile element 41 and calculates with the aid of a table or a stored law the corresponding flow. The display of chart area 7311 is controlled to reflect the absolute value of this rate.

At the same time, the first electronic card

46 identifies the times at which the flow is zero or positive to identify the transition from an expiry phase to an insufflation phase. The flow measurement means thus form detection means for detecting the end of the expiration and insufflation phases. The first electronic card 46 integrates on time the flow on the one hand on the insufflation phase and on the other hand on the expiration phase to determine respectively a volume of insufflation and a volume of expiration. At the end of the expiration phase, the ratio between the Vexp expiration and Vinsp insufflation volumes is displayed as a percentage on the first display 431 in the balance area 4313. This ratio is calculated for example by the formula Vexp / Vinsp x 100. Thus, the user can be alerted if this ratio deviates substantially from 100%. The electronic card can be programmed to generate this alert at a predetermined threshold and display it.

The first electronic card 46 further comprises timing means for signaling to a user instants conducive to insufflation. For this purpose, it uses the buzzer 462 to generate sound signals that inform the user of the moment at which he can perform the insufflation. The timing means also uses the flow measurement to synchronize with the expiration of the person. It is conventionally considered that the insufflation rate is positive and the expiration rate is negative.

For this, when the user has started by pressing one of the buttons, the flow measurement means 4 and the level of the battery are tested. If the test is considered satisfactory, the position of the movable element 41 as measured is considered as corresponding to the zero flow. This initialization may be preceded by an observation period to verify that the flow measurement is fixed during this period. The timing means wait for the input of a person size, via the display of the size value and two "+" and "-" keys to increase or decrease the size value. Once the size is filled in and validated, a sound signal is emitted, corresponding to an invitation to the user to perform insufflation. The first electronic card 46 counts a predetermined time interval, depending on the size of the person as initially indicated. At the end of this elapsed time, the electronic card 46 waits for the flow to be zero. If it is already positive or zero, or when it is positive or zero, a new beep is emitted to request the next insufflation, and we start a cycle by the countdown. The timing is thus synchronized with the breathing of the person, avoiding giving a new signal of insufflation if the expiration is not completed.

In a complementary manner, if the time between the end of the expiration and the beginning of the insufflation is greater than a predetermined threshold, the timing means give an indication "faster", to invite the operator to reduce the delay after the insufflation signal to resume insufflation. Similarly, if the cumulative duration of a successive expiration and insufflation phase is less than the interval determined according to the size of the patient between two successive insufflation phases, then the timing means give an indication " slower "to prompt the operator to wait for the timing signal before resuming insufflation.

During the insufflation phase, that is to say, as long as the air flow is positive, the volume injected is estimated by performing a numerical integration of the flow over time. The electronic card 46 evaluates a predetermined volume according to the size indicated initially, and compares the measured volume to this predetermined volume. If the difference is greater than a determined threshold, the electronic card generates an alert to the user, asking by a displayed message to press harder. If the difference is less than another determined threshold, lower than the previous threshold, the electronic card generates an alert to the user, asking by a displayed message to press less strong.

At the same time, the flow is monitored by starting a countdown of a predetermined duration, for example 300 seconds, as soon as the flow is zero. We stop the countdown and reset this counter as soon as the flow is no longer zero. At the end of the delay, that is to say at the end of the count, it is considered that the device is no longer used and the first electronic card 46 is stopped, that is to say that the supply of at least a portion of the electronic card is cut off.

The cell 75 of the sensor 7 observes the air flowing in the guide 40. When the air is blown in, the movable element 41 moves in the direction of the arrow F2 and intercepts the beam of the cell 75. In this way, the cell 75 can not measure the level of carbon dioxide in the blown air, but only that of the expelled air. The carbon dioxide level is then written on the second display 702.

The invention is not limited to the embodiment described solely by way of example. In particular, the adjusting ring 24 or the adjusting knob 65 may be replaced by fixed parts, so that the flow limitation or the pressure level for the opening of the pressure relief valve 6 are set at the factory. Moreover, the flow measurement means 4 can be implemented independently of the regulation means 2. The display of the air flow can be carried out independently of the implementation of the timing means. Rather than optical means, the measurement of the displacement of the movable element can be done using magnetic markers and adapted detection cells. Other non-contact measurement principles may also be be used as induction sensors or magnetostrictive sensors. The functions of measuring the rate of clocking and measuring the rate of Co2 could be realized by the same electronic card and restored on the same display. The flow detection function could be performed by electromechanical means delivering an all-or-nothing signal depending on the presence or absence of the flow rate. In the case where the insufflator does not comprise flow control means, the timing means emit a signal as long as the measured insufflation volume is insufficient.

Claims

1. Device for a manual resuscitator, for the respiratory assistance of a person in distress, comprising timing means for signaling to a user instants suitable for insufflation, the device being intended to be mounted between interface means ( 5) for connecting the insufflator to the distressed person and an exhalation valve (3) arranged to let out the breath exhaled by the person and direct blown air provided by a balloon (1) to the means of d interface (5), characterized in that it comprises air flow detection means (4) arranged to identify the passage from an insufflation phase to an expiration phase and vice versa, and input means for indicating the size of the person, the timing means being arranged to give a new signal after at least the flow of a predetermined time depending on the size since the transmission of the previous signal and after the detection of l at the end of the expiry phase of the person in distress.

2. Device according to claim 1, wherein the duration of the timing signal is a function of the size entered by the person in distress.

3. Device according to claim 1, wherein the timing signal is sound and / or light.

4. Device according to claim 1, characterized in that the flow detection means are air flow measuring means (4).

5. Device according to claims 2 and 4 taken in combination, wherein the flow measuring means (4) are arranged to identify by flow measurement the passage from an insufflation phase to an expiration phase and the timing means provide an alarm signal when after the duration of the signal of predetermined timing the blown volume measured by the flow measuring means (4) during the blowing phase does not reach a predetermined volume depending on the size of the distressed person.

6. Device according to claim 4, wherein the flow measurement means (4) comprise a movable member (41) in a guide (40), the movable member (41) carrying a second restriction (410) and being connected to the guide by second elastic means (42), the flow measuring means (4) indicating the flow rate by a conversion of the displacement of the movable member (41) captured.

7. Device according to claim 6, wherein the displacement of the movable element (41) is measured by optical or magnetic means fixed on the guide (40) and interacting with a series of marks (4111) materialized on the element mobile (41).

8. Device according to claim 4, wherein the flow measuring means (4) are arranged to identify by the flow measurement the passage from an insufflation phase to an expiration phase, and to calculate and display a ratio between the volume of air blown and the volume of air expelled during the insufflation phase and the expiratory phase, respectively.

9. Device according to claim 1, wherein the timing means and those of measurement are arranged to be stopped if the flow rate measured by the flow measuring means (4) does not vary for a predetermined period.

10. Insufflator, characterized in that it comprises a device according to one of claims 1 to 9 and further means for regulating (2) the flow of air blown to a constant function beyond a predetermined threshold the pressure provided by the balloon (1).

11. Insufflator according to claim 10, wherein the flow control means (2) comprise a slide (23) movable in a slide (20) in function flow and passages for air whose section is modulated by the position of the slide (23).

12. Insufflator according to claim 11, wherein the slide (23) comprises first elastic means (231) for connecting with the slide (20) and a first restriction (230) capable of generating a pressure drop in the flow of air, the pressure drop generating a pressure causing the slide (23) against the first elastic means (231).

The insufflator according to claim 11, wherein the passages comprise at least one slide opening (232) at the periphery of the slide (23) and a slide opening (203) at the periphery of the slide (20), the slide openings (232) and slider (20) facing each other when no air flow passes through the regulating means (2) and staggered to reduce the section of the passage when the drawer (23) ) moves.

14. Insufflator according to claim 12, wherein the regulating means (2) comprise a ring

Adjusting means (23) acting on the first resilient means (231) to change the predetermined flow rate threshold.

The insufflator of claim 12, wherein the first restriction is a first diaphragm

(230).

16. Device according to claim 1, characterized in that it comprises a sensor (7) of carbon dioxide content.

The device of claim 16, wherein the sensor (7) has a second display (702) and displays the carbon dioxide level only of the expelled air.

18. Device according to claims 6 and 17 taken in combination, wherein the sensor (7) comprises an infrared sensitive cell (75), the measurement being based on the absorption of infrared radiation, the infrared sensitive cell (75) being masked by the movable element (41) during the insufflation phases.

19. Device according to claims 4 or 16, wherein the flow measuring means (4) and / or the sensor (7) are housed in a housing (43, 70) releasably placed on the guide (40).