Abstract: A method for improving the cardiac output of a patient who is suffering from pulseless electrical activity or shock and yet still displays some myocardial wall motion including sensing myocardial activity to determine the presence of residual left ventricular pump function having a contraction or ejection phase and a filling or relaxation phase. In such cases, a compressive force is repeatedly applied to the chest based on the sensed myocardial activity such that the compressive force is applied during at least some of the ejection phases and is ceased during at least some of the relaxation phases to permit residual cardiac filling, thereby enhancing cardiac output and organ perfusion. Also incorporated may be a logic circuit capable of utilizing multiple sensing modalities and optimizing the synchronization pattern between multiple phasic therapeutic modalities and myocardial residual mechanical function.

Abstract: A method of processing a raw acceleration signal, measured by an accelerometer-based compression monitor, to produce an accurate and precise estimated actual depth of chest compressions. The raw acceleration signal is filtered during integration and then a moving average of past starting points estimates the actual current starting point. An estimated actual peak of the compression is then determined in a similar fashion. The estimated actual starting point is subtracted from the estimated actual peak to calculate the estimated actual depth of chest compressions. In addition, one or more reference sensors (such as an ECG noise sensor) may be used to help establish the starting points of compressions. The reference sensors may be used, either alone or in combination with other signal processing techniques, to enhance the accuracy and precision of the estimated actual depth of compressions.

Abstract: Embodiments of the invention include an implantable medical device having a digital signal processing circuit associated with an implantable medical device function. The digital signal processing circuit can be selectively implementable according to the clinical need of a patient. Embodiments of the invention also include methods of making and using such implantable medical devices.

Abstract: Systems and methods related to the field of cardiac resuscitation, and in particular to devices for assisting rescuers in performing cardio-pulmonary resuscitation (CPR) are described herein.

Abstract: An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a cardiac activity monitor to sense cardiac activity and provide a signal indicative of the cardiac activity, and a baroreflex stimulator. The stimulator includes a pulse generator and a modulator. The pulse generator provides a baroreflex stimulation signal adapted to provide a baroreflex therapy. The modulator receives the signal indicative of the cardiac activity and modulates the baroreflex stimulation signal based on the signal indicative of the cardiac activity to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy.

Abstract: An external defibrillator having a battery; a capacitor electrically communicable with the battery; at least two electrodes electrically communicable with the capacitor and with the skin of a patient; a controller configured to charge the capacitor from the battery and to discharge the capacitor through the electrodes; and a support supporting the battery, capacitor, electrodes and controller in a deployment configuration, the defibrillator having a maximum weight per unit area in the deployment configuration of 0.1 lb/in2 and/or a maximum thickness of 1 inch. The support may be a waterproof housing.

Abstract: An adaptive method and apparatus for forecasting and controlling neurological abnormalities in humans such as seizures or other brain disturbances. The system is based on a multi-level control strategy. Using as inputs one or more types of physiological measures such as brain electrical, chemical or magnetic activity, heart rate, pupil dilation, eye movement, temperature, chemical concentration of certain substances, a feature set is selected off-line from a pre-programed feature library contained in a high level controller within a supervisory control architecture. This high level controller stores the feature library within a notebook or external PC. The supervisory control also contains a knowledge base that is continuously updated at discrete steps with the feedback information coming from an implantable device where the selected feature set (feature vector) is implemented.

Abstract: A resuscitation device for automatic compression of victim's chest using a compression belt which exerts force evenly over the entire thoracic cavity. The belt is constricted and relaxed through a motorized spool assembly which repeatedly tightens the belt and relaxes the belt to provide repeated and rapid chest compression. An assembly includes various resuscitation devices including chest compression devices, defibrillation devices, and airway management devices, along with communications devices and senses with initiate communications with emergency medical personnel automatically upon use of the device.

Abstract: An implantable medical device such as a cardiac pacemaker or implantable cardioverter/defibrillator with the capability of storing body temperature measurements taken periodically and/or when triggered by particular events.

Abstract: One embodiment of the present invention relates to an implantable medical device (“IMD”) that can be programmed from one operational mode to another operational mode when in the presence of electro-magnetic interference (“EMI”). In accordance with this particular embodiment, the IMD includes a communication interface for receiving communication signals from an external device, such as a command to switch the IMD from a first operation mode to a second operation mode. The IMD further includes a processor in electrical communication with the communication interface, which is operable to switch or reprogram the IMD from the first operation mode to the second operation mode upon receiving a command to do so. In addition, the IMD includes a timer operable to measure a time period from when the processor switches the IMD to the second operation mode.

Abstract: An energy accumulator arrangement for an electromedical implant includes a battery, a capacitor, and a charging device which is designed to supply an electric charge from the battery to the capacitor according to a charging program. A maintenance system for maintaining the energy accumulator arrangement includes a monitoring device contained in the implant which captures a physical parameter value of the energy accumulator arrangement; an evaluation unit for evaluating the captured physical parameter value and generating a resulting evaluation result signal; a transceiver contained in the implant which sends the captured physical parameter value to the evaluation unit, and receive the evaluation result signal generated by the evaluation unit; and additionally a control unit contained in the implant which controls the charging device and the monitoring device, and adapts the charging program as a function of the evaluation result signal.

Abstract: Systems and methods are provided for graphically configuring leads for a medical device. According to one aspect, the system generally comprises a medical device and a processing device, such as a programmer or computer, adapted to be in communication with the medical device. The medical device has at least one lead with at least one electrode in a configuration that can be changed using the processing device. The processing device provides a graphical display of the configuration, including a representative image of a proposed electrical signal to be applied by the medical device between the at least one electrode of the medical device and at least one other electrode before the medical device applies the electrical signal between the at least one electrode and the at least one other electrode. In one embodiment, the graphical display graphically represents the lead(s), the electrode(s), a pulse polarity, and a vector.

Abstract: An implantable cardiac rhythm management device for delivering anti-tachyarrhythmia therapy is provided with a temporary disablement feature so that the delivery of anti-tachyarrhythmia therapy may be conveniently disabled and re-enabled. The feature is particularly useful to patients who are undergoing imaging procedures or surgical procedures where electro-cauterizing instruments may cause inadvertent triggering of cardioversion/defibrillation shocks and/or anti-tachycardia pacing.

Abstract: A medical device (implantable or external) is provided that comprises a power source, a charge storage member, a terminal connector, a switch network, a controller and a leak detection module. The charge storage member is configured to receive and store energy from the power source. The terminal connector is configured to be coupled to a lead to be implanted in a patient proximate to tissue of interest. The switch network is electrically disposed between the charge storage member and the terminal connector. The switch network changes between open and closed states to disconnect and connect the charge storage member and the terminal connector. The controller controls storage of energy in the charge storage member and delivery of stimulating pulses from the charge storage member to the lead coupled to the terminal connector. The leak detection module obtains a leakage measurement by sensing at least one of i) a voltage potential of the charge storage member and ii) current flow from the charge storage member.

Abstract: Cardiac systems and methods using ECG and blood information for arrhythmia detection and discrimination. Detection circuitry is configured to produce an ECG. An implantable blood sensor configured to produce a blood sensor signal is coupled to a processor. The processor is coupled to the detection and energy delivery circuitry, and used to evaluate and treat cardiac rhythms using both the cardiac electrophysiologic and blood sensor signals. The blood sensor is configured for subcutaneous non-intrathoracic placement and provided in or on the housing, on a lead coupled to the housing, and/or separate to the housing and coupled to the processor via hardwire or wireless link. The blood sensor may be configured for optical sensing, using a blood oxygen saturation sensor or pulse oximeter. A cardiac rhythm may be evaluated using the electrocardiogram signal and the blood sensor signal, and tachyarrhythmias may be treated after confirmation using the blood sense signal.

Abstract: Vector selection is automatically achieved via a thoracic or intracardiac impedance signal collected in a cardiac function management device or other implantable medical device that includes a test mode and a diagnostic mode. During a test mode, the device cycles through various electrode configurations for collecting thoracic impedance data. At least one figure of merit is calculated from the impedance data for each such electrode configuration. In one example, only non-arrhythmic beats are used for computing the figure of merit. A particular electrode configuration is automatically selected using the figure of merit. During a diagnostic mode, the device collects impedance data using the selected electrode configuration. In one example, the figure of merit includes a ratio of a cardiac stroke amplitude and a respiration amplitude. Other examples of the figure of merit are also described.

Abstract: The present invention comprises a cardiopulmonary resuscitation (CPR) feedback device and a method for performing CPR. A chest compression detector device is provided that measures chest compression during the administration of CPR. The chest compression detector device comprises a signal transmitter operably positioned on the chest of the patient and adapted to broadcast a signal, and a signal receiver adapted to receive the signal. The chest compression detector device also comprises a processor, operably connected to the signal transmitter and the signal receiver. The processor repeatedly analyzes the signal received to determine from the signal a series of measurements of compression of the chest, and feedback is provided to the rescuer based on the series of measurements.

Abstract: Apparatus for treating a subject suffering from spontaneous atrial fibrillation includes an electrode device, adapted to be coupled to a vagus nerve of the subject, and a control unit, adapted to drive the electrode device to apply an electrical current to the vagus nerve, and to configure the current to maintain the spontaneous AF for at least about 24 hours, so as to modify blood flow within the atria and reduce risk of thromboembolic events.

Abstract: A method is provided, including identifying that a subject is at risk of suffering from atrial fibrillation (AF). Responsively to the identifying, a risk of an occurrence of an episode of the AF is reduced by applying an electrical current to a site of the subject selected from the group consisting of: a vagus nerve, a sinoatrial (SA) node fat pad, a pulmonary vein, a carotid artery, a carotid sinus, a coronary sinus, a vena cava vein, a jugular vein, an azygos vein, an innominate vein, and a subclavian vein, and configuring the current to stimulate autonomic nervous tissue in the site. Other embodiments are also described.

Abstract: Detected changes in respiration parameters, either alone or in conjunction with other physiological signals, can be used to discriminate between hemodynamically stable and hemodynamically unstable tachyarrhythmias.

Abstract: An active medical device such as pacemaker, defibrillator and/or resynchronizer with automatic optimization of atrioventricular delay is disclosed. The active medical device is adapted for analyzing a signal delivered by a hemodynamic sensor such as an endocardial acceleration sensor, whose variation according to the AVD is represented by a sigmoid function. An optimal AVD is searched by: applying a reference AVD (XC), at least one left AVD (XL, XLL) and at least one right AVD (XR, XRR); measuring the corresponding hemodynamic parameters (Y1, Y2, Y3, Y4, Y5); evaluating the second derivative of the function at the respective points (XC, Y3; XL, Y2, XR, Y4) of the characteristic corresponding to the reference AVD, to the left AVD and to the right AVD; estimating from these values of second derivatives, the position of an intermediate point of the characteristic for which the second derivative is zero or minimum, and determining the corresponding AVD for that intermediate point as the optimal AVD.

Abstract: Systems and methods related to the field of cardiac resuscitation, and in particular to devices for assisting rescuers in performing cardio-pulmonary resuscitation (CPR) are described herein.

Abstract: An implantable medical device and associated method perform ECG morphology monitoring. A subcutaneous ECG signal and a posture signal are sensed in a patient. A cardiac condition is detected in response to the ECG signal and the posture signal. In one embodiment, multiple ECG morphology templates corresponding to each of a number of different patient postures are acquired and stored for use in detecting a cardiac condition.

Abstract: A medical device is disclosed for implantation on an epicardial surface of the heart. The device has a transmural member providing optimal electrode locations for various therapies. The hemodynamically optimal therapy is guided by sensed left ventricular pressure and electrical activity. The device may be used alone or with a companion implanted cardiac rhythm management device.

Abstract: Implantable medical devices, implantable medical device systems that include such implantable medical devices, and implantable medical device batteries, as well as methods of making. Such devices can include a battery of relatively small volume but of relatively high power (reported as therapeutic power) and relatively high capacity (reported as capacity density).

Abstract: An implantable cardiac device that detects and protects against strong magnetic fields produced by MRI equipment is disclosed. The device has a magnetic field sensor for detecting the presence of a relatively weak static magnetic field (102, 110, 118, 122) of a level equivalent to that of a permanent magnet in the vicinity of the device. The device is switched from a standard operating mode (100) where the nominal functions of the device are active, to a specific protected MRI mode (114, 116) in the presence of a magnetic static field of a level corresponding to that emitted by MRI equipment. The device further temporarily switches the device from the standard operating mode (100) to an MRI stand-by state (108) when a magnetic field is detected by the magnetic field sensor such that a subsequent detection of a magnetic field switches the device from an MRI stand-by state to the specific protected MRI mode.

Abstract: A wearable defibrillator consists of a vest (or belt) which is worn by the patient. The device monitors the patient's ECG with sensing electrodes and can monitor other patient conditions and in appropriate cases can treat certain conditions. An accelerometer(s) in the wearable defibrillator can allow for the device to determine the position, movements, forces applied to the patient, and/or the device. The device can use a least one patient motion detector generating a signal indicative of patient activity. Analysis of the signal can be indicative of patient activity appropriate for treatment or indication of device condition.

Abstract: Techniques for performing a lead integrity test during a suspected tachyarrhythmia are described. An implantable medical device (IMD) may perform the test prior to delivering a therapeutic shock to treat the suspected tachyarrhythmia and, in some cases, may withhold the shock based on the test. In some examples, the IMD measures an impedance of a lead a plurality of times during the suspected tachyarrhythmia. In some examples, the IMD measures the impedance a plurality of times between two sensed events of the suspected tachyarrhythmia. The IMD or another device may determine a variability of, or otherwise compare, the measured impedances to evaluate the integrity of the lead. Instead of or in addition to withholding a shock, the IMD or another device may change a sensing or stimulation vector of the IMD, or provide an alert to a user, if the integrity test indicates a possible lead integrity issue.

Abstract: New decision paradigms for ICDs are described. In one implementation, an implantable system senses cardiac output and arterial pressure parameters and shocks the heart in inverse relation to the arterial pressure, if the cardiac output is insufficient. In another implementation, the implantable system applies atrial anti-tachycardia pacing before applying ventricular anti-tachycardia pacing, if the heart rate is tachycardic.

Abstract: The presence of a cardiac pulse in a patient is determined by evaluating physiological signals in the patient. In one embodiment, a medical device evaluates two or more different physiological signals, such as phonocardiogram (PCG) signals, electrocardiogram (ECG) signals, patient impedance signals, piezoelectric signals, and accelerometer signals for features indicative of the presence of a cardiac pulse. Using these features, the medical device determines whether a cardiac pulse is present in the patient. The medical device may also be configured to report whether the patient is in a VF, VT, asystole, or PEA condition, in addition to being in a pulseless condition, and prompt different therapies, such as chest compressions, rescue breathing, defibrillation, and PEA-specific electrotherapy, depending on the analysis of the physiological signals. Auto-capture of a cardiac pulse using pacing stimuli is further provided.

Abstract: A modular external defibrillator system in embodiments of the teachings may include one or more of the following features: a base containing a defibrillator to deliver a defibrillation shock to a patient, (b) one or more pods each connectable to a patient via patient lead cables to collect at least one patient vital sign, the pods operable at a distance from the base, (c) a wireless communications link between the base and a selected one of the two or more pods to carry the at least one vital sign from the selected pod to the base, the selection being based on which pod is associated with the base.

Abstract: An external cardiac medical device for delivering Cardiac Potentiation Therapy (CPT). Techniques used with the device include initial diagnosis of the patient, delivery of the CPT, and configuration of the external device, so that CPT can be effectively and efficiently provided. In particular, these techniques include initially determining whether a patient should receive CPT, how to set the coupling interval for delivering CPT, how to configure the external medical device to deliver CPT stimulation pulses while not adversely affecting the device's ability to sense a patient's cardiac parameters and/or signals.

Abstract: An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: In specific embodiments, a method to monitor left atrial pressure and/or intra-thoracic fluid volume of a patient, comprises (a) monitoring posture of the patient using a posture sensor implanted within the patient, and (b) using portions of an impedance signal, obtained using implanted electrodes, to monitor the left atrial pressure and/or intra-thoracic fluid volume of the patient. Each portion of the impedance signal used to monitor the left atrial pressure and/or intra-thoracic fluid volume of the patient corresponds to a period after which the patient has maintained a predetermined posture for at least a predetermined period of time, and during which the patient has remained in the predetermined posture.

Abstract: Various different implementations of lead systems are disclosed for use with implantable stimulation systems. Generally, the lead systems incorporate, within an elongate lead body, one or more electrical conduits that connect to one or more distal electrodes, and a liquid-filled pressure transmission catheter lumen that extends proximally from a distal entry port. Use of the lead systems allows accurate pressure sensing at a location near where the electrodes are positioned. In addition, a defibrillator lead is disclosed having such features, and a system using that lead is capable of directly monitoring pressure within a heart chamber, and using that information to confirm the delivery of a defibrillation pulse.

Abstract: A resuscitation system for use by a rescuer for resuscitating a patient, comprising at least two high-voltage defibrillation electrodes, a first electrical unit comprising circuitry for providing resuscitation prompts to the rescuer, a second electrical unit separate from the first unit and comprising circuitry for providing defibrillation pulses to the electrodes, and circuitry for providing at least one electrical connection between the first and second units.

Abstract: A method comprises monitoring a heart rate, a respiration rate and an activity level of a patient, comparing the monitored heart rate, respiration rate and activity level to a predetermined threshold zone which is a function of heart rate, respiration rate and activity level, determining the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone; and after determining the patient is experiencing worsening heart failure when the monitored heart rate, respiration rate and activity level are outside the predetermined threshold zone, issuing an alert to indicate that the patient is experiencing worsening heart failure.

Abstract: An implantable cardiac device includes a housing (2), pulse generator (7) therein to generate physiologically effective electrical pulses, a shock lead (3), externally of the housing (2), connectable to the pulse generator (7) and implantable into a patient's body to apply physiologically effective electrical pulses to the patient's body, a monitor (8) to automatically detect a lead condition as to whether the shock lead (3) is implanted or not, and control (9), which due to the detected lead condition automatically enables or disables the pulse generator (7).

Abstract: The presence of a cardiac pulse in a patient is determined by evaluating physiological signals in the patient. In one embodiment, a medical device evaluates two or more different physiological signals, such as phonocardiogram (PCG) signals, electrocardiogram (ECG) signals, patient impedance signals, piezoelectric signals, and accelerometer signals for features indicative of the presence of a cardiac pulse. Using these features, the medical device determines whether a cardiac pulse is present in the patient. The medical device may also be configured to report whether the patient is in a VF, VT, asystole, or PEA condition, in addition to being in a pulseless condition, and prompt different therapies, such as chest compressions, rescue breathing, defibrillation, and PEA-specific electrotherapy, depending on the analysis of the physiological signals. Auto-capture of a cardiac pulse using pacing stimuli is further provided.

Abstract: An apparatus comprises an implantable sensor and a signal analyzer circuit communicatively coupled to the implantable sensor. The implantable sensor is configured for coupling to an implantable lead and the implantable sensor provides an electrical vibration sensor signal representative of mechanical vibration of the implantable lead. The signal analyzer circuit is configured to determine a baseline of the vibration sensor signal, detect a change in the vibration sensor signal from the baseline vibration sensor signal, and provide an indication of the change to a user or process.

Abstract: An exemplary method includes acquiring patient activity information and/or nerve activity information, detecting one or more episodes of atrial fibrillation, associating the information with atrial fibrillation and, upon occurrence of particular patient activity and/or nerve activity, calling for delivery of an anti-atrial fibrillation therapy. Various other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: Hemodynamic signals, such as photoplethysmography (PPG) signals, pressure signals, and impedance signals, are sampled once per cyclical body cycle to reduce the amount of data, processing and/or power required to analyze the hemodynamic signals.

Abstract: A device and method for defrosting a defibrillation electrode are provided. This includes an automated external defibrillator that is capable of defrosting one or more frozen electrodes. The device is includes a portable housing containing a battery powered energy source and a controller as well as at least a pair of electrodes which are operably coupled to the housing. The electrodes are designed for attachment to the chest of a patient in need of resuscitation and contain a conductive interface medium that has temperature dependent properties. A controller is configured to selectively heat the conductive interface medium by applying limited electrical impulses and raise the electrode temperature to a desired temperature range.

Abstract: An apparatus for indicating cardiac output comprises means for monitoring a patient's transthoracic impedance and generating a corresponding impedance signal, and signal processing means for (a) deriving a signal S1 which is a measure of the average amplitude of the impedance signal, (b) filtering the impedance signal at a plurality of different wavelengths within a predetermined frequency band, (c) for each filter deriving a signal S2 which is a measure of the average amplitude of the respective filter output, (d) calculating the ratio of the maximum one of the signals S2 derived from step (c) to the signal S1 derived from step (a), and (e) using the ratio from step (d) in a decision tree to provide a signal indicating cardiac output or not.

Abstract: A system and method for organization and analysis of complex and dynamically interactive time series is disclosed. One example comprises a processor based system for relational analysis of physiologic signals for providing early recognition of catastrophic and pathologic events such as pathophysiologic divergence. The processor is programmed to identify pathophysiologic divergence of at least one of first and second physiologic parameters in relationship to the other and to output an indication of the divergence. An object-based method of iterative relational processing waveform fragments in the time domain is described wherein each more complex waveform object inherits the characteristics of the waveform objects from which it is derived. The first physiologic parameter can be the amplitude and frequency of the variation in chest wall impedance or nasal pressure and the second parameter can be a measure or indication of the arterial oxygen saturation.

Abstract: An implantable medical system includes a first die substrate with a first outer surface. The system also includes a second die substrate with a second outer surface. Furthermore, the system includes a medical device with a first portion that is mounted to the first die substrate and a second portion that is mounted to the second die substrate. The first and second die substrates are fixed to each other and substantially hermetically sealed to each other. Also, the medical device is substantially encapsulated between the first and second die substrates. The first portion is electrically connected to the second portion. Moreover, the first and second outer surfaces of the first and second die substrates are directly exposed to a biological material.

Abstract: A heart monitor is disclosed including an electroacoustic transducer such as an earphone coupled to a controller. The transducer is positioned in a person's ear in acoustic communication with the tympanum. Signals from the transducer are processed to determine the presence of pulsatile blood flow. The heart monitor may be incorporated into a defibrillator to sense the presence of blood flow for use in a shock delivery decision.

Abstract: An implantable heart defibrillator for use with an electrode lead system is provided. The implantable heart defibrillator includes an electrode lead connector that is connectable to the electrode lead system. A sensor is operable to sense a condition of a heart and emit a condition signal that identifies the condition. A control unit is operable to identify whether a state of fibrillation exists from the condition signal and emit a command signal if the state of fibrillation exists. A shock pulse generator is operable to emit at least one defibrillation shock to the electrode lead connector upon receipt of the command signal. The at least one defibrillation shock comprises at least one pulse having a voltage of more than 600 volts and a time duration of 30 to 100 microseconds.

Abstract: An implantable cardiac defibrillation device provides pre-shock stimuli to reduce the defibrillation threshold (DFT). The device includes an arrhythmia detector that detects fibrillation of a fibrillating chamber of a heart and a pulse generator that provides a fibrillation therapy output responsive to the arrhythmia detector detecting fibrillation of the fibrillating chamber of the heart. The therapy output includes a defibrillating shock having an output magnitude exceeding a temporary defibrillation threshold of the fibrillating chamber and at least one pre-defibrillating shock output pulse that reduces an initial defibrillation threshold of the fibrillating chamber to the temporary defibrillation threshold. An electrode system having at least two defibrillation electrodes delivers both the at least one pre-defibrillating shock output pulse to the heart and the defibrillating shock to the fibrillating chamber of the heart.

Abstract: An external defibrillator is customized for at least one person, i.e., an anticipated patient, through creation of a profile for the anticipated patient that allows the defibrillator and users of the defibrillator to provide customized treatment to the patient. The profile may include treatment parameters for the anticipated patient, such as defibrillation therapy parameters selected for the patient. The profile may also include a baseline recording of a physiological parameter of the patient, and medical history and personal information regarding the patient. In some embodiments, the external defibrillator stores a profile for each of one or more anticipated patients within a memory. In other embodiments, a profile for an anticipated patient is stored within a medium associated with that anticipated patient. The medium may, for example, be a removable medium for external defibrillators.