US20190239824A1 - Patient position detection system - Google Patents

Abstract

A patient movement detector can receive inputs from position sensors, a thermal imaging camera, a video camera, and/or triangulation data. Based on one or more of these inputs, the patient movement detector can perform one or more of the following: fall prevention detection, bedsore prevention analysis, patient location detection, and patient walk test scoring. The patient movement detector can, for example, output a fall warning alarm, a bedsore warning alarm, patient location information, and walk test scores.

Description

RELATED APPLICATIONS
• The present application is a continuation of U.S. patent application Ser. No. 14/511,974, filed Oct. 10, 2014, titled Patient Position Detection System, which claims priority to U.S. Provisional Patent Application Ser. No. 61/889,939, filed Oct. 11, 2013, titled Patient Position Detection System, and is a continuation-in-part of U.S. patent application Ser. No. 13/762,270, filed Feb. 7, 2013, titled Wireless Patient Monitoring Device, which claims priority as a non-provisional of U.S. Provisional Patent Application Ser. No. 61/597,126, filed Feb. 9, 2012, titled Wireless Patient Monitoring System, U.S. Provisional Patent Application Ser. No. 61/625,584, filed Apr. 17, 2012, titled Wireless Patient Monitoring Device, and U.S. Provisional Patent Application Ser. No. 61/703,713, filed Sep. 20, 2012, titled Wireless Patient Monitoring Device. All of the foregoing applications are hereby incorporated by reference in their entirety.
BACKGROUND
• Hospitals, nursing homes, and other patient care facilities typically include patient monitoring devices at one or more bedsides in the facility. Patient monitoring devices generally include sensors, processing equipment, and displays for obtaining and analyzing a medical patient's physiological parameters such as blood oxygen saturation level, respiratory rate, and the like. Clinicians, including doctors, nurses, and other medical personnel, use the physiological parameters obtained from patient monitors to diagnose illnesses and to prescribe treatments. Clinicians also use the physiological parameters to monitor patients during various clinical situations to determine whether to increase the level of medical care given to patients.
• For example, the patient monitoring devices can be used to monitor a pulse oximeter. Pulse oximetry is a widely accepted noninvasive procedure for measuring the oxygen saturation level of arterial blood, an indicator of a person's oxygen supply. A typical pulse oximetry system utilizes an optical sensor clipped onto a fingertip to measure the relative volume of oxygenated hemoglobin in pulsatile arterial blood flowing within the fingertip. Oxygen saturation (SpO₂), pulse rate, a plethysmograph waveform, perfusion index (PI), pleth variability index (PVI), methemoglobin (MetHb), carboxyhemoglobin (CoHb), total hemoglobin (tHb), glucose, and/or otherwise can be displayed on a monitor accordingly.
• The patient monitoring devices can also communicate with an acoustic sensor comprising an acoustic transducer, such as a piezoelectric element. The acoustic sensor can detect respiratory and other biological sounds of a patient and provide signals reflecting these sounds to a patient monitor. An example of such an acoustic sensor, which can implement any of the acoustic sensing functions described herein, is described in U.S. application Ser. No. 12/643,939, filed Dec. 21, 2009, titled “Acoustic Sensor Assembly,” and in U.S. application Ser. No. 61/313,645, filed Mar. 12, 2010, titled “Acoustic Respiratory Monitoring Sensor Having Multiple Sensing Elements,” the disclosures of which are hereby incorporated by reference in their entirety.
• Blood pressure is another example of a physiological parameter that can be monitored. Many devices allow blood pressure to be measured by sphygmomanometer systems that utilize an inflatable cuff applied to a person's arm. The cuff is inflated to a pressure level high enough to occlude a major artery. When air is slowly released from the cuff, blood pressure can be estimated by detecting “Korotkoff” sounds using a stethoscope or other detection means placed over the artery. Other Examples of physiological parameters that can be measured include respiration rate, blood analyte measurements, such as oxygen saturation, and ECG.
SUMMARY
• One aspect of the disclosure is a wireless patient monitoring device including one or more sensors configured to obtain physiological information. The one or more sensors can include an optical sensor, an acoustic respiratory sensor, and/or a blood pressure measurement device. Other sensors, including but not limited to, an EEG, ECG, and/or a sedation state sensor can also be used with the present disclosure. The one or more sensors are connected to a wireless monitor configured to receive the sensor data and to wirelessly transmit sensor data or physiological parameters reflective of the sensor data to a bedside monitor. The bedside monitor can be configured to output the physiological parameters, communication channel, and/or communication status.
• Another aspect of the disclosure is directed toward a system configured to wirelessly communicate physiological information, the system including a battery, a housing, a rechargeable electrical storage module, and a memory module configured to store wireless communication information.
• In some aspects of the disclosure, the wireless communication information stored on the data storage component facilitates communication between the wireless monitor and the bedside monitor. The information may be a unique identifier used to pair the wireless monitor with the bedside monitor. The information may be a password used to make sure only the correct receiver has access to the transmitted physiological data. The information may be channel information to make certain the wireless monitor and bedside monitor communicate on the same channel.
• In some aspects of the disclosure, the bedside monitor can be configured to receive and recharge the removable battery. The battery may include a data storage component configured to store wireless communication information. In some embodiments, the bedside monitor communicates wireless communication information to the battery through a hard wired connection, and the battery stores the information. In some embodiments, the battery communicates wireless communication information to the bedside monitor through a hard wired connection.
• Another aspect of the disclosure is directed toward a bedside monitor configured to receive the wireless monitor. In some embodiments, the bedside monitor communicates wireless communication information to the wireless monitor when the wireless monitor is physically and electrically connected with the bedside monitor. In some embodiments, the wireless monitor communicates information to the bedside monitor when the wireless monitor is physically and electrically connected with the bedside monitor.
• In another aspect of the disclosure, the wireless monitor can be configured to transmit physiological data over a first wireless technology when a signal strength of the first wireless technology is sufficiently strong and transmit physiological data over a second wireless technology when the signal strength of the first wireless technology is not sufficiently strong.
• In yet another aspect of the disclosure, the wireless monitor can be configured to transmit physiological data over a first wireless technology when the wireless monitor is within a pre-determined distance from the wireless receiver and transmit physiological data over a second wireless technology when the wireless monitor is not within a pre-determined distance from the bedside monitor.
• In another aspect of the disclosure, the battery includes a display. The display can be configured to activate when the wireless transmitter transmits physiological data over a first wireless technology and deactivate when the wireless transmitter transmits physiological data over a second wireless technology.
• One aspect of the disclosure is a method of wirelessly monitoring physiological information. The method includes providing a battery including a data storage component, physically connecting the battery to a bedside monitor, storing data on the data storage component of the battery, connecting the battery to a wireless monitor, and transmitting physiological data from the wireless monitor to the bedside monitor.
• In another aspect of the disclosure, transmitting physiological data from the wireless monitor to the bedside monitor includes transmitting physiological data over a first wireless technology when the wireless monitor is within a pre-determined distance from the bedside monitor and transmitting physiological data over a second wireless technology when the wireless monitor is not within a pre-determined distance from the bedside monitor. In some embodiments of the disclosure, the first wireless technology is Bluetooth or ZigBee, and the second wireless technology is Wi-Fi or cellular telephony.
• In yet another aspect of the disclosure, transmitting physiological data from the wireless monitor to the bedside monitor includes transmitting physiological data over a first wireless technology when a signal strength of the first wireless technology is sufficiently strong and transmitting physiological data over a second wireless technology when the signal strength of the first wireless technology is not sufficiently strong.
• In some aspects of the disclosure, the wireless monitor can be configured to be coupled to an arm band attached to the patient. Alternatively, the wireless monitor can be configured to be coupled to a patient's belt, can be carried by the patient (e.g., via a shoulder strap or handle), or can be placed on the patient's bed next to the patient, among other locations.
• In another aspect of the disclosure, the wireless monitor battery includes a display screen. When the wireless monitor is within a pre-determined distance from the bedside monitor and transmits data over Bluetooth or Zigbee, the display screen deactivates. When the wireless monitor is not within a pre-determined distance from the bedside monitor and transmits data over Wi-Fi or cellular telephony, the display screen activates. Alternatively, independent of the communication protocol used by the device, when the wireless monitor is a pre-determined distance from the bedside monitor, the display screen activates. Similarly when the wireless monitor is within a pre-determined distance to the bedside monitor, the display screen deactivates.
• In certain aspects of the disclosure, a blood pressure device can be used. The blood pressure device can be coupled to a medical patient and a wireless transceiver electrically coupled with the blood pressure device. The wireless transceiver can wirelessly transmit blood pressure data received by the blood pressure device and physiological data received from one or more physiological sensors coupled to the blood pressure device. To further increase patient mobility, in some embodiments, a single cable can be provided for connecting multiple different types of sensors together.
• In certain aspects of the disclosure, a wireless patient monitoring device for measuring one or more parameters can be secured to an arm of the patient. For example, a wireless measurement device for measuring oxygen saturation and respiration rate can be secured to the arm of a patient. The wireless monitoring device can connect to an oximeter probe and an acoustic respiration probe. The monitor can have a display screen and/or can transmit wireless information to a bedside monitor. In an embodiment, a docking station can be provided for the wireless monitoring device to dock it to a docking station forming a bedside monitor.
• In some aspects of the disclosure, the patient monitoring devices can be coupled to a blood pressure cuff and measure blood pressure.
• In some aspects of the disclosure, the patient monitoring system can include a sensor configured to obtain physiological information, an anchor connected to the sensor, and a wireless transceiver connected to the anchor. A first cable can connect the sensor to the anchor and a second cable can connect the anchor to the wireless transceiver. In certain aspects, the anchor can adhere to the patient or be carried by the patient in any manner discussed herein.
• In some aspects of the disclosure, the patient monitoring system can include one or more sensors configured to obtain physiological information and a wireless transceiver configured to receive the physiological information. The wireless transceiver can include a housing having a first side and a second side. At least one connector can be positioned on the first side and at least one connector can be positioned on the second side. In certain aspects, the first side of housing can be opposite the second side of the housing.
• In some aspects of the disclosure, a docking station can include a bedside monitor having a docking port configured to receive a first patient monitor and a docking station adapter configured to adapt the docking port to receive a second patient monitor. The second patient monitor can be a different size than the first patient monitor. In certain aspects, the first patient monitor can communicate with the bedside monitor over a wired connection when the first patient monitor is connected to the docking port. In certain aspects, the second patient monitor can communicate with the bedside monitor over a wired connection when the second patient monitor is connected to the docking station adapter and the docking station adapter is connected to the docking port.
• In some aspects of the disclosure, a patient monitoring system can include a first sensor, a second sensor, and a wireless patient monitor configured to receive physiological information from the first sensor and the second sensor. The patient monitoring system can include a single cable connecting the first sensor and the second sensor to the wireless patient monitor. In certain aspects, the single cable can include a first cable section connecting the wireless patient monitor and the first sensor and a second cable section connecting the first sensor and the second sensor. In certain aspects, the first sensor and the second sensor can be powered by a shared power line and/or can transmit signals over a shared signal line.
• In some aspects of the disclosure, a patient monitoring system can include one or more sensors configured to obtain physiological information, a patient monitor configured to receive the physiological information, and a cable hub having one or more inlet connectors connected to the one or more sensors and an outlet connector connected to the patient monitor. In certain aspects, the one or more inlet connectors can be positioned on a first end of the cable hub and the outlet connector can be positioned on a second end of the cable hub, opposite the first end. In certain aspects, the patient monitor can include a wireless transceiver. In certain aspects, the patient monitor can be configured to be worn by the patient. In certain aspects, the cable hub can be configured to adhere to the patient. In certain aspects, a first cable extends from at least one of the one or more sensors to one of the one or more inlet connectors, and a second cable extends from the outlet connector to the patient monitor.
• Some aspects of the disclosure describe a method of using a patient monitoring system. The method can include providing a wireless transceiver having a first end and a second end opposite the first end, a first connector positioned on the first end, and a second connector positioned on the second end. The method can include connecting a first end of a first cable to the first connector, and connecting a first end of a second cable to the second connector. In certain aspects, the method can include connecting a second end of the first cable to a first sensor. In certain aspects, the method can include connecting a second end of the second cable to a second sensor or a cable hub connected to one or more sensors. In certain aspects, the method can include connecting a third sensor and/or anchor to the second cable. In certain aspects, the method can include connecting a third cable to a third connector on the second end of the wireless transceiver.
• Certain aspects of this disclosure are directed toward a wireless monitor including a housing, a battery, and a strap. The housing can include one or more outlets configured to receive one or more sensors. The battery can be configured to removably engage the housing. A portion of the strap can be disposed between the housing and the battery when the housing is engaged with the battery. In certain aspects, the portion of the strap disposed between the housing and the battery can be a separately formed component from a remainder of the strap. In certain aspects, the portion of the strap can include one or more mating features configured to mate with corresponding features of the housing. In certain aspects, the one or more mating features are flush with the corresponding features of the housing. In certain aspects, the housing can include a recessed portion for receiving the strap.
• For purposes of summarizing the disclosure, certain aspects, advantages and novel features of the inventions have been described herein. It is to be understood that not necessarily all such advantages can be achieved in accordance with any particular embodiment of the inventions disclosed herein. Thus, the inventions disclosed herein can be embodied or carried out in a manner that achieves or optimizes one advantage or group of advantages as taught herein without necessarily achieving other advantages as can be taught or suggested herein.
BRIEF DESCRIPTION OF THE DRAWINGS
• Various embodiments will be described hereinafter with reference to the accompanying drawings. These embodiments are illustrated and described by example only, and are not intended to limit the scope of the disclosure. In the drawings, similar elements have similar reference numerals.
• FIGS. 1A and 1B illustrate embodiments of wireless patient monitoring systems.
• FIGS. 1C and 1D illustrate further embodiments of wireless patient monitoring systems.
• FIG. 1E illustrates the embodiment of the wireless patient monitoring system illustrated inFIGS. 1A-1B in schematic form.
• FIGS. 2A and 2B illustrate embodiments of wireless patient monitoring systems having a single cable connection system.
• FIGS. 3A and 3B illustrates additional embodiment of patient monitoring systems.
• FIGS. 4A and 4B illustrate embodiments of an optical ear sensor and an acoustic sensor connected via a single cable connection system.
• FIG. 5 illustrates an embodiment of a wireless transceiver that can be used with any of the patient monitoring systems described above.
• FIGS. 6A through 6C illustrate additional embodiments of patient monitoring systems.
• FIG. 7 illustrates an embodiment of a physiological parameter display that can be used with any of the patient monitoring systems described above.
• FIG. 8 illustrates a further embodiment of a patient monitoring system.
• FIGS. 9A-9D illustrate an embodiment of a wireless patient monitoring system.
• FIG. 10 illustrates the embodiment of the wireless patient monitoring system illustrated inFIGS. 9A-9D in schematic form.
• FIG. 11 illustrates one embodiment of a method of using a wireless patient monitoring system.
• FIG. 12 illustrates a wireless monitor having a display screen.
• FIGS. 13-15 illustrate methods of using a wireless monitor having a display screen.
• FIGS. 16A-16G illustrate another embodiment of a wireless patient monitoring system.
• FIGS. 17A-17C illustrate another embodiment of a wireless patient monitoring system.
• FIGS. 18A-18C illustrate an animation of patient movement created using a wireless patient monitor.
• FIG. 19 depicts an embodiment of a patient movement detector.
• FIG. 20 depicts an embodiment of a fall warning process.
• FIG. 21 depicts an embodiment of a bedsore warning process.
• FIG. 22 depicts an embodiment of another fall warning process.
DETAILED DESCRIPTIONI. Introduction
• In clinical settings, medical sensors are often attached to patients to monitor physiological parameters of the patients. Some examples of medical sensors include, but are not limited to, blood oxygen sensors, such as pulse oximetry sensors, acoustic respiratory sensors, EEGs, ECGs, blood pressure sensors, sedation state sensors, etc. Typically, each sensor attached to a patient is connected to a bedside monitoring device with a cable. The cables limit the patient's freedom of movement and impede a care providers access to the patient. The cables connecting the patient to the bedside monitoring device also make it more difficult to move the patient from room to room or switch to different bedside monitors.
• This disclosure describes embodiments of wireless patient monitoring systems that include a wireless device coupled to a patient and to one or more sensors. In one embodiment, the wireless device transmits sensor data obtained from the sensors to a patient monitor. By transmitting the sensor data wirelessly, these patient monitoring systems can advantageously replace some or all cables that connect patients to bedside monitoring devices. To further increase patient mobility and comfort, in some embodiments, a single cable connection system is also provided for connecting multiple different types of sensors together.
• These patient monitoring systems are primarily described in the context of an example blood pressure cuff that includes a wireless transceiver. The blood pressure cuff and/or wireless transceiver can also be coupled to additional sensors, such as optical sensors, acoustic sensors, and/or electrocardiograph sensors. The wireless transceiver can transmit blood pressure data and sensor data from the other sensors to a wireless receiver, which can be a patient monitor. These and other features described herein can be applied to a variety of sensor configurations, including configurations that do not include a blood pressure cuff. In an embodiment, an arm band without a blood pressure cuff can be used to secure a wireless patient monitor connected to various sensors.
II. Example Embodiments
• FIGS. 1A and 1B illustrate embodiments of wirelesspatient monitoring systems100A,100B, respectively. In the wireless patient monitoring systems100 shown, a blood pressure device110 is connected to apatient101. The blood pressure device110 includes awireless transceiver116, which can transmit sensor data obtained from thepatient101 to awireless transceiver120. Thus, thepatient101 is advantageously not physically coupled to a bedside monitor in the depicted embodiment and can therefore have greater freedom of movement.
• Referring toFIG. 1A, theblood pressure device110aincludes aninflatable cuff112, which can be an oscilometric cuff that is actuated electronically (e.g., via intelligent cuff inflation and/or based on a time interval) to obtain blood pressure information. Thecuff112 is coupled to awireless transceiver116. Theblood pressure device110ais also coupled to a fingertipoptical sensor102 via acable107. Theoptical sensor102 can include one or more emitters and detectors for obtaining physiological information indicative of one or more blood parameters of thepatient101. These parameters can include various blood analytes such as oxygen, carbon monoxide, methemoglobin, total hemoglobin, glucose, proteins, glucose, lipids, a percentage thereof (e.g., concentration or saturation), and the like. Theoptical sensor102 can also be used to obtain a photoplethysmograph, a measure of plethysmograph variability, pulse rate, a measure of blood perfusion, and the like.
• Additionally, theblood pressure device110ais coupled to anacoustic sensor104avia a cable105. The cable105 connecting theacoustic sensor104ato the blood pressure device110 includes two portions, namely acable105aand acable105b. Thecable105aconnects theacoustic sensor104ato ananchor104b, which is coupled to theblood pressure device110avia thecable105b. Theanchor104bcan be adhered to the patient's skin to reduce noise due to accidental tugging of theacoustic sensor104a.
• Theacoustic sensor104acan be a piezoelectric sensor or the like that obtains physiological information reflective of one or more respiratory parameters of thepatient101. These parameters can include, for example, respiratory rate, inspiratory time, expiratory time, inspiration-to-expiration ratio, inspiratory flow, expiratory flow, tidal volume, minute volume, apnea duration, breath sounds, rales, rhonchi, stridor, and changes in breath sounds such as decreased volume or change in airflow. In addition, in some cases therespiratory sensor104a, or another lead of therespiratory sensor104a(not shown), can measure other physiological sounds such as heart rate (e.g., to help with probe-off detection), heart sounds (e.g., S1, S2, S3, S4, and murmurs), and changes in heart sounds such as normal to murmur or split heart sounds indicating fluid overload. In some implementations, a second acoustic respiratory sensor can be provided over the patient's101 chest for additional heart sound detection. In one embodiment, the acoustic sensor104 can include any of the features described in U.S. patent application Ser. No. 12/643,939, filed Dec. 21, 2009, titled “Acoustic Sensor Assembly,” the disclosure of which is hereby incorporated by reference in its entirety.
• The acoustic sensor104 can be used to generate an exciter waveform that can be detected by theoptical sensor102 at the fingertip, by an optical sensor attached to an ear of the patient (seeFIGS. 2A, 3), by an ECG sensor (seeFIG. 2C), or by another acoustic sensor (not shown). The velocity of the exciter waveform can be calculated by a processor (such as a processor in thewireless transceiver120, described below). From this velocity, the processor can derive a blood pressure measurement or blood pressure estimate. The processor can output the blood pressure measurement for display. The processor can also use the blood pressure measurement to determine whether to trigger theblood pressure cuff112.
• In another embodiment, the acoustic sensor104 placed on the upper chest can be advantageously combined with an ECG electrode (such as instructure208 ofFIG. 2B), thereby providing dual benefit of two signals generated from a single mechanical assembly. The timing relationship from fidicial markers from the ECG signal, related cardiac acoustic signal and the resulting peripheral pulse from the finger pulse oximeters produces a transit time that correlates to the cardiovascular performance such as blood pressure, vascular tone, vascular volume and cardiac mechanical function. Pulse wave transit time or PWTT in currently available systems depends on ECG as the sole reference point, but such systems may not be able to isolate the transit time variables associated to cardiac functions, such as the pre-ejection period (PEP). In certain embodiments, the addition of the cardiac acoustical signal allows isolation of the cardiac functions and provides additional cardiac performance metrics. Timing calculations can be performed by the processor in thewireless transceiver120 or a in distributed processor found in an on-body structure (e.g., such as any of the devices herein or below:112,210,230,402,806).
• In certain embodiments, the wireless patient monitoring system100 uses some or all of the velocity-based blood pressure measurement techniques described in U.S. Pat. No. 5,590,649, filed Apr. 15, 1994, titled “Apparatus and Method for Measuring an Induced Perturbation to Determine Blood Pressure,” or in U.S. Pat. No. 5,785,659, filed Jan. 17, 1996, titled “Automatically Activated Blood Pressure Measurement Device,” the disclosures of which are hereby incorporated by reference in their entirety. An example display related to such blood pressure calculations is described below with respect toFIG. 7.
• Thewireless transceiver116 can transmit data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like. Thewireless transceiver116 can perform solely telemetry functions, such as measuring and reporting information about thepatient101. Alternatively, thewireless transceiver116 can be a transceiver that also receives data and/or instructions, as will be described in further detail below.
• Thewireless receiver120 receives information from and/or sends information to the wireless transceiver via anantenna122. In certain embodiments, thewireless receiver120 is a patient monitor. As such, thewireless receiver120 can include one or more processors that process sensor signals received from thewireless transceiver116 corresponding to the sensors102a,102b,104, and/or106 in order to derive any of the physiological parameters described above. Thewireless transceiver120 can also display any of these parameters, including trends, waveforms, related alarms, and the like. Thewireless receiver120 can further include a computer-readable storage medium, such as a physical storage device, for storing the physiological data. Thewireless transceiver120 can also include a network interface for communicating the physiological data to one or more hosts over a network, such as to a nurse's station computer in a hospital network.
• Moreover, in certain embodiments, thewireless transceiver116 can send raw data for processing to a central nurse's station computer, to a clinician device, and/or to a bedside device (e.g., the receiver116). Thewireless transceiver116 can also send raw data to a central nurse's station computer, clinician device, and/or to a bedside device for calculation, which retransmits calculated measurements back to the blood pressure device110 (or to the bedside device). Thewireless transceiver116 can also calculate measurements from the raw data and send the measurements to a central nurse's station computer, to a pager or other clinician device, or to a bedside device (e.g., the receiver116). Many other configurations of data transmission are possible.
• In addition to deriving any of the parameters mentioned above from the data obtained from the sensors102a,102b,104, and/or106, thewireless transceiver120 can also determine various measures of data confidence, such as the data confidence indicators described in U.S. Pat. No. 7,024,233 entitled “Pulse oximetry data confidence indicator,” the disclosure of which is hereby incorporated by reference in its entirety. Thewireless transceiver120 can also determine a perfusion index, such as the perfusion index described in U.S. Pat. No. 7,292,883 entitled “Physiological assessment system,” the disclosure of which is hereby incorporated by reference in its entirety. Moreover, thewireless transceiver120 can determine a plethysmograph variability index (PVI), such as the PVI described in U.S. Publication No. 2008/0188760 entitled “Plethysmograph variability processor,” the disclosure of which is hereby incorporated by reference in its entirety.
• In addition, thewireless transceiver120 can send data and instructions to thewireless transceiver116 in some embodiments. For instance, thewireless transceiver120 can intelligently determine when to inflate thecuff112 and can send inflation signals to thetransceiver116. Similarly, thewireless transceiver120 can remotely control any other sensors that can be attached to thetransceiver116 or thecuff112. Thetransceiver120 can send software or firmware updates to thetransceiver116. Moreover, the transceiver120 (or the transceiver116) can adjust the amount of signal data transmitted by thetransceiver116 based at least in part on the acuity of the patient, using, for example, any of the techniques described in U.S. Patent Publication No. 2009/0119330, filed Jan. 7, 2009, titled “Systems and Methods for Storing, Analyzing, and Retrieving Medical Data,” the disclosure of which is hereby incorporated by reference in its entirety.
• In alternative embodiments, thewireless transceiver116 can perform some or all of the patient monitor functions described above, instead of or in addition to the monitoring functions described above with respect to thewireless transceiver120. In some cases, thewireless transceiver116 might also include a display that outputs data reflecting any of the parameters described above (see, e.g.,FIG. 5). Thus, thewireless transceiver116 can either send raw signal data to be processed by thewireless transceiver120, can send processed signal data to be displayed and/or passed on by thewireless transceiver120, or can perform some combination of the above. Moreover, in some implementations, thewireless transceiver116 can perform at least some front-end processing of the data, such as bandpass filtering, analog-to-digital conversion, and/or signal conditioning, prior to sending the data to thetransceiver120. An alternative embodiment may include at least some front end processing embedded in any of the sensors described herein (such assensors102,104,204,202,208,412,804,840,808) or cable hub806 (seeFIG. 8).
• In certain embodiments, thecuff112 is a reusable, disposable, or resposable device. Similarly, any of thesensors102,104aorcables105,107 can be disposable or resposable. Resposable devices can include devices that are partially disposable and partially reusable. Thus, for example, theacoustic sensor104acan include reusable electronics but a disposable contact surface (such as an adhesive) where thesensor104acomes into contact with the patient's skin. Generally, any of the sensors, cuffs, and cables described herein can be reusable, disposable, or resposable.
• Thecuff112 can also can have its own power (e.g., via batteries) either as extra power or as a sole source of power for thetransceiver116. The batteries can be disposable or reusable. In some embodiments, thecuff112 can include one or more photovoltaic solar cells or other power sources. Likewise, batteries, solar sources, or other power sources can be provided for either of thesensors102,104a.
• Referring toFIG. 1B, another embodiment of thesystem100B is shown. In thesystem100B, theblood pressure device110bcan communicate wirelessly with theacoustic sensor104aand with theoptical sensor102. For instance, wireless transceivers (not shown) can be provided in one or both of thesensors102,104a, using any of the wireless technologies described above. The wireless transceivers can transmit data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like. The wireless transceivers can transmit data, raw signals, processed signals, conditioned signals, or the like to theblood pressure device110b. Theblood pressure device110bcan transmit these signals on to thewireless transceiver120. In addition, in some embodiments, theblood pressure device110bcan also process the signals received from thesensors102,104aprior to transmitting the signals to thewireless transceiver120. Thesensors102,104acan also transmit data, raw signals, processed signals, conditioned signals, or the like directly to thewireless transceiver120 or patient monitor. In one embodiment, thesystem100B shown can be considered to be a body LAN, piconet, or other individual network.
• FIGS. 1C and 1D illustrate another embodiment in which awireless monitor150 is secured to the arm of the patient. The wireless monitor150 is a fully functional stand-alone monitor capable of various physiological measurements. The wireless monitor is small and light enough to comfortably be secured to and carried around on the arm of a patient. In the embodiment shown inFIG. 1C, thewireless monitor150 connects to anacoustic respiration sensor104A on a first side ofpatient monitor150 and anoximeter sensor102 on a second side ofpatient monitor150. This configuration of connected sensors to opposite sides of the monitor prevents cable clutter and entanglements. The wireless monitor150 includes ascreen154. The wireless monitor150 couples to and is held to the arm of the patient byarm band152. InFIG. 1C, the arm band is not an inflatable blood pressure cuff, however, as described with respect to the other figures, thearm band152 can incorporate a blood pressure cuff for blood pressure readings.
• The wireless monitor150 can transmit data to a bedside monitor using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• In an embodiment shown inFIG. 1D, themonitor150 can be docked to adocking station163. Thedocking station163 includes abedside monitor164 anddocking station adapter160.Docking station adapter160 adapts an otherwise incompatible docking port of bedside monitor164 so thatpatient monitor150 can dock. Thedocking station adapter162 includes aport162 for docking with thepatient monitor150. When the patient monitor150 is physically docked in thedocking station adapter160, the patient monitor150 can communicate with the bedside monitor164 over a wired connection.
• Also shown inFIG. 1D is handheldpatient monitor166.Handheld monitor166 is configured to dock directly to bedside monitor164 without the need for adocking station adapter162. When thehandheld monitor166 is physically docked in thebedside monitor164, thehandheld monitor166 can communicate with the bedside monitor164 over a wired connection.
• FIG. 1E illustrates details of an embodiment of thewireless monitoring system100A in a schematic form. Although other types of sensors can be used, thewireless monitoring system100A is drawn in connection with theacoustic sensor104aand theoptical sensor102. Thesystem100A sends signals from theacoustic sensor104aand theoptical sensor102 to thesensor interface170 and passes the signals to theDSP172 for processing into representations of physiological parameters. In some embodiments, the DSP also communicates with a memory or information element, such as a resistor or capacitor, located on one of the sensors, such memory typically contains information related to the properties of the sensor that may be useful in processing the signals, such as, for example, emitter energy wavelengths.
• In some embodiments, the physiological parameters are passed to aninstrument manager174, which may further process the parameters for display. Theinstrument manager174 may include amemory buffer176 to maintain this data for processing throughout a period of time.Memory buffer176 may include RAM, Flash or other solid state memory, magnetic or optical disk-based memories, combinations of the same or the like.
• Thewireless transceiver120 is capable of wirelessly receiving the physiological data and/or parameters fromDSP172 orinstrument manager174. The bedside monitor916 can include one ormore displays178, control buttons, a speaker for audio messages, and/or a wireless signal broadcaster. Thewireless transceiver120 can also include aprocessor180 to further process the data and/or parameters for display.
• FIGS. 2A and 2B illustrate additional embodiments ofpatient monitoring systems200A and200B, respectively. In particular,FIG. 2A illustrates a wirelesspatient monitoring system200A, whileFIG. 2B illustrates a standalonepatient monitoring system200B.
• Referring specifically toFIG. 2A, ablood pressure device210ais connected to apatient201. Theblood pressure device210aincludes awireless transceiver216a, which can transmit sensor data obtained from thepatient201 to a wireless receiver at220 viaantenna218. Thewireless transceiver216acan transmit data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• In the depicted embodiment, theblood pressure device210aincludes aninflatable cuff212a, which can include any of the features of thecuff112 described above. Additionally, thecuff212aincludes apocket214, which holds thewireless transceiver216a(shown by dashed lines). Thewireless transceiver216acan be electrically connected to thecuff212avia a connector (see, e.g.,FIG. 5) in some embodiments. As will be described elsewhere herein, the form of attachment of thewireless transceiver216ato thecuff212ais not restricted to a pocket connection mechanism and can vary in other implementations.
• Thewireless transceiver216ais also coupled to various sensors inFIGS. 2A, including anacoustic sensor204aand/or anoptical ear sensor202a. Theacoustic sensor204acan have any of the features of the acoustic sensor104 described above. Theear clip sensor202acan be an optical sensor that obtains physiological information regarding one or more blood parameters of thepatient201. These parameters can include any of the blood-related parameters described above with respect to theoptical sensor102. In one embodiment, theear clip sensor202ais an LNOP TC-I ear reusable sensor available from Masimo® Corporation of Irvine, Calif. In some embodiments, theear clip sensor202ais a concha ear sensor (seeFIGS. 4A and 4B).
• Advantageously, in the depicted embodiment, thesensors202a,204aare coupled to thewireless transceiver216avia a single cable205. The cable205 is shown having two sections, acable205aand acable205b. For example, thewireless transceiver216ais coupled to anacoustic sensor204avia thecable205b. In turn, theacoustic sensor204ais coupled to theoptical ear sensor202avia thecable205a. Advantageously, because thesensors202a,204 are attached to the wireless transceiver216 in the cuff212 in the depicted embodiment, the cable205 is relatively short and can thereby increase the patient's201 freedom of movement. Moreover, because a single cable205 is used to connect two or more different types of sensors, such assensors202a,204a, the patient's mobility and comfort can be further enhanced.
• In some embodiments, the cable205 is a shared cable205 that is shared by theoptical ear sensor202aand theacoustic sensor204a. The shared cable205 can share power and ground lines for each of thesensors202a,204a. Signal lines in the cable205 can convey signals from thesensors202a,204ato the wireless transceiver216 and/or instructions from the wireless transceiver216 to thesensors202a,204a. The signal lines can be separate within the cable205 for thedifferent sensors202a,204a. Alternatively, the signal lines can be shared as well, forming an electrical bus.
• The twocables205a,205acan be part of a single cable or can beseparate cables205a,205b. As a single cable205, in one embodiment, thecable205a,205bcan connect to theacoustic sensor204avia a single connector. As separate cables, in one embodiment, thecable205bcan be connected to a first port on theacoustic sensor204aand thecable205acan be coupled to a second port on theacoustic sensor204a.
• FIG. 2B further illustrates an embodiment of the cable205 in the context of a standalonepatient monitoring system200B. In the standalonepatient monitoring system200B, a blood pressure device210bis provided that includes apatient monitor216bdisposed on acuff212b. The patient monitor216bincludes adisplay219 for outputting physiological parameter measurements, trends, waveforms, patient data, and optionally other data for presentation to a clinician. Thedisplay219 can be an LCD display, for example, with a touch screen or the like. The patient monitor216bcan act as a standalone device, not needing to communicate with other devices to process and measure physiological parameters. In some embodiments, the patient monitor216bcan also include any of the wireless functionality described above. For example, the patient monitor216bcan transmit data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• The patient monitor216bcan be integrated into thecuff212bor can be detachable from thecuff212b. In one embodiment, the patient monitor216bcan be a readily available mobile computing device with a patient monitoring software application. For example, the patient monitor216bcan be a smart phone, personal digital assistant (PDA), or other wireless device. The patient monitoring software application on the device can perform any of a variety of functions, such as calculating physiological parameters, displaying physiological data, documenting physiological data, and/or wirelessly transmitting physiological data (including measurements or uncalculated raw sensor data) via email, text message (e.g., SMS or MMS), or some other communication medium. Moreover, any of the wireless transceivers or patient monitors described herein can be substituted with such a mobile computing device.
• In the depicted embodiment, the patient monitor216bis connected to three different types of sensors. Anoptical sensor202b, coupled to a patient's201 finger, is connected to the patient monitor216bvia acable207. In addition, anacoustic sensor204band an electrocardiograph (ECG)sensor206 are attached to the patient monitor206bvia the cable205. Theoptical sensor202bcan perform any of the optical sensor functions described above. Likewise, theacoustic sensor204bcan perform any of the acoustic sensor functions described above. TheECG sensor206 can be used to monitor electrical activity of the patient's201 heart.
• Advantageously, in the depicted embodiment, theECG sensor206 is a bundle sensor that includes one or more ECG leads208 in a single package. For example, theECG sensor206 can include one, two, or three or more leads. One or more of theleads208 can be an active lead or leads, while another lead208 can be a reference lead. Other configurations are possible with additional leads within the same package or at different points on the patient's body. Using abundle ECG sensor206 can advantageously enable a single cable connection via the cable205 to thecuff212b. Similarly, an acoustical sensor can be included in theECG sensor206 to advantageously reduce the overall complexity of the on-body assembly.
• Thecable205ainFIG. 2B can connect two sensors to thecuff212b, namely theECG sensor206 and theacoustic sensor204b. Although not shown, thecable205acan further connect an optical ear sensor to theacoustic sensor204bin some embodiments, optionally replacing the fingeroptical sensor202b. Thecable205ashown inFIG. 2B can have all the features described above with respect tocable205aofFIG. 2A.
• Although not shown, in some embodiments, any of the sensors, cuffs, wireless sensors, or patient monitors described herein can include one or more accelerometers or other motion measurement devices (such as gyroscopes). For example, inFIG. 2B, one or more of theacoustic sensor204b, theECG sensor206, thecuff212b, the patient monitor216b, and/or theoptical sensor202bcan include one or more motion measurement devices. A motion measurement device can be used by a processor (such as in the patient monitor216bor other device) to determine motion and/or position of a patient. For example, a motion measurement device can be used to determine whether a patient is sitting up, lying down, walking, or the like.
• Movement and/or position data obtained from a motion measurement device can be used to adjust a parameter calculation algorithm to compensate for the patient's motion. For example, a parameter measurement algorithm that compensates for motion can more aggressively compensate for motion in response to high degree of measured movement. When less motion is detected, the algorithm can compensate less aggressively. Movement and/or position data can also be used as a contributing factor to adjusting parameter measurements. Blood pressure, for instance, can change during patient motion due to changes in blood flow. If the patient is detected to be moving, the patient's calculated blood pressure (or other parameter) can therefore be adjusted differently than when the patient is detected to be sitting.
• A database can be assembled that includes movement and parameter data (raw or measured parameters) for one or more patients over time. The database can be analyzed by a processor to detect trends that can be used to perform parameter calculation adjustments based on motion or position. Many other variations and uses of the motion and/or position data are possible.
• Although the patient monitoring systems described herein, including thesystems100A,100B,200A, and200B have been described in the context of blood pressure cuffs, blood pressure need not be measured in some embodiments. For example, the cuff can be a holder for the patient monitoring devices and/or wireless transceivers and not include any blood pressure measuring functionality. Further, the patient monitoring devices and/or wireless transceivers shown need not be coupled to the patient via a cuff, but can be coupled to the patient at any other location, including not at all. For example, the devices can be coupled to the patient's belt (seeFIGS. 3A and 3B), can be carried by the patient (e.g., via a shoulder strap or handle), or can be placed on the patient's bed next to the patient, among other possible locations.
• Additionally, various features shown inFIGS. 2A and 2B can be changed or omitted. For instance, the wireless transceiver216 can be attached to the cuff212 without the use of thepocket214. For example, the wireless transceiver can be sewn, glued, buttoned or otherwise attached to the cuff using any various known attachment mechanisms. Or, the wireless transceiver216 can be directly coupled to the patient (e.g., via an armband) and the cuff212 can be omitted entirely. Instead of a cuff, the wireless transceiver216 can be coupled to a non-occlusive blood pressure device. Many other configurations are possible.
• FIGS. 3A and 3B illustrate further embodiments of apatient monitoring system300A,300B having a single cable connecting multiple sensors.FIG. 3A depicts a tetheredpatient monitoring system300A, whileFIG. 3B depicts a wirelesspatient monitoring system300B. Thepatient monitoring systems300A,300B illustrate example embodiments where a single cable305 can be used to connect multiple sensors, without using a blood pressure cuff.
• Referring toFIG. 3A, the acoustic andECG sensors204b,206 ofFIG. 2 are again shown coupled to thepatient201. As above, thesesensors204b,206 are coupled together via a cable205. However, thecable250 is coupled to ajunction device230ainstead of to a blood pressure cuff. In addition, theoptical sensor202bis coupled to thepatient201 and to thejunction device230avia acable207. Thejunction device230acan anchor thecable205bto the patient201 (such as via the patient's belt) and pass through any signals received from thesensors202b,204b,206 to apatient monitor240 via asingle cable232.
• In some embodiments, however, thejunction device230acan include at least some front-end signal processing circuitry. In some embodiments, thejunction device230aalso includes a processor for processing physiological parameter measurements. Further, thejunction device230acan include all the features of the patient monitor216bin some embodiments, such as providing a display that outputs parameters measured from data obtained by thesensors202b,204b,206.
• In the depicted embodiment, the patient monitor240 is connected to amedical stand250. The patient monitor240 includes parameter measuring modules242, one of which is connected to thejunction device230avia thecable232. The patient monitor240 further includes adisplay246. Thedisplay246 is a user-rotatable display in the depicted embodiment.
• Referring toFIG. 3B, thepatient monitoring system300B includes nearly identical features to thepatient monitoring system300A. However, thejunction device230bincludes wireless capability, enabling thejunction device230bto wirelessly communicate with the patient monitor240 and/or other devices. The wirelesspatient monitoring system300B can transmit data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• FIGS. 4A and 4B illustrate embodiments ofpatient monitoring systems400A,400B that depict alternativecable connection systems410 for connecting sensors to a patient monitor402. Like the cable205 described above, thesecable connection systems410 can advantageously enhance patient mobility and comfort.
• Referring toFIG. 4A, thepatient monitoring system400A includes a patient monitor402athat measures physiological parameters based on signals obtained fromsensors412,420 coupled to a patient. These sensors include anoptical ear sensor412 and anacoustic sensor420 in the embodiment shown. Theoptical ear sensor412 can include any of the features of the optical sensors described above. Likewise, theacoustic sensor420 can include any of the features of the acoustic sensors described above.
• Theoptical ear sensor412 can be shaped to conform to the cartilaginous structures of the ear, such that the cartilaginous structures can provide additional support to thesensor412, providing a more secure connection. This connection can be particularly beneficial for monitoring during pre-hospital and emergency use where the patient can move or be moved. In some embodiments, theoptical ear sensor412 can have any of the features described in U.S. application Ser. No. 12/658,872, filed Feb. 16, 2010, entitled “Ear Sensor,” the disclosure of which is hereby incorporated by reference in its entirety.
• Aninstrument cable450 connects the patient monitor402ato thecable connection system410. Thecable connection system410 includes asensor cable440 connected to theinstrument cable250. Thesensor cable440 is bifurcated into twocable sections416,422, which connect to theindividual sensors412,420 respectively. Ananchor430aconnects thesensor cable440 andcable sections416,422. Theanchor430acan include an adhesive for anchoring thecable connection system410 to the patient, so as to reduce noise from cable movement or the like. Advantageously, thecable connection system410 can reduce the number and size of cables connecting the patient to a patient monitor402a. Thecable connection system410 can also be used to connect with any of the other sensors, patient-worn monitors, or wireless devices described above.
• FIG. 4B illustrates thepatient monitoring system400B, which includes many of the features of themonitoring system400A. For example, anoptical ear sensor412 and anacoustic sensor420 are coupled to the patient. Likewise, thecable connection system410 is shown, including thecable sections416,422 coupled to ananchor430b. In the depicted embodiment, thecable connection system410 communicates wirelessly with apatient monitor402b. For example, theanchor430bcan include a wireless transceiver, or a separate wireless dongle or other device (not shown) can couple to theanchor430b. Theanchor430bcan be connected to a blood pressure cuff, wireless transceiver, junction device, or other device in some embodiments. The wireless transceiver, wireless dongle, or other device can transmit data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• FIG. 5 illustrates a more detailed embodiment of awireless transceiver516. Thewireless transceiver516 can have all of the features of thewireless transceiver516 described above. For example, thewireless transceiver516 can connect to a blood pressure cuff and to one or more physiological sensors, and thetransceiver516 can transmit sensor data to a wireless receiver. Thewireless transceiver516 can transmit data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• The depicted embodiment of thetransceiver516 includes ahousing530, which includesconnectors552 for sensor cables (e.g., for optical, acoustic, ECG, and/or other sensors) and aconnector560 for attachment to a blood pressure cuff or other patient-wearable device. Thetransceiver516 further includes anantenna518, which although shown as an external antenna, can be internal in some implementations.
• Thetransceiver516 can include one or more connectors on one or more sides of thehousing530. Providing connectors on different sides of thehousing530 allows for convenient sensor connection and prevents the sensor cables from tangling. For example, as shown inFIG. 5, the housing can include twoconnectors552 on a first side of thehousing530 and anadditional connector560 on a second side of thehousing530.
• In addition, thetransceiver516 includes adisplay554 that depicts values of various parameters, such as systolic and diastolic blood pressure, SpO2, and respiratory rate (RR). Thedisplay554 can also display trends, alarms, and the like. Thetransceiver516 can be implemented with thedisplay554 in embodiments where thetransceiver516 also acts as a patient monitor. Thetransceiver516 further includescontrols556, which can be used to manipulate settings and functions of thetransceiver516.
• FIGS. 6A through 6C illustrate embodiments of wireless patient monitoring systems600. These wireless patient monitoring systems can transmit data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• FIG. 6A illustrates apatient monitoring system600A that includes awireless transceiver616, which can include the features of any of the transceivers216,216 described above. Thetransceiver616 provides a wireless signal over awireless link612 to apatient monitor620. The wireless signal can include physiological information obtained from one or more sensors, physiological information that has been front-end processed by thetransceiver616, or the like.
• The patient monitor620 can act as thewireless receiver220 ofFIG. 2. The patient monitor620 can process the wireless signal received from thetransceiver616 to obtain values, waveforms, and the like for one or more physiological parameters. The patient monitor620 can perform any of the patient monitoring functions described above with respect toFIGS. 2 through 5.
• In addition, the patient monitor620 can provide at least some of the physiological information received from thetransceiver616 to a multi-patient monitoring system (MMS)640 over anetwork630. TheMMS640 can include one or more physical computing devices, such as servers, having hardware and/or software for providing the physiological information to other devices in thenetwork630. For example, theMMS640 can use standardized protocols (such as TCP/IP) or proprietary protocols to communicate the physiological information to one or more nurses' station computers (not shown) and/or clinician devices (not shown) via thenetwork630. In one embodiment, theMMS640 can include some or all the features of the MMS described in U.S. Publication No. 2008/0188760, referred to above.
• Thenetwork630 can be a LAN or WAN, wireless LAN (“WLAN”), or other type of network used in any hospital, nursing home, patient care center, or other clinical location. In some implementations, the network210 can interconnect devices from multiple hospitals or clinical locations, which can be remote from one another, through the Internet, one or more Intranets, a leased line, or the like. Thus, theMMS640 can advantageously distribute the physiological information to a variety of devices that are geographically co-located or geographically separated.
• FIG. 6B illustrates another embodiment of apatient monitoring system600B, where thetransceiver616 transmits physiological information to abase station624 via thewireless link612. In this embodiment, thetransceiver616 can perform the functions of a patient monitor, such as any of the patient monitor functions described above. Thetransceiver616 can provide processed sensor signals to thebase station624, which forwards the information on to theMMS640 over thenetwork630.
• FIG. 6C illustrates yet another embodiment of apatient monitoring system600B, where thetransceiver616 transmits physiological information directly to theMMS640. TheMMS640 can include wireless receiver functionality, for example. Thus, the embodiments shown inFIGS. 6A through6C illustrate that thetransceiver616 can communicate with a variety of different types of devices.
• FIG. 7 illustrates an embodiment of aphysiological parameter display700. Thephysiological parameter display700 can be output by any of the systems described above. For instance, thephysiological parameter display700 can be output by any of the wireless receivers, transceivers, or patient monitors described above. Theparameter display700 can be output over a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like. Advantageously, in certain embodiments, thephysiological parameter display700 can display multiple parameters, including noninvasive blood pressure (NIBP) obtained using both oscillometric and non-oscillometric techniques.
• Thephysiological parameter display700 can display any of the physiological parameters described above, to name a few. In the depicted embodiment, thephysiological parameter display700 is shown displayingoxygen saturation702,heart rate704, andrespiratory rate706. In addition, thephysiological parameter display700 displaysblood pressure708, including systolic and diastolic blood pressure.
• Thedisplay700 further shows aplot710 of continuous or substantially continuous blood pressure values measured over time. Theplot710 includes atrace712afor systolic pressure and atrace712bfor diastolic pressure. Thetraces712a,712bcan be generated using a variety of devices and techniques. For instance, thetraces712a,712bcan be generated using any of the velocity-based continuous blood pressure measurement techniques described above and described in further detail in U.S. Pat. Nos. 5,590,649 and 5,785,659, referred to above.
• Periodically, oscillometric blood pressure measurements (sometimes referred to as Gold Standard NIBP) can be taken, using any of the cuffs described above. These measurements are shown bymarkers714 on theplot710. By way of illustration, themarkers714 are “X's” in the depicted embodiment, but the type ofmarker714 used can be different in other implementations. In certain embodiments, oscillometric blood pressure measurements are taken at predefined intervals, resulting in the measurements shown by themarkers714.
• In addition to or instead of taking these measurements at intervals, oscillometric blood pressure measurements can be triggered using ICI techniques, e.g., based at least partly on an analysis of the noninvasive blood pressure measurements indicated by thetraces712a,712b. Advantageously, by showing both types of noninvasive blood pressure measurements in theplot710, thedisplay700 can provide a clinician with continuous and oscillometric blood pressure information.
• FIG. 8 illustrates another embodiment of apatient monitoring system800. The features of thepatient monitoring system800 can be combined with any of the features of the systems described above. Likewise, any of the features described above can be incorporated into thepatient monitoring system800. Advantageously, in the depicted embodiment, thepatient monitoring system800 includes acable hub806 that enables one or many sensors to be selectively connected and disconnected to thecable hub806.
• Like the patient monitoring systems described above, themonitoring system800 includes acuff810 with apatient device816 for providing physiological information to amonitor820 or which can receive power from a power supply (820). Thecuff810 can be a blood pressure cuff or merely a holder for thepatient device816. Thepatient device816 can instead be a wireless transceiver having all the features of the wireless devices described above. The wireless transceiver can transmit data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• Thepatient device816 is in coupled with anoptical finger sensor802 viacable807. Further, thepatient device816 is coupled with thecable hub806 via acable805a. Thecable hub806 can be selectively connected to one or more sensors. In the depicted embodiment, example sensors shown coupled to thecable hub806 include an ECG sensor808aand abrain sensor840. The ECG sensor808acan be single-lead or multi-lead sensor. Thebrain sensor840 can be an electroencephalography (EEG) sensor and/or an optical sensor. An example of EEG sensor that can be used as thebrain sensor840 is the SEDLine™ sensor available from Masimo® Corporation of Irvine, Calif., which can be used for depth-of-anesthesia monitoring among other uses. Optical brain sensors can perform spectrophotometric measurements using, for example, reflectance pulse oximetry. Thebrain sensor840 can incorporate both an EEG/depth-of-anesthesia sensor and an optical sensor for cerebral oximetry.
• The ECG sensor808ais coupled to anacoustic sensor804 and one or more additional ECG leads808b. For illustrative purposes, fouradditional leads808bare shown, for a 5-lead ECG configuration. In some embodiments, one or twoadditional leads808bare used instead of four additional leads . In some embodiments, up to at least 12 leads808bcan be included. Acoustic sensors can also be disposed in the ECG sensor808aand/or lead(s)808bor on other locations of the body, such as over a patient's stomach (e.g., to detect bowel sounds, thereby verifying patient's digestive health, for example, in preparation for discharge from a hospital). Further, in some embodiments, theacoustic sensor804 can connect directly to thecable hub806 instead of to the ECG sensor808a.
• As mentioned above, thecable hub806 can enable one or many sensors to be selectively connected and disconnected to thecable hub806. This configurability aspect of thecable hub806 can allow different sensors to be attached or removed from a patient based on the patient's monitoring needs, without coupling new cables to themonitor820. Instead, a single, light-weight cable832 couples to themonitor820 in certain embodiments, or wireless technology can be used to communicate with the monitor820 (see, e.g.,FIG. 1). A patient's monitoring needs can change as the patient is moved from one area of a care facility to another, such as from an operating room or intensive care unit to a general floor. The cable configuration shown, including thecable hub806, can allow the patient to be disconnected from a single cable to themonitor820 and easily moved to another room, where a new monitor can be coupled to the patient. Of course, themonitor820 may move with the patient from room to room, but thesingle cable connection832 rather than several can facilitate easier patient transport.
• Further, in some embodiments, thecuff810 and/orpatient device816 need not be included, but thecable hub806 can instead connect directly to the monitor wirelessly or via a cable. Additionally, thecable hub806 or thepatient device816 may include electronics for front-end processing, digitizing, or signal processing for one or more sensors. Placing front-end signal conditioning and/or analog-to-digital conversion circuitry in one or more of these devices can make it possible to send continuous waveforms wirelessly and/or allow for a small, more user-friendly wire (and hence cable832) routing to themonitor820.
• Thecable hub806 can also be attached to the patient via an adhesive, allowing thecable hub806 to become a wearable component. Together, the various sensors, cables, andcable hub806 shown can be a complete body-worn patient monitoring system. The body-worn patient monitoring system can communicate with apatient monitor820 as shown, which can be a tablet, handheld device, a hardware module, or a traditional monitor with a large display, to name a few possible devices.
• FIGS. 9A-9D illustrate another embodiment of awireless monitoring system900 including awireless monitor902 coupled to asensor930. Thewireless monitoring system900 is configured to connect to one or more sensors and/or a bedside monitor. The features of thewireless monitoring system900 can be combined with any of the features of the systems described above. Likewise, any of the features described above can be incorporated into thepatient monitoring system900. The wireless monitor902 includes aremovable battery904 having a data storage component. Theremovable battery904 can be used to pair thewireless monitor902 with the correct bedside monitor as described below. Thebattery904 is positioned on the front side of thewireless monitor902, so thebattery904 can be replaced without disconnecting a wireless monitor housing from the patient. Further details of these drawings are described below.
• FIG. 10 illustrates details of an embodiment of thewireless monitoring system900 in a schematic form. Typically, thesensor930 includesenergy emitters1016 located on one side of apatient monitoring site1018 and one ormore detectors1020 located generally opposite. Thepatient monitoring site1018 is usually a patient's finger (as pictured), toe, ear lobe, or the like.Energy emitters1016, such as LEDs, emit particular wavelengths of energy through the flesh of a patient at themonitoring site1018, which attenuates the energy. The detector(s)1020 then detect the attenuated energy and send representative signals to thewireless monitor902.
• The wireless monitor902 can include asensor interface1024 and a digital signal processor (DSP)1026. Thesensor interface1024 receives the signals from thesensor930 detector(s)1020 and passes the signals to theDSP1026 for processing into representations of physiological parameters. In some embodiments, theDSP1026 also communicates with a memory or information element, such as a resistor or capacitor,1030 located on thesensor930, such memory typically contains information related to the properties of the sensor that may be useful in processing the signals, such as, for example,emitter1016 energy wavelengths.
• In some embodiments, the physiological parameters are passed to aninstrument manager1028, which may further process the parameters for display by abedside monitor916. Theinstrument manager1028 may include amemory buffer1034 to maintain this data for processing throughout a period of time.Memory buffer1034 may include RAM, Flash or other solid state memory, magnetic or optical disk-based memories, combinations of the same or the like.
• In some embodiments, the wireless monitor is able to display one or more physiological parameters. The wireless monitor902 can include one ormore displays1036,control buttons1040, one ormore speakers1038 for audio messages.Control buttons1040 may comprise a keypad, a full keyboard, a touch screen, a track wheel, and the like.
• The wireless monitor902 is powered by abattery904. In some embodiments, thebattery904 directly or indirectly powers thesensor interface1024,DSP1026, and theinstrument manager1028.
• Thebattery904 includesmemory932, such memory stores wireless communication information needed for thewireless monitor902 to wirelessly communicate withbedside monitor916. Thebattery904 can communicate the information stored on thememory932 to thewireless monitor902 or bedside monitor916, and thememory932 can store information received from thewireless monitor902 orbedside monitor916.
• The bedside monitor916 wirelessly receives the physiological data and/or parameters from thewireless monitor902 and is able to display one or more physiological parameters. The bedside monitor916 can include one ormore displays1008,control buttons1010, aspeaker1012 for audio messages, and/or a wireless signal broadcaster.Control buttons1010 may comprise a keypad, a full keyboard, a track wheel, and the like.
• As shown inFIG. 10, thewireless monitor902 can include an optionalinternal battery905 capable of powering thewireless monitor902 when thebattery904 is disconnected from thewireless monitor902. Theinternal battery905 can includeadditional backup memory933 to store information when thebattery904 is disconnected from thewireless monitor902. Theinternal battery905 can be useful when a caregiver replaces thebattery904 with a different, fully-charged battery. While thebattery904 is disconnected from thewireless monitor902, thewireless monitor902 can continue to display and communicate information.
• In several embodiments, the wireless patient monitoring system includes one or more sensors, including, but not limited to, asensor930 to monitor oxygen saturation and pulse rate. These physiological parameters can be measured using a pulse oximeter. In general, thesensor930 has light emitting diodes that transmit optical radiation of red and infrared wavelengths into a tissue site and a detector that responds to the intensity of the optical radiation after absorption (e.g. by transmission or transreflectance) by pulsatile arterial blood flowing within the tissue site. Based on this response, a processor determines measurements for SpO₂, pulse rate, and can output representative plethsmorgraphic waveforms. Thus, “pulse oximetry” as used herein encompasses its broad ordinary meaning known to one of skill in the art, which includes at least those noninvasive procedures for measuring parameters of circulating blood through spectroscopy.
• Thewireless monitoring system900 can include any of the sensors described herein in addition to or in alternative to the pulse oximeter. For example, thewireless monitoring system900 can also include sensors for monitoring acoustics, sedation state, blood pressure, ECG, body temperature, and/or cardiac output. The wireless monitor may also include an accelerometer or gyroscope. The wireless patient monitoring system may include any of the above-mentioned sensors alone or in combination with each other.
• In several embodiments, thewireless monitor902 includes a wireless transmitter to transmit sensor data and/or a wireless receiver to receive data from another wireless transmitter or transceiver. By transmitting the sensor data wirelessly, thewireless monitor902 can advantageously replace some or all cables that connect patients to bedside monitoring devices. Alternatively, thewireless monitor902 calculates physiological parameters based on the sensor data and wirelessly transmits the physiological parameters and/or the sensor data itself to the bedside monitor. The physiological parameter can be numerical information, such as oxygen saturation (SpO₂) or pulse rate, or a graphical depiction of the sensor data. The data processors can be positioned in the wireless monitor housing or the battery. By configuring thewireless monitor902 to calculate the physiological parameter, less data transfer is required to transmit information from the wireless monitor to the bedside monitor. Processing the sensor data in thewireless monitor902 also improves the quality of the signal transferred to the bedside monitor.
• As shown inFIGS. 9B-9C, thewireless monitor902 includes aremovable battery904 and abase906. The base906 can include processing and wireless transmission capabilities and/or share processing function with thebattery904.Removable battery904 includes arelease mechanism912 to release thebattery904 from thebase906. As depicted inFIG. 9B, the base906 can include abattery receiving portion914 and anotch917 to lock theremovable battery904 in place. Wireless monitor902 can have one ormore outlets910 to plug in thesensor930, such as the pulse oximeter, acoustic respiratory sensor,
• ECG, sedation sensor, blood pressure cuff, or any other sensor. In some embodiments, one ormore outlets910 can be positioned on one or more sides of thewireless monitor902. For example, the wireless monitor can include an outlet on one side for an acoustic respiratory sensor and an outlet on an opposite side for a pulse oximeter.
• Wireless monitor902 can include anopening908 through which anarm band934 can be passed to secure thewireless monitor902 to the arm of the patient, as shown inFIG. 9A. Thearm band934 can be reusable, disposable or resposable. Similarly, any of thesensors930 can be disposable or resposable. Resposable devices can include devices that are partially disposable and partially reusable. Thus, for example, the acoustic sensor can include reusable electronics, but a disposable contact surface (such as an adhesive) where the sensor comes into contact with the patient's skin.
• Thesensors930 and/or wireless monitor902 need not be worn around the patient's arm, but can be worn at any other location, including not at all. Thesensors930 and/or wireless monitor902 need not be coupled to an arm band, but can be coupled to a patient's belt or a chest strap, can be carried by the patient (e.g., via a shoulder strap or handle), or can be placed on the patient's bed next to the patient, among other locations.
• FIG. 9D illustrates thebattery904 docked with abedside monitor916.Bedside monitor916 has abattery charging station922 for receiving and chargingremovable battery904. When thewireless monitor902 is using a first battery, thebattery charging station922 can charge a second battery, so when the battery levels of the first battery are low, a second battery is readily available. Each battery is capable of powering thewireless monitor902 for at least one nursing shift, so each nurse only has to replace the battery once either at the beginning or end of each shift.
• Anadapter918 can be integrated with the bedside monitor or separately connected to bedside monitor916. The bedside monitor916 includes arelease mechanism926 to release theadaptor918 from thebedside monitor916.Adaptor918 includesdocking station920 to receive the entire wireless monitor (not shown).Locking mechanism924 holds thewireless monitor902 in place. Other components may be connected to the bedside monitor916 instead of theadaptor918, such as a handheld patient monitor device.
• In some embodiments, theadaptor918 includes adocking station920 to receive theentire wireless monitor902. The wireless monitor902 can be placed in thedocking station920 when it is not in use to prevent the wireless monitor902 from being lost. The bedside monitor916 can charge thebattery904 when thewireless monitor902 is connected to thebedside monitor916. In certain aspects, the bedside monitor916 can communicate a password, unique identifier, appropriate channel information, or other wireless communication information to thewireless monitor902, and vice versa, when thewireless monitor902 is connected to thebedside monitor916.
• As shown inFIG. 9D, the bedside monitor916 is capable of simultaneously receiving a first battery and awireless monitor902 having a second battery. The bedside monitor916 is configured to charge and sync both the first and second batteries. When the first battery and/or thewireless monitor902 and second battery are physically docked in thebedside monitor916, the first and/or second battery can communication with the bedside monitor916 over a wired connection.
• The bedside monitor916 can include adisplay screen928 for displaying the physiological parameters, including trends, waveforms, related alarms, and the like. In certain aspects, the bedside monitor916 can display the appropriate channel for communication and/or whether thewireless monitor902 is properly communicating with thebedside monitor916.
• The bedside monitor916 can include a computer-readable storage medium, such as a physical storage device, for storing the physiological data. In certain aspects, the bedside monitor can include a network interface for communicating the physiological data to one or more hosts over a network, such as to a nurse's station computer in a hospital network.
• The wireless monitor902 can transmit data to the bedside monitor916 using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth, ZigBee, cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like. The wireless monitor902 can perform solely telemetry functions, such as measuring and reporting information about the patient.
• Thewireless monitor902, or any of the wireless monitor embodiments discussed herein, can be configured to utilize different wireless technologies. In certain scenarios, it may be desirable to transmit data over Bluetooth or ZigBee, for example, when the distance between thewireless monitor902 and the bedside monitor916 is within range of Bluetooth or ZigBee communication. Transmitting data using Bluetooth or ZigBee is advantageous because these technologies require less power than other wireless technologies. In other scenarios, it may be desirable to transmit data using Wi-Fi or cellular telephony, for example, when the wireless monitor is out of range of communication for Bluetooth or ZigBee. Awireless monitor902 may be able to transmit data over a greater distance using Wi-Fi or cellular telephony than other wireless technologies. In still other scenarios, it may be desirable to transmit data using a first wireless technology and automatically switch to a second wireless technology in order to maximize data transfer and energy efficiency.
• In some embodiments, thewireless monitor902 automatically transmits data over Bluetooth or ZigBee when thewireless monitor902 is within a pre-determined distance frombedside monitor916. Thewireless transmitter902 automatically transmits data over Wi-Fi or cellular telephony when thewireless monitor902 is beyond a pre-determined distance away from thebedside monitor916. In certain embodiments, thewireless monitor902 can automatically convert from Bluetooth or ZigBee to Wi-Fi or cellular telephony, and vice versa, depending on the distance between thewireless monitor902 and bedside monitor916.
• In some embodiments, thewireless monitor902 automatically transmits data over Bluetooth or ZigBee when the Bluetooth or ZigBee signal strength is sufficiently strong or when there is interference with Wi-Fi or cellular telephony. The wireless monitor902 automatically transmits data over Wi-Fi or cellular telephony when the Bluetooth or ZigBee signal strength is not sufficiently strong. In certain embodiments, thewireless monitor902 can automatically convert from Bluetooth or ZigBee to Wi-Fi or cellular telephony, and vice versa, depending on signal strength.
• Existing wireless bedside monitoring devices can be difficult to use because it can be difficult to pair the wireless device with the correct bedside monitor, making it difficult to switch wireless devices or switch bedside monitors. Some wireless systems require the care provider to program the wireless device to communicate with the correct patient monitor. Other wireless systems require a separate token or encryption key and several steps to pair the wireless device with the correct bedside monitors. Some systems require the token to be connected to the bedside monitor, then connected to the wireless device, and then reconnected to the bedside monitor.
• In certain scenarios, it may be desirable to share wireless communication information between awireless monitor902 and abedside monitor916 without a separate token or encryption key. In some embodiments, theremovable battery904 includes a data storage component, such asmemory932, capable of storing wireless communication information. Thebattery904 is configured to connect to both thewireless monitor902 and thebedside monitor916. Combining thebattery904 with a data storage component can decrease the total number of components and decrease the number of steps it takes to transfer wireless communication information between thewireless monitor902 and bedside monitor916 because a separate token or encryption key is not needed. This method of data transfer also eliminates user input errors arising from users having to program thewireless monitor902 and/or bedside monitor916 and allows for easy transfer of wireless communication information between thewireless monitor902 and bedside monitor916.
• For security purposes, it may be desirable to use security tokens to ensure that thecorrect bedside monitor916 receives the correct wirelessly transmitted data. Security tokens prevent the bedside monitor916 from accessing the transmitted data unlesswireless monitor902 and bedside monitor916 share the same password. The password may be a word, passphrase, or an array of randomly chosen bytes.
• When thebattery904 is connected to thebedside monitor916, the bedside monitor916 can communicate a password to thebattery904, and thebattery904 stores the password on its data storage component. Thebattery904 can communicate a password for thewireless monitor902 to thebedside monitor916. Thebattery904 can then be disconnected from the bedside monitor916 and connected to thewireless monitor902. When thebattery904 is connected to thewireless monitor902, thebattery904 can communicate the password to thewireless monitor902. The wireless monitor902 can then communicate wirelessly with thecorrect bedside monitor916.
• In some scenarios, it may be desirable to pair thewireless monitor902 with the bedside monitor916 to avoid interference from other wireless devices. When theremovable battery904 is connected to thebedside monitor916, the bedside monitor916 communicates a unique identifier to thebattery904, and thebattery904 stores the unique identifier on its data storage component. Thebattery904 can communicate a unique identifier for thewireless monitor902 to thebedside monitor916. Thebattery904 can then be disconnected from the bedside monitor916 and connected to thewireless monitor902. When thebattery904 is connected to thewireless monitor902, thebattery904 can communicate the unique identifier to thewireless monitor902, so that thewireless monitor902 can transmit data to thecorrect bedside monitor916.
• In some scenarios, it is desirable for thewireless monitor902 to be configured to transmit data over the correct channel. Channels provide a mechanism to avoid sources of wireless interference. When theremovable battery904 is connected to thebedside monitor916, the bedside monitor916 communicates the appropriate channel to thebattery904, and thebattery904 stores the channel information on its data storage component. If necessary, thebattery904 can communicate a wireless monitor channel thebedside monitor916. Thebattery904 is then disconnected from the bedside monitor916 and connected to thewireless monitor902. When thebattery904 is connected to thewireless monitor902, thebattery904 can communicate the appropriate channel information to thewireless monitor902, thereby ensuring thewireless monitor902 transmits data over the correct channel.
• Thebattery904, or any battery embodiment described herein, can receive or communicate any one or combination of passwords, tokens, or channels as described above. The wireless communication information can include information to communicate over each protocol thewireless monitor902 is configured to communicate over. For example, if thewireless monitor902 is capable of communicating over Wi-Fi and Bluetooth, then thebattery904 is capable of receiving wireless communication information to communicate over both Wi-Fi and Bluetooth.
• In some scenarios, the method in any of the above mentioned methodologies may be reversed. For example, in some embodiments, thebattery904 is initially connected to thewireless monitor902. When thebattery904 is connected to thewireless monitor902, thewireless monitor902 can communicate wireless communication information identifying thewireless monitor902 to thebattery904, and thebattery904 can store the information on its data storage component. The battery can communicate wireless communication information identifying the bedside monitor916 to thewireless monitor902. After thebattery904 is disconnected from thewireless monitor902, thebattery904 is connected to thebedside monitor916. Thebattery904 can then communicate wireless communication information stored on the data storage component to thebedside monitor916, such as a password, unique identifier, channel, or other data information.
• FIG. 11 illustrates an embodiment for using the wireless patient monitoring system that can be used in connection with any wireless patient monitoring system described herein. The operator connects the removable battery to the bedside monitor (block1102) and the bedside monitor and the battery communicate wireless communication information with each other (block1104). The operator then disconnects the battery from the bedside monitor (block1106) and connects the battery to the wireless monitor (block1108). The battery and the wireless monitor communicate wireless communication information with each other (block1110). After the wireless monitor receives data from the one or more sensors (block1112), the wireless monitor processes the sensor data into representations of physiological parameters (block1114). The wireless monitor then wireless communicates the physiological parameters and/or the sensor data to the bedside monitor (block1116).
• In some embodiments, the data storage component of thebattery904 stores wireless communication information related to thewireless monitor902. The wireless communication information can be a password, unique identifier, channel, etc. When thebattery904 is engaged with thebedside monitor916, the bedside monitor916 can communicate wireless communication information to thebattery904, and thebattery904 can communicate wireless communication information to thebedside monitor916. Thebattery904 is then disconnected from the bedside monitor16 and connected to thewireless monitor902. Since thebattery904 already communicated the wireless communication information to thebedside monitor916, thebattery904 provides all remaining wireless communication information to the wireless monitor. The wireless monitor reconfigures itself according to the information on the battery and no further information is required to be communicated with thebedside monitor916. This reduces the total number of steps necessary to pair thewireless monitor902 with thecorrect bedside monitor916.
• FIG. 12 illustrates another embodiment of thewireless patient monitor1202. The features of the wireless patient monitor1202 can be combined with any of the features of the systems described above. Likewise, any of the features described above can be incorporated into thepatient monitor1202.
• As shown inFIG. 12, the wireless patient monitor1202 can include a housing1205 that removably engages abattery1204. Themonitor1202 can include arelease mechanism1212 for releasing thebattery1204 from thehousing1206 and/or one ormore outlets1210 for engaging one or more sensors.
• The wireless patient monitor1202 can include a wireless transceiver capable of transmitting data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• As shown inFIG. 12, thebattery1204 can include adisplay screen1240. Thedisplay screen1240 can indicate any number of parameters, including, but not limited to, physiological parameters, battery levels, and wireless signal strength. Positioning thedisplay screen1240 on thebattery1204 helps reduce the size of the housing.
• Thedisplay screen1240 can include a touch interface to permit a user to access different parameters or settings (e.g., display settings, connectivity settings, etc.). In certain aspects, thedisplay screen1240 can rotate depending on the orientation of thebattery1204.
• To save energy, thedisplay screen1240 can selectively display certain parameters depending on the location of thebattery1204. For example, if the battery is connected to the bedside monitor or disconnected from the wireless monitor, the battery may only display battery levels. If the battery is connected to the wireless monitor, then the battery may display additional parameters other than battery levels.
• Thedisplay screen1240 can selectively display certain parameters depending on the distance between thewireless monitor1202 and the bedside monitor1216. Referring toFIG. 13, if thewireless monitor1202 is within a predetermined distance from the bedside monitor—(block1300), then thedisplay screen1240 deactivates (block1302). If thewireless monitor1202 is not within a predetermined distance from the bedside monitor (block1300), then thedisplay screen1240 initializes (block1304). Thedisplay screen1240 only needs to be active when the patient is not close to the bedside monitor.
• Thedisplay screen1240 can selectively display certain parameters depending on the type of wireless connection between thewireless monitor1202 and the bedside monitor and/or hospital IT infrastructure. Referring toFIG. 14, if thewireless monitor1202 wirelessly communicates physiological parameters and/or sensor data over Bluetooth (block1410), then the display screen deactivates (block1412). If thewireless monitor1202 wirelessly communicates physiological parameters and/or sensor data over Wi-Fi (block1414), then thedisplay screen1240 initializes (block1416).
• Thewireless monitor1202 can selectively transmit information over different wireless connections and display certain parameters depending on the distance between thewireless monitor1202 and the bedside monitor. Referring toFIG. 15, if thewireless monitor1202 is within a predetermined distance from the bedside monitor (block1520), then thewireless monitor1202 wirelessly communicates physiological parameters and/or sensor data to the bedside monitor over Bluetooth (block1522). If thewireless monitor1202 wirelessly communicates to the bedside monitor over Bluetooth (block1522), then thedisplay screen1240 deactivates (block1524). Thedisplay screen1240 does not need to be active since the bedside monitor is nearby.
• If thewireless monitor1202 is not within a predetermined distance from the bedside monitor (block1520), then thewireless monitor1202 wirelessly communicates physiological parameters and/or sensor data to the bedside monitor over Wi-Fi (block1526). If thewireless monitor1202 wireless communicates to the bedside monitor over Wi-Fi (block1526), then thedisplay screen1240 initializes (block1528). If thewireless monitor1202 is communicating over Wi-Fi, then it is more likely that the patient is not in the patient room. In that case, it is necessary to have a secondary display screen available to monitor the patient's physiological parameters.
• AlthoughFIGS. 14 and 15 were discussed in reference to Bluetooth and Wi-Fi, the system can wirelessly communication information over ZigBee or cellular telephony. Also, the system may convert from a first wireless technology (e.g., Bluetooth) to a second wireless technology (Wi-Fi) based on signal strength rather than distance.
• Thewireless monitor1202 can help the hospital staff monitor the patient when the patient is not close to the bedside monitor. When the patient is close to the bedside monitor, the bedside monitor will notify the staff if any of the patient's physiological parameters are irregular by activating an audible alarm and/or by alerting a staff member using the hospital IT infrastructure. When the patient is more than a pre-determined distance from the bedside monitor, thewireless monitor1202 can send the physiological parameters and/or sensor data directly over the hospital IT infrastructure, so the hospital staff can continuously monitor the patient at the nurse's station or any other location. If the patient exhibits any irregular physiological parameters, thewireless monitor1202 can activate an audible alarm and/or alert a staff member using the hospital IT infrastructure. Thewireless monitor1202 can use triangulation to provide the location of the patient, so the staff member can quickly find the patient. By configuring thewireless monitor1202 to process the sensor data, thewireless monitor1202 is capable of communicating physiological parameters over the hospital IT infrastructure without the bedside monitor.
• Any of the systems described herein can include a display screen and can be configured to carry out any of the methods described inFIGS. 13-15.
• FIGS. 16A-F illustrate another embodiment of a wireless patient monitoring system. The features of the wireless patient monitoring system can be combined with any of the features of the systems described above. Likewise, any of the features described above can be incorporated into the wireless patient monitoring system.
• FIG. 16A illustrates thewireless monitor1602 with thebattery1604 detached from thebase1606. Thebase1606 can include processing and wireless transmission capabilities and/or share processing function with thebattery1604. Thebattery1602 removably engages an anterior surface of thebase1606. Thebattery1602 can engage thehousing1602 via a magnet, a clip, a band, a snap fit, a friction fit, or otherwise. Thehousing1602 can include one ormore outlets1610 for engaging one ormore sensors1630. As shown inFIG. 16A, thehousing1206 can include an outlet on one end of the housing and another outlet on the opposite end of the housing. Disposing outlets on opposite ends of the housing can be useful to prevent sensor cables from tangling.
• Thebattery1604 can include adisplay screen1640 and auser input device1644. The user input device can activate the screen, adjust display settings, select physiological parameters to display, and/or otherwise control thedisplay screen1640. As shown inFIG. 16A, theuser input device1644 can be a touch pad. A user can tap the touch pad to select a feature and/or swipe in different directions to change selections. For example, the user can swipe right or left to change the parameters displayed on the display screen. Other functions can also be performed using the three inputs of the touch pad—left swipe, right swipe, and tap. Otheruser input devices1644 can include one or more buttons, switches, or other control. In certain aspects, the display screen can be the user input device.
• FIG. 16B illustrates astrap1646 for securing thewireless monitor1602 to the patient. Thestrap1646 can include any fabric, elastic, or otherwise flexible material. In certain aspects, thestrap1646 can be waterproof. One or both ends of thestrap1646 can be tapered. One or both ends of thestrap1646 can include a covering to protect the strap ends.
• Thestrap1646 can be secured to the patient as an arm band, a shoulder strap, a belt, or in any other configuration. A portion of thestrap1646 can be secured to another portion of thestrap1646 usingVelcro1660, clasps, adhesive, snap-fits, or any other connector. Thestrap1646 can include a band (not shown) for securing an excess portion of thestrap1646.
• As shown inFIG. 16B, thestrap1646 can include aconnector1650 for engaging thewireless monitor1602 and anadjustment mechanism1648 to adjust the length of thestrap1646 and/or secure anyexcess strap1646. Theconnector1650 can be an integral portion of thestrap1646 or a separately formed component secured to thestrap1646. As shown inFIG. 16B, theconnector1650 can include anopening1656 on opposite sides of theconnector1650 for securing either end of thestrap1646. One or both ends of thestrap1646 can be removably secured to theconnector1650.
• In certain aspects, theconnector1650 engages the housing by being disposed between the base1606 and thebattery1604. At least a portion of theconnector1650 can overlay a portion of the housing. Theconnector1650 can include certain features to mate with a corresponding feature of thebase1606 and/orbattery1604. For example, theconnector1650 can include one ormore recesses1652 configured to mate with one ormore protrusions1658 on thebase1606. As shown inFIG. 16C, theconnector1650 can include arecess1652 on opposite ends of theconnector1650 that mate withprotrusions1658 on opposite ends of thebase1606. Theconnector1650 can be flush with theprotrusions1658 to provide a flat surface for thebattery1604.
• In other aspects, theconnector1650 can pass through an opening of the wireless monitor. For example, as shown inFIG. 12, the wireless monitor can include anopening1208 for engaging thestrap1646. In still other aspects, theconnector1650 can engage thewireless monitor1602 using clips, ties, buckles, buttons, or any other connector.
• Thewireless monitor1602 can include a wireless transceiver capable of transmitting data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• FIGS. 16D-16F illustrate abedside monitor1616 configured to receive thewireless monitor1602. The bedside monitor can include one ormore input ports1627 configured to receive cables. In certain aspects, thebedside monitor1616 can include aport1617 configured to receive a handheld device, such as thehandheld monitor166 shown inFIG. 1D. Further details about the handheld device can be found in U.S. application Ser. No. 13/651,167, filed Oct. 12, 2012, entitled “Medical Monitoring Hub,” which is hereby incorporated by reference in its entirety.
• Theport1617 can removably engage anadapter1618. For example, theadapter1618 can include arelease mechanism1626 to release theadapter1618 from theport1617. In certain aspects, therelease mechanism1626 is studded, so a user must use one or more tools to release therelease mechanism1626.
• Theadapter1618 can be configured to receive abattery1604 and/or awireless monitor1602. Theadapter1618 can include adocking adaptor door1620 configured to receive the standalone battery1604 and/or and a port for receiving a thewireless monitor1602 including abattery1604. In certain aspects, as shown inFIG. 16F, thedocking adaptor door1620 can pivot to facilitate insertion and removal of thewireless monitor1602. When thebattery1604 and/orwireless monitor1602 having abattery1604 is physically connected to theadapter1618, thebatteries1606 can charge and can communicate and/or receive information from thebedside monitor1616 over a wired connection.
• FIGS. 17A-17C illustrate another embodiment of awireless monitor1702. Thewireless monitor1702 can include any of the other wireless monitor features described herein. Likewise, any of the other wireless monitor embodiments discussed herein can include any of the features of thewireless monitor1702.
• Thewireless monitor1702 can include abattery1704 removably engaged with abase1706. Thebase1706 can include processing and wireless transmission capabilities and/or share processing function with thebattery1704.FIG. 17A illustrates an exploded view of thewireless monitor1702. The housing can include one ormore outlets1710 configured to connect to one or more sensors (not shown). The battery can include adisplay1740 capable of displaying physiological parameters, connectivity information, and/or other content. Thebattery1704 can include atouch pad1744 or other user input device. Thetouch pad1744 can permit the user to swipe right, swipe left, or tap to control thewireless monitor1702. Thebattery1704 can include an additional user input device (e.g., button1745) that can activate/deactivate the wireless monitor or provide other functionality.
• The battery can include one or more protrusions, ribs, struts, detents, or the like configured to be received in corresponding grooves, notches, recesses, openings, or the like in thebase1706.FIG. 17B illustrates views of an inner portion of thebattery1704 and an inner portion of the housing. Thebattery1704 can include twoprotrusions1741 on each end of thebattery1704 and along an inner portion of thebattery1704. One or more of theprotrusions1741 can be a different size or shape from theother protrusions1741. Thebase1706 can include twogrooves1743 on each end of thebase1706 and along an inner portion of thebase1706. Each of thegrooves1743 can be configured to receive one of theprotrusions1741. One or more of thegrooves1743 can be a different size or shape from theother grooves1743.FIG. 17C illustrates a perspective view of thebattery1704 engaged with thebase1706.
• Thewireless monitor1702 can include a wireless transceiver capable of transmitting data using any of a variety of wireless technologies, such as Wi-Fi (802.11x), Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony, infrared, RFID, satellite transmission, proprietary protocols, combinations of the same, and the like.
• As described above, any of the wireless monitoring systems described herein can include an accelerometer or gyroscope that can be used to detect one or more of patient orientation, patient movement, whether the patient is falling, or the like. In certain aspects, the wireless monitoring system can include an alert system to alert the caregiver that the patient is falling, getting out of bed, or otherwise moving in a prohibited manner. The alert can be an audible and/or visual alarm on the monitoring system or transmitted to a caregiver (e.g., nurses' station, pager, home computer, or otherwise).
• In certain aspects, the information received by the accelerometer or gyroscope can be used to create an indication and/or animation of patient movement. This animation can be displayed on the patient monitor or transmitted to a nurses station or other off-site location to enable the caregiver to monitor the patient. The animation can be viewed real time and/or be recorded for playback. For example, if an alarm alerts the caregiver that the patient has fallen out of bed, the caregiver can be presented playbacks of one or more of the patient's movement during that period of time.
• FIGS. 18A-18C illustrate examples of the animation that can be displayed on a bedside monitor, nurses' station monitor, or other display screen.FIG. 18A illustrates a patient lying inbed1801, and the patient rolling over1803.FIG. 18B illustrates the patient lying inbed1805, and the patient sitting up1807.FIG. 18C illustrates the patient lying inbed1809, and the patient getting out ofbed1811. Other patient movements can also be illustrated, such as a patient falling, walking, or otherwise.
III. Additional Patient Movement Detection Embodiments
• Sometimes unnecessary injuries occur to hospital patients due to falling, whether while walking or falling out of a patient bed. Patient falls can be difficult to detect because rarely do patients fall out of bed quickly, which might be easy to detect as an impact with an accelerometer. Rather, patients often tend to slide out of bed more slowly, resulting in accelerometer outputs that may not register any hard impact.
• Another problem sometimes occurring in hospitals results from lack of patient movement, which can result in bedsores (sometimes called pressure sores). Bedsores often result from patients maintaining the same position in bed (or in a chair) over an extended period of time. If left untreated, bedsores can result in life-threatening staph infections. Nurses may attempt to prevent bedsores by instructing patients to turn over, get up, or manually turning patients with limited mobility from time to time. However, with increasingly large workloads, it can be difficult for hospital staff to keep track of each patient's turning/movement schedule to prevent bedsores.
• Advantageously, in certain embodiments, a patient movement detector can address these and other issues. The patient movement detector may receive inputs from position sensors, a thermal imaging camera, a video camera, and/or triangulation data. Based on one or more of these inputs, the patient movement detector can perform one or more of the following: fall prevention detection, bedsore prevention analysis, patient location detection, and patient walk test scoring. The patient movement detector can, for example, output a fall warning alarm, a bedsore warning alarm, patient location information, and/or walk test scores.
• An examplepatient movement detector1910 is shown inFIG. 19. Thepatient movement detector1910 includes afall warning module1912, abedsore warning module1914, apatient location detector1916, and a walktest scoring module1918. In addition, thepatient movement detector1910 receives inputs, including position sensor data, infrared (IR) or thermal imaging camera data, video camera data, triangulation data, and physiological parameter data. In response to one or more of these inputs, thepatient movement detector1910 outputs a fall warning alarm, bedsore warning alarm, the patient's location, and a walk test score. Some of the inputs to thepatient movement detector1910 may be omitted in some embodiments. Likewise, any of the modules may be omitted, and some of the outputs may be omitted as well.
• In general, thepatient movement detector1910 can include hardware and/or software, such as hardware processor comprising digital logic circuitry, a memory, and the like for performing the tasks described herein, among possibly others. Thepatient movement detector1910 can be implemented by any of the patient monitoring systems or devices, including wireless devices, described herein. In an embodiment, however, thepatient movement detector1910 is implemented by themulti-patient monitoring system640 described above. For instance, thepatient movement detector1910 can be implemented in a central hospital server or clinical facility server or the like. In other embodiments, thepatient movement detector1910 can be implemented by a bedside device that communicates wirelessly with any of the patient-worn monitoring systems described above.
• For instance, the patient-worn monitoring system can send thepatient movement detector1910 position sensor data from an accelerometer, gyroscope, or compass in the patient-worn monitoring system. The IR camera data and/or video camera data can be sent to thepatient movement detector1910 from an IR camera and/or video camera installed at or in the bedside device or elsewhere in the patient's room. The IR camera and video camera may be implemented in a single device. Triangulation data can be provided to thepatient movement detector1910 from wireless access points in a hospital, for example, wherever a patient's wireless transceiver (e.g., the patient-worn monitoring system) is detected. Further, the patient-worn monitoring system can transmit physiological parameter data to thepatient movement detector1910.
• However, in other embodiments, thepatient movement detector1910 can operate at least in part without interacting with a patient-worn monitoring system. Instead, the patient may be coupled with a bedside monitoring device via sensors connected to the bedside monitoring device or wirelessly. The bedside monitoring device may implement thepatient monitoring detector1910. One or more position sensors may be integrated with one or more of the physiological sensors coupled with the patient. Alternatively, the position sensors are omitted and thepatient movement detector1910 uses IR camera data and/or video camera data to perform patient movement detection.
• Thefall warning module1912 can help prevent patient falls by anticipating falls before they are about to occur. In an embodiment, thefall warning module1912 performs fall prevention detection for patients who are marked as high risk for falling (e.g., in an EMR system). Alternatively, thefall warning module1912 performs fall prevention detection for all patients. Thefall warning module1912 may also detect when a fall has occurred. In either case (actual fall or predicted potential fall), thefall warning module1912 can issue an audible and/or visual alarm, which may also be sent over a network, to one or more clinicians regarding a possible fall or actual occurrence of a fall.
• Thefall warning module1912 can analyze IR camera data to determine whether a fall has occurred in one embodiment. For instance, thefall warning module1912 can monitor the IR image data for changes in thermal temperature in the IR image. If the temperature detected in the image, which may be represented by pixel intensity or luminosity, drops, then thefall warning module1912 can sound an alarm. This drop in IR temperature can be indicative of the patient leaving the bed (e.g., by falling) or having already left the bed. Other embodiments are also described below with respect toFIG. 20.
• Thefall warning module1912 may also detect potential falls based on position sensor data from an accelerometer, gyroscope, or compass. Any of these devices can provide outputs that reflect changes in patient position. For instance, the gyroscope can output motion data indicative of an orientation of the patient or a rotation of the patient. Thefall warning module1912 can analyze the changes in patient position, such as changes in the orientation or rotation of the patient, to predict an upcoming fall and alarm accordingly. In one example, thefall warning module1912 can determine that the changes in the orientation or rotation of the patient suggest that the patient performed a sideways roll or partial sideways roll where the patient rotated in the bed while the patient's body remained parallel to the surface of the bed. Such a sideways roll or partial sideways roll can be indicative of an elevated risk that the patient subsequently leaves the bed in an unsafe manner. More generally, thefall warning module1912 can determine whether a portion of the patient to which the position sensor is attached has rolled or turned a certain amount and alarm accordingly if that amount is indicative of a potential fall or actual fall.
• Moreover, thefall warning module1912 may also perform sensor fusion or parallel analysis of sensor inputs to improve fall prevention and/or fall detection. For instance, thefall warning module1912 can analyze both position sensor data and IR camera data. If both the position sensor data and IR camera data indicate that the patient may be falling or has fallen, thefall warning module1912 can have greater confidence that a fall has occurred or is about to occur. Accordingly, in one embodiment, thefall warning module1912 alarms a fall warning alarm if both the position sensor data and the IR camera data indicate that a fall may have occurred or may be about to occur. In another embodiment, thefall warning module1912 calculates an internal confidence value of a fall based on both the position data and the IR camera data. Thefall warning module1912 can analyze the confidence values to determine whether to alarm, for example, by averaging the confidence values and comparing the average value to a threshold (e.g., above a threshold indicates an alarm should be made). Thefall warning module1912 can also analyze the confidence values by determining that if one of the confidence values is over a threshold, a fall warning alarm should be made.
• Many other configurations are possible that combine the outputs of the position sensor(s), IR camera data, and the like.
• Further, thefall warning module1912 can use other inputs, such as the triangulation data and/or video camera data to detect falls that are about to occur or that have occurred. Triangulation data, as described above, can be used to detect a patient's position in the hospital or clinical facility (e.g., by the patient location detector1916). If the triangulation data indicates that the patient is in a single location, not moving, and that position is other than the patient's bed, and the position sensor data indicates that the patient is not moving, and the IR camera data indicates that the bed is empty, or based on another combination of these inputs, thefall warning module1912 may issue an alarm. IR cameras may also be placed in other locations of the hospital, such as the bathroom, to determine whether a patient is still on a toilet or whether the patient has fallen to the floor (e.g., by analyzing thermal image data of the toilet to determine whether the patient is still on the toilet).
• Likewise, thefall warning module1912 may analyze video camera data to compare images of the patient in the bed and out of the bed, for example, by comparing pixels to determine whether the patient has left the bed. However, if the patient covers himself or herself with a sheet, the video camera image data may be less useful than IR camera data, which can detect thermal energy given off by a patient even when a sheet is over the patient.
• Thus, thefall warning module1912 can use the various inputs to thepatient movement detector1910 to determine whether the patient 1) has left the bed, 2) has rolled over in the bed (and is possibly about to fall), 3) is rolling off the bed, or 4) is on the floor, among many other possibilities. Further, such analysis may also be applied to patients sitting in a chair. In an embodiment, the thermal camera and/or the video camera use motion-tracking algorithms to swivel and track the patient wherever the patient moves within a room. The cameras can output thermal imaging data and/or video camera images to a clinician over a network, for example, by sending the image data to a nurse's station computer, a clinician device, or to a server that can send the image data to the nurse's station computer or clinician device.
• Thebedsore warning module1914 can perform similar analysis as thefall warning module1912, with one difference being in one embodiment that thebedsore warning module1914 looks for lack of movement in the patient to predict whether the patient has been in one place too long. If the patient has been in one place too long or in one position too long, the patient may be at risk for developing a bedsore, whether the patient is in a bed or in a chair. Thebedsore warning module1914 can therefore analyze the IR image data, position sensor data, and/or triangulation data (and/or video camera data) to determine whether the patient has not moved for a period of time. As above, thebedsore warning module1914 can compute the change of a patient not moving based on one of these inputs or based on a plurality of these inputs. Thebedsore warning module1914 can also compute a confidence that the patient has not moved. Either thefall warning module1912 or thebedsore warning module1914 can output their respective calculated confidence values or scores for presentation on a display to a clinician.
• Thebedsore warning module1914 can compare the amount of time that a patient has not moved or has moved only a small amount to a threshold. If the threshold is met or exceeded, thebedsore warning module1914 can trigger an audible and/or visual alarm (which may also be sent to a clinician over a network). The alarm can remind the clinician to check the patient and possibly move the patient or instruct the patient to move (e.g., by rolling over in bed or by getting up) to reduce the risk of bedsores.
• Thepatient location detector1916 may perform any of the patient location detection techniques described above, such as triangulation using triangulation data obtained from different wireless access points in a clinical facility. Thepatient location detector1916 can also perform dead reckoning to determine patient position based on the position sensor data. Accelerometer or gyroscope data can be integrated, for instance, by thepatient location detector1916 to detect approximate patient position, speed, distance traveled, and so forth. Likewise, the triangulation techniques described herein may detect approximate patient position, speed, distance traveled, and so forth. Sometimes, position sensors drift, and accordingly, position, distance, and/or speed can become inaccurate over time. Accordingly, thepatient location detector1916 can update the position, distance, and/or speed information obtained from the position sensor(s) with triangulation information. The triangulation information can therefore act to calibrate the position sensor data in an embodiment.
• The walktest scoring module1918 can compute a walk test score automatically based on an analysis of walking behavior of a patient. Hospitals often administer walk tests to patients to determine whether patients are fit for discharge. For example, a clinician may instruct a patient to walk down a hallway or walk for a set period of time (such as a few minutes). The clinician may then evaluate the patient's walking performance to see whether the patient is well enough to leave the hospital.
• In an embodiment, the walktest scoring module1918 can automate walk test scoring based on any of the inputs to thepatient movement detector1910 described above. For instance, the walktest scoring module1918 can evaluate the position sensor data or triangulation data to determine a patient's location, distance traveled, and/or speed. If the patient walks a relatively longer distance in a period of time, or if the patient walks relatively faster, the walktest scoring module1918 can assign a higher score to the patient than if the patient were to walk a shorter distance or walk slower. The walktest scoring module1918 can be invoked in response to request from a clinician (e.g., through a user interface output on a display) or may instead programmatically monitor a patient whenever the patient walks and update a walk score accordingly. More generally, the walktest scoring module1918 could instead calculate a general patient movement score, which can reflect any of a variety of factors, including distance traveled in a given time period (such as a day, an hour, etc.), walking speed, degree of patient movement within a bed (which data may be determined in part by the IR or video camera data in addition to or instead of position sensor data), and so forth.
• In addition, the walktest scoring module1918 can use the parameter data to adjust walk test scores. If a patient's respiratory rate or SpO2 are severely adversely affected by walking, the walktest scoring module1918 can score the test lower than if the respiratory rate or SpO2 (or other parameter values) stay within normal expected limits for patient walking.
• Further, in some embodiments, the walktest scoring module1918 can compute a steadiness of the patient or use a steadiness calculation to adjust the walk test score. The walktest scoring module1918 may, for instance, detect any wobbling or unsteadiness of the patient when walking or standing using output from a position sensor. The walktest scoring module1918 may lower the walk test score if the patient is more wobbly or unsteady. Further, the walktest scoring module1918 orpatient location detector1916 can output a fall warning alarm if the patient appears to be wobbling or unsteady as detected by the position sensor(s).
• FIG. 20 depicts an embodiment of afall warning process2000, which may be implemented by thefall warning module1912 or any other patient monitoring system.
• Atblock2002, thefall warning module1912 captures a baseline thermal image of patient bed with patient in the bed. Thefall warning module1912 then can capture thermal images of the bed over time atblock2004.
• Atblock2006, thefall warning module1912 can determine a thermal profile of the bed. The thermal profile may be a value that represents a sum of thermal values from a thermal image. Alternatively, the thermal profile may be represented as a thermal image map of the bed, or a spectrogram of thermal images (e.g., in the frequency or spectral domain).
• Thefall warning module1912 can determine atblock2008 whether a significant drop or change in the thermal profile has occurred. For instance, if the sum of thermal values from the thermal image differs significantly from the baseline image, the change may be significant. This analysis may be performed in the frequency or spectral domain, e.g., by analyzing a spectrogram of the thermal imaging data.
• If the significant change or drop has occurred, atblock2010, thefall warning module1912 can trigger an alarm that the patient may have left the bed (or has fallen, or is falling). Thereafter, theprocess2000 may end. Otherwise, if the significant change has not occurred, thefall warning module1912 can detect rolling or sliding in the thermal profile atblock2012. If the patient has moved in the bed, rolling may be inferred, for instance. If the patient's thermal profile indicates movement off the bed, thefall warning module1912 may infer that the patient is sliding or falling off the bed and alarm that the patient may be leaving the bed atblock2014. Theprocess2000 may be modified to performblock2012 or2008 but not both in one embodiment.
• FIG. 21 depicts an embodiment of abedsore warning process2100, which may be implemented by thebedsore warning module1912 or any other patient monitoring system.
• Blocks2102 through2106 of theprocess2100 can proceed similarly toblocks2002 through2006 of theprocess2000. Atblock2108, thebedsore warning module1912 determines whether a significant change in the thermal profile has occurred after a certain time period, which may be minutes, an hour or hours, or the like. The significant thermal change can be indicated by the sum or spectrogram described above. If so, theprocess2100 can loop back to block2104, continuing to capture thermal images and thereby monitoring the patient. If not, thebedsore warning process2100 can issue an alarm atblock2110.
• FIG. 22 depicts an embodiment of afall warning process2200, which may be implemented by thefall warning module1912 or any other patient monitoring system.
• Atblock2202, thefall warning module1912 receives motion data from a position sensor, such as a gyroscope. The motion data can be indicative of an orientation or a rotation of the patient while the patient is in the bed.
• Atblock2204, thefall warning module1912 compares the motion data with a predetermined fall threshold indicative of a degree or significance of motion or rotation of the patient. In one example, the predetermined fall threshold can be a degree of rotation, such as 30°, 60°, 90°, 120°, 150°, or 180° (or some other value) of sideways rotation, by the patient while the patient's body remains parallel to the surface of the bed.
• In response to thefall warning module1912 determining atblock2206 that the predetermined fall threshold is not exceeded by the motion data, theprocess2200 may end. For instance, if the motion data indicates that the patient rotated sideways by 20°, thefall warning module1912 can determine that the 20° of sideways rotation does not exceed a predetermined fall threshold of (for example) 90° of sideways rotation, so theprocess2200 ends.
• On the other hand, in response to thefall warning module1912 determining atblock2206 that the predetermined fall threshold is exceeded by the motion data, thefall warning module1912 atblock2208 can trigger an alarm that the patient may leave the bed, may have left the bed, may have fallen, or is falling. In one example, if the motion data indicates that the patient rotated sideways by 100°, thefall warning module1912 can determine that the 100° of sideways rotation exceeds the predetermined fall threshold of (e.g.) 90° of sideways rotation, so thefall warning module1912 triggers the alarm. The alarm can, in some cases, be considered an early fall warning alarm that indicates a greater risk that the patient may subsequently leave the bed in an unsafe manner. Thereafter, theprocess2200 may end.
• Theprocess2200 may be modified to so that before an alarm is triggered atblock2208, thefall warning module1912 also performs one or more additional checks before triggering the alarm. Thefall warning module1912 can, for instance, determine whether a significant drop or change in the thermal profile has occurred as described with respect to block2008 of theprocess2000, before triggering the alarm. Such one or more additional checks can advantageously, in certain embodiments, provide greater confidence that an alarm is triggered under conditions that may require or soon require the attention of a caregiver, and thereby reduce a number of false alarms. Moreover, in some instances, certain rolling motions (for example, a partial sideways roll) followed by leaving the bed can be more likely to indicate of a dangerous situation for the patient than other motions by the patient before the patient leaves the bed. Accordingly, the ability to detect such rolling motions followed by detecting leaving the bed can desirably enable caregivers to treat an alarm triggered under such conditions with an elevated priority because the alarm may likely reflect a greater need for urgent attention or for significant attention or resources to attend to the patient relative to one or more other conditions or alarms. In addition, thefall warning module1912 may take into account how fast the motion data is changing in order to trigger an alarm. If the motion data changes quickly, or has a high rate of change, this may indicate that the patient is now falling or has fallen.
IV. Additional Embodiments
• In certain embodiments, a method of triggering a medical monitoring alarm can include, under control of a hardware processor comprising digital logic circuitry: receiving, from a position sensor, movement data indicative of an orientation or rotation of a patient occupying a patient bed; receiving, from a thermal imaging camera, a baseline thermal image of the patient bed with the patient occupying the patient bed; receiving a second thermal image of the patient bed from the thermal imaging camera; determining whether a portion of the patient to which the position sensor is attached rotated sideways more than a threshold amount in the patient bed based at least on the movement data; determining a degree of change in thermal data between the second thermal image and the baseline thermal image; and triggering an alarm responsive to determining that the patient rotated sideways more than the threshold amount and the determined degree of change in the thermal data.
• In certain embodiments, determining the degree of any change includes determining whether a temperature value of the thermal data has decreased to or below a threshold. The alarm can include a fall warning alarm indicating that the patient is at fall risk or has fallen. The alarm can include a fall warning alarm indicating that the patient has left the patient bed. Determining the degree of change can include determining whether the degree of change in the thermal data has not met or exceeded a threshold. The alarm can include a bedsore warning alarm. The position sensor can be an accelerometer, gyroscope, or compass.
V. Terminology
• Many other variations than those described herein will be apparent from this disclosure. For example, depending on the embodiment, certain acts, events, or functions of any of the algorithms described herein can be performed in a different sequence, can be added, merged, or left out altogether (e.g., not all described acts or events are necessary for the practice of the algorithms). Moreover, in certain embodiments, acts or events can be performed concurrently, e.g., through multi-threaded processing, interrupt processing, or multiple processors or processor cores or on other parallel architectures, rather than sequentially. In addition, different tasks or processes can be performed by different machines and/or computing systems that can function together.
• The various illustrative logical blocks, modules, and algorithm steps described in connection with the embodiments disclosed herein can be implemented as electronic hardware, computer software, or combinations of both. To clearly illustrate this interchangeability of hardware and software, various illustrative components, blocks, modules, and steps have been described above generally in terms of their functionality. Whether such functionality is implemented as hardware or software depends upon the particular application and design constraints imposed on the overall system. The described functionality can be implemented in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the disclosure.
• The various illustrative logical blocks and modules described in connection with the embodiments disclosed herein can be implemented or performed by a machine, such as a general purpose processor, a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. A general purpose processor can be a microprocessor, but in the alternative, the processor can be a controller, microcontroller, or state machine, combinations of the same, or the like. A processor can include electrical circuitry configured to process computer-executable instructions. In another embodiment, a processor includes an FPGA or other programmable device that performs logic operations without processing computer-executable instructions. A processor can also be implemented as a combination of computing devices, e.g., a combination of a DSP and a microprocessor, a plurality of microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration. A computing environment can include any type of computer system, including, but not limited to, a computer system based on a microprocessor, a mainframe computer, a digital signal processor, a portable computing device, a device controller, or a computational engine within an appliance, to name a few.
• The steps of a method, process, or algorithm described in connection with the embodiments disclosed herein can be embodied directly in hardware, in a software module stored in one or more memory devices and executed by one or more processors, or in a combination of the two. A software module can reside in RAM memory, flash memory, ROM memory, EPROM memory, EEPROM memory, registers, hard disk, a removable disk, a CD-ROM, or any other form of non-transitory computer-readable storage medium, media, or physical computer storage known in the art. An example storage medium can be coupled to the processor such that the processor can read information from, and write information to, the storage medium. In the alternative, the storage medium can be integral to the processor. The storage medium can be volatile or nonvolatile. The processor and the storage medium can reside in an ASIC.
• Conditional language used herein, such as, among others, “can,” “might,” “may,” “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements and/or states. Thus, such conditional language is not generally intended to imply that features, elements and/or states are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without author input or prompting, whether these features, elements and/or states are included or are to be performed in any particular embodiment. The terms “comprising,” “including,” “having,” and the like are synonymous and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations, and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list. Further, the term “each,” as used herein, in addition to having its ordinary meaning, can mean any subset of a set of elements to which the term “each” is applied.
• While the above detailed description has shown, described, and pointed out novel features as applied to various embodiments, it will be understood that various omissions, substitutions, and changes in the form and details of the devices or algorithms illustrated can be made without departing from the spirit of the disclosure. As will be recognized, certain embodiments of the inventions described herein can be embodied within a form that does not provide all of the features and benefits set forth herein, as some features can be used or practiced separately from others.

Claims (17)

1. (canceled)

2. A system for remotely monitoring a wellbeing of a medical patient, the system comprising:

an optical-based sensor for monitoring a patient;

a wireless monitor configured to couple to an armband attached to the patient occupying a patient bed, the wireless monitor configured to receive physiological information from a physiological sensor coupled with the patient and to wirelessly transmit physiological data reflective of the physiological information to a bedside monitor, the wireless monitor comprising a wireless position sensor disposed in the wireless monitor or in the armband such that the wireless position sensor is configured to be coupled with the patient; and

one or more computer processors configured to:

receive, from the optical-based sensor, a baseline optical-based profile of a patient;

receive additional optical-based profiles of the patient from the optical-based sensor, wherein the additional optical-based profiles are captured during a period of time;

determine whether a degree of change in profile data between the additional optical-based profiles and the baseline optical-based profile has satisfied a threshold degree of change;

receive, from the wireless position sensor, movement data indicative of movement of the patient during a period of time, wherein the wireless position sensor includes at least one of: an accelerometer, a gyroscope, or a compass;

update the movement data to produce updated movement data based on triangulation data received from a plurality of wireless access points;

determine, based at least in part on the updated movement data, that an amount of movement of the patient during the period of time satisfies a threshold amount; and

transmit, over a network, an indication of a wellbeing of the patient, wherein said transmitting is responsive to a combination of both of the following:

determining that the degree of change in the profile data has satisfied the threshold degree of change, and

determining that the amount of movement of the patient during the period of time satisfies the threshold amount based at least in part on the updated movement data received from the wireless position sensor.

3. The system ofclaim 2, wherein the indication of the wellbeing of the patient comprises at least one of: a bedsore warning or a fall warning

4. The system ofclaim 3, wherein the indication of the wellbeing of the patient further comprises at least one of: a location of the patient or a walking performance of the patient.

5. The system ofclaim 2, wherein the one or more hardware processors are further configured to:

determine, based at least in part on the updated movement data, a confidence that the amount of movement of the patient during the period of time satisfies the threshold amount.

6. The system ofclaim 2, wherein the indication of the wellbeing of the patient is transmitted, over the network, to a remotely located caregiver for notification.

7. The system ofclaim 2, wherein the optical-based sensor comprises a camera, wherein the profile data comprises image data, wherein said determining the degree of change in the profile data comprises determining whether a value of the image data has changed, and wherein the value comprises at least one of: a pixel intensity or a pixel luminosity.

8. A method of remotely monitoring a wellbeing of a medical patient, the method comprising:

by one or more computer processors:

providing a wireless monitor configured to couple to an armband so as to attach to a patient occupying a patient bed, the wireless monitor configured to receive physiological information from a physiological sensor coupled with the patient and to wirelessly transmit physiological data reflective of the physiological information to a bedside monitor, the wireless monitor comprising a wireless position sensor disposed in the wireless monitor or in the armband such that the wireless position sensor is configured to be coupled with the patient;

wirelessly receiving, from the wireless position sensor, movement data indicative of movement of the patient during a period of time, wherein the wireless position sensor includes at least one of: an accelerometer, a gyroscope, or a compass;

updating the movement data to produce updated movement data based on triangulation data received from a plurality of wireless access points;

determining, based at least in part on the updated movement data, that an amount of movement of the patient during the period of time satisfies a threshold amount;

receiving, from an optical-based sensor, a baseline optical-based profile of the patient;

receiving additional optical-based profiles of the patient from the optical-based sensor, wherein the additional optical-based profiles are captured during the period of time;

determining whether a degree of change in profile data between the additional optical-based profiles and the baseline optical-based profile has satisfied a threshold degree of change; and

transmitting, over a network, an indication of a wellbeing of the patient, wherein said transmitting is responsive to a combination of both of the following:

determining that the degree of change in the profile data has satisfied the threshold degree of change, and

determining that the amount of movement of the patient during the period of time satisfies the threshold amount based at least in part on the updated movement data received from the wireless position sensor.

9. The method ofclaim 8, wherein the indication of the wellbeing of the patient comprises at least one of: a bedsore warning or a fall warning

10. The method ofclaim 9, wherein the indication of the wellbeing of the patient further comprises at least one of: a location of the patient or a walking performance of the patient.

11. The method ofclaim 8, further comprising:

by the one or more computer processors:

determining, based at least in part on the updated movement data, a confidence that the patient has not moved or has moved less than a threshold amount during the period of time.

12. The method ofclaim 8, wherein the indication of the bedsore warning alarm is transmitted, over the network, to a remotely located caregiver for notification.

13. The method ofclaim 8, wherein the optical-based sensor comprises a camera, wherein the profile data comprises image data, wherein said determining the degree of change in the profile data comprises determining whether a value of the image data has changed, and wherein the value comprises at least one of: a pixel intensity or a pixel luminosity.

14. A method of triggering a medical bedsore warning alarm, the method comprising:

by one or more computer processors:

providing a wireless monitor configured to couple to an armband so as to attach to a patient occupying a patient bed, the wireless monitor configured to receive physiological information from a physiological sensor coupled with the patient and to wirelessly transmit physiological data reflective of the physiological information to a bedside monitor, the wireless monitor comprising a wireless position sensor disposed in the wireless monitor or in the armband such that the wireless position sensor is configured to be coupled with the patient;

wirelessly receiving, from the wireless position sensor, movement data indicative of movement or lack of movement of the patient during a period of time, wherein the wireless position sensor includes at least one of: an accelerometer, a gyroscope, or a compass;

updating the movement data to produce updated movement data based on triangulation data received from a plurality of wireless access points;

determining, based at least in part on the updated movement data, that a portion of the patient to which the wireless position sensor is attached has not moved or has moved less than a threshold amount during the period of time;

receiving, from an optical-based sensor, a baseline optical-based profile of the patient;

receiving additional optical-based profiles of the patient from the optical-based sensor, wherein the additional optical-based profiles are captured during the period of time;

determining whether a degree of change in profile data between the additional optical-based profiles and the baseline optical-based profile has not met or exceeded a threshold degree of change; and

transmitting, over a network, an indication of a bedsore warning alarm, wherein said transmitting is responsive to a combination of both of the following:

determining that the degree of change in the profile data has not met or exceeded the threshold degree of change, and

determining that the portion of the patient has not moved or has moved less than a threshold amount during the period of time based at least in part on the updated movement data received from the wireless position sensor.

15. The method ofclaim 14, further comprising:

by the one or more computer processors:

determining, based at least in part on the updated movement data, a confidence that the patient has not moved or has moved less than a threshold amount during the period of time.

16. The method ofclaim 14, wherein the indication of the bedsore warning alarm is transmitted, over the network, to a remotely located caregiver for notification.

17. The method ofclaim 14, wherein the optical-based sensor comprises a camera, wherein the profile data comprises image data, wherein said determining the degree of change in the profile data comprises determining whether a value of the image data has changed, and wherein the value comprises at least one of: a pixel intensity or a pixel luminosity.

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