Methods and systems to determine multi-parameter managed alarm hierarchy during patient monitoring

• US 10,699,811 B2
• Filed: 03/20/2017
• Issued: 06/30/2020
• Est. Priority Date: 03/11/2011
• Status: Active Grant

• Current Assignee: Spacelabs Healthcare LLC (OSI Systems Incorporated)
• Original Assignee: Spacelabs Healthcare LLC (OSI Systems Incorporated)
• Inventors: Gilham, Jeffrey Jay, Downs, William Gregory
• Primary Examiner(s): Lee, Erica S
• Application Number:
  US15/463,250
• Publication Number:
  US 20170281276A1
• Time in Patent Office: 1,198 Days
• Field of Search: None
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/02455 provided with high/low alarm devices
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1117 Fall detection
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/1123 Discriminating type of movement, e.g. walking or running A61B5/1116, A61B5/112 take precedence
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/364 Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: G08B 25/016 Personal emergency signalling and security systems emergency non-personal manually actuated alarm activators G08B25/12
• CPC Class Codes: G16H 40/63 for local operation

Abstract

The present specification discloses systems and methods of patient monitoring in which multiple sensors are used to detect physiological parameters and the data from those sensors are correlated to determine if an alarm should, or should not, be issued, thereby resulting in more precise alarms and fewer false alarms. Electrocardiogram readings can be combined with invasive blood pressure, non-invasive blood pressure, and/or pulse oximetry measurements to provide a more accurate picture of pulse activity and patient respiration. In addition, the monitoring system can also use an accelerometer or heart valve auscultation to further improve accuracy.

Claims

1. A non-transitory computer readable medium configured to store a plurality of programmatic instructions for processing data indicative of physiological parameters comprising:

code for receiving accelerometer data generated by an accelerometer device;

code for analyzing the accelerometer data over a period of time, wherein the accelerometer data over the period of time is indicative of at least one of a number of steps taken by a wearer of the accelerometer device or a rate of the steps, and wherein the analyzed accelerometer data is indicative of a motion of the wearer;

code for receiving physiological data generated by at least one physiological sensor used to monitor the wearer, wherein said physiological data has a time of occurrence associated therewith and wherein the physiological data comprises electrocardiogram (ECG) data and data indicative of the wearer'"'"'s pulse signal;

code for correlating the analyzed accelerometer data with the time of occurrence of the ECG data to determine a degree of correlation;

code for causing an alarm to issue if the ECG data, which are correlated with the accelerometer data, is indicative of an abnormal physiological condition; and

code for suppressing said alarm, which is based upon the ECG data, if the accelerometer data correlated with the ECG data is indicative of a regular motion of the wearer;

code for suppressing said alarm if the ECG data comprises noise above a threshold value and the pulse signal is indicative of a normal state;

code for increasing a priority level of the alarm if the ECG data comprises ectopic beats and the pulse signal is indicative of a lower than normal pulse rate; and

code for increasing a priority level of the alarm if the ECG data is indicative of an asystolic pause and the pulse signal is not received.

2. The non-transitory computer readable medium of claim 1 wherein said plurality of programmatic instructions further comprises code for comparing said degree of correlation between the analyzed accelerometer data and the time of occurrence of the physiological data to a predetermined value.

3. The non-transitory computer readable medium of claim 1 wherein said code for correlating determines if an abnormal feature in the analyzed accelerometer data is correlated in time with the abnormal physiological condition.

4. The non-transitory computer readable medium of claim 1 wherein said degree of correlation is dependent upon at least one of the number of steps, the rate of steps, an amplitude of a physiological signal indicative of the physiological data, a duration of the physiological signal, or a noise level within the physiological data.

5. The non-transitory computer readable medium of claim 1 wherein the at least one physiological sensor comprises an ECG electrode.

6. The non-transitory computer readable medium of claim 1 further comprising code for modifying a sensitivity of an alarm.

7. The non-transitory computer readable medium of claim 6 wherein code for modifying the sensitivity of the alarm comprises code for reducing the sensitivity of the alarm if the analyzed accelerometer data is indicative of the regular motion of the wearer.

8. The non-transitory computer readable medium of claim 1 further comprises code for varying a correlation of the physiological data generated by the at least one physiological sensor.

9. The non-transitory computer readable medium of claim 1 further comprising code for suspending an operation of the at least one physiological sensor if the analyzed accelerometer data is indicative of the motion of the wearer.

10. The non-transitory computer readable medium of claim 1 further comprising code for analyzing the motion of the wearer using the analyzed accelerometer data to determine if the wearer is engaged in an activity causing an increase in the wearer'"'"'s respiration rate and causing the alarm to issue based, at least in part, on said analysis.

11. The non-transitory computer readable medium of claim 1 wherein the accelerometer device is a tri-axial accelerometer.

12. The non-transitory computer readable medium of claim 11 wherein the accelerometer device is integrated with an ECG electrode attached to the wearer.

13. The non-transitory computer readable medium of claim 11 wherein the accelerometer device is integrated into an electrode wire snap of an ECG electrode.

14. The non-transitory computer readable medium of claim 1 further comprising code for causing the alarm to issue if the accelerometer data is indicative of cessation of all regular motion of the wearer or if the physiological data is unavailable.

15. The non-transitory computer readable medium of claim 1 further comprising code for analyzing the accelerometer data to determine a posture of the wearer and for recording changes in the posture.

16. The non-transitory computer readable medium of claim 15 further comprising code for causing the alarm to issue if a change in the wearer'"'"'s posture is indicative of a fall.

17. The non-transitory computer readable medium of claim 16 further comprising code for causing a notification to issue if the overall activity state of the wearer does not lie with a predefined range.

18. The non-transitory computer readable medium of claim 15 further comprising code for determining a number of posture changes per hour and correlating the determined number with the accelerometer data to obtain an overall activity state of the wearer.

19. The non-transitory computer readable medium of claim 1 further comprising code for analyzing the accelerometer data to determine a posture of the wearer and for recording changes in the posture in relation to data obtained from the at least one physiological sensor, wherein the at least one physiological sensor comprises an ECG electrode.

20. The non-transitory computer readable medium of claim 1 further comprising code for detecting motion artifact induced signal changes in the physiological data using the accelerometer data.

21. The non-transitory computer readable medium of claim 1 wherein said plurality of programmatic instructions further comprises code for suppressing an alarm associated with a non-invasive blood pressure reading if the accelerometer data is indicative of physical activity greater than a threshold value.

22. The non-transitory computer readable medium of claim 1 further comprising code for suppressing an alarm by correlating the accelerometer data with one or more ECG waveforms.

23. The non-transitory computer readable medium of claim 1 further comprising code for increasing a priority level of the alarm if the physiological data is indicative of an arrhythmia and if the accelerometer data is indicative of a fainting by the wearer.

24. The non-transitory computer readable medium of claim 1 further comprising code for decreasing a priority level of the alarm if the physiological data is indicative of an ST segment change and if the accelerometer data is indicative of a positional change by the wearer.