METHOD FOR CONTINUOUSLY MONITORING A PATIENT USING A BODY-WORN DEVICE AND ASSOCIATED SYSTEM FOR ALARMS/ALERTS
First Claim
1. A method for continuously monitoring a patient, comprising the following steps:
- detecting a first time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart with a first sensor comprising a first detector configured to be worn on the patient'"'"'s body;
detecting a second time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart with a second sensor comprising a second detector configured to be worn on the patient'"'"'s body;
detecting sets of time-dependent motion waveforms with at least two motion-detecting sensors positioned on locations selected from a forearm, upper arm, and a body location other than the forearm or upper arm of the patient, wherein each set of motion waveforms is indicative of motion of the location on the patient'"'"'s body to which it is affixed;
processing the first and second time-dependent physiological waveforms to determine at least one vital sign from the patient;
analyzing at least a portion of the sets of time-dependent motion waveforms with a motion-determining algorithm to determine if the patient is in an activity state selected from the group of resting, moving, sitting, standing, walking, running, falling, lying down, and convulsing; and
generating an alarm by processing the patient'"'"'s activity state and comparing the vital sign to a predetermined alarm criteria corresponding to the activity state.
2 Assignments
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Accused Products
Abstract
The invention provides a body-worn monitor that measures a patient'"'"'s vital signs (e.g. blood pressure, SpO2, heart rate, respiratory rate, and temperature) while simultaneously characterizing their activity state (e.g. resting, walking, convulsing, falling). The body-worn monitor processes this information to minimize corruption of the vital signs by motion-related artifacts. A software framework generates alarms/alerts based on threshold values that are either preset or determined in real time. The framework additionally includes a series of ‘heuristic’ rules that take the patient'"'"'s activity state and motion into account, and process the vital signs accordingly. These rules, for example, indicate that a walking patient is likely breathing and has a regular heart rate, even if their motion-corrupted vital signs suggest otherwise.
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Citations
23 Claims
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1. A method for continuously monitoring a patient, comprising the following steps:
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detecting a first time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart with a first sensor comprising a first detector configured to be worn on the patient'"'"'s body; detecting a second time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart with a second sensor comprising a second detector configured to be worn on the patient'"'"'s body; detecting sets of time-dependent motion waveforms with at least two motion-detecting sensors positioned on locations selected from a forearm, upper arm, and a body location other than the forearm or upper arm of the patient, wherein each set of motion waveforms is indicative of motion of the location on the patient'"'"'s body to which it is affixed; processing the first and second time-dependent physiological waveforms to determine at least one vital sign from the patient; analyzing at least a portion of the sets of time-dependent motion waveforms with a motion-determining algorithm to determine if the patient is in an activity state selected from the group of resting, moving, sitting, standing, walking, running, falling, lying down, and convulsing; and generating an alarm by processing the patient'"'"'s activity state and comparing the vital sign to a predetermined alarm criteria corresponding to the activity state. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. A system for processing at least one vital sign from a patient and generating an alarm, the system comprising:
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a first sensor comprising a first detector configured to detect a first time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart; a second sensor comprising a second detector configured to detect a second time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart; at least two motion-detecting sensors positioned on locations selected from a forearm, upper arm, and a body location other than the forearm or upper arm of the patient, each of the motion-detecting sensors generating at least one motion waveform indicative of motion of the location on the patient'"'"'s body to which the motion-detecting sensor is affixed; a first processing component configured to receive the time-dependent physiological and motion waveforms and determine therefrom;
(i) at least one vital sign calculated using at least one of the first and second time-dependent physiological waveforms; and
(ii) at least one motion parameter selected from the patient'"'"'s posture, activity state, and degree of motion calculated using at least one motion waveform generated by each of the motion-detecting sensors; anda second processing component configured to receive the at least one vital sign and motion parameter and determine therefrom;
(i) a first alarm condition, calculated by comparing the at least one vital sign to an alarm threshold;
(ii) a second alarm condition, calculated from the at least one motion parameter; and
(iii) an alarm rule, determined by collectively processing the first and second alarm conditions with an alarm algorithm, the alarm rule indicating whether or not the system generates an alarm.
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20. A system for continuously monitoring a plurality of patients, the system comprising:
a patient monitor configured to be worn on the body of each of the plurality of patients, each patient monitor comprising; a first sensor comprising a first detector configured to detect a first time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart; a second sensor comprising a second detector configured to detect a second time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart; at least two motion-detecting sensors positioned on locations selected from a forearm, upper arm, and a body location other than the forearm or upper arm of the patient, each of the motion-detecting sensors generating at least one motion waveform indicative of motion of a body location onto which the motion-detecting sensor is affixed; a location sensor comprising a wireless component and a location processing component, the location processing component configured to receive a signal from the wireless component and process this signal to determine a physical location of the patient to which the location sensor is attached; a processing component configured to receive the time-dependent physiological and motion waveforms and determine therefrom;
(i) at least one vital sign calculated using at least one of the first and second time-dependent physiological waveforms;
(ii) at least one motion parameter selected from the patient'"'"'s posture, activity state, and degree of motion calculated using at least one motion waveform generated by each of the motion-detecting sensors; and
(iii) an alarm parameter calculated from the at least one of the vital sign and motion parameter; and
,a wireless transceiver configured to wirelessly transmit the vital sign, motion parameter, location of the patient, and alarm parameter through a wireless system; and
,a remote computer system comprising a display and an interface to the wireless system, the interface configured to receive from the wireless system a vital sign, motion parameter, location of the patient, and alarm parameter corresponding to each of the plurality of patients comprising a patient monitor, and the display configured to render a user interface that describes at least one of a vital sign, motion parameter, location of the patient, and alarm parameter for each patient of the plurality of patients comprising a patient monitor.
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21. A system for continuously monitoring a patient, the system configured to be worn on the patient'"'"'s body and comprising:
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an optical sensor comprising a first light source, a second light source, and a light detector, the optical sensor configured to detect a first time-dependent optical waveform from radiation generated by the first light source, and a second time-dependent optical waveform from radiation generated by the second light source, wherein both the first and second time-dependent optical waveforms are indicative of one or more contractile properties of the patient'"'"'s heart; an electrical sensor comprising at least two electrodes and an electrical circuit, wherein each electrode is configured to attach to separate locations on the patient and measure an electrical signal, and the electrical circuit is configured to receive and process an electrical signal from each electrode to generate a first time-dependent electrical waveform indicative of one or more contractile properties of the patient'"'"'s heart and a second time-dependent electrical waveform indicative of a respiratory rate; at least two motion-detecting sensors positioned on two separate locations on the body of the patient, the locations selected from a forearm, upper arm, chest, and hand of the patient, wherein each of the motion-detecting sensors generates at least one motion waveform indicative of motion of a body location onto which the motion-detecting sensor is affixed; and a processing component configured to receive the first and second time-dependent optical waveforms, the first and second time-dependent electrical waveforms, and the motion waveforms, and determine therefrom;
(i) a time difference between a feature in one of the first and second time-dependent optical waveforms and a feature in one of the first and second electrical waveforms;
(ii) a blood pressure value calculated from the time difference;
iii) an SpO2 value calculated from both the first and second time-dependent optical waveforms;
(iii) a heart rate calculated from at least one of the time-dependent electrical waveforms;
(iv) a respiratory rate calculated from the second time-dependent electrical waveform;
(v) at least one motion parameter selected from the patient'"'"'s posture, activity state, and degree of motion calculated using at least one motion waveform generated by each of the motion-detecting sensors; and
(vi) an alarm parameter calculated from at least one of the blood pressure value, SpO2 value, heart rate, respiratory rate, and the motion parameter.
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22. A system for processing at least one vital sign from a patient and generating an alarm, the system comprising:
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a first sensor comprising a first detector worn on the patient'"'"'s body and configured to detect a first time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart; a second sensor comprising a second detector worn on the patient'"'"'s body and configured to detect a second time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart; a first motion-detecting sensor positioned on a first location on the patient'"'"'s body, the motion-detecting sensor configured to generate a first set of motion waveforms indicative of motion of the location on the patient'"'"'s body to which it is affixed; a processing component configured to be worn on the patient'"'"'s body, the processing component comprising; a second motion-detecting sensor positioned on a second location on the patient'"'"'s body, the second motion-detecting sensor configured to generate a second set of motion waveforms indicative of motion of the location on the patient'"'"'s body to which the processing component is affixed; and a microprocessor configured to receive the time-dependent physiological waveforms and at least of portion of the first and second set of motion waveforms and determine therefrom;
(i) at least one vital sign calculated using at least one of the first and second time-dependent physiological waveforms;
(ii) at least one motion parameter selected from the patient'"'"'s posture, activity state, and degree of motion, the motion parameter calculated by comparing at least one of the following components to a predetermined threshold value;
(a) a component calculated from a time-dependent waveform generated by the motion-detecting sensor;
(b) a component calculated from a frequency-dependent waveform calculated from the time-dependent waveform; and
(c) a component determined from an ROC curve; and
(iii) an alarm, determined by collectively processing the at least one vital sign and the motion parameter with an alarm algorithm.
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23. A method for generating an alarm while monitoring vital signs and posture of a patient, the method comprising the following steps:
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(a) detecting a first time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart with a first sensor comprising a first detector configured to be worn on the patient'"'"'s body; (b) detecting a second time-dependent physiological waveform indicative of one or more contractile properties of the patient'"'"'s heart with a second sensor comprising a second detector configured to be worn on the patient'"'"'s body; (c) detecting a set of time-dependent motion waveforms with at least one motion-detecting sensor positioned on the patient'"'"'s torso, wherein the one motion-detecting sensor detects a set of motion waveforms indicative of motion of the patient'"'"'s torso; (d) processing the first and second time-dependent physiological waveforms to determine at least one vital sign from the patient; (e) analyzing at least a portion of the set of time-dependent motion waveforms, or a mathematical derivative thereof, to determine a vector corresponding to motion of the patient'"'"'s torso; (f) comparing the vector to a coordinate space representative of how the motion-detecting sensor is oriented on the patient to determine a posture parameter; (g) comparing the posture parameter to a threshold value to estimate the patient'"'"'s posture; and
p1 (h) generating an alarm by processing at least one of the patient'"'"'s posture and a parameter resulting from a comparison of the vital sign to a predetermined alarm criteria, wherein the alarm is indicated by a variance of the vital sign relative to the predetermined alarm criteria and is regulated according to the patient'"'"'s posture.
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Specification