Medical signal monitoring and display

• US 6,224,549 B1
• Filed: 04/20/1999
• Issued: 05/01/2001
• Est. Priority Date: 04/20/1999
• Status: Active Grant

• Current Assignee: CareFusion 209, Inc.
• Original Assignee: Nicolet Biomedical, Inc. (Thermo Fisher Scientific Incorporated)
• Inventors: Drongelen, Wim van
• Primary Examiner(s): O'Connor, Cary
• Assistant Examiner(s): CARTER, RYAN CHRISTOPHER
• Application Number:
  US09/295,167
• Time in Patent Office: 742 Days
• Field of Search: 600/300-301, 600/309, 600/322, 600/345, 600/437, 600/481, 600/485, 600/490, 600/500, 600/503-504, 600/508-509, 600/526, 600/529, 600/549, 600/561 , 600/587, 600/554-555, 600/558-559
• US Class Current: 600/300
• CPC Class Codes: A61B 5/00 Measuring for diagnostic purposes radiation diagnosis A61B6/00; diagnosis by ultrasonic, sonic or infrasonic waves A61B8/00; Identification of persons
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• CPC Class Codes: A61B 6/467 characterised by special input means
• CPC Class Codes: A61B 6/468 allowing annotation or message recording
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: G16H 40/63 for local operation

Abstract

The present invention provides a medical signal monitoring system and method for displaying physiological signals of different types and modalities in different formats on a single system. Physiological signals, e.g., electrical physiological signals from electrodes attached to a subject, are provided to the system. The raw wide band physiological signals may be recorded on disk, and may be processed multiple times to display desired signals of interest. The parameters used to process the signals to be displayed are selectable by an operator employing a user interface. The user interface allows an operator to define a set of panels in which one or more signals will be displayed. The type of panel selected to display the signal determines the basic format of the signal to be displayed, e.g., various types of waveforms. A signal to be displayed in a panel is defined by selecting, for example, the signals from two electrodes attached to a subject from which a montaged pair signal to be displayed is derived. The modality of the signal to be displayed, e.g., EEG, EMG, or evoked potential (EP) is operator selectable employing the user interface. The user interface also provides for operator selection of other display and analysis parameters, such as triggering, averaging, and spectral trend analysis. A signal to be displayed in a panel may be triggered from an auditory, visual, or electrical stimulation signal provided to a subject. The characteristics of the stimulation to be provided to the subject are operator selectable employing the user interface. A separate stimulus context may be established for each panel defined by an operator. Switching between different stimulus contexts is achieved via the user interface by activating a panel to which a stimulator context has been assigned.

Claims

1. A medical monitoring system for displaying physiological signals from a subject, comprising:

(a) a computer system for receiving physiological signals from a subject via an acquisition system and including means for recording the physiological signals from the subject, means for receiving operator commands, and a computer display for displaying signals to an operator of the system; and

(b) a user interface implemented in the computer system, displayed on the means for displaying signals to an operator of the system, accessed by an operator of the system via the means for receiving operator commands, and including means for selecting a panel in which a physiological signal is to be displayed from a plurality of available panel types for defining the format of the signal to be displayed, wherein a different format for displaying a physiological signal is assigned to each panel type, and means for defining the signal to be displayed in the panel, and the modality of the signal to be displayed.

2. The medical monitoring system of claim 1 wherein the means for recording the physiological signals includes a disk memory storage system.

3. The medical monitoring system of claim 1 where the means for receiving operator commands is selected from the group of computer system input devices consisting of a keyboard and a mouse.

4. The medical monitoring system of claim 1 wherein a format for displaying a physiological signal assigned to a one of the panel types includes a wave format for displaying the physiological signal as a waveform.

5. The medical monitoring system of claim 4 wherein the formats for displaying physiological signals assigned to the panel types include a standard wave format for displaying the physiological signal as a waveform scrolling from right to left, a sweep line wave format for displaying the physiological signal as a waveform scrolling from left to right, and a stack panel wave format for displaying the physiological signal as waveforms in a column scrolling in a vertical direction.

6. The medical monitoring system of claim 4 wherein the formats for displaying physiological signals assigned to the panel types includes additionally an indicator panel format for displaying a characteristic of the physiological signal as an area of a bar.

7. The medical monitoring system of claim 1 wherein the physiological signals received by the computer system are electrical physiological signals received from a plurality of electrodes attached to the subject.

8. The medical monitoring system of claim 7 wherein the means for defining the signal to be displayed in a panel includes means for selecting signals provided by a pair of the plurality of electrodes attached to the subject, and wherein the computer system includes means for deriving a montaged signal from the selected signals.

9. The medical monitoring system of claim 8 wherein the means for defining the modality of the signal to be displayed includes means for selecting the modality of the signal to be displayed from a plurality of modalities including EEG and EMG.

10. The medical monitoring system of claim 9 wherein the means for defining the modality of the signal to be displayed includes means for selecting the modality of the signal to be displayed from a plurality of modalities including evoked potentials.

11. A method for displaying physiological signals of a subject, comprising the steps of:

(a) providing a plurality of electrical physiological signals from a plurality of electrodes attached to a subject;

(b) selecting a panel in which a physiological signal is to be displayed from a plurality of panel types, wherein a different format for displaying a physiological signal is assigned to each panel type;

(c) defining a signal to be displayed by selecting a pair of electrical physiological signals from the plurality of electrical physiological signals and deriving a montaged pair signal to be displayed from the pair of electrical physiological signals selected;

(d) selecting a modality of the physiological signal to be displayed; and

(e) displaying the montaged pair physiological signal in the panel in the format assigned and the modality selected.

12. The method of claim 11 comprising the additional steps of:

defining a stimulation context defining stimulation to be applied to the subject, assigning the stimulation context to the selected panel, and controlling the providing of stimulation to the subject in the manner defined by the stimulation context when the panel is activated.

13. The method of claim 12 wherein the signal displayed in the panel is a triggered signal which is triggered by the stimulation applied to the subject.

14. A method for controlling stimulation applied to a subject and displaying physiological signals of the subject in response thereto, comprising the steps of:

(a) providing a plurality of physiological signals from a subject;

(b) selecting a panel in which a physiological signal is to be displayed;

(c) selecting at least one signal derived from the plurality of signals to be displayed in the panel;

(d) defining a stimulation context defining the stimulation to be applied to the subject;

(e) assigning the stimulation context to the selected panel; and

(f) controlling the providing of stimulation to the subject in the manner defined by the stimulation context and displaying the physiological signal in the panel when the panel is activated.

15. The method of claim 14 wherein the plurality of physiological signals received from the subject are electrical physiological signals received from a plurality of electrodes attached to the subject.

16. The method of claim 15 wherein the step of selecting at least one signal derived from the plurality of signals to be displayed in the panel includes the step of selecting a pair of electrical physiological signals from the plurality of electrical physiologic signals and deriving a montaged pair signal to be displayed from the pair of electrical physiological signals selected.

17. The method of claim 14 wherein the step of selecting a panel in which the physiological signal is to be displayed includes the step of selecting a panel from a plurality of panel types wherein a different format for displaying a physiological signal is assigned to each panel type.

18. The method of claim 14 wherein the physiological signal displayed in the panel is a triggered signal which is triggered by the stimulation applied to the subject.

19. A medical monitoring system for controlling the providing of stimulation to a subject and for displaying physiological signals of the subject in response thereto, comprising:

(a) a computer implemented system for controlling a stimulation system for providing stimulation signals to the subject, for receiving a plurality of physiological signals from the subject, and for displaying the physiological signals received from the subject;

(b) means for selecting panels in which the physiological signals from the subject will be displayed and for selecting at least one signal derived from the plurality of physiological signals to be displayed in each panel;

(c) means for assigning a stimulation context defining the stimulation to be applied to the subject to each panel; and

(d) means for controlling the stimulation system to provide stimulation to the subject in the manner defined by a stimulation context in response activation of a panel having the stimulation context assigned thereto.

20. The medical monitoring system of claim 19 comprising additionally a stimulation system connected to and controlled by the medical monitoring system for providing stimulation signals to the subject, wherein the stimulation system includes one or more stimulators selected from the group of stimulators consisting of electrical stimulators, audio stimulators, and visual stimulators.

21. The medical monitoring system of claim 19 comprising additionally a physiological signal acquisition system for providing the plurality of physiological signals from the subject to the medical monitoring system, wherein the physiological signal acquisition system includes a plurality of electrodes attached to the subject to detect electrical physiological signals from the subject.

22. The medical monitoring system of claim 19 wherein the signal to be displayed in the panel is a triggered signal the display of which is triggered in response to the stimulation provided to the subject.

23. A method for displaying physiological signals of a subject, comprising the steps of:

(a) receiving a plurality of raw wide band physiological signals from a plurality of portions of a subject'"'"'s body;

(b) selecting at least one first pair of the plurality of raw wide band physiological signals;

(c) selecting a first modality of interest;

(d) combining and filtering the first pair of raw wide band physiological signals for the modality of interest to define a first physiological signal to be displayed; and

(e) displaying the first physiological signal to be displayed.

24. The method of claim 23 wherein the step of receiving a plurality of raw wide band physiological signals includes the step of attaching a plurality of electrodes to the plurality of portions of the subject'"'"'s body.

25. The method of claim 23 wherein the step of receiving a plurality of raw wide band physiological signals includes the step of receiving a plurality of electrical physiological signals wherein a frequency range of each electrical physiological signal is wide enough to include EEG, EMG and EP frequency bands.

26. The method of claim 25 wherein the step of selecting a first modality of interest includes the step of selecting a frequency range corresponding to a frequency band selected from the group of frequency bands consisting of EEG, EMG and EP frequency bands.

27. The method of claim 23 wherein the step of combining the first pair of raw wide band physiological signals includes the step of montaging the first pair of raw wide band physiological signals.

28. The method of claim 23 comprising additionally the step of defining a format in which the first physiological signal to be displayed is displayed.

29. The method of claim 28 wherein the step of defining a format in which the first physiological signal to be displayed is displayed includes the step of selecting a panel in which the first physiological signal to be displayed is to be displayed from a plurality of panel types, wherein a different format for displaying a physiological signal is assigned to each panel type.

30. The method of claim 23 comprising additionally the steps of:

(a) selecting a second pair of the plurality of raw wide band physiological signals;

(b) selecting a second modality of interest;

(c) combining and filtering the second pair of raw wide band physiological signals for the second modality of interest to define a second physiological signal to be displayed; and

(d) displaying the second physiological signal to be displayed.

31. The method of claim 30 wherein the second pair of raw wide band physiological signals includes at least one raw wide band physiological signal included in the first pair of raw wide band physiological signals.

32. The method of claim 31 wherein the second modality of interest is different from the first modality of interest.

33. The method of claim 30 wherein the second physiological signal to be displayed is displayed simultaneously with the first physiological signal to be displayed.

34. The method of claim 23 comprising additionally the step of saving the plurality of raw wide band physiological signals.

35. The method of claim 34 comprising additionally the steps of:

(a) selecting at least one pair of the saved plurality of raw wide band physiological signals;

(b) selecting a third modality of interest;

(c) combining and filtering the selected pair of saved raw wide band physiological signals for the third modality of interest to define a third physiological signal to be displayed; and

(d) displaying the third physiological signal to be displayed.

36. The method of claim 35 wherein the selected pair of saved raw wide band physiological signals includes at least one raw wide band physiological signal corresponding to at least one of the raw wide band physiological signals included in the first pair of raw wide band physiological signals.

37. The method of claim 35 wherein the third modality of interest is different from the first modality of interest.

38. A medical monitoring system for displaying physiological signals of a subject, comprising:

(a) means for receiving a plurality of raw wide band physiological signals from a plurality of portions of a subject'"'"'s body;

(b) a user interface for selecting pairs of the plurality of raw wide band physiological signals, wherein any one of the raw wide band physiological signals may be included in more than one pair, and for selecting a modality for each selected pair of raw wide band physiological signals;

(c) means for combining and filtering the signals in each selected pair of raw wide band physiological signals for the corresponding modality to define physiological signals to be displayed; and

(d) means for displaying the physiological signals to be displayed.

39. The medical monitoring system of claim 38 wherein the means for receiving a plurality of raw wide band physiological signals includes a physiological signal acquisition system including a plurality of electrodes attached to the plurality of portions of the subject'"'"'s body.

40. The medical monitoring system of claim 39 wherein the physiological signal acquisition system provides a plurality of electrical physiological signals wherein a frequency range of each electrical physiological signal is wide enough to include EEG, EMG and EP frequency bands.

41. The medical monitoring system of claim 38 wherein the user interface for selecting a modality for each selected pair of raw wide band physiological signals includes means for selecting a frequency range corresponding to a frequency band selected from the group of frequency bands consisting of EEG, EMG and EP frequency bands for each selected pair of raw wide band physiological signals.

42. The medical monitoring system of claim 38 wherein the means for combining the signals in each selected pair of raw wide band physiological signals includes means for montaging the signals in each selected pair of raw wide band physiological signals.

43. The medical monitoring system of claim 38 comprising additionally means for defining formats in which the physiological signals to be displayed are displayed.

44. The medical monitoring system of claim 43 wherein the means for defining formats in which the physiological signals to be displayed are displayed includes means for selecting panels in which the physiological signals to be displayed are to be displayed from a plurality of panel types, wherein a different format for displaying a physiological signal is assigned to each panel type.

45. The medical monitoring system of claim 38 comprising additionally means for saving the plurality of raw wide band physiological signals.

46. The medical monitoring system of claim 45, wherein the user interface includes means for selecting pairs of the saved plurality of raw wide band physiological signals, wherein any one of the saved plurality of raw wide band physiological signals may be included in more than one pair, and for selecting a modality for each selected pair of saved raw wide band physiological signals;

wherein the means for combing and filtering includes means for combining and filtering the selected pairs of saved raw wide band physiological signals for the corresponding modality to define physiological signals to be displayed; and

wherein the means for displaying includes means for displaying the physiological signals to be displayed.