Apparatus and method of monitoring and responding to respiratory depression

• US 8,695,591 B2
• Filed: 11/15/2010
• Issued: 04/15/2014
• Est. Priority Date: 05/26/2010
• Status: Active Grant

• Current Assignee: Elizabeth Ann Olson, Lloyd Verner Olson
• Original Assignee: Elizabeth Ann Olson, Lloyd Verner Olson
• Inventors: Olson, Lloyd Verner, Olson, Elizabeth Ann
• Primary Examiner(s): Thanh, Loan H
• Assistant Examiner(s): Lo, Andrew S
• Application Number:
  US12/946,698
• Publication Number:
  US 20110290250A1
• Time in Patent Office: 1,247 Days
• Field of Search: 128/200.24, 12820312-20318, 128/204.23, 604 65- 67, 604/131, 604/151, 600/323
• US Class Current: 128/203.14
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/4821 Determining level or depth of anaesthesia A61B5/1106 takes precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61M 15/08 Inhaling devices inserted into the nose
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/021 operated by electrical means A61M16/202 – A61M16/205 take precedence
• CPC Class Codes: A61M 16/0666 Nasal cannulas or tubing devices for improving normal breathing through the nose A61F5/08; nose filters A62B23/06; outside holding devices A61M25/02
• CPC Class Codes: A61M 16/104 specially adapted for anaesthetics A61M16/18 takes precedence
• CPC Class Codes: A61M 2021/0016 by the smell sense
• CPC Class Codes: A61M 2021/0027 by the hearing sense
• CPC Class Codes: A61M 2021/0072 with application of electrical currents
• CPC Class Codes: A61M 2021/0077 with application of chemical or pharmacological stimulus
• CPC Class Codes: A61M 2021/0083 especially for waking up
• CPC Class Codes: A61M 21/00 Other devices or methods to cause a change in the state of consciousness; Devices for producing or ending sleep by mechanical, optical, or acoustical means, e.g. for hypnosis
• CPC Class Codes: A61M 2202/0208 Oxygen
• CPC Class Codes: A61M 2202/0241 Anaesthetics; Analgesics
• CPC Class Codes: A61M 2205/3375 Acoustical, e.g. ultrasonic, measuring means
• CPC Class Codes: A61M 2205/3561 local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/52 : with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2230/04 : Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/205 : partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/208 : pH-value
• CPC Class Codes: A61M 2230/30 : Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 2230/42 : Rate
• CPC Class Codes: A61M 2230/432 : partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 5/1452 : pressurised by means of pistons
• CPC Class Codes: A61M 5/1723 : using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/3937 : Monitoring output parameters

Abstract

The present disclosure involves a system for monitoring patients, and more specifically post-operative patients receiving narcotics, and a novel apparatus for automatically delivering a narcotic-reversing agent, including but not limited to the agent commonly known as naloxone, in response to dangerous respiratory conditions such as respiratory depression or other undesired consequences caused by reaction to narcotic dosage.

Claims

1. A system configured to monitor and treat respiratory depression comprising:

a patient monitoring unit configured to monitor at least one patient condition(s) and to output a signal;

an interface unit including a microprocessor and a user interface configured to provide an interface for at least one user, wherein the interface unit is in communication with the patient monitoring unit;

a first device for dispensing at least a narcotic;

a second device configured to automatically dispense at least one dosage of a narcotic reversal agent in response to at least the signal from the patient monitoring unit, the signal indicating at least one patient condition is outside a preset condition value; and

wherein the interface unit is configured to continuously receives information from the patient monitoring unit after dispensing at least one dosage of a narcotic reversal agent, and wherein the interface unit is configured to signal the first device for dispensing at least a narcotic to be suspended when appropriate patient conditions are detected.

2. The system of claim 1, wherein the at least one patient condition is selected from the group consisting of:

a respiratory rate, a carbon dioxide, oxygen and pH value, a blood pressure, an acoustic measurement of respiration, a heart rate, a physiological response and a response to an audible signal.

3. The system of claim 1, wherein the interface unit is selected from the group consisting of:

a laptop computer, a desktop computer, a tablet, a mobile device, a cellular telephone, a pager and a portable desktop accessory.

4. The system of claim 1, wherein the narcotic reversal agent comprises naloxone and is provided to a patient intravenously.

5. The system of claim 1, wherein the second device configured to automatically dispense the narcotic reversal agent comprises a pump and a nasal cannula, wherein the narcotic reversal agent comprises naloxone in spray form dispersed in an oxygen stream, and is provided to the patient intranasally.

6. The system of claim 1, wherein the second device configured to automatically dispense the narcotic reversal agent comprises:

a first pump and a nasal cannula, wherein the narcotic reversal agent comprises naloxone in spray form dispersed in an oxygen stream, and is provided to the patient intranasally; and

a second pump, wherein the narcotic reversal agent comprises naloxone in liquid form and is provided to the patient by an intravenous line.

7. The system of claim 6, wherein the first pump is dedicated to the delivery of the narcotic reversal agent, which releases the at least one dosage of the narcotic reversal agent upon receiving the signal from the patient monitoring unit, wherein the controlled dosage is at least based on the signal.

8. The system of claim 1, wherein the second device configured to automatically dispense the narcotic reversal agent releases the narcotic reversal agent upon receiving the signal from the patient monitoring unit and a second signal from the interface unit.

9. The system of claim 6, wherein the first pump is independent of the first device for dispensing at least a narcotic to a patient.

10. The system of claim 1, wherein the first device for dispensing at least a narcotic comprises a pump, wherein the at least a narcotic is dispensed via an intravenous line.

11. The system of claim 1, further comprising a stimulation device for applying at least one stimulus to the patient comprising at least one of a low voltage electrical stimulus applied to the skin, an audible alarm, a means for dispensing smelling salts, a means for transcutaneous stimulation of the phrenic nerve, and combinations thereof.

12. The system of claim 1, wherein the patient monitoring unit triggers an alarm when the at least one patient condition is outside the preset condition value, wherein the present condition value is at least one of a respiratory rate less than about 4 for more than about 60 seconds, an end-tidal CO₂ absolute level less than about 10, apnea for greater than about 30 seconds, a pulse oximetry less than about 85 percent for greater than about 15 seconds, and combinations thereof.

13. The system of claim 1, wherein the patient monitoring unit triggers an alarm when the at least one patient condition is outside the preset condition value, wherein the alarm is communicated to a care-giver via a paging system.

14. The system of claim 1, wherein the interface unit communicates information comprising at least one of the at least one patient condition, narcotic reversal agent dispensing rates, narcotic dispensing rates, alarm conditions, and combinations thereof to at least one of an electronic medical record, a nursing station, and combinations thereof.

15. The system of claim 14, wherein the information communicated is stored, displayed, or both, at the electronic medical record, the nursing station, or both.

16. The system of claim 14, wherein the information communicated is transferred wirelessly.

17. A system configured to monitor and treat respiratory depression in a human patient comprising:

at least one patient monitoring unit configured to monitor at least one patient condition and to output a signal when the at least one patient condition approximates a predetermined danger level;

an interface unit including a microprocessor and a user interface configured to provide an interface for at least one user, wherein the interface unit is in communication with the patient monitoring unit;

a first device for dispensing at least a narcotic;

a second device configured to automatically dispense at least one dosage of a narcotic reversal agent in response to at least the signal from the patient monitoring unit; and

a stimulation device configured to apply at least one stimulus to the patient comprising at least one of a low voltage electrical stimulus applied to the skin, an audible alarm, a means for dispensing smelling salts, a means for transcutaneous stimulation of the phrenic nerve, and combinations thereof,

wherein the interface unit is configured to signal application of the at least one stimulus to the patient and to continuously receive information from the patient monitoring unit after dispensing at least one dosage of a narcotic reversal agent, and wherein the interface unit is configured to signal the first device for dispensing at least a narcotic to be suspended when appropriate patient conditions are detected.

18. The system of claim 17, wherein the second device configured to automatically dispense at least one dosage of a narcotic reversal agent comprises:

a first pump and a nasal cannula, wherein the narcotic reversal agent comprises a spray dispersed in an oxygen stream, and is provided to the patient intranasally; and

a second pump, wherein the narcotic reversal agent comprises a liquid, and is provided to the patient by an intravenous line.

19. The system of claim 17, wherein the first device for dispensing at least a narcotic comprises a third pump wherein the at least a narcotic is dispensed via an intravenous line.