ECG monitoring with reduced false asystole alarms
First Claim
1. A patient monitor comprising:
- an electrocardiograph monitoring an electrocardiographic signal of a patient;
a secondary physiological signal monitor monitoring a second physiological signal of the patient concurrently with the electrocardiograph monitoring the electrocardiographic signal of the patient;
an alarm condition detector configured to detect an asystole alarm condition in which the electrocardiographic signal of the patient does not exhibit pulsatile behavior indicative of a beating heart;
an alarm condition validator configured to validate the asystole alarm condition based on whether a pulse regularity index (PRI) quantifying pulse regularity of a pulsatile component of the concurrently monitored second physiological signal of the patient satisfies a validation criterion, the PRI being computed based on a set of N+1 pulses including (i) a current pulse of the pulsatile component of the monitored second physiological signal and (ii) N immediately preceding pulses of the pulsatile component of the monitored second physiological signal, where N is a positive integer greater than or equal to two, wherein the alarm condition validator is configured to define one or more pulses of the set of N+1 pulses as a forced pulse detection conditional upon the pulsatile component of the monitored second physiological signal having no pulses in a preselected time interval and wherein the PRI is computed based on (i) amplitude information for the pulses of the set of N+1 pulses including any forced pulse detections, (ii) time interval information between the pulses of the set of N+1 pulses including any forced pulse detections, and (iii) the number of forced pulse detections; and
an alarm indicator configured to generate a human perceptible alarm conditional upon both the alarm condition detector detecting an asystole alarm condition and the asystole alarm condition validator validating the asystole alarm condition.
1 Assignment
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Accused Products
Abstract
A patient monitor comprises: an electrocardiograph (14, 20) monitoring an electrocardiographic signal (40) of a patient (10); a secondary physiological signal monitor (16, 20) monitoring a second physiological signal (50) of the patient concurrently with the electrocardiograph monitoring the electrocardiographic signal of the patient; an alarm condition detector (42, 44) configured to detect an alarm condition based on the electrocardiographic signal of the patient; an alarm condition validator (52, 54, 56) configured to validate the alarm condition based on pulse regularity of a pulsatile component of the concurrently monitored second physiological signal of the patient; and an alarm indicator (24, 26, 58) configured to generate a human perceptible alarm conditional upon both the alarm condition detector detecting an alarm condition and the alarm condition validator validating the alarm condition.
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Citations
12 Claims
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1. A patient monitor comprising:
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an electrocardiograph monitoring an electrocardiographic signal of a patient; a secondary physiological signal monitor monitoring a second physiological signal of the patient concurrently with the electrocardiograph monitoring the electrocardiographic signal of the patient; an alarm condition detector configured to detect an asystole alarm condition in which the electrocardiographic signal of the patient does not exhibit pulsatile behavior indicative of a beating heart; an alarm condition validator configured to validate the asystole alarm condition based on whether a pulse regularity index (PRI) quantifying pulse regularity of a pulsatile component of the concurrently monitored second physiological signal of the patient satisfies a validation criterion, the PRI being computed based on a set of N+1 pulses including (i) a current pulse of the pulsatile component of the monitored second physiological signal and (ii) N immediately preceding pulses of the pulsatile component of the monitored second physiological signal, where N is a positive integer greater than or equal to two, wherein the alarm condition validator is configured to define one or more pulses of the set of N+1 pulses as a forced pulse detection conditional upon the pulsatile component of the monitored second physiological signal having no pulses in a preselected time interval and wherein the PRI is computed based on (i) amplitude information for the pulses of the set of N+1 pulses including any forced pulse detections, (ii) time interval information between the pulses of the set of N+1 pulses including any forced pulse detections, and (iii) the number of forced pulse detections; and an alarm indicator configured to generate a human perceptible alarm conditional upon both the alarm condition detector detecting an asystole alarm condition and the asystole alarm condition validator validating the asystole alarm condition. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A patient monitoring method comprising:
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monitoring an electrocardiographic signal of a patient; monitoring a second physiological signal of the patient concurrently with the monitoring of the electrocardiographic signal of the patient; detecting an asystole alarm condition in which the electrocardiographic signal of the patient is Ratline; validating the asystole alarm condition based on short-term pulse regularity of a pulsatile component of the concurrently monitored second physiological signal of the patient, the validating including; detecting N+1 pulses including a current pulse and N immediately preceding pulses of the pulsatile component of the concurrently monitored second physiological signal of the patient where N is a positive integer greater than or equal to two; computing a pulse regularity index (PRI) quantifying pulse regularity of the N+1 detected pulses based on (i) mean value of the N+1 pulse amplitudes of the N+1 pulses, (ii) standard deviation of the N+1 pulse amplitudes of the N+1 pulses, (iii) mean value of the pulse-to-pulse interval (PPI) between successive pulses of the N+1 pulses, and (iv) standard deviation of the PPI; and comparing the PRI with a validation criterion; and generating a human perceptible alarm conditional upon the alarm condition being validated by the validating. - View Dependent Claims (8, 9, 10, 11)
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12. A non-transitory storage medium storing instructions executable by a digital processor to perform a patient monitoring method comprising:
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monitoring an electrocardiographic signal of a patient; monitoring a second physiological signal of the patient concurrently with the monitoring of the electrocardiographic signal of the patient; detecting an asystole alarm condition in which the electrocardiographic signal of the patient is Ratline; validating the asystole alarm condition based on short-term pulse regularity of a pulsatile component of the concurrently monitored second physiological signal of the patient, the validating including; detecting N+1 pulses including a current pulse and N immediately preceding pulses of the pulsatile component of the concurrently monitored second physiological signal of the patient where N is a positive integer greater than or equal to two; computing a pulse regularity index (PRI) quantifying pulse regularity of the N+1 detected pulses based on (i) mean value of the N+1 pulse amplitudes of the N+1 pulses, (ii) standard deviation of the N+1 pulse amplitudes of the N+1 pulses, (iii) mean value of the pulse-to-pulse interval (PPI) between successive pulses of the N+1 pulses, and (iv) standard deviation of the PPI; and comparing the PRI with a validation criterion; and generating a human perceptible alarm conditional upon the alarm condition being validated by the validating.
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Specification