Configurable vital signs system

• US 9,301,700 B2
• Filed: 09/28/2012
• Issued: 04/05/2016
• Est. Priority Date: 09/27/2012
• Status: Active Grant

• Current Assignee: Welch Allyn Incorporated
• Original Assignee: Welch Allyn Incorporated
• Inventors: St. Pierre, Shawn C., Lane, John A., Quinn, David E.
• Primary Examiner(s): BERHANU, ETSUB D
• Application Number:
  US13/631,046
• Publication Number:
  US 20140088446A1
• Time in Patent Office: 1,285 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• 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 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/6801 specially adapted to be attached to or worn on the body surface
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick

Abstract

A method of determining a value indicative of a hemodynamic parameter of a patient includes performing a plurality of value determinations. Performing the plurality of value determinations includes determining a first value indicative of the hemodynamic parameter, determining, with a controller, a difference between the first value and a baseline associated with the first value, and replacing the baseline with the first value, in a memory of the controller, if the difference is outside of a predetermined range. The method also includes determining an estimate of the hemodynamic parameter based on acceptable values determined during the plurality of value determinations.

Claims

1. A method of determining a value indicative of a hemodynamic parameter of a patient, comprising:

performing a plurality of value determinations, wherein performing the plurality of value determinations includes

inflating an inflatable cuff disposed around a limb of the patient until a vessel within the limb is at least partially occluded,

determining, with a sensor, a first value indicative of the hemodynamic parameter, wherein the first value is an initial determined value and comprises one of a cuff pressure, cuff volume, or blood pressure value,

determining, with a controller in communication with the sensor, a difference between the first value and a baseline associated with the first value,

replacing the baseline with the first value, in a memory of the controller, if the difference is outside of a predetermined range;

determining, with the controller, an estimate of the hemodynamic parameter based on values determined during the plurality of value determinations; and

outputting the estimate.

2. The method of claim 1, wherein the first value comprises a systolic blood pressure of the patient and a diastolic blood pressure of the patient, and wherein determining the estimate comprises calculating an average systolic blood pressure of the patient over an average diastolic blood pressure of the patient.

3. The method of claim 1, further including receiving an input indicative of the predetermined range.

4. The method of claim 1, further including determining that fewer than a desired number of value determinations have been performed, and automatically determining at least one additional value indicative of the hemodynamic parameter in response to the determination that fewer than the desired number of value determinations have been performed.

5. The method of claim 1, further including determining that a desired number of value determinations have been performed, and automatically determining whether any acceptable values have been determined in response to the determination that the desired number of value determinations have been performed, wherein the acceptable values comprise a subset of values determined during the plurality of value determinations and are identified as being acceptable at least partly as a result of a difference between each respective value of the subset of values and the baseline being within the predetermined range.

6. The method of claim 5, wherein performing the plurality of value determinations includes determining a plurality of values indicative of the hemodynamic parameter, the method further including outputting at least one value of the plurality of values in response to determining that no acceptable values have been determined.

7. The method of claim 5, wherein performing the plurality of value determinations includes determining a plurality of values indicative of the hemodynamic parameter, the method further including determining that acceptable values have been determined, and determining the estimate based on only the acceptable values.

8. The method of claim 1, further including receiving an input indicative of a time interval between initiation of each value determination of the plurality of value determinations.

10. The method of claim 1, further including receiving an input comprising a value determination selection, wherein, in response to the selection, a value corresponding to the selected value determination is omitted from the determination of the estimate.

11. The method of claim 10, wherein the input is received prior to performing the plurality of value determinations.

12. The method of claim 1, wherein the plurality of value determinations is performed in less than approximately one minute.

13. The method of claim 1, wherein:

the sensor comprises a blood pressure sensor configured to generate a signal associated with the vessel of the patient,

and

determining the first value comprises determining a systolic blood pressure of the patient during transition of the vessel of the patient from unoccluded to at least partially occluded.

14. The method of claim 1, further including

receiving a first input indicative of a wait time,

receiving a second input comprising a value determination initiation command, and

delaying determining the first value by the wait time.

15. The method of claim 1, wherein the sensor comprises a first sensor, the method further comprising determining a second value indicative of an additional hemodynamic parameter with a second sensor different than the first sensor.

16. The method of claim 1, wherein the first value comprises a systolic blood pressure of the patient.

17. The method of claim 1, further including:

determining, with the sensor, a second value indicative of the hemodynamic parameter, wherein the second value comprises a value determined immediately subsequent to the first value and comprises one of a cuff pressure, cuff volume, or blood pressure value;

determining, with the controller, a difference between the second value and the baseline;

replacing the baseline with the second value, in the memory of the controller, if the difference is outside of the predetermined range; and

determining, with the controller, the estimate of the hemodynamic parameter based at least partly on the second value.

9. The method of clam 1, further including receiving an input indicative of a desired number of value determinations to be performed, and performing the plurality of value determinations based on the desired number.

18. A method of determining a value indicative of a blood pressure of a patient, comprising:

automatically performing a plurality of value determinations, in a closed-loop manner, in response to receiving at least one input associated with the plurality of values, wherein performing the plurality of value determinations includes

inflating a cuff disposed around a limb of the patient until a vessel within the limb is at least partially occluded,

determining a first blood pressure value of the patient while the cuff is being inflated,

determining whether a component of the first blood pressure is within a predetermined range of a baseline blood pressure value,

substantially deflating the cuff and reinflating the cuff until the vessel is at least partially occluded,

determining a second blood pressure value of the patient while the cuff is being reinflated, and

determining, if the first blood pressure value is within the predetermined range of the baseline, whether the second blood pressure value is within the predetermined range of the baseline, and

if the first blood pressure is outside of the predetermined range of the baseline, determining whether the second blood pressure is within the predetermined range of the first blood pressure value;

replacing the baseline with the first blood pressure value, in a memory of a controller, in response to determining that the first blood pressure value is outside of the predetermined range of the baseline, wherein the first blood pressure value is an initial determined value, and wherein the second blood pressure value is a value determined immediately subsequent to the first value;

determining an estimate of the blood pressure of the patient, wherein the estimate is based on at least one of the first and second blood pressure values; and

outputting the estimate.

19. The method of claim 18, wherein determining the estimate comprises calculating an average systolic blood pressure of the patient, and wherein the average is calculated using the first blood pressure value only if the first blood pressure value is within the predetermined range of the baseline.

20. The method of claim 18, wherein the at least one input is indicative of the predetermined range.

21. The method of claim 18, wherein the at least one input comprises a first input indicative of a time interval between initiation of each value determination of the plurality of value determinations, and a second input indicative of a wait time, the method further including delaying determining the first blood pressure value by the wait time.

22. The method of claim 18, wherein the at least one input comprises a value determination selection, the method further including omitting a blood pressure value corresponding to the selected value determination from the determination of the estimate.

23. The method of claim 18, wherein the at least one input is indicative of a desired number of value determinations to be performed, the method further including performing the plurality of value determinations based on the desired number.

24. A patient monitoring system, comprising:

a sensor configured to determine a value indicative of a hemodynamic parameter of a patient during transition of a vessel of the patient from unoccluded to at least partially occluded;

an inflatable cuff configured to be disposed around a limb of the patient, wherein inflation of the cuff transitions the vessel from unoccluded to at least partially occluded; and

a controller in communication with the sensor, the controller including a memory and being configured to assist in performing a plurality of value determinations, wherein performing the plurality of value determinations includes;

determining, with the sensor, a first value indicative of the hemodynamic parameter, wherein the first value is an initial determined value and comprises one of a cuff pressure, cuff volume, or blood pressure value,

determining, with the controller, a difference between the first value and a baseline associated with the first value, and

replacing the baseline with the first value, in the memory of the controller, if the difference is outside of a predetermined range,

wherein the controller is further configured to determine an estimate of the hemodynamic parameter based on values determined during the plurality of value determinations, and to output the estimate.

25. The system of claim 24, further including a user interface in communication with the controller and configured to receive an input from a user, the input being associated with performing the plurality of value determinations.

26. The system of claim 25, wherein the input comprises a first input indicative of the baseline and a second input indicative of the range.

27. The system of claim 25, wherein the input comprises a first input indicative of a time interval between initiation of each value determination of the plurality of value determinations, and a second input indicative of a wait time, the controller being configured to delay determining the first value by the wait time.

28. The system of claim 25, wherein the input comprises a value determination selection, the controller being configured to omit a value corresponding to the selected value determination when determining the estimate.

29. The system of claim 25, wherein the input is indicative of a desired number of value determinations to be performed, the controller being configured to perform the plurality of value determinations based on the desired number.