Patient care recommendation system

• US 9,532,721 B2
• Filed: 08/05/2011
• Issued: 01/03/2017
• Est. Priority Date: 08/06/2010
• Status: Expired due to Fees

• Current Assignee: United States Secretary of the Army, U.S. Army Medical Research And Materiel Command
• Original Assignee: The United States Of America As Represented By The Secretary Of The Army
• Inventors: Batchinsky, Andriy, Cancio, Leopoldo C., Salinas, Jose
• Primary Examiner(s): Thomson, William
• Assistant Examiner(s): Downey, John R.
• Application Number:
  US13/204,490
• Publication Number:
  US 20150150517A1
• Time in Patent Office: 1,978 Days
• Field of Search: 600/301
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• 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 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/7228 Signal modulation applied to the input signal sent to patient or subject; demodulation to recover the physiological signal modulation H03C
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• 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 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Disclosed are systems and methods to provide a patient care recommendation. The systems and methods receive patient information and a plurality of patient physiological signals that are related to a patient. The systems and methods are then operable to produce at least one derived patient signal from at least one of the plurality of patient physiological signals. The systems and methods use the patient information, at least one of the plurality of patient physiological signals, and the at least one derived patient signal to provide at least one patient care recommendation.

Claims

1. A patient care recommendation system, comprising:

a diagnosis engine;

a waveform analysis engine coupled to the diagnosis engine;

an input device coupled to the diagnosis engine and operable to transmit patient physical characteristics; and

at least one physiological signal monitoring device coupled to each of the waveform analysis engine and the diagnosis engine, wherein the at least one physiological signal monitoring device is operable to produce a plurality of patient physiological signals related to a patient;

wherein the waveform analysis engine is operable to use at least one of the plurality of patient physiological signals to produce at least one derived patient signal; and

wherein the diagnosis engine is operable to provide at least one patient care recommendation using together the patient physical characteristics, at least one of the plurality of patient physiological signals, and the at least one derived patient signal, and

the patient care recommendation further includes a patient life saving intervention (LSI) recommendation selected from a group of recommendations where the group of recommendations include perform cardiopulmonary resuscitation on a patient, perform a chest-tube placement on a patient, perform a needle chest decompression on a patient, perform a blood transfusion on a patient, perform cricothyroidotomy on a patient, perform a pneumothorax decompression on a patient, perform hemorrhage control on a patient, perform fluid resuscitation on a patient, provide fluids to the patient, and perform a particular operation on the patient.

2. The system of claim 1, wherein the at least one physiological signal monitoring device includes a respiration monitoring device that is operable to provide a respiratory rate signal to each of the waveform analysis engine and the diagnosis engine.

3. The system of claim 1, wherein the at least one physiological signal monitoring device includes a heart monitoring device that is operable to provide a heart rate signal to each of the waveform analysis engine and the diagnosis engine.

4. The system of claim 1, wherein the at least one derived patient signal produced by the waveform analysis engine includes a respiratory sinus arrhythmia signal produced using a patient respiratory signal and a patient heart signal received from the at least one physiological signal monitoring device.

5. The system of claim 1, wherein the at least one derived patient signal produced by the waveform analysis engine includes a sample entropy signal.

6. The system of claim 1, wherein the at least one patient care recommendation includes a patient triage category recommendation including a representation of the need of care of a patient.

7. The system of claim 6, wherein the patient triage category recommendation further includes recommended patient location and the patient LSI recommendation includes a predetermined severity scale value.

8. The system of claim 1, wherein the patient physical characteristics are selected from a group consisting of a patient age, a patient sex, a patient weight, and a patient height.

9. The system of claim 1, further comprising:

a display coupled to the diagnosis engine and operable to display the at least one patient care recommendation.

10. The system of claim 1, wherein the waveform analysis engine is operable to produce the at least one derived patient signal using at least one of a fast Fourier transform, a complex demodulation, a detrended fluctuation analysis, a similarity of distribution, and a fractal analysis.

20. The system of claim 1, wherein the waveform analysis engine is operable to produce the at least one derived patient signal using at least one of a detrended fluctuation analysis, a similarity of distribution, and a fractal analysis.

11. A triage category and life saving intervention (LSI) recommendation system, comprising:

a processor coupled to at least one computer-readable medium to provide a waveform analysis engine and a diagnosis engine;

an input device that is operable to provide patient physical characteristics to the diagnosis engine;

a respiration monitoring device that is operable to provide a respiratory rate signal to each of the waveform analysis engine and the diagnosis engine; and

a heart monitoring device that is operable to provide a heart rate signal to each of the waveform analysis engine and the diagnosis engine;

wherein the waveform analysis engine includes instructions located on the at least one computer-readable medium that, when executed by the processor, cause the processor to use the respiratory rate signal and the heart rate signal to produce at least one derived patient signal that includes a respiratory sinus arrhythmia signal; and

wherein the diagnosis engine includes instructions located on the at least one computer-readable medium that, when executed by the processor, cause the processor to provide a patient triage category recommendation including a representation of the need of care of a patient and a patient LSI recommendation using together the patient physical characteristics, the respiratory sinus arrhythmia signal, and at least one of the respiratory rate signal and the heart rate signal.

12. The system of claim 11, further comprising:

a display coupled to the diagnosis engine and operable to display the patient triage category recommendation and the patient LSI recommendation.

13. The system of claim 11, wherein the waveform analysis engine includes instructions located on the at least one computer-readable medium that, when executed by the processor, cause the processor to produce the at least one derived patient signal that includes a sample entropy signal.

14. The system of claim 11, wherein the patient triage category recommendation further includes recommended patient location and the patient LSI recommendation includes a predetermined severity scale value.

15. The system of claim 11, wherein the patient physical characteristics are selected from a group consisting of a patient age, a patient sex, a patient weight, and a patient height.

16. A method to provide a plurality of patient care recommendations for a group of patients at a trauma scene, comprising:

for each patient;

providing patient physical characteristics to a diagnosis engine using an input device;

receiving into each of the diagnosis engine and a waveform analysis engine at least one patient physiological signal that is related to the respective patient where the at least one physiological signal monitoring device is coupled to the respective patient;

producing at least one derived patient signal from the at least one patient physiological signal using the waveform analysis engine and sending the at least one derived patient signal to the diagnosis engine;

providing at least one patient care recommendation from the diagnosis engine using together the patient physical characteristics, at least one of the plurality of patient physiological signals, the at least one derived patient signal, and trends in at least one of the at least one of the plurality of physiological signals and the at least one derived patient signal, and

wherein the at least one patient care recommendation includes a patient triage category recommendation including a value expressing the priority the patient has to be evacuated from the trauma scene as compared to other patients and a patient life saving intervention (LSI) recommendation produced by a neural network present in the diagnosis engine.

17. The method of claim 16, wherein the at least one physiological signal monitoring device includes a respiration monitoring device that sends a respiratory rate signal to each of the waveform analysis engine and the diagnosis engine, and a heart monitoring device that sends a heart rate signal to each of the waveform analysis engine and the diagnosis engine.

18. The method of claim 16, wherein the at least one derived patient signal produced by the waveform analysis engine includes a respiratory sinus arrhythmia signal produced using a patient respiratory signal and a patient heart signal received from the at least one physiological signal monitoring device.

19. The method of claim 16, wherein the at least one derived patient signal produced by the waveform analysis engine includes a sample entropy signal.