Automated interpretive medical care system and methodology

• US 9,895,065 B2
• Filed: 01/02/2014
• Issued: 02/20/2018
• Est. Priority Date: 12/07/2000
• Status: Active Grant

• Current Assignee: Children's Medical Center Corporation, Oridion Medical 1987 1987 Ltd.
• Original Assignee: Children's Medical Center Corporation, Oridion Medical (1987) Ltd. (Medtronic Plc)
• Inventors: Kraus, Baruch Shlomo, Carlebach, Ephraim
• Primary Examiner(s): Natnithithadha, Navin
• Assistant Examiner(s): MESSERSMITH, ERIC J
• Application Number:
  US14/146,556
• Publication Number:
  US 20140135640A1
• Time in Patent Office: 1,510 Days
• CPC Class Codes: A61B 2560/0431 Portable apparatus, e.g. comprising a handle or case
• CPC Class Codes: A61B 2560/0437 Trolley or cart-type apparatus
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• 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 5/022 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 5/02438 with portable devices, e.g. worn by the patient
• 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 5/082 Evaluation by breath analysis, e.g. determination of the chemical composition of exhaled breath A61B5/083, A61B5/091 take precedence
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/1455 using optical sensors, e.g. spectral photometrical oximeters
• CPC Class Codes: A61B 5/14552 Details of sensors specially adapted therefor
• CPC Class Codes: A61B 5/14553 specially adapted for cerebral tissue
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/411 Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: A61B 5/6835 Supports or holders, e.g., articulated arms
• CPC Class Codes: A61B 5/7264 : Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• 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 5/7282 : 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 5/7425 : Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image geometric transforms for image registration G06T3/14; enhancement using image fusion G06T5/50; algorithms for registration of images G06T7/30
• 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 40/63 : for local operation
• CPC Class Codes: G16H 40/67 : for remote operation
• CPC Class Codes: G16H 50/30 : for calculating health indices; for individual health risk assessment

Abstract

Improved apparatus and methods for monitoring, diagnosing and treating at least one medical respiratory condition of a patient are provided, including a medical data input interface adapted to provide at least one medical parameter relating at least to the respiration of the patient, and a medical parameter interpretation functionality (104, 110) adapted to receive the at least one medical parameter relating at least to the respiration (102) of the patient and to provide at least one output indication (112) relating to a degree of severity of at least one medical condition indicated by the at least one medical parameter.

Claims

1. A method for identifying a degree of severity of a respiratory disorder of a patient, the method comprising:

receiving, from a capnograph coupled to an element positioned within an airway of the patient, a CO₂ waveform indicative of partial-pressure CO₂ values of the patient at consecutive time intervals;

receiving from a second sensing unit comprising a sensor positioned on the patient a second signal, and computing at least one additional parameter based on the second signal;

wherein the second signal comprises a cardiac function, a systemic oxygenation, a cerebral oxygenation, or a systemic circulation or any combination thereof;

using a processor;

computing at least one parameter relating to the CO₂ waveform, wherein the CO₂ waveform comprises a slope of a CO₂ concentration curve, an angle of rise, a time to rise, run time of the rise, curvature, acceleration, or area under the curve, or any combination of these parameters;

determining a change in the at least one parameter relating to the CO₂ waveform over the consecutive time intervals;

determining a change in the at least one additional parameter over the consecutive time intervals;

identifying an improvement, lack of change or deterioration in a respiratory status based on the determined change in the at least one parameter relating to the CO₂ waveform;

identifying an improvement, lack of change or deterioration in a vital sign of the patient based on an integrated analysis of the determined change in the at least one additional parameter and on a change in end-tidal CO₂ (EtCO₂) values obtained over the consecutive time intervals;

determining a degree of severity of a respiratory disorder based on the improvement, lack of change or deterioration in the respiratory status and in the vital sign;

determining that the patient has a severe respiratory disorder based at least in part on the degree of severity; and

providing an instruction to a display to provide an alert in response to the determination that the patient has the severe respiratory disorder; and

displaying, using the display, the alert in response to the determination that the patient has the severe respiratory disorder.

2. The method of claim 1, further comprising wirelessly transmitting, via a transmitter, an output indication indicative of the degree of severity of the respiratory disorder.

3. The method of claim 1, further comprising:

comparing, using the processor, a value of the at least one parameter relating to the CO₂ waveform to a predetermined value; and

determining, using the processor, whether the value of the parameter crosses the predetermined value.

4. The method of claim 1, further comprising:

comparing, using the processor, a value of the at least one additional parameter to a predetermined value; and

determining, using the processor, whether the value of the additional parameter crosses the predetermined value.

5. The method of claim 1, further comprising computing, using the processor, a trend in the change in the at least one parameter relating to the CO₂ waveform.

6. The method of claim 1, further comprising storing the at least one parameter relating to the CO₂ waveform and the at least one additional parameter in a memory device.

7. The method of claim 1, wherein the respiratory disorder is selected from the group consisting of:

restrictive lung disease, bronchospasm, asthma, bronchitis, emphysema, respiratory failure, fibrosis, and upper airway obstructive disease.

8. The method of claim 7, wherein the respiratory disorder is bronchospasm.

9. The method of claim 1, wherein the at least one parameter relating to the CO₂ waveform comprises run time of the rise and slope of the CO₂ concentration curve.

10. The method of claim 1, wherein the second sensing unit comprises an ECG comprising electrodes positioned on a chest of the patient, a pulse oximeter comprising the sensor positioned on a finger of the patient, a cerebral oximeter comprising the sensor positioned on a forehead of the patient, an NIBP comprising a cuff positioned on an arm of the patient, or any combination thereof.

11. The method of claim 1, further comprising

wirelessly transmitting, via a transmitter, an output indication indicative of the degree of severity of the respiratory disorder to a remote device in response to the determination that the patient has the severe respiratory disorder.

12. The method of claim 1, wherein the alert comprises a text message that provides information related to the degree of severity, the severe respiratory disorder, or a combination thereof.

13. The method of claim 1, wherein

the severe respiratory disorder based at least in part on the degree of severity is that the patient is entering respiratory failure, and the method further comprises wirelessly transmitting, via a transmitter, data related to the respiratory failure to a remote device in response to the determination that the patient is entering respiratory failure.

14. The method of claim 13, wherein

the alert indicates that the patient is entering respiratory failure.

15. The method of claim 14, wherein the alert comprises a text message that recommends intubation of the patient.

16. The method of claim 1, wherein the element positioned within the airway of the patient comprises an intubation tube, and the method further comprises:

receiving, at the processor, an input indicating successful intubation of the patient;

determining, using the processor, an interruption in the CO₂ waveform from the capnograph; and

providing, using the processor, another instruction to the display to provide an intubation alert indicative of possible dislodgement of the intubation tube in response to the determination of the interruption in the CO₂ waveform from the capnograph.

17. The method of claim 1, wherein the element positioned within the airway of the patient comprises an intubation tube, and the method further comprises:

receiving, at the processor, an input indicating successful intubation of the patient;

comparing, using the processor, the CO₂ waveform to standardized capnograms associated with intubated patients in response to receipt of the input;

verifying, using the processor, that the intubation is successful in response to the CO₂ waveform corresponding to the standardized capnograms; and

providing, using the processor, another instruction to the display to provide an indication of successful intubation.

18. A system, comprising:

an apparatus for identifying a degree of severity of a respiratory disorder of a patient, the apparatus comprising;

a processor configured to;

receive, from a capnograph coupled to an element positioned within an airway of the patient, a CO₂ waveform indicative of partial-pressure CO₂ values of the patient at consecutive time intervals;

receive, from a second sensing unit comprising a sensor positioned on the patient, a second signal;

compute at least one parameter based on the second signal, wherein the second signal comprises a cardiac function, a system oxygenation, a cerebral oxygenation, or a system circulation or any combination thereof;

compute at least one parameter relating to the CO₂ waveform, wherein the CO₂ waveform comprises a slope of a CO₂ concentration curve, an angle of rise, a time to rise, run time of the rise, curvature, acceleration, area under the curve, and any combination of these parameters;

determine a change in the at least one parameter relating to the CO₂ waveform over the consecutive time intervals;

determine a change in the at least one additional parameter over the consecutive time intervals;

identify an improvement, lack of change or deterioration in a respiratory status based on the determined change in the at least one parameter relating to the CO₂ waveform;

identify an improvement, lack of change or deterioration in a vital sign of the patient based on an integrated analysis of the determined change in the at least one additional parameter and on a change in end-tidal CO₂ (EtCO₂) values obtained over the consecutive time intervals;

determine a degree of severity of the respiratory disorder based on the improvement, lack of change or deterioration in the respiratory status and in the vital sign;

determine that the patient has a severe respiratory disorder based at least in part on the degree of severity; and

provide an instruction to the display to provide an alert in response to the determination that the patient has the severe respiratory disorder; and

a display configured to display the alert in response to the determination that the patient has the severe respiratory disorder.

19. The system of claim 18, comprising the capnography and the second sensing unit, wherein the second sensing unit comprises an ECG comprising electrodes positioned on a chest of the patient, a pulse oximeter comprising the sensor positioned on a finger of the patient, a cerebral oximeter comprising the sensor positioned on a forehead of the patient, an NIBP comprising a cuff positioned on an arm of the patient, or any combination thereof.