Automated interpretive medical care system and methodology

• US 20040236240A1
• Filed: 06/10/2004
• Published: 11/25/2004
• Est. Priority Date: 12/07/2000
• Status: Active Grant

• Current Assignee: Children's Medical Center Corporation, Oridion Medical 1987 Limited (Medtronic Plc), Physio-Control Incorporated (Stryker Corporation)
• Original Assignee: Physio-Control Incorporated (Stryker Corporation)
• Inventors: Kraus, Baruch Shlomo, Hampton, David Robert
• Granted Patent: US 8,147,419 B2
• Time in Patent Office: Days
• US Class Current: 600/529
• 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

1-212. -212. (cancelled).

213. A system employing at least one medical parameter relating at least to respiration of a patient for providing an output indication relating to at least one medical condition, the system comprising:

a medical data input interface adapted to provide the at least one medical parameter relating at least to respiration of the patient; and

a medical parameter interpretation functionality receiving said at least one medical parameter relating at least to respiration of said patient and providing at least one output indication relating to a degree of severity of at least one medical condition indicated by said at least one medical parameter.

214. A system according to claim 213 and wherein said data input interface comprises at least one monitoring device operative to continuously monitor the at least one medical parameter.

215. A system according to claim 214 and wherein said at least one monitoring device includes a capnograph.

216. A system according to claim 214 and wherein said at least one monitoring device is operative to collect a sample of expired air from said patient.

217. A system according to claim 214 and wherein said at least one monitoring device includes at least one of the following:

an electrocardiogram (ECG) monitoring device;

a blood pressure monitoring device;

an electroencephalogram (EEG) monitoring device;

an NI blood pressure monitoring device;

a respiratory rate monitoring device;

a heart rate monitoring device;

a systemic perfusion monitoring device; and

an exhaled air monitoring device.

218. A system according to claim 214 and wherein said at least one monitoring device is operative to monitor at least one of:

an expired air carbon dioxide concentration; and

an expired air carbon dioxide profile parameter.

219. A system according to claim 214 and wherein said at least one monitoring device is operative to monitor at least one of the following waveforms:

a carbon dioxide waveform (capnogram);

an EEG waveform; and

an ECG waveform.

220. A system according to claim 219, and wherein said at least one monitoring device is adapted to digitize at least one of said waveforms.

221. A system according to claim 214 and wherein at least one of:

said at least one monitoring device; and

said medical parameter interpretation functionality;

is further operative to provide at least one of the following measurements;

a slope of the increase in the carbon dioxide concentration;

a run of time taken to reach 80% maximum exhaled CO₂ concentration; and

an angle of rise to 80% maximum exhaled CO₂ concentration.

222. A system according to claim 214 and wherein at least one of:

said at least one monitoring device; and

said medical parameter interpretation functionality,

is further operative to a value of CAP-FEV1.

223. A system according to claim 221, and wherein said medical parameter interpretation functionality is further operative to provide an alert responsive to a measure of CAP-FEV1 being less than 50% of an expected value.

224. A system according to claim 221, and wherein said medical parameter interpretation functionality is further operative to provide an alert responsive to the run being greater than 0.3 seconds and the slope being less than 100 mm Hg/sec.

225. A system according to claim 214 and wherein said medical parameter interpretation functionality is further operative to provide an indication of at least one of:

defective functioning of said monitoring device; and

,

defective placing of said monitoring device,

responsive to a value of at least one of said indications.

226. A system according to claim 213 wherein said at least one medical parameter includes at least one of:

an expired air carbon dioxide concentration; and

an expired air carbon dioxide profile parameter.

227. A system according to claim 213, wherein said at least one medical parameter includes at least one of:

a visual parameter;

a breathing parameter;

an oxygen parameter;

an ECG parameter;

a heart function parameter;

a neurological parameter;

a blood pressure parameter; and

an EEG parameter.

228. A system according to claim 213 and wherein said medical parameter interpretation functionality is operative to provide an indication of the patient'"'"'s status being within a normal range if at least one of the following requirements is fulfilled:

a) the blood pressure values are within the normal range;

b) the respiratory rate is normal;

c) CO2 run is less than or equal to 0.3 sec;

d) CO2 slope is more than or equal to 100 mm Hg/sec;

e) SPO2 is greater or equal to than 95%; and

f) ETCO2 is less than or equal to 45 mm Hg.

229. A system according to claim 213 and wherein said medical parameter interpretation functionality is operative to provide an indication of the patient'"'"'s status being within a normal range if all of the following requirements are fulfilled:

a) the blood pressure values are within the normal range;

b) the respiratory rate is normal;

c) CO2 run is less than or equal to 0.3 sec;

d) CO2 slope is more than or equal to 100 mm Hg/sec;

e) SPO2 is greater or equal to than 95%; and

f) ETCO2 is less than or equal to 45 mm Hg.

230. A system according to claim 229, and wherein the medical parameter interpretation functionality comprises:

a medical condition diagnosis functionality for diagnosing the presence of said at least one medical condition; and

a medical condition severity indication functionality for indicating the degree of severity of said at least one medical condition.

231. A system according to claim 229 and wherein said medical parameter interpretation functionality is operative to provide an indication of the patient'"'"'s status being outside the normal range if any of said requirements are not fulfilled.

232. A system according to claim 230, and wherein said medical condition severity indication functionality is operative to provide an indication of the degree of severity of said at least one medical condition responsive to a degree of deviation from at least one of said requirements.

233. A system according to claim 230, and wherein said medical condition diagnosis functionality is operative to diagnose a respiratory disorder.

234. A system according to claim 233, and wherein said medical condition diagnosis functionality is further operative to provide a diagnosis of a respiratory disorder responsive to any of said requirements not being fulfilled.

235. A system according to claim 234, and wherein said medical condition severity indication functionality is further operative to provide a diagnosis of a severity of said respiratory disorder responsive to a quantitative measure of deviation of at least one parameter from at least one of said requirements.

236. A system according to claim 233 and wherein said respiratory disorder includes at least one of:

a restrictive lung disease;

bronchospasm;

asthma;

bronchitis;

emphysema;

a respiratory failure;

fibrosis; and

an upper airway obstructive disease.

237. A system according to claim 236, and wherein said medical condition diagnosis functionality is operative to provide a diagnosis of said restrictive lung disease responsive to at least one of the following cases:

said run is greater or equal to 0.3 sec;

or

said slope is less than or equal to 100 mm Hg/sec.

238. A system according to claim 236, and wherein said medical condition diagnosis functionality is operative to provide a diagnosis of obstructive lung disease responsive to at least one of the following cases:

said run is less than 0.3 sec;

or

said slope is more than 100 mm Hg/sec.

239. A system according to claim 230 and wherein said medical condition diagnosis functionality is further operative to provide a diagnosis of a heart disorder responsive to any of said requirements not being fulfilled.

240. A system according to claim 239, and wherein said medical condition diagnosis functionality is further operative to provide a diagnosis of a heart failure if the following requirements are fulfilled:

CAP-FEV1 is less than or equal to a 40;

10 point ratio;

a normal CAP-FEV1/FVC ratio;

CO2 run is less than 0.3 sec; and

CO2 slope is more than 100 mm Hg/sec.

241. A system according to claim 239, and wherein said medical condition diagnosis functionality is further operative to provide a diagnosis of a severity of said heart disorder responsive to a quantitative measure of a deviation from any of said requirements.

242. A system according to claim 228 and wherein said medical parameter interpretation functionality is operative to provide a recommendation to perform at least one of the following treatments responsive to said indication:

intubation of said patient;

hospitalization of said patient;

treat said patient with medication; and

transfer of said patient to an intensive care unit.

243. A system according to claim 227 and wherein said visual parameter includes a visual appearance of said patient.

244. A system according to claim 227 and wherein said breathing parameter includes at least one of:

a respiratory rate of said patient;

an FEV value; and

an FVC value.

245. A system according to claim 227 and wherein said oxygen parameter includes at least one of:

PO2; and

SPO2.

246. A system according to claim 227 and wherein said ECG parameter includes at least one of:

a QRS parameter; and

an ST segment.

247. A system according to claim 227 and wherein said heart function parameter includes a heart rate parameter.

248. A system according to claim 227 and wherein said neurological parameter includes a reflex parameter.

249. A system according to claim 227 and wherein said blood pressure parameter includes at least one of:

a blood pressure measurement; and

a systolic;

diastolic ratio.

250. A system according to claim 213 and wherein said medical parameter interpretation functionality is operative to provide said at least one output indication responsive to a pattern of changes in said at least one medical parameter over time.

251. A system according to claim 213 and wherein said medical parameter interpretation functionality is further operative to provide an output indication responsive to a pattern of changes in the degree of severity of said at least one medical condition over time.

252. A system according to claim 213 and also comprising treatment recommendation functionality.

253. A system according to claim 252, and wherein said treatment recommendation functionality is operative to recommend treatment responsive to the location of said patient.

254. A system according to claim 252, and wherein said treatment recommendation functionality is operative to recommend treatment responsive to a change in at least one of the following:

a change in the run;

a change in the ETCO2;

a change in the slope;

a change in the angle of rise of CO2; and

a change in the SPO2.

255. A system according to claim 252, and wherein said treatment recommendation functionality is responsive to a pattern of changes in the degree of severity of said at least one medical condition over time.

256. A system according to claim 252 and wherein said treatment recommendation functionality is operative to provide an alert if at least one of the following requirements is fulfilled:

a change in the run of more than 0.1 s;

a change in the slope is more negative than −

15 mm Hg/sec; and

a change in the SPO2 is more negative than −

5%.

257. A system according to claim 256 and wherein said treatment recommendation functionality is operative to provide a recommendation for at least one of the following treatments responsive to at least one of said requirements:

intubation of said patient;

hospitalization of said patient;

treat said patient with intravenous medication; and

transfer of said patient to an intensive care unit.

258. A system according to claim 252 and wherein said treatment recommendation functionality is operative to provide a recommendation to perform at least one of:

continue monitoring; and

continue treating the patient if at least one of the following conditions is fulfilled;

a change in the run is less negative or equal to −

0.1 s but less positive or equal to 0.1 s;

a change in the slope is less negative or equal to −

15 Hg/sec, but less positive or equal to +15 mm Hg/sec; and

a change in the SPO₂ is less negative or equal to −

5%, but less positive or equal to +5%.

259. A system according to claim 252 and wherein said treatment recommendation functionality is operative to perform at least one of the following:

provide a message indicative of an improvement in the patient'"'"'s status; and

recommend discontinuing a treatment procedure, if at least one of the following conditions is fulfilled;

a change in the run is more negative than −

0.1 s;

a change in the slope is more positive than +15 mm Hg/sec; and

a change in the SPO₂ is more positive than 5%.

260. A system according to claim 252 and wherein said treatment recommendation functionality is operative to provide a recommendation to continue monitoring said patient responsive to the pattern of changes indicating at least one of:

a deterioration in the status of said patient; and

,

a non-significant change in the status of said patient.

261. A system according to claim 252 and wherein said treatment recommendation functionality is operative to provide a recommendation to stop monitoring said patient responsive to a pattern of changes indicating an improvement in the status of said patient.

262. A system according to claim 252 and wherein said treatment recommendation functionality is additionally responsive to information regarding other treatment received by the patient.

263. A system according to claim 213 and also comprising treatment control functionality for controlling the provision of at least one treatment to a patient.

264. A system according to claim 263 and wherein said treatment control functionality is additionally responsive to information regarding other treatment received by the patient.

265. A system according to claim 263 and wherein said treatment control functionality controls the provision of said at least one treatment to said patient in response to changes in said at least one output indication over time.

266. A system according to claim 213 and wherein said at least one medical parameter comprises a plurality of medical parameters.

267. A system according to claim 213 and wherein said output indication relating to a degree of severity of at least one medical condition is determined at least partially by changes in said at least one medical parameter.

268. A system according to claim 213 and also comprising a transmitter functionality adapted to convey said output indication to a remote location.

269. A medical care system according to claim 268, and further operative to provide a treatment responsive to at least one of:

said output indication; and

said remote location.

270. A system according to claim 214 and wherein said medical parameter interpretation functionality is operative to provide said at least one output indication responsive to a pattern of changes in said at least one medical parameter over time.

271. A system according to claim 251 and also comprising treatment recommendation functionality.

272. A system according to claim 263 and wherein said output indication relating to a degree of severity of at least one medical condition is determined at least partially by changes in said at least one medical parameter.

292. A method according to claim 230, and also comprising providing an indication of the degree of severity of said at least one medical condition responsive to a degree of deviation from at least one of said requirements.

273. A method employing at least one medical parameter relating at least to respiration of a patient for providing an output indication relating to at least one medical condition, the method comprising:

providing at least one medical parameter relating at least to respiration of the patient; and

receiving said at least one medical parameter relating at least to respiration of said patient and providing at least one output indication relating to a degree of severity of at least one medical condition indicated by said at least one medical parameter.

274. A method according to claim 273 and wherein said providing at least one medical parameter comprises continuously monitoring the at least one medical parameter.

275. A method according to claim 274 and wherein said monitoring comprises employing a capnograph.

276. A method according to claim 274 and wherein said providing at least one medical parameter comprises collecting a sample of expired air from said patient.

277. A method according to claim 274 and wherein said providing at least one medical parameter comprises employing at least one of the following:

an electrocardiogram (ECG) monitoring device;

a blood pressure monitoring device;

an electroencephalogram (EEG) monitoring device;

an NI blood pressure monitoring device;

a respiratory rate monitoring device;

a heart rate monitoring device;

a systemic perfusion monitoring device; and

an exhaled air monitoring device.

278. A method according to claim 274 and wherein said providing at least one medical parameter comprises monitoring at least one of:

an expired air carbon dioxide concentration; and

an expired air carbon dioxide profile parameter.

279. A method according to claim 274 and wherein said providing at least one medical parameter comprises monitoring at least one of the following waveforms:

a carbon dioxide waveform (capnogram);

an EEG waveform; and

an ECG waveform.

280. A method according to claim 279, and wherein said providing at least one medical parameter comprises digitizing at least one of said waveforms.

281. A method according to claim 274 and also comprising providing at least one of the following measurements:

a slope of the increase in the carbon dioxide concentration;

a run of time taken to reach 80% maximum exhaled CO₂ concentration; and

an angle of rise to 80% maximum exhaled CO₂ concentration.

282. A method according to claim 274 and wherein at least one of the steps is further operative to a value of CAP-FEV1.

283. A method according to claim 281, and also comprising providing an alert responsive to a measure of CAP-FEV1 being less than 50% of an expected value.

284. A method according to claim 281, and also comprising providing an alert responsive to the run being greater than 0.3 seconds and the slope being less than 100 mm Hg/sec.

285. A method according to claim 274 and also comprising providing an indication of at least one of:

defective functioning of said monitoring; and

,

defective placing of a device performing said monitoring,

responsive to a value of at least one of said indications.

286. A method according to claim 273 wherein said at least one medical parameter includes at least one of:

an expired air carbon dioxide concentration; and

an expired air carbon dioxide profile parameter.

287. A method according to claim 273, wherein said at least one medical parameter includes at least one of:

a visual parameter;

a breathing parameter;

an oxygen parameter;

an ECG parameter;

a heart function parameter;

a neurological parameter;

a blood pressure parameter; and

an EEG parameter.

288. A method according to claim 273 and also comprising providing an indication of the patient'"'"'s status being within a normal range if at least one of the following requirements is fulfilled:

a) the blood pressure values are within the normal range;

b) the respiratory rate is normal;

c) CO2 run is less than or equal to 0.3 sec;

d) CO2 slope is more than or equal to 100 mm Hg/sec;

e) SPO2 is greater or equal to than 95%; and

f) ETCO2 is less than or equal to 45 mm Hg.

289. A method according to claim 273 and also comprising providing an indication of the patient'"'"'s status being within a normal range if all of the following requirements are fulfilled:

a) the blood pressure values are within the normal range;

b) the respiratory rate is normal;

c) CO2 run is less than or equal to 0.3 sec;

d) CO2 slope is more than or equal to 100 mm Hg/sec;

e) SPO2 is greater or equal to than 95%; and

f) ETCO2 is less than or equal to 45 mm Hg.

290. A method according to claim 289, and also comprising:

diagnosing the presence of said at least one medical condition; and

indicating the degree of severity of said at least one medical condition.

291. A method according to claim 289 and also comprising providing an indication of the patient'"'"'s status being outside the normal range if any of said requirements are not fulfilled.

293. A method according to claim 290, and also comprising diagnosing a respiratory disorder.

294. A method according to claim 293, and also comprising providing a diagnosis of a respiratory disorder responsive to any of said requirements not being fulfilled.

295. A method according to claim 294, and also comprising providing a diagnosis of a severity of said respiratory disorder responsive to a quantitative measure of deviation of at least one parameter from at least one of said requirements.

296. A method according to claim 293 and wherein said respiratory disorder includes at least one of:

a restrictive lung disease;

bronchospasm;

asthma;

bronchitis;

emphysema;

a respiratory failure;

fibrosis; and

an upper airway obstructive disease.

297. A method according to claim 296, and also comprising providing a diagnosis of said restrictive lung disease responsive to at least one of the following cases:

said run is greater or equal to 0.3 sec;

or

said slope is less than or equal to 100 mm Hg/sec.

298. A method according to claim 296, and also comprising providing a diagnosis of obstructive lung disease responsive to at least one of the following cases:

said run is less than 0.3 sec;

or

said slope is more than 100 mm Hg/sec.

299. A method according to claim 290 and also comprising providing a diagnosis of a heart disorder responsive to any of said requirements not being fulfilled.

300. A method according to claim 299, and also comprising providing a diagnosis of a heart failure if the following requirements are fulfilled:

CAP-FEV1 is less than or equal to a 40;

10 point ratio;

a normal CAP-FEV1/FVC ratio;

CO2 run is less than 0.3 sec; and

CO2 slope is more than 100 mm Hg/sec.

301. A method according to claim 299, and also comprising providing a diagnosis of a severity of said heart disorder responsive to a quantitative measure of a deviation from any of said requirements.

302. A method according to claim 288 and also comprising providing a recommendation to perform at least one of the following treatments responsive to said indication:

intubation of said patient;

hospitalization of said patient;

treat said patient with medication; and

transfer of said patient to an intensive care unit.

303. A method according to claim 287 and wherein said visual parameter includes a visual appearance of said patient.

304. A method according to claim 287 and wherein said breathing parameter includes at least one of:

a respiratory rate of said patient;

an FEV value; and

an FVC value.

305. A method according to claim 287 and wherein said oxygen parameter includes at least one of:

PO2; and

SPO2.

306. A method according to claim 287 and wherein said ECG parameter includes at least one of:

a QRS parameter; and

an ST segment.

307. A method according to claim 287 and wherein said heart function parameter includes a heart rate parameter.

308. A method according to claim 287 and wherein said neurological parameter includes a reflex parameter.

309. A method according to claim 287 and wherein said blood pressure parameter includes at least one of:

a blood pressure measurement; and

a systolic;

diastolic ratio.

310. A method according to claim 273 and also comprising providing said at least one output indication responsive to a pattern of changes in said at least one medical parameter over time.

311. A method according to claim 273 and also comprising providing an output indication responsive to a pattern of changes in the degree of severity of said at least one medical condition over time.

312. A method according to claim 273 and also comprising providing treatment recommendation.

313. A method according to claim 312, and wherein said providing treatment recommendation is responsive to the location of said patient.

314. A method according to claim 312, and wherein said providing treatment recommendation is responsive to a change in at least one of the following:

a change in the run;

a change in the ETCO2;

a change in the slope;

a change in the angle of rise of CO2; and

a change in the SPO2.

315. A method according to claim 312, and wherein said providing treatment recommendation is responsive to a pattern of changes in the degree of severity of said at least one medical condition over time.

316. A method according to claim 312 and wherein said providing treatment recommendation is operative to provide an alert if at least one of the following requirements is fulfilled:

a change in the run of more than 0.1 s;

a change in the slope is more negative than −

15 mm Hg/sec; and

a change in the SPO2 is more negative than −

5%.

317. A method according to claim 316 and wherein said providing treatment recommendation is operative to provide a recommendation for at least one of the following treatments responsive to at least one of said requirements:

intubation of said patient;

hospitalization of said patient;

treat said patient with intravenous medication; and

transfer of said patient to an intensive care unit.

318. A method according to claim 312 and wherein said providing treatment recommendation is operative to provide a recommendation to perform at least one of:

continue monitoring; and

continue treating the patient if at least one of the following conditions is fulfilled;

a change in the run is less negative or equal to −

0.1 s but less positive or equal to 0.1 s;

a change in the slope is less negative or equal to −

15 Hg/sec, but less positive or equal to +15 mm Hg/sec; and

a change in the SPO₂ is less negative or equal to −

5%, but less positive or equal to +5%.

319. A method according to claim 312 and wherein said providing treatment recommendation comprises performing at least one of the following:

providing a message indicative of an improvement in the patient'"'"'s status; and

recommending discontinuing a treatment procedure, if at least one of the following conditions is fulfilled;

a change in the run is more negative than −

0.1 s;

a change in the slope is more positive than +15 mm Hg/sec; and

a change in the SPO₂ is more positive than 5%.

320. A method according to claim 312 and wherein said providing treatment recommendation comprises providing a recommendation to continue monitoring said patient responsive to the pattern of changes indicating at least one of:

a deterioration in the status of said patient; and

,

a non-significant change in the status of said patient.

321. A method according to claim 312 and wherein said providing treatment recommendation comprises providing a recommendation to stop monitoring said patient responsive to a pattern of changes indicating an improvement in the status of said patient.

322. A method according to claim 312 and wherein said providing treatment recommendation is additionally responsive to information regarding other treatment received by the patient.

323. A method according to claim 273 and also comprising controlling the provision of at least one treatment to a patient.

324. A method according to claim 323 and wherein said controlling of treatment provision is responsive to information regarding other treatment received by the patient.

325. A method according to claim 323 and wherein said controlling of treatment provision comprises controlling the provision of said at least one treatment to said patient in response to changes in said at least one output indication over time.

326. A method according to claim 273 and wherein said at least one medical parameter comprises a plurality of medical parameters.

327. A method according to claim 273 and wherein said output indication relating to a degree of severity of at least one medical condition is determined at least partially by changes in said at least one medical parameter.

328. A method according to claim 273 and also comprising conveying said output indication to a remote location.

329. A medical care method according to claim 328, and further operative to provide a treatment responsive to at least one of:

said output indication; and

said remote location.

330. A method according to claim 274 and also comprising providing said at least one output indication responsive to a pattern of changes in said at least one medical parameter over time.

331. A method according to claim 311 and also comprising providing a treatment recommendation.

332. A method according to claim 323 and wherein said output indication relating to a degree of severity of at least one medical condition is determined at least partially by changes in said at least one medical parameter.