Patient-controlled analgesia with patient monitoring system and method

• US 20050177096A1
• Filed: 12/06/2004
• Published: 08/11/2005
• Est. Priority Date: 12/05/2003
• Status: Abandoned Application

• Current Assignee: Carefusion 303 Incorporated (Becton, Dickinson & Co)
• Original Assignee: Carefusion 303 Incorporated (Becton, Dickinson & Co)
• Inventors: Brook, Sandra C., Bollish, Stephen J., Steinhauer, Thomas C.
• Application Number:
  US11/006,421
• Publication Number:
  US 20050177096A1
• Time in Patent Office: Days
• US Class Current: 604/65
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/032 Spinal fluid pressure
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1455 using optical sensors, e.g. spectral photometrical oximeters
• CPC Class Codes: A61B 5/411 Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: A61B 5/4821 Determining level or depth of anaesthesia A61B5/1106 takes precedence
• 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: A61M 2005/1405 Patient controlled analgesia [PCA]
• CPC Class Codes: A61M 2202/048 Anaesthetics see also A61M19/00
• CPC Class Codes: A61M 2205/3576 with non implanted data transmission devices, e.g. using external transmitter or receiver
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2205/6072 Bar codes
• CPC Class Codes: A61M 2230/20 Blood composition characteristics
• CPC Class Codes: A61M 2230/432 partial CO2 pressure (P-CO2)
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: G16H 20/17 delivered via infusion or injection

Abstract

A patient care system in which a physiological parameter of a patient is monitored while the patient self-administers analgesic. A display presents a trend of the patient'"'"'s physiological parameter along with the time of self-administration of the analgesic (“PCA”—patient controlled analgesic) such that the effect of the analgesic on the physiological parameter can be seen over selectable time periods. The physiological parameter may be ETCO₂ or SpO₂ or other. Also included is a drug library having acceptable pumping parameters as well as other PCA specific data. Should the operator program a pumping parameter that is outside an acceptable range, or should the patient attempt to self-administer more analgesic than the acceptable range permits, or should a patient'"'"'s physiological parameter change during infusion such that a pumping parameter becomes outside an acceptable range, an indication of such will be given and action, such as stopping the pump, will be taken.

Claims

1. A patient care system, comprising:

a medication delivery device configured to deliver medication to a patient;

a patient request device with which a patient provides a request signal for delivery of medication;

a physiological monitor disposed to measure a physiological parameter of the patient and provide a physiological signal indicating a value of the measured physiological parameter; and

a controller that receives the request signal and the physiological signal and controls the operation of the medication delivery device to deliver medication to the patient in accordance with the request signal and the physiological signal.

2. The patient care system of claim 1 further comprising a display on which the controller presents a trend of the values of the measured physiological parameter with an indication of the point of delivery of the medication.

3. The patient care system of claim 2 wherein the trend comprises a display in graphical form of the values of the measured physiological parameter over a time period with the point of delivery of medication shown on the trend.

4. The patient care system of claim 2 wherein the trend comprises a display in tabular form of the values of the measured physiological parameter over a time period with the point of delivery of medication shown on the trend.

5. The patient care system of claim 2 wherein the time period over which the trend is displayed is selectable.

6. The patient care system of claim 1 wherein:

the physiological monitor measures ETCO₂ of the patient and provides an ETCO₂ signal; and

the controller controls the delivery of medication to the patient based on the ETCO₂ signal.

7. The patient care system of claim 1 wherein:

the physiological monitor measures SpO₂ of the patient and provides an SpO₂ signal; and

the controller controls the delivery of medication to the patient based on the SpO₂ signal.

8. The patient care system of claim 7 wherein:

the physiological monitor measures ETCO₂ of the patient and provides an ETCO₂ signal; and

the controller controls the delivery of medication to the patient based on both the SpO₂ signal and on the ETCO₂ signal.

9. The patient care system of claim 6 wherein a waveform of the measured ETCO2 is displayed.

10. The patient care system of claim 7 wherein a waveform of the measured SpO₂ is displayed.

11. The patient care system of claim 1 wherein in response to the physiological signal the controller controls the operation of the delivery device in accordance with actions consisting of:

stop medication delivery;

pause medication delivery;

disable response to the request signal;

establish a time period within which response to the request signal is disabled; and

restart medication delivery.

12. The patient care system of claim 1 wherein:

the medication delivery device comprises a PCA pump controlled by a patient request to deliver a bolus of medication;

the controller presents on a display a series of values of the monitored physiological parameter over time in graphical form and on the same graphical display, presents the point at which occurred the PCA request signal from the patient.

13. The patient care system of claim 12 further comprising a drug library in which is stored data related to analgesic delivery parameters and patient physiological parameters;

wherein the controller is programmed to compare the medication delivery request signal and the physiological signal to the stored data of the drug library.

14. The patient care system of claim 6 wherein the controller responds to an ETCO₂ measured value to control the pump to titrate a drug to the patient.

15. The patient care system of claim 6 wherein the controller responds to an ETCO₂ measured value to control the pump to administer a drug reversal agent.

16. The patient care system of claim 6 wherein the controller sends an alert based on an ETCO₂ measured value.

17. The patient care system of claim 14 further comprising a memory in which the controller stores:

measured physiological parameter values; and

request signals;

wherein the controller forwards the stored signals from memory to another location for analysis.

18. The patient care system of claim 1 further comprising a drug library in which ranges of acceptable values for delivery of medication are stored, the controller comparing pumping delivery parameters programmed into the medication delivery device to the drug library and if outside a range of acceptable values, providing an alert.

19. The patient care system of claim 18 wherein:

the drug library includes a soft range of acceptable values, wherein the controller will provide an alert if a programmed parameter of the medication delivery device is outside the soft range however will permit medication delivery to commence is requested;

the drug library includes a hard range of acceptable values, wherein the controller will provide an alert if a programmed parameter of the medication delivery device is outside the hard range and will not permit medication delivery to commence and will require reprogramming of the alerted delivery parameter.

20. The patient care system of claim 17 wherein the controller accesses a data source for patient-specific information and compares it to drug library, provides alert if this patient combined with this drug are outside ranges.

21. The patient care system of claim 17 wherein the data set is configurable by an operator of an editor program.

22. A method for patient-controlled self administration of analgesic, comprising:

receiving a request signal from a patient-controlled device for the delivery of analgesic to the patient;

receiving physiological parameter data from a monitor disposed to measure a physiological parameter of the patient; and

controlling the self administration of the analgesic to the patient in accordance with the request signal and the physiological parameter data.

23. The method of claim 22 further comprising displaying a trend of the values of the measured physiological parameter with an indication of the point of delivery of the medication.

24. The method of claim 23 wherein the step of displaying comprise displaying in graphical form the values of the measured physiological parameter over a time period with the point of delivery of medication shown on the trend.

25. The method of claim 23 wherein the step of displaying comprise displaying in tabular form the values of the measured physiological parameter over a time period with the point of delivery of medication shown on the trend.

26. The method of claim 23 wherein the step of displaying comprises the step of selecting the time period over which the trend is displayed.

27. The method of claim 22 further comprising:

measuring ETCO₂ of the patient and providing an ETCO₂ signal; and

controlling the delivery of medication to the patient based on the ETCO₂ signal.

28. The method of claim 22 further comprising:

measuring SpO₂ of the patient and providing an SpO₂ signal; and

controlling the delivery of medication to the patient based on the SpO₂ signal.

29. The method of claim 28 further comprising:

measuring ETCO₂ of the patient and providing an ETCO₂ signal; and

controlling the delivery of medication to the patient based on both the ETCO₂ signal and the SpO₂ signal.

30. The method of claim 22 wherein in response to the physiological signal the step of controlling the medication delivery comprises controlling in accordance with the actions consisting of:

stop medication delivery;

pause medication delivery;

disable response to the request signal;

establish a time period within which response to the request signal is disabled; and

restart medication delivery.

31. The method of claim 22 further comprising comparing parameters programmed into the medication delivery device with a drug library in which is stored data related to analgesic delivery parameters and patient physiological parameters;

and

controlling the delivery of medication in accordance with the programmed parameters and the drug library.