Ambulatory patient monitoring system having multiple monitoring units and optical communications therebetween

• US 5,238,001 A
• Filed: 11/12/1991
• Issued: 08/24/1993
• Est. Priority Date: 11/12/1991
• Status: Expired due to Fees

• Current Assignee: Protocol Systems Inc, Stuart Medical, Inc.
• Original Assignee: Stuart Medical, Inc.
• Inventors: Gallant, Stuart L., Caron, Paul R., Palmer, Walter E.
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US07/790,500
• Time in Patent Office: 651 Days
• Field of Search: 128/670, 128/671, 128/700, 128/908, 364/413.02
• US Class Current: 600/513
• 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 5/02208 using the Korotkoff method
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/0225 the pressure being controlled by electric signals, e.g. derived from Korotkoff sounds
• CPC Class Codes: A61B 5/335 using integrated circuit memory devices
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 7/045 Detection of Korotkoff sounds A61B5/0225 takes precedence; measuring blood pressure A61B5/021
• CPC Class Codes: Y10S 128/90 Blood pressure recorder
• CPC Class Codes: Y10S 128/908 Patient protection from electric shock

Abstract

An ambulatory patient monitoring system (100) is provided for measuring and storing predetermined diagnostic parameters of a patient. The monitoring system includes a personal type computer (120) which may be selectively coupled to the portable portion (102) of system (100). Portable portion (102) may include one or more monitoring modules, such as ECG monitoring unit (110) and blood pressure monitoring unit (210). When ECG monitoring unit (110) and blood pressure monitoring unit (210) are disposed in side-by-side relationship and with respective optical interfaces (50, 254) in optical alignment, the two units operate in concert. ECG monitoring unit (110) supplies an R-wave gating signal to blood pressure monitoring unit (210) for establishing a window in which the receipt of a Korotkoff sound is expected. Additionally, the ECG unit (110) may trigger the blood pressure unit (210) to take a reading responsive to unit (110) identifying a predetermined abnormality in the ECG signal. Alternately, ECG monitoring unit (110) and blood pressure monitoring unit (210) may be used independently of one another as separate monitoring devices.

Claims

1. An ambulatory patient monitoring system including a carrying pouch coupled to a patient, comprising:

a. first portable monitoring means for independently measuring and storing a predetermined first diagnostic parameter of a first patient, said first portable monitoring means including;

(1) a first power supply, (2) first control means coupled to said power supply for controlling said independent measurement and storage of said first diagnostic parameter, (3) means for sensing said first diagnostic parameter having an output coupled to said first control means, (4) first optical interface means coupled to said first control means for providing for digital communication external thereto, and (5) first memory means coupled to said first control means for storing a multiplicity of measurements of said first diagnostic parameter;

b. at least a second portable monitoring means for measuring and storing a predetermined second diagnostic parameter, said second diagnostic parameter being a different physiological parameter than said first diagnostic parameter, said second portable monitoring means including;

(1) a second power supply, (2) second control means coupled to said second power supply for generating a first control signal to initiate said measurement of said second diagnostic parameter, (3) means for sensing said second diagnostic parameter having an output coupled to said second control means, (4) second memory means coupled to said second control means for storing a multiplicity of measurements of said second diagnostic parameter, and (5) second optical interface means coupled to said second control means for digital communication with at least said first monitoring means, said first control signal being generated by said second control means at one of a plurality of predetermined variable repetition rates, said variable repetition rates being actuated by said second control means for predetermined time intervals, said second monitoring means being (1) operable independent of said first monitoring means for measuring said second diagnostic parameter of a second patient, and (2) positionable within said carrying pouch with said second optical interface in optical alignment with said first optical interface of said first monitoring means for measuring said second diagnostic parameter of said first patient responsive to both said first control signal and a second control signal generated by said first control means of said first monitoring means, said second control signal being transmitted by said first optical interface means to said second optical interface means responsive to a predetermined characteristic of said first diagnostic parameter being identified by said first control means; and

c. computing means selectively couplable to both said first and second monitoring means for transferring data there between and selectively displaying said first and second diagnostic parameters, said computing means including at least a pair of serial interface ports, said computing means including means for input of (1) said variable repetition rates and said time intervals for transfer to said second control means, and (2) said first diagnostic parameter characteristic to said first control means.

2. The ambulatory patient monitoring system as recited in claim 1 where said computing means includes third optical interface means for selectable coupling with either said first or second monitoring means for transmitting data therebetween.

3. The ambulatory patient monitoring system as recited in claim 2 where said third optical interface means provides means for selectively transmitting either real time or stored diagnostic parameter information from a respective one of said first or second monitoring means.

4. The ambulatory patient monitoring system as recited in claim 1 where said first monitoring means includes means for detecting said second monitoring means being operative and disposed adjacent thereto.

5. The ambulatory patient monitoring system as recited in claim 1 where said first memory means is formed by a plurality of electrically erasable, electrically programmable, nonvolatile semiconductor memory devices.

6. The ambulatory patient monitoring system as recited in claim 1 where said first control means includes:

a. first serial interface means for said selected coupling with one of said pair of serial interface ports of said computing means;

b. first microprocessor means coupled to (1) said first serial interface means, (2) said first optical interface means, and (3) said first memory means for transmission of digital data therebetween; and

,

c. signal conditioning means coupled to said microprocessor means for amplifying, filtering and converting analog input signals to digital signals, said microprocessor means analyzing said digital signals to identify and categorize any of said digital signals representing any of a plurality of abnormal conditions.

7. The ambulatory patient monitoring system as recited in claim 6 where said second control signal is generated by said first microprocessor means responsive to (1) identifying a predetermined abnormality in said electrocardiographic signal, and (2) detection of said second monitoring means being operative and positionally located adjacent said first monitoring means for triggering a measurement by said second monitoring means.

8. The ambulatory patient monitoring system as recited in claim 6 where said first microprocessor means transmits an R-wave gate signal to said second monitoring means through said first optical interface means.

9. The ambulatory patient monitoring system as recited in claim 6 where said means for sensing said first diagnostic parameter includes a plurality of electrodes coupled to said signal conditioning means and being affixable to said first patient for conducting electrocardiographic signals therefrom.

10. The ambulatory patient monitoring system as recited in claim 9 where said second monitoring means includes an air pump fluidly coupled to an inflatable cuff affixable to a patient for inflation of said cuff responsive to either of said first or second control signals.

11. The ambulatory patient monitoring system as recited in claim 10 where said means for sensing said second diagnostic parameter includes (1) an audio transducer affixable to said patient, and (2) a pressure transducer fluidly coupled to said inflatable cuff.

12. The ambulatory patient monitoring system as recited in claim 11 where said second monitoring means further includes second microprocessor means coupled to both said audio and pressure transducers and said air pump for determining a blood pressure measurement, said second microprocessor means being further coupled to said second memory means for storing blood pressure measurement values therein.

13. The ambulatory patient monitoring system as recited in claim 12 where said microprocessor means determines said blood pressure measurement by (1) an auscultatory method using input signal from both said audio transducer and said pressure transducer when K sounds are present, and (2) an oscillometric method using input signals from said pressure transducer when K sounds are not detected.

14. The ambulatory patient monitoring system as recited in claim 1 where said second monitoring means includes second serial interface means for selective coupling with one of said pair of serial interface ports of said computing means for (1) reading data stored in said second memory means, (2) erasing said second memory means, (3) transmitting a replacement control algorithm to said second monitoring means, (4) entering patient identification data, and (5) entering measurement protocols.

15. An ambulatory patient monitoring system for measuring and storing a plurality of diagnostic parameter values, comprising:

a portable power supply;

microprocessor means coupled to said portable power supply for determining said diagnostic parameter values;

nonvolatile memory means coupled to said microprocessor means for storing both said plurality of diagnostic parameter values and a control algorithm, said nonvolatile memory being formed by a plurality of electrically programmable, electrically erasable semiconductor memory devices, said memory devices being all substantially simultaneously electrically erasable;

random access memory means coupled to said microprocessor means for temporary storage of said control algorithm, said microprocessor means transferring said control algorithm (1) from said nonvolatile memory means to said random access memory means preceding electrical erasure of said nonvolatile memory means, and (2) back to said nonvolatile memory means subsequent to said erasure thereof; and

,

sensor means coupled to said microprocessor means for providing measurement data thereto, said microprocessor means calculating said diagnostic parameter values from said measurement data.

16. The ambulatory patient monitoring system as recited in claim 15 further comprising:

means for supplying fluid to an inflatable cuff affixable to a patient coupled to said microprocessor means, said fluid supply means being actuated responsive to an inflate command control signal from said microprocessor means; and

,

means for deflating said inflatable cuff coupled to said microprocessor means, said deflating means being responsive to a deflate command signal from said microprocessor means.

17. An ambulatory patient monitoring system for measuring and storing a plurality of diagnostic parameter values powered by a portable power source, comprising:

microprocessor means coupled to said portable power source for determining said diagnostic parameter values;

memory means coupled to said microprocessor means for storing said plurality of diagnostic parameter values;

means for stopping and starting operation of said microprocessor means to thereby conserve power from said portable power source; and

,

sensor means coupled to said microprocessor means for providing measurement data thereto, said microprocessor means calculating said diagnostic parameter values from said measurement data.

18. The ambulatory patient monitoring system as recited in claim 17 further comprising:

means for supplying fluid to a inflatable cuff affixable to a patient, said fluid supply means being coupled to said microprocessor means and being actuated responsive to an inflate command control signal from said microprocessor means; and

,

means for deflating said inflatable cuff coupled to said microprocessor means, said deflating means being responsive to a deflate command signal from said microprocessor means.

19. The ambulatory patient monitoring system as recited in claim 18 where said diagnostic parameter values are blood pressure values and said microprocessor means includes means for selectably calculating said blood pressure values by (1) an auscultatory method, and (2) an oscillometric method.

20. The ambulatory patient monitoring system as recited in claim 19 where said sensor means includes (1) an audio transducer affixable to said patient, and (2) a pressure transducer fluidly coupled to said inflatable cuff.

21. The ambulatory patient monitoring system as recited in claim 19 further comprising an optical interface coupled to said microprocessor means for receiving a gating signal optically transmitted from an external monitoring unit.

22. The ambulatory patient monitoring system as recited in claim 21 where said external monitoring unit is an ECG monitoring unit and said gating signal indicates the occurrence of an R-wave, thereby improving the accuracy of said blood pressure measurement methods.

23. The ambulatory patient monitoring system as recited in claim 17 where said stopping and starting means includes clock means for generating a periodic interrupt signal to restart said microprocessor means.

24. An ambulatory patient monitoring system, comprising:

at least two monitoring units releasably secured to a patient for measuring different diagnostic parameters, each of said monitoring units comprising;

a. a portable power source;

b. microprocessor means coupled to said portable power source for controlling the measurement and storage of predetermined diagnostic parameters;

c. memory means coupled to said microprocessor means for storing said predetermined diagnostic parameters;

d. optical interface means coupled to said microprocessor means for communicating with another of said monitoring unit, said optical interface of a first of said at least two monitoring units optically transmitting a control signal representing detection of a predetermined characteristic of a first diagnostic parameter measured by said first monitoring unit to a second of said at least two monitoring units, said control signal being received by said optical interface of said second monitoring unit for initiating a measurement by said second monitoring unit of a second diagnostic parameter;

e. signal conditioning means coupled to said microprocessor means for providing said diagnostic parameters thereto; and

,

f. input means coupled to a patient for sensing diagnostic parameters therefrom, said input means having an output coupled to said signal conditioning means.