Noninvasive multi-parameter patient monitor

• US 8,912,909 B2
• Filed: 11/11/2013
• Issued: 12/16/2014
• Est. Priority Date: 03/01/2005
• Status: Active Grant

• Current Assignee: Cercacor Laboratories
• Original Assignee: Cercacor Laboratories
• Inventors: Al-Ali, Ammar, Kiani, Joe E
• Primary Examiner(s): Lu, Shirley
• Application Number:
  US14/076,556
• Publication Number:
  US 20140142399A1
• Time in Patent Office: 400 Days
• Field of Search: 340/573.1, 600/316, 600/323
• US Class Current: 340/573.1
• CPC Class Codes: A61B 1/00 Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes examination of body cavities or body tracts using ultrasonic, sonic or infrasonic waves A61B8/12; endoscopic instruments for taking cell samples or for biopsy A61B10/04; for surgical purposes A61B17/00; endoscopic surgical cutting instruments A61B17/32; surgical instruments using a laser beam being directed along or through a flexible conduit A61B18/22; Illuminating arrangements therefor for the eyes A61B3/00
• CPC Class Codes: A61B 2562/08 Sensors provided with means for identification, e.g. barcodes or memory chips
• CPC Class Codes: A61B 2562/085 combined with means for recording calibration data
• CPC Class Codes: A61B 2562/185 Optical shielding, e.g. baffles
• CPC Class Codes: A61B 2562/222 Electrical cables or leads therefor, e.g. coaxial cables or ribbon cables
• 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 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/02427 Details of sensor
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/14546 for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/1455 using optical sensors, e.g. spectral photometrical oximeters
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/14552 Details of sensors specially adapted therefor
• CPC Class Codes: A61B 5/1495 Calibrating or testing of in-vivo probes
• CPC Class Codes: A61B 5/6815 Ear
• CPC Class Codes: A61B 5/6826 Finger
• CPC Class Codes: A61B 5/6829 Foot or ankle
• CPC Class Codes: A61B 5/6832 : using adhesives A61B5/259 takes precedence
• CPC Class Codes: A61B 5/6838 : Clamps or clips
• CPC Class Codes: A61B 5/7221 : Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61B 5/7246 : using correlation, e.g. template matching or determination of similarity
• 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 5/7405 : using sound
• 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: A61B 5/7475 : User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: G16H 10/40 : for data related to laboratory analysis, e.g. patient specimen analysis
• CPC Class Codes: G16H 40/67 : for remote operation
• CPC Class Codes: H05K 999/99 : dummy group
• CPC Class Codes: Y10S 439/909 : Medical use or attached to human body

Abstract

Embodiments of the present disclosure include a handheld multi-parameter patient monitor capable of determining multiple physiological parameters from the output of a light sensitive detector capable of detecting light attenuated by body tissue. For example, in an embodiment, the monitor is capable of advantageously and accurately displaying one or more of pulse rate, plethysmograph data, perfusion quality, signal confidence, and values of blood constituents in body tissue, including for example, arterial carbon monoxide saturation (“HbCO”), methemoglobin saturation (“HbMet”), total hemoglobin (“Hbt”), arterial oxygen saturation (“SpO2”), fractional arterial oxygen saturation (“SpaO2”), or the like. In an embodiment, the monitor displays a line associated with a patient wellness level.

Claims

1. A method comprising:

processing one or more signals with one or more signal processors, said signals responsive to attenuation of light by body tissue of a monitored patient;

noninvasively, electronically determining measured values of oxygen saturation and arterial carbon monoxide saturation, based at least in part on the processed one or more signals;

providing an alarm threshold for the oxygen saturation;

altering the alarm threshold for the oxygen saturation based at least in part on at least one measured value of the arterial carbon monoxide saturation satisfying a threshold value; and

activating a caregiver alert based at least in part on at least one measured value of the oxygen saturation satisfying the altered alarm threshold.

2. The method of claim 1, wherein the caregiver alert comprises at least one of an LED activation, an alarm message, and an audible alarm.

3. The method of claim 1, wherein the caregiver alert changes as measured values of the oxygen saturation move further from the altered alarm threshold.

4. The method of claim 1, wherein activating the caregiver alert comprises emphasizing on a display the measured values of the oxygen saturation.

5. The method of claim 1, wherein activating the caregiver alert further comprises at least one of altering a size of measured values of the oxygen saturation on a display and alternately displaying and removing from the display the measured values of the oxygen saturation.

6. The method of claim 1, further comprising:

displaying on a display the at least one measured value of the oxygen saturation and;

displaying on the display a prediction indicator corresponding to the oxygen saturation, wherein the prediction indicator indicates a predicted trend of measured values of the oxygen saturation.

7. A patient monitor, comprising:

a sensor port configured to receive one or more signals from a sensor, wherein the signals are responsive to attenuation of light by body tissue of a monitored patient; and

a processor in communication with the sensor port and configured to;

noninvasively, electronically determine measured values of a first blood constituent and a second blood constituent using the one or more signals received from the sensor,

provide an alarm threshold for the first blood constituent,

alter the alarm threshold for the first blood constituent based at least in part on at least one measured value of the second blood constituent satisfying a threshold value, and

activate a caregiver alert based at least in part on at least one measured value of the first blood constituent satisfying the altered alarm threshold.

8. The patient monitor of claim 7, wherein the caregiver alert comprises an LED activation on a display device.

9. The patient monitor of claim 7, wherein the caregiver alert comprises at least one of an alarm message and an audible alarm.

10. The patient monitor of claim 7, wherein the caregiver alert comprises emphasizing on a display measured values of the first blood constituent.

11. The patient monitor of claim 7, wherein the caregiver alert comprises at least one of altering a size of measured values of the first blood constituent on a display and alternately displaying and removing from the display the measured values of the first blood constituent.

12. The patient monitor of claim 7, wherein the processor is further configured to cause a display to display thereon:

the at least one measured value of the first blood constituent, and

a prediction indicator corresponding to the first blood constituent, wherein the prediction indicator indicates a predicted trend of measured values of the first blood constituent.

13. The patient monitor of claim 7, wherein the processor is further configured to cause a display in communication with the processor to display thereon a wellness qualitative indication indicative of a patient wellness level based at least in part on a combination of the measured values of the first blood constituent and the second blood constituent.

21. The patient monitor of claim 7, wherein the first blood constituent comprises at least one of oxygen saturation, fractional oxygen saturation, carbon monoxide saturation, methemoglobin saturation, and total hemoglobin, and the second blood constituent comprises a different one of the at least one of oxygen saturation, fractional oxygen saturation, carbon monoxide saturation, methemoglobin saturation, and total hemoglobin.

14. A method comprising:

noninvasively, electronically determining measured values of a plurality of blood constituent including at least a first blood constituent and a second blood constituent, wherein the determining is performed by processing one or more signals with one or more signal processors, said signals responsive to attenuation of light by body tissue of a monitored patient;

providing an alarm threshold for the first blood constituent;

altering the alarm threshold for the first blood constituent based at least in part on at least one measured value of the second blood constituent satisfying a threshold value; and

activating a caregiver alert upon an occurrence of a predetermined event, wherein the predetermined event is based at least in part on at least one measured value of the first blood constituent satisfying the altered alarm threshold.

15. The method of claim 14, wherein the plurality of blood constituent comprise at least one of carb oxyhemoglobin, methemoglobin, hemoglobin, oxygen saturation, and fractional saturation.

16. The method of claim 14, wherein the caregiver alert comprises at least one of an LED activation, an alarm message, and an audible alarm.

17. The method of claim 14, wherein the caregiver alert changes as measured values of the first blood constituent move further from the altered alarm threshold.

18. The method of claim 14, wherein activating the caregiver alert comprises emphasizing on a display the measured values of the first blood constituent.

19. The method of claim 14, wherein activating the caregiver alert comprises at least one of altering a size of measured values of the first blood constituent displayed on a display and alternately displaying and removing from display the measured values of the first blood constituent.

20. The method of claim 14, further comprising:

displaying on a display the at least one measured value of the first blood constituent and;

displaying on the display a prediction indicator corresponding to the first blood constituent, wherein the prediction indicator indicates a predicted trend of measured values of the first blood constituent.

22. The method of claim 14, wherein the first blood constituent comprises at least one of oxygen saturation, fractional oxygen saturation, carbon monoxide saturation, methemoglobin saturation, and total hemoglobin, and the second blood constituent comprises a different one of the at least one of oxygen saturation, fractional oxygen saturation, carbon monoxide saturation, methemoglobin saturation, and total hemoglobin.