Method for automatic setting time varying parameter alert and alarm limits

• US 9,445,764 B2
• Filed: 06/15/2010
• Issued: 09/20/2016
• Est. Priority Date: 07/15/2009
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Gross, Brian D., Wang, Jyh-Yun J., Holland-Moritz, Marcus, Wilm, Bernd, Lange, Axel, Latz, Benedikt, Hubert, Volker Manfred, Tivig, Gerhard
• Primary Examiner(s): Thomson, William
• Assistant Examiner(s): JENNESS, NATHAN JAY
• Application Number:
  US13/383,736
• Publication Number:
  US 20120116194A1
• Time in Patent Office: 2,289 Days
• Field of Search: 600/300, 600/301, 128903-905, 128920-925, 128/898
• US Class Current: 1/1
• CPC Class Codes: A61B 2560/0276 Determining malfunction
• CPC Class Codes: A61B 5/00 Measuring for diagnostic purposes radiation diagnosis A61B6/00; diagnosis by ultrasonic, sonic or infrasonic waves A61B8/00; Identification of persons
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• 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 5/1455 using optical sensors, e.g. spectral photometrical oximeters
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/358 Detecting ST segments
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• 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 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

When monitoring physiological parameters (e.g., blood pressure, heart rate, etc.) of a patient, a threshold limit (30) is set (e.g., automatically or manually) and the monitored parameter is continuously compared to the threshold limit, which may be constant or may vary with time. An alarm (36) is triggered if the monitored parameter exceeds the threshold limit at any time, or if the monitored parameter has not reached a target value by the end of a predefined time period by which an administered drug or therapy should have been effective.

Claims

1. A method of providing a time-varying physiological parameter alert, comprising:

monitoring, via one or more sensors, a physiologic parameter, patient data, or clinical information of a patient; and

via a processor programmed to perform the following;

comparing the monitored physiologic parameter, patient data, or clinical information to an initial threshold criteria;

following a drug administration, intervention or therapy administration event, temporarily changing the initial threshold criteria to a worsened condition threshold criteria that permits worsening of the monitored parameter for a duration of an allotted time period and to a post-administration threshold criteria after the allotted time period;

determining whether the drug or therapy administration event is known to impact the monitored parameter by evaluating historical information about patient physiology lab study and alarm history;

during the allotted time period, comparing the monitored parameter to the worsened condition threshold criteria when the drug or therapy administration event is known to impact the monitored parameter;

after the allotted time period, comparing the monitored parameter to the post-administration threshold criteria; and

in response to the monitored parameter violating one or more of the initial threshold criteria, the worsened condition threshold criteria, and the post-administration threshold criteria, triggering an alarm.

2. The method according to claim 1, wherein the worsened condition threshold criteria is constant.

3. The method according to claim 1, wherein the worsened condition threshold criteria diminishes to the post-administration target level in a plurality of steps.

4. The method according to claim 1, wherein the worsened condition threshold criteria is varied with time.

5. The method according to claim 1, wherein the worsened condition threshold criteria follows a monotonically decreasing or increasing curve, or an exponentially increasing or decreasing time function.

6. The method according to claim 1, further including:

triggering an alert when the monitored parameter is not improved at the expiration of the allotted time period.

7. The method according to claim 1, further including determining whether the drug or therapy administration event is known to impact the monitored parameter by evaluating at least one of:

available physiological patient information; and

knowledge of administration or an intervention event that affects patient physiology.

8. The method according to claim 1, the monitored parameter including at least one of:

ST segment elevation or depression;

blood pressure;

heart rate;

blood-oxygen level;

respiratory rate; and

blood-metabolite level.

9. A non-transitory computer-readable medium carrying software for controlling the processor to configure and perform the method of claim 1.

10. The method according claim 1, wherein a notification of the drug administration, intervention or therapy administration event is manually input by a user.

11. The method according claim 1, where a notification of the drug administration, intervention or therapy administration event is automated.

12. A system that provides a time-varying physiological parameter alert to a user;

comprising;

one or more sensors that monitor a physiological parameter of a patient;

a processor programmed to;

receive one or more of patient data, clinical lab data, and monitored data or measurements that describe the physiological parameter;

compare the monitored parameter to an initial threshold criteria;

following a drug administration, intervention or therapy administration event, temporarily change the initial threshold criteria to a worsened condition threshold criteria that permits worsening of the monitored parameter for a duration of an allotted time period and to a post-administration threshold criteria after the allotted time period;

determine whether the drug or therapy administration event is known to impact the monitored parameter by evaluating historical information about patient physiology lab study and alarm history;

during the allotted time period, compare the monitored parameter to the worsened condition threshold criteria when the drug or therapy administration event is known to impact the monitored parameter;

after the allotted time period, compare the monitored parameter to the post-administration threshold criteria; and

in response to the monitored parameter violating one or more of the initial threshold criteria, the worsened condition threshold criteria, and the post-administration threshold criteria, trigger an alarm.

13. The system according to claim 12, wherein the worsened condition threshold criteria is constant.

14. The system according to claim 12, wherein the worsened condition threshold criteria diminishes or increases to the post-administration target level in a plurality of steps.

15. The system according to claim 12, wherein the worsened condition threshold criteria is varied with time.

16. The system according to claim 12, wherein the worsened condition threshold criteria follows a continuous curve, or an exponentially increasing or decreasing time function.

17. The system according to claim 12, wherein the processor triggers an alert when the monitored parameter is not improved at the expiration of the allotted time period.

18. The system according to claim 12, wherein the processor determines whether the drug or therapy administration event is known to impact the monitored parameter by evaluating at least one of:

available physiological patient information; and

knowledge of medicinal administration or an intervention event that affects patient physiology.

19. The system according to claim 12, the monitored parameter including at least one of:

ST segment elevation or depression;

blood pressure;

heart rate;

blood-oxygen level;

respiratory rate; and

blood-metabolite level.

20. The system according to claim 12, further including a user interface including:

a display on which monitored parameter information is presented to the user along with threshold limit information; and

an input device by which the user sets at least one threshold limit.

21. The system according claim 12, wherein a notification of the drug administration, intervention or therapy administration event is manually input by a user.

22. The system according claim 12, wherein a notification of the drug administration, intervention or therapy administration event is automated.