Methods and systems to determine multi-parameter managed alarm hierarchy during patient monitoring

• US 9,629,566 B2
• Filed: 03/11/2011
• Issued: 04/25/2017
• Est. Priority Date: 03/11/2011
• Status: Active Grant

• Current Assignee: Spacelabs Healthcare LLC (OSI Systems Incorporated)
• Original Assignee: Spacelabs Healthcare LLC (OSI Systems Incorporated)
• Inventors: Gilham, Jeffrey Jay, Downs, William Gregory
• Primary Examiner(s): Lee, Erica
• Application Number:
  US13/045,539
• Publication Number:
  US 20120232416A1
• Time in Patent Office: 2,237 Days
• Field of Search: None
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• 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 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/02455 provided with high/low alarm devices
• CPC Class Codes: A61B 5/0836 Measuring rate of CO2 production
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1117 Fall detection
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/1123 Discriminating type of movement, e.g. walking or running A61B5/1116, A61B5/112 take precedence
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/364 Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• 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: G08B 25/016 Personal emergency signalling and security systems emergency non-personal manually actuated alarm activators G08B25/12
• CPC Class Codes: G16H 40/63 for local operation

Abstract

The present specification discloses systems and methods of patient monitoring in which multiple sensors are used to detect physiological parameters and the data from those sensors are correlated to determine if an alarm should, or should not, be issued, thereby resulting in more precise alarms and fewer false alarms. Electrocardiogram readings can be combined with invasive blood pressure, non-invasive blood pressure, and/or pulse oximetry measurements to provide a more accurate picture of pulse activity and patient respiration. In addition, the monitoring system can also use an accelerometer or heart valve auscultation to further improve accuracy.

Claims

1. A non-transitory computer readable medium storing a plurality of programmatic instructions for processing data indicative of physiological parameters comprising:

code for receiving ECG data generated at least in part by an ECG device, wherein said ECG data comprises a plurality of features, wherein at least one of said features has a designation associated therewith and a time of occurrence associated therewith, and wherein said ECG data is indicative of a ventricular tachycardia condition;

code for receiving blood pressure and pulse data indicative of a patient'"'"'s pulse response, wherein said blood pressure and pulse data are obtained from an invasive blood pressure monitoring device separate from said ECG device and wherein said pulse data has a designation associated therewith and a time of occurrence associated therewith;

code for correlating the designation and time of said at least one feature of the ECG data with the designation and time of the pulse data to determine a degree of correlation;

code for causing a low priority alarm, indicative of a noisy ECG, to issue, wherein the low priority alarm is issued if said pulse data correlated with the ECG data is indicative of a regular rhythm and amplitude; and

code for causing a high priority alarm to issue, wherein said high priority alarm is issued if said pulse data correlated with the ECG data is indicative of a cessation of pulsatile activity.

2. The non-transitory computer readable medium of claim 1 wherein said plurality of programmatic instructions further comprises code for comparing said degree of correlation to a predetermined value.

3. The non-transitory computer readable medium of claim 2 wherein the code for causing the high priority alarm to issue only causes the alarm to issue if said comparison indicates the patient has an abnormal heart condition.

4. The non-transitory computer readable medium of claim 1 wherein said designation of at least one feature of the ECG data is either normal or abnormal.

5. The non-transitory computer readable medium of claim 4 wherein said designation of the pulse data is either normal or abnormal.

6. The non-transitory computer readable medium of claim 1 wherein said correlation functions to determine if an abnormal feature in the ECG data is correlated in time with an abnormal pulse.

7. The non-transitory computer readable medium of claim 1 wherein said correlation is further dependent upon at least one of an amplitude of an ECG signal, amplitude of a pulse signal, duration of a pulse signal, noise level within said ECG data, or noise level within said pulse data.

8. The non-transitory computer readable medium of claim 1 further comprising at least one sensor, wherein said at least one sensor is a non-invasive blood pressure (NIBP) monitoring device, heart valve sounds monitoring device, or pulse oximetry (SpO₂) monitoring device.

9. The non-transitory computer readable medium of claim 1 further comprising code for causing the invasive blood pressure monitoring device to initiate a collection of pulse data based on said ECG data.