WO2007142872A2 - Système de surveillance de patient - Google Patents

Système de surveillance de patient Download PDF

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Publication number
WO2007142872A2
WO2007142872A2 PCT/US2007/012459 US2007012459W WO2007142872A2 WO 2007142872 A2 WO2007142872 A2 WO 2007142872A2 US 2007012459 W US2007012459 W US 2007012459W WO 2007142872 A2 WO2007142872 A2 WO 2007142872A2
Authority
WO
WIPO (PCT)
Prior art keywords
controller
mattress
alarm
patient
sensor
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2007/012459
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English (en)
Other versions
WO2007142872A3 (fr
Inventor
Mark Shaw
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO2007142872A2 publication Critical patent/WO2007142872A2/fr
Publication of WO2007142872A3 publication Critical patent/WO2007142872A3/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A61B5/1118—Determining activity level
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6887—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient mounted on external non-worn devices, e.g. non-medical devices
    • G—PHYSICS
    • G08—SIGNALLING
    • G08B—SIGNALLING SYSTEMS, e.g. PERSONAL CALLING SYSTEMS; ORDER TELEGRAPHS; ALARM SYSTEMS
    • G08B21/00—Alarms responsive to a single specified undesired or abnormal condition and not otherwise provided for
    • G08B21/02—Alarms for ensuring the safety of persons
    • G08B21/04—Alarms for ensuring the safety of persons responsive to non-activity, e.g. of elderly persons
    • G08B21/0438—Sensor means for detecting
    • G08B21/0461—Sensor means for detecting integrated or attached to an item closely associated with the person but not worn by the person, e.g. chair, walking stick, bed sensor

Definitions

  • the present invention generally relates to a patient monitoring system that monitors a patient on a time basis.
  • In-patient care one concern is the formation of bed sores or decubitus sores resulting from the patient remaining in bed for extended periods of time.
  • the most common solution is to turn the patient.
  • a patient who is susceptible to such sores may need to be turned every two hours and, in some cases, more frequently.
  • This process of monitoring a patient to reduce the likelihood of the patient developing such sores will generally be referred to as "wound care.”
  • wound care To ensure that adequate wound care is performed or to make sure that the patient is moving sufficiently on their own, a system for monitoring a patient on a time basis is needed.
  • the present invention provides, a patient monitoring system used in connection with a mattress, the system including a controller, a sensor in communication with the controller and adapted to detect movement on the mattress, a timer in communication with the controller, and an alarm in communication with the controller, wherein the controller is adapted to communicate an alarm signal after a selected period of time has passed without sensing any movement on the mattress.
  • Fig. 1 is a to plan view of the patient migration monitor according to the concepts of the present invention showing a single chamber migration sensor having a pair of insertable ends located near the lateral edges of a mattress;
  • Fig. 2 is a partially fragmented sectional side elevational view, as might be seen along line 2-2 in Fig. 1 , depicting details of one insertable end;
  • Fig. 3 is a partially fragmented partially sectional end view as might be seen along line 3-3 in Fig. 1;
  • Fig. 4 is a patient migration monitor according to the concepts of the present invention having two migration sensors shown near the edges of a mattress having a first end insertable within the mattress for detecting patient movement and a second end connected to a sensor that detects changes in the internal pressure within the sensor and reports the same to a controller;
  • Fig. 5 is a partially fragmented side elevational view of the mattress depicted in Fig. 4 shown on a pivotable bed frame depicting a portion of the mattress in an elevated position;
  • Fig. 5a is an enlarged fragmented sectional side elevational view showing details of the migration sensor, when a portion of the mattress is raised;
  • Fig. 6 is a patient migration monitor according to the concepts of the present invention having an array of migration sensors within the mattress;
  • Fig. 7 is a partially schematic section side elevational view of a migration sensor according to the concepts of the present invention, where the sensor defines a chamber that has been filled with foam;
  • Fig. 8 is a partially schematic section side elevational view of a migration sensor according to the concepts of the present invention, where a pump communicates with the sensor's chamber to over inflate the chamber;
  • Fig.9 is an operational diagram depicting a controller according to the concepts of the present invention that monitors a patient on a time basis;
  • Fig. 10 is a flow chart depicting operation of a controller according to the concepts of the present invention that monitors a patient on a time basis.
  • the present invention generally provides a patient monitoring system used in connection with a mattress, overlay, cover, cushion, or pad, on which a patient is at least partially supported, collectively referred to herein as a "mattress".
  • the mattress may be used in connection with any supporting frame including, without limitation, a bed, chair, or sofa.
  • the present invention relates to a monitoring system that incorporates a migration sensor that includes a member that defines a chamber fluidly connected to a pressure sensor. The migration sensor is placed in proximity to a patient such that movement of the patient applies a force to the member, which is detected by the sensor as a pressure change.
  • Pressure changes are monitored by a controller and reported to a care giver to help alert the care giver of a potentially dangerous condition, for example a patient attempting to exit the mattress or moving to a position where they might fall from the mattress.
  • patient and care giver should be understood as any person and are not limiting. They are merely used to provide context in the sense that a patient is the person being monitored by the care giver. This monitoring could occur in any setting including, for example, hospitals, managed care facilities, emergency shelters, or a home.
  • System 10 includes a migration sensor, generally indicated by the numeral 15.
  • Migration sensor includes a member 20 that defines a chamber 25.
  • a pressure sensor 30 is placed in sensing communication with the member 20. As a result, changes in the external forces on the member 20 are detected as pressure changes within the chamber 25 by the pressure sensor 30.
  • the member 20 may be constructed of a compressible material including, but not limited to, nylon, vinyl, rubber, and similar materials.
  • the member 20 may be constructed of a material that gives the member 20 a softness substantially equal to or less than that of the surrounding mattress material.
  • the therapeutic value of the mattress is improved because the member 20 will not create a pressure point in the mattress.
  • the member 20 may be fluid-tight, but some fluid loss is permissible. As will be appreciated, changes in the chamber pressure caused by patient migration will still be detected by the sensor 30 even if a loss of fluid is occurring. If necessary, losses may be compensated for by periodically refilling the member 20 with fluid.
  • an air supply including, but not limited to a pump P (Fig. 8), may be fluidly connected to the member 20: When using a pump P, to minimize losses through the pump P, a valve V may be used to close off the pump P from the member 20 after the desired inflation of the chamber 25 is achieved.
  • the member 20 maybe given any desired shape and may be of any suitable size.
  • a member having an elongate tubular shape is shown.
  • the member 20 may have a circular cross-section.
  • member 20 may have a first end 21 and a second end 22 that are located on opposite sides of the mattress centerline C. While the ends 21,22 are shown at the lateral outward edges 23,24 of the mattress 12, it will be appreciated that the member 20 may be located at any position relative to the mattress 12.
  • the member 20 may be located at the periphery 26 of the mattress 12, or as shown in Fig. 6, member 20 may be located at positions inboard of the mattress periphery 26.
  • the ends 21 , 22 or individual members 20, when multiple members 20 are used may be arranged symmetrically about the mattress centerline C or in an unsymmetrical fashion.
  • member 20 may have any length.
  • member 20 may extend the entire length of the mattress 12 or a selected portion of the mattress 12.
  • the member 20 may have a length that allows it to be adjacent to the patient's torso. Locating the member 20 at the upper end 14 of the mattress 12 near the patient's torso is believed to provide earlier detection of movement that might lead to a dangerous condition because the patient' s torso is closest to the edge of the mattress 12.
  • the member 20 extends from one end of the mattress 12 to a point near or beyond the mattress's transverse center-line TC.
  • the member 20 may be located near or extend beyond the axis A to provide information relating to the incline of the mattress 12 as will discussed more completely below.
  • the member 20 is placed in proximity to the patient, as by attaching the member 20 to the mattress 12.
  • “attachment” of the member 20 may include any mechanical attachment of the member 20 to the mattress 12, insertion of the member 20 within a receiver formed in the mattress 12 or an adjacent structure, or simply laying the member 20 on or beneath the mattress 12.
  • member 20 may also be attached by inserting the member 20 within a member support 35 that is attached to the mattress 12.
  • the member support 35 may be any member suitable for supporting the member 20.
  • member support 35 is a bolster 36 that defines a receiver 37 for the member 20.
  • the member support 35 may be constructed of materials commonly used to construct mattresses.
  • the member support 35 may be constructed of foam.
  • member support 35 defines a cylindrical shaped receiver 37 at a depth D from the upper surface 38 of the member support 35.
  • the depth D at which the receiver 37 is located may be increased or decreased.
  • the support 35 may alternatively define a receiver 37 that extends the entire length L of the support 35. This provides flexibility in that the migration sensor 15 may be inserted at either end of the support 35 and facilitates the use of extrusion methods of forming the support 35.
  • the support 35 allows forces to be transmitted from the patient to the migration sensor 15 and may be made flexible to facilitate the transmission of these forces. As best shown in Fig.
  • the support 35 may be provided with a slot 39 that extends radially outward from the receiver 37. Legs 41 on either side of the slot 39 may be flexed outwardly to allow radial insertion of the member 20. In the example shown, the slot 39 extends downward from the receiver 37.
  • Figs.7 and 8 depict examples of members 20, but are not to be considered limiting.
  • the member 20 maybe made compressible as by having crushable zones or, as discussed above, by selecting a material that will deform under suitable force.
  • a thin membrane may be used to construct the member 20.
  • the member's chamber 23 may be filled with a porous material 40 including, but not limited to, foam.
  • a pump P may be used to maintain the member 20 in an over inflated condition.
  • a valve V may be used to close the conduit to the pump P to avoid fluid loss back through the pump P.
  • a sensor 30 is in sensing communication with member 20.
  • member 20 may provided with an opening 28 that opens to the sensor 30.
  • Other methods of sensing the pressure or changes in pressure within member 20 may be used as well.
  • a conduit 31 extends from member 20 to the sensor 30 to fluidly connect the member 20 to the sensor 30.
  • the member 20 may directly connect to the sensor 30 with the opening formed at the member's second end 22.
  • the sensor 30, in turn, communicates with a controller C, which monitors changes in the member's pressure and notifies the care giver.
  • the term controller encompasses any device capable of receiving pressure information from the pressure sensor 30 and notifying the care giver.
  • the controller C may be simple in the sense that any change in pressure is communicated to the caregiver by activating an alarm, described more completely below. In this example, the controller C acts much like a switch. Alternatively, the controller C may be programmable and include a processor and memory if necessary.
  • the controller C may be programmed with instructions to alert a care giver only under certain circumstances.
  • controller C may be programmed with a selected threshold pressure.
  • the controller C may, then, compare the sensed pressure to the selected threshold pressure. In comparing the sensed pressure to the threshold pressure the controller C may warn the care giver in a variety of ways.
  • the selected threshold is programmed to indicate a dangerous condition. If the controller C detects a pressure equal to or exceeding this pressure it may activate an alarm or otherwise communicates this condition to a care giver.
  • the controller C may be programmed to incrementally alert the care giver as the sensed pressure approaches the threshold.
  • the controller C may be programmed to signal the care giver with increasing frequency or intensity as the threshold is approached.
  • the controller C may be programmed with a base pressure value that must be exceeded before the controller C notifies the care giver.
  • the controller C may notify the user by communicating an alarm signal to an existing system within the care giver facility, for example, a nurse call or similar system.
  • Notification may be in any perceptible form including for example, visual, audible, or tactile forms.
  • the device used to notify the caregiver will be referred to as an alarm AL.
  • the alarm AL may form part of the controller C or, as shown in Fig. 6, may be separate from the controller C.
  • the alarm AL may be located remotely from the mattress 12, for example at a central care giver's station.
  • Thealarm AL may be mobile and carried by a care giver. Multiple alarms AL may be used together, as well.
  • the controller C may simultaneously signal an alarm within the controller C and a remote alarm AL. Any known device capable of receiving a signal from the controller C and notifying the care giver may be used as an alarm AL. Or, a custom alarm AL may be designed.
  • Alarm AL may be any suitable device for generating a perceptible form of notice.
  • alarm AL may include, but not be limited to, a speaker that generates an audible tone, bell, or recorded voice or other audible cue; a light, an LED, a display screen, or other viewable device; or a vibrating unit, Braille reader, or other tactile device.
  • controller C may be programmed, such that, at a selected pressure range corresponds to a selected risk level.
  • the controller C Upon detecting pressures within the respective ranges, the controller C itself, or through alarm AL, notifies the care giver of the selected risk level.
  • the controller C itself, or through alarm AL, notifies the care giver of the selected risk level.
  • One example which is not considered limiting, provides low, medium, and high risk levels associated with increasing pressure ranges.
  • the actual pressure value may be communicated to the care giver.
  • the controller C or alarm AL will include a suitable audible, visual, or tactile device for communicating the risk level, such as those described above with respect to the alarm AL.
  • a suitable audible, visual, or tactile device for communicating the risk level, such as those described above with respect to the alarm AL.
  • Other examples which are not considered limiting, would be visual displays or simply a "display", including, but not limited to, a numeric or alpha-numeric LED, series of lights associated with a printed scale, or a monitor.
  • Figs.4-5 A depict an alternate patient monitoring system, generally indicated by the number 110.
  • Patient monitoring system 110 is similar to the system 10 and thus like numbers will be used to refer to like components.
  • system 110 differs from system 10 in that it includes multiple migration sensors, generally indicated by the number 115.
  • each migration sensor 115 includes a member 120 that defines a chamber 125, and is in fluid communication with a sensor 130.
  • individual pressure changes within the members 120 may be independently sensed at multiple locations.
  • a pair of members 120 is used, but any number of migration sensors 115 may be used.
  • pressures (P 1 , P 2 ) are detected by a pair of sensors 130, which respectively report the pressures (P 1 , P 2 ) to controller C.
  • controller C may be programmed to reset after the detection of simultaneous pressure changes in separate migration sensors 115 located on opposite sides of the mattress 112. For example, upon detecting such changes in pressure, the controller C may be programmed to zero the pressure values detected at the simultaneously changing migration sensors 115 to filter out pressure changes not associated with the patient.
  • one migration sensor 115 is located at each lateral outward extremity 113 of mattress 112.
  • the migration sensor 115 may be incorporated as part of the mattress 112 or be separately attached.
  • a migration sensor support generally indicated by the number 135, may be provided and attached or positioned adjacent the mattress 112 in any known manner, for example, snaps, Velcro, buttons, or other mechanical fasteners, or adhesives, welds, and the like.
  • Support 135 may be similar to the support 135 described above and include an elongate member that defines a receiver 137 adapted to receive the migration sensor 115.
  • the support 135 may define a receiver 137 that extends the entire length of the support 135. This provides flexibility in that the migration sensor 115 may be inserted at either end of the support 135 and facilitates the use of extrusion methods of forming the support 135.
  • the support 135 allows forces to be transmitted from the patient to the migration sensor 115 and may be made flexible to facilitate the transmission of these forces.
  • support 135 is constructed of foam. As discussed, the type of support material or depth D at which the receiver 137 is located may be altered to increase or decrease the migration sensor's sensitivity to the patient's movement.
  • members 120 are used in connection with an articulating mattress 112.
  • the articulating mattress 112 folds or bends along an axis A. It will be appreciated that in some mattresses more than one axis may be provided.
  • the length and position of the migration sensor 115 maybe adjusted to compensate for pressure changes along these axes in the same manner as the single axis case described below.
  • articulation of the bed or mattress 112 may be detected as a pressure change within migration sensors 115 located on opposite sides of the mattress 112. As shown in Fig.5A, the change in the mattress 112 angle ⁇ causes the member 120 to bend at an ( ⁇ ) or otherwise compresses the member 120 near the axis A.
  • the controller C may be programmed with a permissible delay between pressure readings at plural migration sensors 115 as indicative of a change in mattress angle, for example, 5 seconds.
  • care giver may enter any time period that it deems to be a safe window for the controller C to rule out conditions that might create a false alarm.
  • controller C may be programmed to automatically recalibrate itself to zero pressure so that a false alarm is not triggered. If the condition triggering the substantially simultaneous pressure changes is ongoing, for example, the mattress angle is being changed over a period of time, the controller may be programmed to continue to recalibrate to zero until the substantially simultaneous change in pressures at plural migration sensors 115 ends.
  • the controller may be programmed to alert the caregiver that the patient is changing the angle of the mattress 112 or otherwise provide notice that would cause the caregiver to investigate the patient's status without indicating an immediately dangerous condition. Since the pressure changes caused by changing the mattress angle are expected to be roughly the same, despite the simultaneous change in pressure at each migration sensor 115, the controller C may still notify the care giver of a dangerous condition if the pressures at each migration sensor 115 are different.
  • Fig.6 schematically depicts a patient monitoring system, generally indicated by the number 210, where the receivers 237 are formed within the mattress 212, and the members 220 are inserted therein. Members 220 could also be placed beneath the mattress 212 in the same configurations. In the example, a single member 220 having four ends is used. Alternatively, as described with respect to system 110, multiple members 220 may be used each separately communicating with the controller C.
  • Fig. 6 also depicts an example of a transversely extending member 220A, which like the previously described member 220, may be placed within a transverse receiver TbIK. While shown near the foot of the mattress 212, the transverse member 220A may be located at any point along the length of the mattress 212.
  • Member 220A while not particularly suited for detecting rolling movement of the patient, may be used to detect pressure changes in local areas on the mattress.
  • member 220A may be used to detect a patient exiting the mattress 212, which might be seen as the pressure being removed from member 220A. A sharp increase in pressure followed by its release might also indicate that a patient has exited the mattress 212.
  • Controller C may be programmed to detect such conditions at member 220A and notify the care giver, as described in the previous embodiments.
  • controller C may further include or be placed in communication with a timer T that monitors a patient on a time basis, hi one example, the timer T monitors a patient for an "absolute" time period meaning that the controller is programmed to notify the caregiver, for example via an alarm AL, after a fixed period of time passes on timer T.
  • controller C may be programmed to monitor the patient for a "dynamic" time period meaning that the controller C monitors the amount of time based on a trigger.
  • the trigger TR may be a signal from a sensor M.
  • controller C may include a sensor that monitors patient movement. If patient movement is sensed by controller C, the timer T starts and does not stop until additional movement is detected.
  • a signal communicated from the sensor M to the controller C would cause controller to restart or reset the dynamic period.
  • a signal from the care giver can act as a trigger TR.
  • the care giver may press a button or otherwise activate an input I in communication with controller C to initially activate or restart the timer T after checking on the patient.
  • Controller C may be programmed such that if a selected period of time, which will be referred to as a dynamic period, passes between triggering events, such as movement or care giver activation, the controller C notifies the care giver via an alarm AL.
  • the controller C may begin the dynamic time period after input I is activated by the caregiver and notify the caregiver if nothing occurs during the time period via an alarm AL.
  • the controller C activates the alarm AL.
  • This method of operation may be useful when an alarm has sounded based on expiration of an absolute or dynamic time period causing the caregiver to activate an input I to silence the alarm AL.
  • the caregiver may deactivate the alarm AL or simply press a mute button.
  • the alarm AL may have sounded to notify the caregiver that a patient needed to be turned or other patient movement was required.
  • a dynamic period may be triggered by the caregiver's input for purposes of detecting whether or not this movement occurred. Therefore, if the dynamic time period expires without the movement sensor detecting movement on the mattress. If the dynamic time period expires without detecting movement, controller C alerts the caregiver via the alarm AL. If movement, however, is detected, the controller stops the dynamic timer and may begin the absolute timer for the next care-giving period.
  • the absolute and dynamic time functions may be combined with a selected time period set for each function.
  • the controller C may include a first time period or absolute time period, where an alert is sent to the care giver after a selected period of time passes on timer T.
  • Controller C might be programmed with a second time period or dynamic time period used to monitor the time between patient movements. For example, if no movement is detected within the dynamic time period, the controller C alerts the caregiver. If a movement occurs within the dynamic time period, the controller may be programmed to restart the time period upon detecting movement.
  • a pressure sensor according to the concepts of the present invention may be used in addition to any other sensor adapted to detect patient movement including load cells, pressure switches, optical sensors, and other devices known in the art.
  • controller C may be programmed into the controller C by the manufacturer or controller C may be made programmable to allow the care giver to customize these time periods. It will be appreciated that different patients may require differing levels of care of different care levels may be required based on whether a patient is unconscious, and accordingly different time periods for each may be programmed into controller C. Controller C may be a single unit monitoring several patients or a controller C may be associated with each mattress so that each patient is monitored by a separate controller C. A flow chart invention is included in Fig. 10 as one example and is not to be considered limiting.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medical Informatics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biophysics (AREA)
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  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Business, Economics & Management (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Emergency Management (AREA)
  • Gerontology & Geriatric Medicine (AREA)
  • Dentistry (AREA)
  • Physiology (AREA)
  • General Physics & Mathematics (AREA)
  • Invalid Beds And Related Equipment (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)

Abstract

L'invention concerne un système de surveillance de patient utilisé en liaison avec un matelas, le système comprenant le matelas et un contrôleur en communication avec une minuterie. Le système est adapté pour alerter un membre de l'équipe soignante après une certaine période de temps sélectionnée.
PCT/US2007/012459 2006-06-02 2007-05-25 Système de surveillance de patient Ceased WO2007142872A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US81036106P 2006-06-02 2006-06-02
US60/810,361 2006-06-02

Publications (2)

Publication Number Publication Date
WO2007142872A2 true WO2007142872A2 (fr) 2007-12-13
WO2007142872A3 WO2007142872A3 (fr) 2008-03-20

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PCT/US2007/012459 Ceased WO2007142872A2 (fr) 2006-06-02 2007-05-25 Système de surveillance de patient

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Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5905436A (en) * 1996-10-24 1999-05-18 Gerontological Solutions, Inc. Situation-based monitoring system
US6208250B1 (en) * 1999-03-05 2001-03-27 Hill-Rom, Inc. Patient position detection apparatus for a bed
US6917293B2 (en) * 2002-05-17 2005-07-12 Tactilitics, Inc. Integral, flexible, electronic patient sensing and monitoring system
CA2393880A1 (fr) * 2002-07-17 2004-01-17 Tactex Controls Inc. Systeme de surveillance pour l'occupant d'un lit

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