Surgery – Diagnostic testing
Reexamination Certificate
1999-04-20
2001-05-01
O'Connor, Cary (Department: 3736)
Surgery
Diagnostic testing
C600S554000, C600S558000, C600S559000
Reexamination Certificate
active
06224549
ABSTRACT:
FIELD OF THE INVENTION
The present invention pertains generally to medical monitoring equipment, and particularly to methods and devices for analyzing and displaying physiological signals provided by such equipment.
BACKGROUND OF THE INVENTION
Medical monitoring involves monitoring the body of a subject to determine the state of health of the subject and to detect, identify, and diagnosis changes or abnormalities in the state of the body which may be indicative of problems or for treatment evaluation. Medical monitoring may involve, for example, the motion of a subject's body, temperature or chemical changes of the subject's body, and/or audible or electrical signals generated by the subject's body. For example, electroencephalography (EEG) is a form of medical monitoring wherein the electrical potentials of the subject's brain are monitored by attaching electrodes to the subject's scalp. In electromyography (EMG), electrical activity generated in the subject's muscles is monitored using surface and/or needle recording electrodes. Medical monitoring may take place when a subject is at rest, in motion, or during the performance of a medical procedure. In some cases, medical monitoring involves monitoring the response of the subject to a stimulus. For example, evoked potential (EP) monitoring may be used to detect the electrical response of a subject's brain to audible, visual, or electrical stimuli. Medical monitoring involving stimulus and response detection may be used in combination with EMG and various other medical monitoring methods as well.
Monitoring of the various physiological signals generated by a subject's body is typically performed using dedicated devices and/or systems. For example, EEG monitoring may be performed using a dedicated EEG monitoring system, by attaching electrodes to a subject to detect the electrical potentials of the subject's brain, amplifying and filtering the signals received from the electrodes for the desired frequency range of interest for EEG analysis, and providing the amplified and filtered signals to an EEG analysis system including software for further manipulating the EEG signals for analysis and display on an EEG system monitor. Similarly, EMG monitoring may be performed using a dedicated EMG monitoring system, by placing electrodes on the subject to detect electrical activity generated in the subject's muscles, amplifying and filtering the signals detected by the electrodes for the desired frequency range of interest for EMG signals, and providing the amplified and filtered signals to an EMG analysis system including software for further manipulating the EMG signals for analysis and display on an EMG system monitor. Other signals of interest, e.g., vital signs, may be monitored in a similar manner, with a separate dedicated system provided for each type or modality of monitored signal of interest. Each such dedicated monitoring system may include or be connected to a system for providing stimulus to a subject, and for analyzing the particular detected signal of interest in response to the stimulus provided.
To provide a fall range of diagnostic capability, a doctor's office or operating room, ICU or ER must have available systems for monitoring various physiological signals. Thus, EEG, EMG, vital signs, and other physiological signal monitoring systems preferably must be readily available. Where the capability for monitoring each different type of physiological signal is implemented in a dedicated system, maintaining a full range of diagnostic capability can be a very expensive proposition. Moreover, in many cases it may be desirable to monitor the various physiological signals generated by a subject's body simultaneously. Thus, it may be desired to monitor simultaneously EEG, EMG, vital signs, and other physiological signals generated by a subject. If each type of signal to be monitored requires a dedicated monitoring system, each system having its own set of electrodes, monitoring and display units, etc., all simultaneously connected to a subject, an operating room or other medical facility will be crowded with equipment, which may interfere with the procedures being performed. More significantly, each such system must be operated independently, and may have its own unique user interface. Thus, critical time and effort may be wasted as a physician or other specialist must constantly switch his attention between different medical monitoring systems in order to monitor various physiological signals of interest.
SUMMARY OF THE INVENTION
The present invention provides a medical signal monitoring system and method providing the capability for an operator of the system to display and analyze physiological signals of various types, frequencies, and modalities. The medical monitoring system in accordance with the present invention may be implemented on a conventional computer system having conventional input, output, and disk storage devices. Data input to the medical monitoring system may be provided from various physiological signal acquisition systems, including systems for acquiring electrical physiological signals from electrodes positioned on a subject. Digitized video and audio inputs may also be provided to the medical monitoring system. The medical monitoring system may further be connected to auditory, visual, and/or electrical stimulator systems, for controlling the providing of stimulation to a subject, while analyzing the physiological signals received in response thereto via the acquisition system.
The medical monitoring system in accordance with the present invention employs a data pipeline structure wherein, for example, raw electrical physiological signals from electrodes attached to a subject are both saved and processed. Processing steps which may be performed on the raw electrode signals thus received include defining and generating a signal to be displayed, filtering the signal, defining a trigger signal, averaging the signal, performing spectral analysis and trend calculation of the signal, and displaying the resulting processed signal. Various parameters for each of the processes performed on a signal to be displayed may be established by an operator of the system employing a software user interface implemented in a Windows-type operating system. Since data may be stored as a stream of raw data recorded from an electrode different signals, having different modalities and formats, may be generated and displayed from the stored data, to review the data in a different desired context.
In accordance with the present invention, physiological signals of interest are displayed in panels. The user interface allows different panel types to be selected. The panel type selected determines the basic format of the physiological signal to be displayed. Panel formats preferably are provided for displaying physiological signals as various waveforms and/or as indicators, such as bar indicators.
The signals to be displayed in a panel are defined by selecting, via the user interface, the signals provided by a pair of electrodes, from which a montaged pair signal to be displayed is generated. An operator also employs the user interface to select the modality of the signal to be derived and displayed, e.g., EEG, EMG, or evoked potential (EP). The user interface preferably also provides an operator of the system with the option of displaying signals of interest as triggered, averaged, or trend (compressed) data. Triggering, averaging, and spectral trend data parameters are operator selectable employing the user interface.
Various different panels may be defined by an operator for a particular operator's use, or for a particular patient, or physiological monitoring session. The panels as defined and their associated controls and stimulus parameters may be saved as a template.
During acquisition mode data is received into the data pipeline and displayed in the format defined by the panels. Received physiological signals may also be recorded to disk at this time, and played b
Carter Ryan
Foley & Lardner
Nicolet Biomedical Inc.
O'Connor Cary
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