Surgery – Respiratory method or device – Means for supplying respiratory gas under positive pressure
Reexamination Certificate
1995-09-05
2002-07-09
Winakur, Eric F. (Department: 3736)
Surgery
Respiratory method or device
Means for supplying respiratory gas under positive pressure
C128S203120, C128S205230
Reexamination Certificate
active
06415792
ABSTRACT:
BACKGROUND OF THE INVENTION
During major surgeries in which general anesthesia is used, it is necessary to monitor the vital functions of the anesthetized patient and additionally to control and monitor the anesthesia process. Systems referred to as “anesthesia machines” have been developed to facilitate such control functions of the anesthesia delivery and some of the monitoring functions thereof. The anesthesia machine provides controls for the flow and mixtures of oxygen and a gaseous anesthetic to the patient with gauges or indicators for monitoring the flow rates and supply pressures. Modern anesthesia machines are equipped with spirometers that measure respiratory volumes within the breathing circuit, ventilators with disconnect alarms, waste gas scavengers, and oxygen analyzers. Humidifiers and nebulizers are available that connect between the anesthesia machine and the breathing circuit. Vital parameters which are monitored and indicated include patient temperature, blood pressure, pulse rate, oxygen and carbon dioxide concentrations and electrocardiographic data.
In the modern day practice of anesthesiology, computers not only facilitate monitoring traditional variables such as blood pressure, heart rate, and electrocardiogram, they also allow the monitoring of variables which could not otherwise be monitored. For example, the use of cardiac output monitors is now commonplace. The monitoring of less available indicators of lung function using computers is now a reality. A lung-water computer can monitor the extra vascular lung water, and real-time monitoring of respiratory gas exchange can be readily accomplished.
Computer processing of the electroencephalogram (EEG) has transformed a complicated chart-oriented activity performed only by neurologists into a real-time monitoring function performed easily during surgical procedures. Computer analysis of the EEG continues to improve and now compares favorably with visual evaluation. Computerized EEG monitoring is beneficial in the analysis of anesthetic effects. EEG analysis is also useful in ascertaining the specific effects of various drugs and anesthetic techniques on cerebral activity. Although the monitoring of the depth of anesthesia has remained an elusive goal, work in this field is showing promise.
Because of the increasing complexity of monitoring equipment, computers have also been employed for analysis and calibrations. For example, complicated mass spectrometers, used in the analysis of gas concentrations in operating rooms are calibrated easily without time consuming human intervention. Alternatives in monitoring methods can be evaluated comprehensively with the aid of computers for selection of the best of possible monitoring choices depending of the circumstances at hand.
Technology in general and computers in particular are providing anesthetists with more information about what is happening to their patients. Computers have been and continue to be of great value in interpreting what is an increasingly complex process of physiological monitoring.
Because of the increasing number of functions and parameters which must be monitored by the anesthetist, the potential exists for information overload in which critical changes in parameters can be missed because of the volume of information which must be monitored. Complicating the situation is that with convention al equipment, the readouts and indicators may be distributed about the operating room and, therefore, difficult to scan visually and locate quickly from the anesthetist's position at the head of the operating table facing the patient. The anesthetist must occasionally make adjustments to the anesthetic and oxygen flow control, intravenous lines, and monitoring equipment which sometimes requires movement away from the head of the operating table and subsequent reorientation to the monitor readouts.
Training and the upgrading and sharpening of skills are constant processes in the medical arts in general. There is also a trend toward the transitioning of many skilled functions away from physicians to technicians and nurses under the supervision of physicians. In anesthesiology, nurse anesthetists are employed for many surgical procedures. Currently, it is often impractical for an anesthesiologist to adequately supervise multiple nurse anesthetists or anesthesiologists in training in simultaneous operations because of the physical layout of a surgical department of a hospital.
SUMMARY OF THE INVENTION
The present invention provides an improved anesthesia machine in which the machine function parameters and patient vital parameters are displayed in a coordinated manner on a single display device which has stereoscopic capabilities. The present invention is intended to be capable of communicating with a medical records computer which stores records of the medical history and test results of a patient for quick access during surgical operations. The patient monitor of the anesthesia machine of the present invention additionally has the capability of communicating with other similar anesthesia machines to selectively display the monitored functions thereof to enable a senior anesthesiologist to supervise anesthesiologists and anesthetists remotely.
The anesthesia machine of the present invention includes a gas delivery system cooperating with a computerized patient monitor system. The gas delivery system includes sources of pressurized oxygen and an anesthesia gas, a gas flow control for each gas, a pressure sensor for each gas source, and a flow sensor for each gas.
The patient monitor system includes a plurality of patient vital parameter sensors, such as temperature, heart rate, blood pressure, a blood flow transducer, an electrocardiogram transducer, an electroencephalogram transducer, blood gas sensors, and the like. A digital monitor processor or central processing unit has one or more monitor communication ports interfaced thereto, to which are interfaced the various vital parameter sensors and gas delivery sensors. Depending on the nature of the particular sensor, an analog to digital converter may be incorporated into the sensor. The sensor assemblies may be interfaced to the monitor ports using a single line per sensor or multiple lines of the ports, again depending on the nature of the sensor. The monitor processor includes conventional peripheral devices, such as a keyboard/trackball unit for data and command input, memory such as RAM and ROM, mass storage devices such as a hard drive and/or CDROM or other optical storage device, a printer, and a display subassembly.
The display subassembly of the anesthesia machine of the present invention includes a stereoscopic display controller and a head worn color stereoscopic display which preferably includes a set of left and right color liquid crystal displays (LCD's). Although the majority of displayed data will be alphanumeric and not benefit from stereoscopic display, some types of graphic data might be more clearly presented stereoscopically. Preferably, a conventional color monitor or cathode ray tube is also connected to the display controller for viewing by other personnel in the operating room, such as the surgeons, nurses, and technicians. A sound controller interfaced to the monitor processor has a microphone and speaker and/or earphone connected thereto and allows digital recording of verbal notes of the anesthesiologist during the operation.
The monitor processor preferably includes a records communication port for quick access to the patient's medical records from a medical records computer of the hospital during the operation. The records communication port may, for example, be a local area network interface. The parameters measured during an operation, and the digitized anesthesiologists verbal notes, are preferably recorded on the mass storage device and may be periodically uploaded to the medical records computer for subsequent analysis and follow-up or for training purposes.
In order to enable a senior anesthesiologist to supervise anesthesiologists in training or nurse
McMahon John C.
Schoolman Scientific Corporation
Winakur Eric F.
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