Electronic patient monitor with automatically configured...

Details Electronic patient monitor with automatically configured... Electronic patient monitor with automatically configured...

2001-08-31

2003-04-08

Winakur, Eric F. (Department: 3736)

Surgery

Diagnostic testing

Measuring anatomical characteristic or force applied to or...

C340S573100, C340S573400

Reexamination Certificate

active

06544200

ABSTRACT:

FIELD OF THE INVENTION
This invention relates generally to monitoring systems and more particularly concerns devices and systems used to monitor seated or lying patients in homes or in medical environments such as hospitals, institutions, and other care-giving environments.
BACKGROUND OF THE INVENTION
It is well documented that the elderly and post-surgical patients are at a heightened risk of falling. These individuals are often afflicted by gait and balance disorders, weakness, dizziness, confusion, visual impairment, and postural hypotension (i.e., a sudden drop in blood pressure that causes dizziness and fainting), all of which are recognized as potential contributors to a fall. Additionally, cognitive and functional impairment, and sedating and psychoactive medications are also well recognized risk factors.
A fall places the patient at risk of various injuries including sprains, fractures, and broken bones—injuries which in some cases can be severe enough to eventually lead to a fatality. Of course, those most susceptible to falls are often those in the poorest general health and least likely to recover quickly from their injuries. In addition to the obvious physiological consequences of fall-related injuries, there are also a variety of adverse economic and legal consequences that include the actual cost of treating the victim and, in some cases, caretaker liability issues.
In the past, it has been commonplace to treat patients that are prone to falling by limiting their mobility through the use of restraints, the underlying theory being that if the patient is not free to move about, he or she will not be as likely to fall. However, research has shown that restraint-based patient treatment strategies are often more harmful than beneficial and should generally be avoided—the emphasis today being on the promotion of mobility rather than immobility. Among the more successful mobility-based strategies for fall prevention include interventions to improve patient strength and functional status, reduction of environmental hazards, and staff identification and monitoring of high-risk hospital patients and nursing home residents.
Of course, direct monitoring of high-risk patients, as effective as that care strategy might appear to be in theory, suffers from the obvious practical disadvantage of requiring additional staff if the monitoring is to be in the form of direct observation. Thus, the trend in patient monitoring has been toward the use of electrical devices to signal changes in a patient's circumstance to a caregiver who might be located either nearby or remotely at a central monitoring facility, such as a nurse's station. The obvious advantage of an electronic monitoring arrangement is that it frees the caregiver to pursue other tasks away from the patient. Additionally, when the monitoring is done at a central facility a single person can monitor multiple patients which can result in decreased staffing requirements.
Generally speaking, electronic monitors work by first sensing an initial status of a patient, and then generating a signal when that status changes, e.g., he or she has sat up in bed, left the bed, risen from a chair, etc., any of which situations could pose a potential cause for concern in the case of an at-risk patient. Electronic bed and chair monitors typically use a pressure sensitive switch in combination with a separate electronic monitor which conventionally contains a microprocessor of some sort. In a common arrangement, a patient's weight resting on a pressure sensitive mat (i.e., a “sensing” mat) completes an electrical circuit, thereby signaling the presence of the patient to the microprocessor. When the weight is removed from the pressure sensitive switch, the electrical circuit is interrupted, which fact is similarly sensed by the microprocessor. The software logic that drives the monitor is typically programmed to respond to the now-opened circuit by triggering some sort of alarm—either electronically (e.g., to the nursing station via a conventional nurse call system) or audibly (via a built-in siren) or both. Additionally, many variations of this arrangement are possible and electronic monitoring devices that track changes in other patient variables (e.g., wetness/enuresis, patient activity/inactivity, etc.) are available for some applications.
General information relating to mats for use in patient monitoring may be found in U.S. Pat. Nos. 4,179,692, 4,295,133, 4,700,180, 5,600,108, 5,633,627, 5,640,145, 5,654,694, and 6,111,509 (concerning electronic monitors generally). Additional information may be found in U.S. Pat. Nos. 4,484,043, 4,565,910, 5,554,835, and 5,623,760 (sensor patents) and U.S. Pat. No. 5,065,727 (holsters for electronic monitors), the disclosures of all of which patents are all incorporated herein by reference. Further, co-pending U.S. patent application Ser. No. 09/285,956, discusses a sensing device which contains a validation circuit incorporated therein, and this application is similarly incorporated herein by reference.
It is well known that the sensing devices that are placed on chairs and beds usually operate in a similar fashion. For example, in the case of pressure sensitive mats, the principal difference between chair and bed mats is the length of the mat, with chair mats usually being shorter. Thus, there would be some economy in developing electronic monitors that can function either as a bed or chair monitor and this has, in fact, been done.
However, the monitor settings in these two environments are different and it falls to the caregiver to adjust the parameters accordingly at the time the switch is made. For example, it is customary in the case of bed sensors to program the electronic monitors to permit brief periods of time “off of the mat” to accommodate those situations where a patient is merely adjusting his or her location in the bed. This, of course, can reduce the incidence of false alarms substantially in a restless patient. This time period, called a “delay time” hereinafter, is usually set to near zero in the case of chair monitors. This is done for many reasons, but among the foremost is that patients that are seated in chairs can arise and place themselves into danger much more quickly than a patient that is lying down because the seated patient is already vertically oriented. As a consequence, it is customary to have relatively short delay times when chair mats are monitored.
Although most electronic monitors will accommodate and can be set to observe a wide range of delay times, it is the responsibility of the caregiver to make certain that the appropriate parameters are adjusted at the time the monitor is reassigned. Failure to do this could possibly place the patient at risk and/or result in false alarms which must be attended to by an increasingly overworked staff.
More generally, it often makes sense economically to design an electronic monitor that can detect the status of a variety of different sensors types such as, for example, pressure sensitive switches, proximity switches, wetness sensors, etc. But, obviously, the particular monitor parameters that should be used might be widely different for an incontinence sensor and a pressure sensitive switch. It should be clear that, where an electronic monitor can be used in a variety of different settings, it would be advantageous to have that monitor automatically configure itself appropriately depending on the particular sensors that it is used with. As a specific example, patient safety would be increased if an electronic patient monitor could automatically reconfigure itself each time it was utilized in a different environment. Currently, the responsibility of changing monitor parameters falls exclusively to the caregiver, who may not know how—or who may forget—to adjust the appropriate parameters. Additionally, even if the caregiver remembers that it is necessary to change a monitor parameter, he or she may make that change imperfectly (e.g., forget to reset the monitor after changing the delay time), thereby leaving the

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