JP2006263384A - Alarm reporting system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an alarm reporting system for allowing a user to adequately recognize the sign of serious bleeding and issuing alarm in response to a degree of seriousness. <P>SOLUTION: The blood pressure, cardiac rate, and temperature data of a subject are independently measured, so as to generate each kind of trend data. A normal range is designated by each trend data, so as to normally perform comparison. When at least two among the three kinds of trend data are deviated from the normal range, alarm indicating the sign of the serious bleeding is issued. An alarm level is varied step by step in response to a passage time from the deviation from the normal range, the degree of the deviation, and the combination of the deviation data, etc. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a system for issuing a warning to an operator based on vital data obtained from a subject in the medical field. In particular, the present invention relates to a system that issues a warning according to the risk of bleeding of a subject.

Various patient monitoring devices have been developed in the medical field, and the benefits that patients and surgeons can obtain from these devices are increasing. Equipment for anesthesia and an electrocardiogram monitor are placed around the patient during the operation, and the operator can know changes in the patient's condition by images and sounds output from these devices ( For example, see Patent Documents 1 to 3). Patent Document 1 discloses a system that sets a threshold value for acquired patient information in advance and generates a warning when the patient information exceeds the threshold value. Patent Document 2 discloses a system that constantly monitors changes in numerical values of certain patient information and generates different warnings according to the numerical values. Patent Document 3 discloses a system that analyzes an ECG signal in the frequency domain.
JP-T-2001-501840 JP 2002-65574 A JP 2003-220044 A

  By the way, in recent years, in addition to the medical meaning obtained from a single patient information, it has become possible to obtain new medical knowledge by combining a plurality of information. According to recent reports by academic societies, it has been confirmed that severe hypotension, an increase in heart rate, and a decrease in skin temperature occur simultaneously as a sign of minor bleeding during surgery.

  However, as described above, all of the existing warning systems only issue a warning based on individual patient information, and a system that issues a warning as new meaningful information by combining a plurality of patient information is known. Not. For example, with regard to major bleeding, it is possible to know in advance the signs by combining blood pressure data, heart rate data, and body temperature data. Etc.).

  The present invention has been made under the circumstances described above, and an object of the present invention is to provide a warning notification system that can accurately know a sign of major bleeding and can issue a warning according to the degree of danger.

  In order to achieve the above object, according to one aspect of the present invention, data acquisition means for acquiring blood pressure data, heart rate data, and body temperature data of a subject, the blood pressure data, the heart rate data, Trend data creating means for creating respective trend data of the body temperature data, trend data of the blood pressure data, trend data of the heart rate data, and trend data of the body temperature data, at least two or more trend data There is provided a warning notification system comprising warning notification means for notifying the operator of a warning when the deviation from the normal range.

  By taking such measures, trend data on the blood pressure, heart rate, and body temperature of the subject is created, and it is possible to obtain new knowledge about signs of major bleeding based on a combination of these data Become. A normal range is set for each trend data by default or by prior data input, and a warning is given to the operator when at least two trend data deviate from the normal range. Therefore, the operator of the system can know the sign of major bleeding more accurately and in advance, and can obtain great benefits for both the patient and the operator.

  According to the present invention, it is possible to provide a warning notification system capable of accurately knowing a sign of major bleeding and capable of issuing a warning according to the degree of risk.

  FIG. 1 is a block diagram showing an embodiment of a warning notification system according to the present invention. In FIG. 1, a data input unit 1 inputs vital data related to a patient acquired from various sensors and a diagnostic device (not shown) to the system. In this embodiment, a patient's blood pressure, heart rate, and body temperature are taken as an example of vital data. Blood pressure includes systolic blood pressure and diastolic blood pressure, and body temperature is, for example, skin surface temperature. An electrocardiogram or an electrocardiogram may be input instead of the heart rate. In this case, it is preferable to measure the RR interval from an electrocardiogram or electrocardiogram and use the time width as patient vital data.

  The console 2 is means for inputting instructions and commands from an operator to the system, and includes a keyboard, for example. An instruction device such as a touch panel display, a light pen, or a mouse can also be used. In particular, the console 2 is used for designating and inputting a normal range of various patient vital data to the system.

  The arithmetic processing unit 3 creates a display screen in which the normal range designated via the console 2 and various patient vital data given from the data input unit 1 are superimposed. This display screen is displayed on the display 4. The arithmetic processing unit 3 calculates trend data for each type of vital data, and compares each trend data with a normal range in real time to monitor the presence or absence of deviation. If there is trend data that deviates from the normal range as a result of this monitoring, the arithmetic processing unit 3 notifies the operator of a warning via the display 4 or the speaker 5. In particular, the arithmetic processing unit 3 generates warnings in stages according to the degree of deviation from the normal range, and how to generate the warnings according to the warning stage (coloring in the display 4 or loudness of the warning sound from the speaker 5). Height, height, etc.).

  The data processed by the arithmetic processing unit 3 and the newly created data are notified to the operator and other operators by the display 4 and the speaker 5. The recording unit 6 records patient vital data given from the data input unit 1 or various data calculated by the calculation processing unit 3. In particular, the recording unit 6 stores a threshold value in the normal range for each vital data and provides the comparison by the arithmetic processing unit 3.

The normal range of the trend data is specified according to the technique as shown in Table 1.

  As shown in Table 1, the normal range threshold varies depending on the risk level of the surgical procedure. For example, in an abdominal tumor excision operation or the like, different thresholds are set according to the risks under laparoscopic and laparoscopic procedures. Table 1 shows that the risk under laparoscope is higher.

  The values in Table 1 are default values determined in advance for each technique, and are stored in the recording unit 6 as a database. When a surgical procedure is designated via the console 2 or surgical procedure data is input from an in-hospital information system, default values of blood pressure, heart rate, and body temperature corresponding to the surgical procedure are read from the recording unit 6. . The read value is set in the system and displayed on the display 4. When the acquisition of various patient vital data by the data input unit 1 is started after the normal range is designated, the display shown in FIG.

  FIG. 2 is a schematic diagram showing display contents of the display 4 in FIG. As shown in FIG. 2, a plurality of patient vital data is displayed on the display 4, and a normal range and a range (shaded portion) deviating from normal are displayed in different colors for each data. Each piece of vital data appears as new data appears from the left side of the screen over time and scrolls toward the right side. When the graph reaches the right end, the display of the data ends and the graph is displayed again from the left end.

  In FIG. 2, blood pressure data, electrocardiogram data, and body temperature data are displayed in order from the top. In the blood pressure data, the graph shows the course of systolic blood pressure and the bottom shows the course of systolic blood pressure. As can be seen from FIG. 2, the blood pressure trend data shows a tendency to gradually decrease, and at present, both the maximum blood pressure and the minimum blood pressure deviate from the normal range. Therefore, a red display color indicating danger is displayed on the right side of the graph. Further, the current maximum and minimum blood pressure values are displayed as reference data in the right column. In FIG. 2, 90 is displayed as the maximum blood pressure value, and 35 is displayed as the minimum blood pressure.

  The blood pressure data in FIG. 2 indicates that the time-series blood pressure data deviates from the normal range for both the maximum blood pressure and the minimum blood pressure. Further, a moving average of the blood pressure data is calculated by the arithmetic processing unit 3, and a tendency that the blood pressure value decreases as a trend is seen. The arithmetic processing unit 3 recognizes this by comparing the arithmetic data with the threshold data of the recording unit 6 and displays red with a higher degree of danger. If either time-series data or trend data is within the danger area, the display is yellow, and if the time-series data is within the normal range, the display is green.

  Next, in the electrocardiogram data of FIG. 2, the upper side shows the measured electrocardiogram data in time series, and immediately below that, data obtained by graphing the RR interval obtained from the electrocardiogram data in a curve with respect to time. Indicates. The numerical value 45 in the right column indicates the current value of the RR interval. The electrocardiogram data also indicates that the RR interval has deviated from the normal range, and a warning yellow is displayed accordingly. It should be noted that, since not much time has passed since the moving average of the RR interval began to decrease compared to the blood pressure data, a yellow display with a not so high risk is displayed.

  In the body temperature data of FIG. 2, changes in skin temperature are shown in time series. A numerical value 36 indicates that the current body temperature is 36 degrees. Here, the skin temperature is within the normal range, and since there is no tendency to decrease due to the moving average, the display is green. Again, if the instantaneous skin temperature data deviates from the normal range, the warning display turns yellow, and if the moving average graph shows a downward trend, the warning display turns red.

  In FIG. 2, a moving average of three types of patient vital data, blood pressure, electrocardiogram, and body temperature, is calculated, and the degree of risk is determined in consideration of the decreasing tendency. Instead, the current raw data (time-series data) at each time may be compared with the moving average value, and a red warning may be displayed when the raw data is below the moving average value. In particular, if the synthesized voice is output from the speaker 5 according to each display color, the surgeon is notified of the danger, and which patient vital data is out of the normal range is also notified. Even if the person concentrates on the operative field, the danger can be easily communicated to the surgeon.

  By the way, in this embodiment, paying attention to the mutual relationship between the blood pressure trend data, the heart rate trend data, and the body temperature trend data, another warning is displayed when any two deviate from the normal region. Like that. For example, in FIG. 2, a warning display indicating <Caution> is displayed separately from the warning of each vital data. This is a warning of a sign of major bleeding, and recent studies have shown that it can be predicted from changes in the three vital data. In FIG. 2, the trend data of blood pressure and heart rate deviate from the normal range, and the display of <Caution> is associated with this. If this state continues, <warning> with a higher degree of danger is displayed, and the color is changed from, for example, yellow to red. Further, the volume of the notification message from the speaker 5 may be increased stepwise, the message content may be changed, or the pitch may be increased.

  Further, not only the combination of blood pressure and heart rate, but also when the heart rate trend data and the body temperature trend data deviate from the normal range, a similar warning may be issued. In particular, if the risk of the combination of both data is higher, a warning may be issued from the beginning. Further, when all the blood pressure, heart rate and body temperature trend data are out of the normal range, <Warning> is displayed immediately.

  As described above, in this embodiment, the blood pressure, heart rate, and body temperature data of the subject are individually measured, and each trend data is created. Also, a normal range is designated for each trend data and is constantly compared. When at least two of the three trend data deviate from the normal range, a warning indicating a sign of major bleeding is generated. Further, the warning level is changed stepwise in accordance with the elapsed time from the deviation from the normal range, the degree of deviation, the combination of the deviation data, and the like.

  Since it did in this way, the operator can receive the warning according to the degree of the sign of major bleeding, and can easily determine the continuation, interruption, emergency response, etc. of the medical practice. In particular, there is no sensor that can detect a sign of major bleeding alone, and this embodiment makes it possible to provide new information to medical personnel, which is a great advantage in the medical field. From the above, it becomes possible to accurately know a sign of major bleeding, and it is possible to provide a warning notification system capable of issuing a warning according to the degree of risk.

  In addition, this invention is not limited to the said embodiment as it is. For example, in the above embodiment, the patient's blood pressure, electrocardiogram (heart rate), and body temperature are focused. In addition, vital data such as oxygen saturation, body ion concentration, or anesthesia depth is measured and combined with other vital data. May be.

Further, instead of Table 1, the normal range of each trend data can be varied depending on the presence or absence of the patient's past history even if the surgical technique is the same. Naturally, as shown in Table 2, it is considered that the risk is high in patients who have a history of surgery in the past. The medical history of each patient is stored in advance in the recording unit 6 in the form of electronic medical record data, and the data is read out and used for setting a normal range during surgery.

Furthermore, as shown in Table 3, the threshold value of each trend data can be specified as a ratio to the normal value of the subject. For example, by specifying a threshold value as a percentage according to the difference in surgical technique, it is possible to specify a value according to the difference in normal value for each patient. The values shown in Tables (1) to (3) are merely examples, and can be freely variably set according to the operator's knowledge according to individual differences for each patient.

  In addition, if there is data on the surgery performed on the patient to be operated in the past, a threshold value of the trend data is set in consideration of an operation method at that time and an analysis value of vital data. Thus, the normal range of each trend data can be variably set for each patient, for each surgical procedure, or based on the patient's usual condition.

  Furthermore, the present invention can be embodied by modifying the constituent elements without departing from the spirit of the invention in the implementation stage. In addition, various inventions can be formed by appropriately combining a plurality of components disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment.

1 is a block diagram showing an embodiment of a warning notification system according to the present invention. The schematic diagram which shows the display content of the indicator 4 of FIG.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 1 ... Data input part, 2 ... Console, 3 ... Arithmetic processing part, 4 ... Display, 5 ... Speaker, 6 ... Recording part

Claims (10)

Data acquisition means for acquiring blood pressure data of the subject, heart rate data, and body temperature data;
Trend data creating means for creating respective trend data of the blood pressure data, the heart rate data, and the body temperature data;
A warning that alerts the operator when at least two of the trend data of the blood pressure data, the trend data of the heart rate data, and the trend data of the body temperature data deviate from the normal range A warning notification system comprising: notification means. Furthermore, it comprises a range designating unit for individually setting a threshold for dividing the normal range for each of the trend data of the blood pressure data, the trend data of the heart rate data, and the trend data of the body temperature data. The warning notification system according to claim 1, wherein The warning notification system according to claim 2, wherein the range specifying unit is capable of changing a threshold value for each trend data in accordance with a past history of the subject. The warning notification system according to claim 2, wherein the range specifying unit is capable of changing a threshold value for each trend data according to a technique. The warning notification system according to claim 2, wherein the range specifying unit is capable of changing a threshold value for each trend data by a ratio to a normal value of the subject. The warning notification system according to claim 2, wherein the trend data creating unit calculates each of the trend data by a moving average value. The warning notification system according to claim 1, wherein the warning notification unit notifies the warning step by step according to the number of trend data that deviates from the normal range. The warning notification system according to claim 7, wherein the warning notification unit varies a pitch of a warning sound according to the stage of the warning. The warning notification system according to claim 7, wherein the warning notification unit varies a volume of a warning sound according to a stage of the warning. The warning notification system according to claim 7, wherein the warning notification unit includes a display that visually displays the warning, and changes a display color on the display according to the stage of the warning.

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