CN101432036A - Medical effector system - Google Patents

Abstract

A medical effector system comprised of a bedside unit and a procedure unit. The bedside unit contains connection points for an oral nasal cannula and for receiving inputs from a series of patient monitors. The procedure unit contains a patient monitoring and a medical effector program, and a drug delivery pump and drug cassette or a magnetic flux generator capable of delivering therapeutic energy to a patient. The medical effector program operates the pump or magnetic flux generator based upon at least some of the patient outputs and program inputs. A removable umbilical cable connects the two units and allows gases, the patient monitors as well as other information to travel between the two units.

Description

Medical effector system

The cross reference of related application

The application requires the priority of the following provisional application more early submitted to: on November 18th, 2004 submitted to is entitled as " Medical Effector System Such As a SedationDelivery System (SDS) and Components Which Can Be Used Therein ", serial number is 60/629,137; And on August 31st, 2004 submit to be entitled as " MedicalEffector System Such As a Sedation Delivery System (SDS) andComponents Which Can Be Used Therein ", serial number is 60/605,717, the content of these two parts of applications all comprises in this application by reference.

Related application

The application relates to following total specified patent application: " Bite Block Assembly " [END5298USNP1], serial number xx/xxx, xxx; " Apparatus For MonitoringA Patient During Drug Delivery " [END5298USNP2], serial number xx/xxx, xxx; " Drug Delivery Cassette " [END5298USNP3], serial number xx/xxx, xxx; " Apparatus For Delivering Oxygen To A Patient Undergoing AMedical Procedure " [END5298USNP4], serial number xx/xxx, xxx; " InfusionPump " [END5298USNP5], serial number xx/xxx, xxx; " Capnometry SystemFor Use With A Medical Effector System " [END5298USNP6], serial number xx/xxx, xxx; " Device For Connecting A Cannula To A MedicalEffector System " [END5298USNP7], serial number xx/xxx, xxx; " ApparatusTo Deliver Oxygen To A Patient " [END5298USNP8], serial number xx/xxx, xxx; " Single Use Drug Delivery Components " [END5298USNP9], serial number xx/xxx, xxx; " Drug Delivery Cassette And A Medical EffectorSystem " [END5298USNP10], serial number xx/xxx, xxx; " Oral NasalCannula " [END5298USNP11], serial number xx/xxx, xxx; The application that all are submitted to simultaneously; " Dose Rate Control ", serial number 10/886,255, on July 7th, 2004 submitted to; " BIS Closed Loop Anesthetic Delivery ", serial number 10/886,322, on July 7th, 2004 submitted to; " Patient Monitoring Systems and Methodof Use ", serial number 10/791,959, on March 3rd, 2004 submitted to; " Air-Bubble-Monitoring Medication Assembly, Medical System andMethod ", serial number 10/726,845, December was submitted on the 3rd in 2003; " CannulaAssembly and Medical System Employing a Known CO2 GasConcentration ", serial number 10/701,737, on November 5th, 2003 submitted to; " Automated Audio Calibration for Conscious Sedation ", serial number 10/674,244, JIUYUE was submitted on the 29th in 2003; " Response Testing for ConsciousSedation Using Finger Movement Response Assembly ", serial number 10/674,184, JIUYUE was submitted on the 29th in 2003; " Personalized Audio Requestsfor Conscious Sedation ", serial number 10/674,185, JIUYUE was submitted on the 29th in 2003; " Response Testing for Conscious Sedation Utilizing aNon-Ear-Canal-Contacting Speaker ", serial number 10/674,183, JIUYUE was submitted on the 29th in 2003; " Response Testing for Conscious Sedation InvolvingHand Grip Dynamics ", serial number 10/674,160, JIUYUE was submitted on the 29th in 2003; " Response Testing for Conscious Sedation Utilizing a Hand MotionResponse ", serial number 10/673,660, JIUYUE was submitted on the 29th in 2003; " ResponseTesting for Conscious Sedation Utilizing a Cannula forSupport/Response ", serial number 10/670,453, JIUYUE was submitted on the 25th in 2003; " Time Variant Vibration Stimulus Response for a Conscious SedationSystem ", serial number 10/670,489, JIUYUE was submitted on the 25th in 2003; " ResponseTesting for Conscious Sedation using Cableless Communication ", serial number 10/671,183, JIUYUE was submitted on the 25th in 2003; " System and Method forMonitoring Gas Supply and Delivering Gas to a Patient ", 10/660286,2003 year JIUYUE of serial number was submitted on the 11st; " Drug Delivery System andMethod ", 10/660201,2003 year JIUYUE of serial number was submitted on the 11st; And " BatteryBackup Method and System ", 10/660285,2003 year JIUYUE of serial number was submitted on the 11st, and all these applications all are contained among the application by reference and in full.

Technical field

The member that the present invention relates generally to medical system and can use in medical system more specifically relates to medical effector system, for example calm induction system, and the member that can use therein.

Background technology

The consciousness tranquilizing system is known and describes in the U.S. Pat 6745764 that is entitled as " alleviating the misery relevant with medical science or surgical operation and the apparatus and the method for anxiety for conscious patient ".In this system, operation room unit comprises controller, and it produces the requirement from patient's predetermined response to.The form that this requires to the audible instructions that is received by the receiver in patient's ear by the patient, perhaps be by the patient by with mobile phone that patient's hands is connected in the form of vibration signal of agitator reception.To the predetermined response to of this requirement is to press button on the mobile phone by the patient, closes the switch that sends signal to controller.Controller is analyzed the medical information from the patient.Described medical information for example comprise from the blood pressure that is connected with operation room unit and is placed on the blood pressure cuff on patient's arm with derive from the carbon dioxide level that is connected and is placed on the exhalation of the intubate (it also gives the patient with oxygen delivery) on patient's face with operation room unit.Controller is also analyzed the time delay between requirement and the response.Based on the time delay between medical information and requirement and the response, controller is measured patient's level of sedation, and if controller measure air-flow or IV (intravenous) the consciousness downern that is reduced to the patient when patient is in than the darker consciousness level of sedation of expection.

Be known that and use peristaltic pump that the IV downern is transported to the patient from drug delivery cassette component, wherein case assembly is connected with operation room unit with pump.

Scientists and engineers are still continuing to seek improved medical actuator system, such as the calm induction system and the member that can use therein.

Summary of the invention

The embodiments of the present invention comprise cannula assembly, bite-block, drug delivery cassette component (using) in the drug conveying as the example of drug conveying medical actuator flows the drug conveying infusion pump assembly of Control Component type, the energy delivery medical actuator, operation room unit, interface between operation room unit and the bedside monitoring nitrogenous source, bedside monitoring unit and member thereof, can be used in combination separately and with various, comprise medical actuator system, such as calm induction system.

The present invention relates to trace calm, the calm operation of medium " consciousness " calmness or the degree of depth, but do not relate to by U.S. anaesthesiologist association (ASA) at document " Continuum of Depth ofSedation:Definition of General Anesthesia and Levels ofSedation/Analgesia ", use in anesthesia or " the general anesthesia " of approval on October 13rd, 1999 and definition in revision on October 27th, 2004 by the ASA chamber of representative.The general anesthesia of ASA definition is because drug-induced consciousness disappears, and the patient can not wake up in this period, even use pain stimulation.In addition, the patient usually requires to assist to keep patient's airway, and positive draft may need, because the inhibition of downtrod spontaneous ventilation or drug-induced neuromuscular function, cardiovascular function may be impaired.

In brief, the present invention provides the mode that provides calmness and/or misery to alleviate for the patient for the program doctor outside the anesthesiology practice.Fill up the scarcity of non-narcotic practice standard by automatic control provided by the present invention, instructed the misery and the anxiety that alleviate the consciousness patient.In addition, the present invention will subsidize can be by the diagnosis of the complication that measure caused or produced of and analgesia calm to the consciousness patient and program doctor's limited training in treating.

Description of drawings

Fig. 1 is the perspective view of the embodiment of the embodiment of the cannula assembly that comprises intubate, BMU adapter and pipe of the present invention and receiver and audio frequency pipe;

Fig. 2 and Fig. 3 are the cutaway view of the pipe of Fig. 1 along line 2-2 and 3-3, show to direct into/from the chamber separately of the gas of mouth/nasal intubation;

Fig. 4 is the perspective view without any the mouth/nasal intubation of Fig. 1 of connection tube;

Fig. 5 is part intubate lid and the intubate main body cutaway view of the line 5-5 in Fig. 4, shows because the position of the pipe accommodation hole of the breathing gas conveying nose that intubate is covered when the intubate lid is connected with the intubate main body the take a sample bending of nose of intubate main body of breathing gas;

Fig. 6 is the block diagram of identification means of embodiment of medical science gas analysis/induction system of the embodiment of the identification means of embodiment of mouth/nasal intubation assembly of comprising mouth/nasal intubation of Fig. 1 and SDS (calm induction system), described SDS comprises PRU (operation room unit) embodiment and BMU (bed side monitoring means) embodiment as the example of medical actuator system;

Fig. 7 is the plan view from above of mouth/nasal intubation of Fig. 4, and wherein the intubate lid is removed;

Fig. 8 and Fig. 9 be mouth/nasal intubation of Fig. 7 along the line 8-8 of Fig. 7 and the cutaway view of 9-9, the path that is used for oxygen and carbon dioxide is shown;

Figure 10 is the distal end view without any the mouth/nasal intubation BMU adapter of Fig. 1 of connection tube;

Figure 11 is the cutaway view of the line 11-11 of mouth/nasal intubation BMU adapter in Figure 10 of Figure 10, shows the groove that is used for the nasal cavity humid room;

Figure 12 is the enlarged drawing of a part of mouth/nasal intubation BMU adapter of Figure 11, shows the details of carbon dioxide gas line;

Figure 13 is the exploded view of mouth/nasal intubation adapter of Figure 10, demonstrates flap, liner and backboard;

Figure 14 is the schematic side elevational cutaway view of the nasal cavity dehumidification air chamber of Figure 13;

Figure 15 is the near-end link view of the backboard of mouth/nasal intubation adapter of discerning Figure 13 of opening separately;

Figure 16 is the proximal end view of outlet cap of mouth/nasal intubation adapter of Figure 13;

Figure 17 and 18 be the outlet cap of Figure 16 along the line 17-17 of Figure 16 and the cutaway view of 18-18, the path that is used for gas and humid room part is shown;

Figure 19 is the front view of first kind of alternate embodiments of bite-block and intubate;

Figure 20 is the cutaway view of the bite-block of Figure 19 along the line 20-20 of Figure 19, has wherein inserted other medical apparatus and instruments in the through-out pathway of bite-block;

Figure 21 is and the similar view of Figure 20, but is second kind of embodiment of bite-block;

Figure 22 is and the similar view of Figure 20, but is the third embodiment of bite-block;

Figure 23 is the sketch map of another embodiment with medical actuator system of intubate, wherein the possible problem of medical actuator system warning user intubate;

Figure 24 is the birds-eye perspective of the embodiment of drug delivery cassette component of the present invention;

Figure 25 is the face upwarding view of the drug delivery cassette component of Figure 24;

Figure 26 is the exploded view of the drug delivery cassette component of Figure 24, shows each member;

Figure 27 is position, Rule (luer) (luer-site) base portion (being also referred to as base, T-position when Rule is "T"-shaped shape) of the drug delivery cassette component of Figure 26;

Figure 28 is the perspective view in nail needle stand district of the drug delivery cassette component of Figure 26;

Figure 29 is the plan view from above of drug delivery cassette mainboard of the drug delivery cassette component of Figure 26;

Figure 30 and 31 be the drug delivery cassette mainboard of Figure 29 in Figure 29 line 30-30 and the cutaway view of 31-31, show vial pick off crossbeam and T position pick off crossbeam;

Figure 32 is the perspective view of nail pin of the drug delivery cassette component of Figure 26;

Figure 33 is the end-view of the nail pin of Figure 32;

Figure 34 is the cutaway view (it be rotated counterclockwise 90 degree) of the nail pin of Figure 33 along the line 34-34 of Figure 33;

Figure 35 and 36 is right side and left side perspective view of nail pin medicated cap of the drug delivery cassette component of Figure 26, shows the details of medicated cap handle and locking system;

Figure 37 is the side view of nail pin medicated cap of the drug delivery cassette component of Figure 26;

Figure 38 is the end-view of nail pin medicated cap of the drug delivery cassette component of Figure 26;

Figure 39 is the plan view from above of nail pin medicated cap of the drug delivery cassette component of Figure 26;

Figure 40 is the cutaway view that the nail pin shade of Figure 39 the line 39-39 among Figure 39, shows nail pin chamber;

Figure 41 is the perspective view of the calm induction system (SDS) of Fig. 6, and it comprises operation room unit (PRU), bed side monitoring means (BMU) and umbilicus cable as the example of medical actuator system;

Figure 42 is the SDS of Figure 41 and the main perspective view of PRU, comprises the multiple power source (UPS) of PRU;

Figure 43 is the top perspective view of the PRU of Figure 41, and drug delivery cassette component and the pump case door wherein installed are closed;

Figure 44 is the perspective view of a part of the PRU of Figure 43, and wherein drug delivery cassette component is opened and do not installed to the pump case door;

Figure 45 is the perspective view of a part of the PRU of Figure 43, drug delivery cassette component has been installed wherein and the pump case door is opened;

Figure 46 is the perspective view of a part of the PRU of Figure 43, and drug delivery cassette component wherein has been installed, and the pump case door is opened and around with the medicine bottle that is mounted;

Figure 47 is the perspective view of a part of the PRU of Figure 43, and drug delivery cassette component wherein has been installed, and the pump case door is closed and has installed medicine bottle;

Figure 48 is the exploded view of the PRU of Figure 43;

Figure 49 is the rear view of a part of the PRU of Figure 43;

Figure 50 is the main perspective view of the observable oxygen delivery collector installed in the rear portion of the PRU among Figure 49;

Figure 51 is the rear view of the oxygen delivery collector of Figure 50;

Figure 52 is the cutaway view of the arrow 52-52 of oxygen delivery collector in Figure 51 of Figure 51;

Figure 53 is the enlarged drawing of a part of the oxygen delivery collector of Figure 52;

Figure 54 is the top perspective view of PRU master controller of the PRU of Figure 43;

Figure 55 is the exploded view of the PRU drug conveying infusion pump assembly of Figure 43;

Figure 56 is the rear view of the UPS of Figure 42;

Figure 57 is the exploded view of the UPS of Figure 42;

Figure 58 is the sketch map of the alternate embodiments of medical actuator system of the present invention, comprises the energy delivery medical actuator;

Figure 59 is the sketch map of embodiment with medical actuator subsystem of drug conveying infusion pump sub-component, wherein the drug delivery pipe of medical actuator subsystem warning user obturation;

Figure 60 is the main perspective view of the BMU of Figure 41, and wherein connecting line is connected;

Figure 61 is the face upwarding view of the BMU of Figure 41, and wherein connecting line is removed;

Figure 62 is the exploded view of the BMU of Figure 41;

Figure 63 is the block diagram of identification means of the embodiment of calm induction system (SDS);

Figure 64 is the block diagram of identification means of the embodiment of the operation room unit (PRU) that uses in the SDS of Figure 63;

Figure 65 is the block diagram of identification means of embodiment that is used for the PRU of Figure 64;

Figure 66 is the block diagram of drug conveying module that is used for the PRU of Figure 64;

Figure 67 is the block diagram of oxygen delivery module that is used for the PRU of Figure 64;

Figure 68 is the block diagram of power liftgate module of the PRU of Figure 64;

Figure 69 is the block diagram of printer module of the PRU of Figure 64;

Figure 70 is the block diagram of uninterrupted power supply (ups) Unity that is used for the PRU of Figure 64;

Figure 71 is the block diagram of UPS module that is used for the UPS of Figure 70;

Figure 72 is the block diagram of bed side monitoring means (BMU) that is used for the SDS of Figure 63;

Figure 73 is the block diagram of BMU expansion oplate that is used for the BMU of Figure 72;

Figure 74 is the block diagram of display assembly that is used for the SDS of Figure 63;

Figure 75 is the block diagram that the single patient that is used for the SDS of Figure 63 uses (MPU) project;

Figure 76 is the block diagram that the many patients that are used for the SDS of Figure 63 use (MPU) projects;

Figure 77 is that the SDS of Figure 63 is BMU and the diagram technological process of PRU during an operating example;

Figure 78 is the composite data stream chart of the preceding aspect of medical surgery that the SDS of Figure 63 is shown;

Figure 79 is the composite data stream chart of medical surgery aspect that the SDS of Figure 63 is shown; With

Figure 80 is the composite data stream chart that aspect behind the medical surgery of SDS of Figure 63 is shown;

Figure 81 is the main perspective view of the peripheral monitor that is used in combination with PRU.

The specific embodiment

Before in detail explaining the present invention, should be noted in the discussion above that the parts that the present invention is not restricted to its application or use in drawing and description to be explained and the configured and disposed details of step.Illustrative embodiments of the present invention can realize in other embodiment, variation and modification or be contained in wherein, and can put into practice in every way or realize.In addition, for convenience of the reader, unless stated otherwise, term of Cai Yonging and expression are chosen as the purpose of describing exemplary embodiment of the present invention in this article, rather than are used to limit purpose of the present invention.

Medical actuator is to be suitable for local and/or common device from the medical science energy of at least a medical science material and/or at least a type to the patient that carry in medical surgery.Medical surgery includes but not limited to that the medical diagnosis operation is cured and treated operation, and/or surgical operation.The medical science material is alone or a kind of gas, fluid and/or the solid that together the patient are had the medical science effect at least, and an example is a medicine.The medical science effect not as the restriction example be sedation effect.Technical term " sedation effect " comprises calm and noncoconscious (anesthesia) calmness of consciousness, and this depends on the type and/or the consumption of employed medical science material and/or medical science energy.In order to describe embodiments of the present invention, analgesic effect is considered to sedation effect, forgets effect and also is considered to sedation effect.Non-limitative example with medical science material of sedation effect is downern propofol (propofol).Being used for the non-limitative example that propofol flows to patient's medical actuator is the drug conveying Control Component that flows, such as drug conveying infusion pump assembly.Non-limitative example with medical science kind of energy of sedation effect is a mM disodium hydrogen phosphate, for example describes in U.S. Pat 6712753.The non-limitative example that is used for mM disodium hydrogen phosphate is flowed to patient's medical actuator is at least a magnetic flux generator, as describing in U.S. Pat 6712753.Therefore, adopting the calm induction system of the mobile Control Component of sedation drug delivery and the calm induction system of at least a magnetic flux generator of employing is the example of calm medical actuator system.Other example of the type of medical actuator system, medical actuator, medical science material, medicine, medical science energy, medical science effect and medical surgery can be expected for a person skilled in the art.That notes after this using comprises respectively directly term " detachably ", " connections ", " can link " and " bindings " or can connect indirectly, directly or indirectly connects, directly or indirectly can link, and direct or indirect binding.Should also be noted that apparatus is described as having particular elements means that this apparatus has a described particular elements at least.Similarly, component description is meaned that for having specific component this member has a described specific component at least.

For easy to understand, with calm induction system 100 and the sedation drug delivery Control Component 220 ' that flows serve as with reference to being described with embodiment to various aspects of the present invention, but is to be understood that described aspect and embodiment are with other medical actuator system 100 different with medical actuator system 100 ' " for reference to the time and/or with sedation drug delivery other different sedation drug delivery of Control Component 220 ' Control Component 220 that flows that flows " for reference to the time have and equate application.Described other example includes but not limited to, comprises the medical actuator system and the medical actuator system that comprises at least one magnetic flux generator of the mobile Control Component of non-sedating drug conveying.

The performance, example etc. that should also be understood that aspect, embodiment, the embodiment of any one or a plurality of following descriptions can combine with the performance of the aspect embodiment of any one or a plurality of other following description, embodiment, example etc.

Cannula assembly

A first aspect of the present invention relates to cannula assembly 145 or its member, perhaps can be used by cannula assembly 145, and its embodiment shows in Fig. 1-18.First kind of performance of the embodiment of Fig. 1-18 is cannula assembly 145, comprises mouth and nose intubate 351 and sliding tube 371 '.Mouth and nose intubate 351 is arranged on patient's 10 faces in disposable mode, and comprises breathing gas sampling nose pin 364 or 365 and respiratory gas sampling port pin 369 '.Be slidingly connected one of in sliding tube 371 ' and breathing gas sampling nose pin or mouthful pin 364,365 or 369 ', with the nose that is provided at different patients 10 and the different distance between the cavity.In an example, sliding tube 371 ' is slidingly connected with respiratory gas sampling port pin 369 ', wherein sliding tube 371 ' has and shows the bending and the far-end 14 of angle to the right greatly, wherein, when very moment nasal intubation 351 is arranged on patient's face, the far-end 14 of sliding tube 371 ' towards or enter the patient oral cavity and slide to extend to far-end.Other example is known for a person skilled in the art.

Second kind of performance of the embodiment of Fig. 1-18 is cannula assembly 145, comprises detachable mouthful of pin extension 370 ' and 370 of intubate 351 ' (such as but not limited to mouth and nose intubate 351) and user ".Intubate 351 ' is arranged on patient's 10 faces in disposable mode, and comprises breathing gas sampling or the breathing gas delivery port pin 369 '/371 ' or 369 with opening "/371 ".Detachable mouthful of pin extension 370 ' or 370 of user " with mouthful pin 369 '/371 ' or 369 "/371 " removably connect, and be used for being connected to mouthful pin 369 '/371 ' or 369 "/371 " opening.In an example of second kind of performance of the embodiment of Fig. 1-18, mouthful pin 369 ' 369 " lack slidably pin 371 ' or 371 ", and it does not lack in another example.In an example of second kind of performance, when the user uses the bite-block (not shown) to the patient, such as needing the esophagus intra-operative of endoscope, mouthful pin extension 370 ' and 370 " be connected with the opening of mouthful pin.In a kind of explanation, detachable mouthful of pin extension 370 ' and 370 of user " can be by user's manual teardown, without any need for instrument.In a kind of structure, mouthful pin extension 370 ' and 370 " can be by manually can broken tethers 12 being detachably attached to mouthful pin 369 '/371 ' or 369 "/371 ".Alternative constructions comprises by using line or perforated removably connecting.Other example, use and structure are known for a person skilled in the art.

The third performance of the embodiment of Fig. 1-18 is a cannula assembly 145, comprise the intubate 351 that can disposable mode be arranged on patient's 10 faces, it comprises respiratory gas sampling port pin 369 '/371 ' with far-end 14 and the breathing gas delivery port pin 369 with far-end 16 "/371 ", wherein, when intubate 351 ' is arranged on patient 10 the face, respiratory gas sampling port pin 369 '/371 ' further towards or enter in patient 10 oral cavities than breathing gas delivery port pin 369 "/371 " extend fartherly.In an example of the third performance of the embodiment of Fig. 1-18, respiratory gas sampling port pin 369 '/371 ' is a carbon dioxide respiratory gas sampling port pin, and breathing gas delivery port pin 369 "/371 " air (sometimes only being called oxygen) that is used for being rich in oxygen flows to patient 10.In this example, as understood by one of ordinary skill in the art, far-end 14 of two pin 369 '/371 ' and 369 '/371 ' and 16 the described staggered dilution that reduces carbon dioxide sample.Other example is known for a person skilled in the art.

The 4th kind of performance of the embodiment of Fig. 1-18 is cannula assembly 145, comprise the intubate 351 ' that can disposable mode be arranged on patient's 10 faces, described intubate 351 ' comprises left and right sides intubate braced wing 367 '/367 ", each braced wing has the detachable tip station that adheres to the adhesive pad of face one side that is connected to patient 10 of band.In an example, there is not other connection to be used for intubate 351 ' is connected to patient 10 face.In this example, to compare with traditional headband etc., intubate connects adhesive pad 366 for the patient provides more easily.Other example is known for a person skilled in the art.

The 4th kind of performance of the embodiment of Fig. 1-18 is cannula assembly 145, comprise the intubate 351 ' that can disposable mode be arranged on patient's 10 faces, described intubate comprises the intubate main body with breathing gas sampling nose pin 364 or 365, and comprises the intubate lid 368 of the breathing gas conveying nose pin 422 with band pipe accommodation hole 26.Intubate lid 368 is connected with intubate main body 18, and the breathing gas nose pin 364 or 365 of taking a sample passes and extends beyond and manages accommodation hole 26.When intubate 351 ' was arranged on patient 10 the face, pipe accommodation hole 26 was set to breathing gas take a sample nose pin 364 or the 365 nose bendings towards patient 10.This set allows to carry out better the breathing gas sample collecting, and is such as understood by a person skilled in the art.In an example of the 5th kind of performance of the embodiment of Fig. 1-18, with before intubate main body 18 is connected, nose pin 364 or 365 is straight fully at intubate lid 368.

The 6th kind of performance of the embodiment of Fig. 1-18 is cannula assembly 145, comprise the intubate 351 ' that can disposable mode be arranged on patient's 10 faces, described intubate comprise breathing gas sampling nose pin 364 with far- end 20 or 365 and breathing gas with far-end 22 carry nose pin 422 ' or 422 "; wherein; when intubate 351 ' is arranged on patient 10 the face, breathing gas sampling nose pin 364 or 365 far-end 20 further towards or enter a nostril of patient 10 and carry nose pin 422 ' or 422 than breathing gas " far-end 22 extend fartherly.Two pins 364 or 365 and 422 ' or 422 " far- end 20 and 22 the described staggered respiratory delivery gas dilution that reduces the breathing gas sample.In an example of the 6th kind of performance of the embodiment of Fig. 1-18, breathing gas sampling nose pin 364 or 365 is carried nose pin 422 ' or 422 by breathing gas " circumferential hoop around.Other example is known for a person skilled in the art.

The 7th kind of performance of the embodiment of Fig. 1-18 is cannula assembly 145, comprises mouth and nose intubate 351 and adapter 363.Mouth and nose intubate 351 can disposable mode be arranged on patient's 10 faces, and comprises left nare breathing gas probe tube 354, right naris breathing gas probe tube 352 and mouth breathing gas sample tube 355.Adapter 363 comprises outer housing 394 and the backboard 423 that is connected with outer housing 394.Outer housing 394 comprise intranasal dehumidification air chamber 412 and with isolated mouthful of intranasal dehumidification air chamber 412 in dehumidification air chambers 411.Backboard 423 comprises nose capnometer port 402 and mouthful capnometer port 400.Left and right sides respiratory gas sample tube 354 is connected with outer housing 394 with 352 and is communicated with intranasal dehumidification air chamber 412 fluids.Mouth breathing gas sample tube 355 is connected with outer housing 394 and is communicated with dehumidification air chamber 411 fluids in the mouth.Nose capnometer port 402 is communicated with intranasal dehumidification air chamber 412 fluids.Mouth capnometer port 400 is communicated with mouthful interior dehumidification air chamber 411 fluids.

In an example of the 7th kind of performance of Fig. 1-18, adapter 363 also comprise be arranged on the hydrophobic filter 395 ' between intranasal dehumidification air chamber 412 and the nose capnometer port 402 and be arranged on mouthful interior dehumidification air chamber 411 and mouthful capnometer port 400 between hydrophobic filter 395 ".In the example that another does not show, desiccant is arranged between nose and mouthful dehumidification air chamber 412 and 411.Other example can be expected for a person skilled in the art.

In a kind of variation of the 7th kind of performance of Fig. 1-18, adapter 363 also comprise be arranged on intranasal and mouthful between the dehumidification air chamber 412 and 11 and the interior stream liner 396 between nose capnometer and mouthful capnometer port 402 and 400.Liner 396 comprises intubate pylon 24, it extends in nose capnometer and mouthful capnometer port 402 and 400, and to small part provide between intranasal dehumidification air chamber 412 and the nose capnometer port 402 and mouthful in fluid between dehumidification air chamber 411 and mouthful capnometer port 400 be communicated with.

The 8th kind of performance of the embodiment of Fig. 1-18 is cannula assembly 145, comprises intubate 351 ' and adapter 363.Intubate 351 ' can be arranged on patient's 10 faces, and comprises breathing gas probe tube 354,352 or 355.Adapter 363 comprises outer housing 394 backboards 423 and liner 396.Backboard 423 is connected with outer housing 394.Outer housing 394 comprises interior dehumidification air chamber 412 or 411.Backboard 423 comprises capnometer port 402 or 400.Breathing gas probe tube 354,352 or 355 is connected with outer housing 394 and is communicated with interior dehumidification air chamber 412 or 411 fluids.Liner 396 be arranged in dehumidification air chamber 412 or 411 and capnometer port 402 or 400 between.Liner 396 comprises annular pylon 24, and it extends in capnometer port 402 and 400, and to small part provide interior dehumidification air chamber 412 or 411 with capnometer port 402 or 400 between fluid be communicated with.

The 9th kind of performance of the embodiment of Fig. 1-18 is cannula assembly adapter 363.Cannula assembly adapter 363 comprises at least one cannula assembly connector members, and has nose capnometer port 402, mouthful capnometer port 400, nose pressure port 401 and breathing gas delivery port 399.Each port 402,400,401 all is connected with the bed side monitoring means (BMU) 300 of calm induction system (SDS) 100 (the perhaps medical actuator system 100 ' of other type) (can from observed embodiment Fig. 6 and the 60-62) fluid with 399.Technical term " but fluid connection " comprises directly that fluid connects with fluid indirectly and is connected.

In an example of the 9th kind of performance of the embodiment of Fig. 1-18, at least one cannula assembly adapter is made up of plate (for example backboard 423).In identical or different example, the distance that each port 402,400,401 and 399 all has between any two port centers in the center and 402,400,401 and 399 all is the shortest for nose capnometer and nose pressure port 402 and 401.In a kind of extension of the 9th kind of performance, at least one cannula assembly connector members comprises backboard 423, one or more or all of the port 402,400,401 and 399 (and 398, when existing) all be the port of backboard 423.In a kind of variation, backboard 423 comprises the adapter pin 397 that is used for aiming at and/or helps port 402,400,401 and 399 (and 398, when existing) is connected to BMU300.In one modification, backboard 423 is configured to shown in Figure 13 and 15.In the structure that another kind does not show, adapter 363 lacks plate or backboard.In a kind of the setting, BMU300 has port, and it enters in the port 402,400,401 and 399 (and 398, when existing) of adapter 363, provides fluid to connect.For connector port can be expected for a person skilled in the art with other setting (comprise the connector port that flushes with backboard, show) that BMU provides fluid to be connected.

In a kind of use of the 9th kind of performance of the embodiment of Fig. 1-18, the operation room unit (PRU) 200 of bed side monitoring means (BMU) 300 and calm induction system (SDS) 100 (the perhaps medical actuator system 100 ' of other type) (embodiment that shows in Fig. 6 and 41-57) fluid is connected.Operation room unit 200 comprises a mouthful capnometer (oral capnometer) 202 and nose capnometer (nasal capnometer) 140 (seeing Figure 54).When the mouth of adapter 363 and nose capnometer port 400 are connected with bed side monitoring means 300 fluids with 402 and a side monitoring means 300 when being connected with operation room unit 200 fluids, mouth capnometer 202 is communicated with mouthful capnometer port 400 fluids, and nose capnometer 140 is communicated with nose monitor port 402 fluids.Technical term " fluid connection " comprises that direct fluid connection is connected with indirect fluid.

The tenth kind of performance of the embodiment of Fig. 1-18 is cannula dewatering sub-assembly 28, comprises cannula dewatering shell 30 and hydrophobic filter 395.Cannula dewatering shell 30 comprises having the dehumidification air chamber 411 or 412 that dampness collection chamber 32 and sampling breathing gas pass chamber 34.The sampling breathing gas passes chamber 34 and is provided with to such an extent that specific humidity shrinkage of QI collection chamber 32 is higher and be communicated with its fluid.It is little that the sampling breathing gas passes the volume ratio dampness collection chamber 32 of chamber 34.The sampling breathing gas passes chamber 34 and has gas sampled inlet and gas sampled outlet.Hydrophobic filter 395 is set to cover the outlet that the sampling breathing gas passes chamber 34.All enter the sampling breathing gas 36 that the sampling breathing gas passes chamber 34 must pass hydrophobic filter 395, passes chamber 34 to discharge the sampling breathing gas.The dampness of sampling breathing gas 36 is collected in the dampness collection chamber 32.

The 11 kind of performance of the embodiment of Fig. 1-18 is cannula assembly 145, comprises intubate 351 ' adapter 363 and audio frequency receiver 362.Intubate 351 ' can disposable mode be arranged on patient 10 the face, and comprises breathing gas probe tube 354,352 or 355.Breathing gas probe tube 354,352 or 355 is connected with adapter 363 fluids, and adapter 363 can be connected with the bed side monitoring means 300 of calm induction system 100 (the perhaps medical actuator system 100 ' of other type).Audio frequency receiver 362 can be provided with in disposable mode near patient 10 ear, and be operably connected to adapter 363, when adapter 363 is connected with bed side monitoring means 300 and audio frequency receiver 362 close patients' 10 ear when being provided with, the direction along bed side monitoring means 300 provides sound for patient 10 at least.Term " close " includes but not limited to " being positioned at wherein " and " position thereon ".

In the example of the 11 kind of performance of the embodiment of Fig. 1-18, audio frequency receiver 362 can disposable mode be arranged in patient 10 the ear, cannula assembly 145 comprises audio frequency (for example sound) pipe 356, it operationally is connected audio frequency receiver 362 with adapter 363, and when adapter 363 is connected with BMU300, can will be from the transfer voice of the speaker of bed side monitoring means (BMU) 300 to audio frequency receiver 363 acoustically.In a kind of use, BMU300 uses audio frequency receiver 362 to offer patient 10, in the pro-operating room, uses training directive to clamp from dynamic response monitor (for example mobile phone) simultaneously, sets up patient's response time and consciousness.In a kind of variation, the training computer programme-control speaker in described training period BMU300.Thereafter, the experience abirritative simultaneously provides operational order to clamp from the dynamic response monitor to patient 10 under the requirement of the operation room unit (PRU) 200 of calm induction system 100 (the perhaps medical actuator system 100 ' of other type) in operating room.PRU200 uses patient's response time to determine the patient's 10 of experience calm (the perhaps medical surgery of other type) level of consciousness at least.In a kind of variation, at patient's computer program control loudspeaker among the PRU200 between killing period.In another kind uses, by in the audio frequency receiver 362 pro-operating rooms with mild sound, offer the patient such as music.In different examples, audio frequency receiver 362 is speakers of wearing overhead receiver, and audio frequency pipe 356 is substituted by electric wiring.Other example can be expected for a person skilled in the art.

In arbitrary application of the performance of above-mentioned Fig. 1-18, comprise its example etc., cannula assembly 145 can directly be connected with a bed side monitoring means (BMU) 300.For example, in a kind of application of the 7th kind of performance of the embodiment of Fig. 1-18, adapter 363 can directly be connected with bed side monitoring means (BMU) 300, wherein the input port of BMU300 enters the intubate pylon 24 of liner 396, and compresses intubate pylons 24 so that nothing leakage sealing to be provided based on corresponding nose capnometer and mouthful capnometer port 402 and 400.In arbitrary different application of the performance of above-mentioned Fig. 1-18, comprise its example etc., cannula assembly 145 can be directly with rest on operating room in the unit (not shown) be connected.For example, in a kind of different application of the 7th kind of performance of the embodiment of Fig. 1-18, adapter 363 can be directly with rest on operating room in the unit (not shown) be connected.In a kind of variation, the unit (not shown) comprises sedation drug delivery to patient 10, and in another kind changed, the unit (not shown) does not comprise gave patient 10 with sedation drug delivery.Other example can be expected for a person skilled in the art.

Any or the multiple performance of the above-mentioned performance of the embodiment of Fig. 1-18, comprise its example etc., but any other one or more performances of the above-mentioned performance of the embodiment of Fig. 1-18 comprise combinations such as its example, as understood by one of ordinary skill in the art.

Figure 19 and 20 has shown first kind of embodiment of bite-block 74, and it is used for the cannula assembly 145 of Fig. 1-18 in an example.In an example, bite-block uses on the patient in last gastrointestinal endoscope medical surgery process.Bite-block has the bite-block main body, and it is inserted in the patient oral cavity.The bite-block main body has and is used for through wherein inserting the through-out pathway of endoscope.The patient stings on the bite-block main body, rather than stings in endoscope.

First kind of performance of Figure 19 and 20 embodiment is bite-block 74, comprises the bite-block main body 76 that is suitable for being inserted in the patient oral cavity.Bite-block main body 76 comprises through-out pathway 78 and comprises the air sampling passage 80 that is provided with at interval with through-out pathway 78.Through-out pathway 78 is suitable for medical apparatus and instruments 82 (only being the non-shaded portion that shows in Figure 20) is contained in therebetween.Air sampling passage 80 has the import 84 that is set to receive from the air of patient's exhalation when bite-block main body 76 is inserted in the patient oral cavity.Air sampling passage 80 has the outlet 86 of the breathing gas sampling port 88 that is set to connect intubate 90 (only be the main body/cover of the embodiment of mouth/nasal intubation, breathing gas carries pin not have to show).In a kind of variation, the outlet 86 of air sampling passage 80 is suitable for being connected to by connector tube 92 the breathing gas sampling port 88 of intubate 90.

Second kind of performance of the embodiment of Figure 19-20 is cannula assembly 94, comprises intubate 90, bite-block 74 and connector tube 92.Intubate 90 can disposable mode be arranged on patient's face, and comprises breathing gas sampling port 88.Bite-block 74 has the bite-block main body 76 that is suitable for being inserted in the patient oral cavity.Bite-block main body 76 comprises through-out pathway 78 and comprises the air sampling passage 80 that is provided with at interval with through-out pathway 78.Through-out pathway 78 is suitable for holding the medical apparatus and instruments 82 that passes wherein.Air sampling passage 80 has the import 84 that is set to receive from the air of patient's exhalation when bite-block main body 76 is inserted in the patient oral cavity, and has outlet 86.Connector tube 92 has and is connected with breathing gas sampling port 88 or can connected first end, and has and be connected with bite-block main body 76 at outlet 86 places of the air sampling passage 80 of bite-block main body 76 or can connected second end.

Figure 21 has shown second kind of embodiment of bite-block.The performance of the embodiment of Figure 21 is a bite-block assembly 96, comprises bite-block main body 98 and air sampling pipe 102.Bite-block main body 98 is suitable for being inserted in the patient oral cavity, and comprises and be suitable for medical apparatus and instruments 106 (only showing its part) is contained in therebetween path 104.Air sampling pipe 102 is connected with bite-block main body 98, has the import 108 that is set to when bite-block main body 98 is inserted in the patient oral cavity to receive the air of breathing out from the patient, and has and be connected with the breathing gas sampling port of intubate or can connected outlet 112.

In a kind of variation of the embodiment of Figure 21, air sampling pipe 102 to small part is arranged in the path 104.In a kind of structure, air sampling pipe 102 can adhere to and be connected on the bite-block main body 98.In a kind of use, the outlet 112 of air sampling pipe 102 is suitable for being connected with the breathing gas sampling port of intubate indirectly by connector tube 118.

Figure 22 has shown the third embodiment of bite-block.The performance of the embodiment of Figure 22 is a bite-block assembly 122, comprises bite-block main body 124 and air sampling pipe 126.Bite-block main body 124 is suitable for being inserted in the patient oral cavity.Bite-block main body 124 comprises and is suitable for medical apparatus and instruments 132 (only showing its part) is contained in therebetween path 124, and comprises air sampling passage 134.Air sampling pipe 126 to small part is arranged in the air sampling passage 134, have the import 136 that is set to when bite-block main body 124 is inserted in the patient oral cavity to receive the air of breathing out from the patient, and have and be connected with the breathing gas sampling port of intubate or can connected outlet 138.In a kind of variation, the outlet 138 of air sampling pipe 126 is suitable for being connected with the breathing gas sampling port of intubate by connector tube 148 with meeting.

The example of Figure 19 and 20,21 and 22 embodiment has following advantage: although in the motion of apparatus during the medical operating in path, and still can be with air sampling passage/guarantee to be held in correct air sampling position.With use to adopt have can not remain on the air sampling pipe in the position with respect to bite-block traditional bite-block of intubate with intubate setting compare, this causes more accurately the density of carbon dioxide gas of patient's breath to be measured.

Figure 23 has shown the another embodiment of medical actuator system 154, and wherein medical actuator system 154 uses the possible problem of intubate 156 warning users of medical actuator system 154.The performance of the embodiment of Figure 23 is a medical actuator system 154, comprises pressure transducer 158, intubate 156 and memorizer 166.Pressure transducer 158 comprises input 168 and has output signal 170.Intubate 156 can disposable mode be arranged on patient's face and comprises the breathing gas probe tube 172 that operationally is connected with the input 168 of pressure transducer 158.Memorizer 166 comprises the intubate program that operationally is connected with the output signal 170 of pressure transducer 158 when operation on processor 174.The intubate program uses intubate 156 to the output signal 170 warning users possible problem of small part (being whole in an example) based on pressure transducer 158.Should be noted in the discussion above that the input 168 of pressure transducer 158 is used for receiving from the patient gas signal of breathing gas form in an example.

In a kind of expansion of the embodiment of Figure 23, when intubate 156 is arranged on patient's face and when breathing gas probe tube 172 is operably connected on the input 168 of pressure transducer 158, the pressure that the output signal 170 and the patient respiratory of pressure transducer 158 are produced is corresponding, and it is and the corresponding time-varying signal of patient respiratory speed.If if do not have intubate 156 to be arranged on patient's face and/or the breathing gas probe tube 172 of intubate 156 is not operably connected with the input 168 of pressure transducer 158, then the output signal 170 of pressure transducer 158 (signal of telecommunication typically) will equal atmospheric output signal in fact.

In a kind of structure of the embodiment of Figure 23, breathing gas probe tube 172 be suitable for from patient oral cavity, left nostril and right nostril at least one breathing gas is taken a sample.In a kind of variation that does not show, the breathing gas probe tube is suitable for from patient's oral cavity and two nostrils breathing gas being taken a sample.In the variation that another kind does not show, the breathing gas probe tube is suitable for only from two nostrils of patient breathing gas being taken a sample.In other changed, breathing gas probe tube 172 only was suitable for that from patient oral cavity, left nostril and right nostril takes a sample to breathing gas.

In a kind of use of the embodiment of Figure 23, possible problem comprises that when the intubate program is moved intubate 156 is not provided with (perhaps incorrect the setting) on patient's face on processor 174.In identical or different use, possible intubate problem comprises that when the intubate program is moved intubate 156 is not connected with the input 168 of pressure transducer 158 in operation on processor 174.

In a kind of application of the embodiment of Figure 23, pressure transducer 158 is members of a side monitoring means (for example, the bed side monitoring means 300 of Fig. 6, wherein pressure transducer 158 alternative nose pressure transducers 47).In identical or different application, memorizer 166 and processor 174 are members of the console controller (such as the console controller 204 of the operation room unit 200 of Fig. 6) of operation room unit.In a kind of variation, medical actuator system 154 also comprises umbilicus cable (such as the umbilicus cable 160 of Fig. 6).In this changed, when at least one of bed side monitoring means and operating room nitrogenous source had been opened, after bed side monitoring means and operation room unit operationally linked together with the umbilicus cable, the intubate Automatic Program brought into operation.In a kind of use, the possible problem of intubate comprises that the umbilicus cable is not connected (perhaps incorrect the connection) with operation room unit with bed side monitoring means.In one modification, operation room unit comprises the capnometer 230 and 234 that operationally is connected with intubate 156, and if the intubate program do not warn the possible problem of user's intubate 156, intubate program start capnometer 230 and 234.In another kind was used, pressure transducer 158, memorizer 166, processor 174 and capnometer 230 and 234 were members of individual unit.

In a kind of setting of the embodiment of Figure 23, breathing gas probe tube 172 is mouth breathing gas sample tubes 236, intubate 156 also comprises the left respiratory gas sample tube 238 that operationally is connected with the input 168 of pressure transducer 158, and intubate 156 also comprises the right respiratory gas sample tube 240 that operationally is connected with the input 168 of pressure transducer 158.In a kind of variation, at least one valve 242,244 and 246 can be by the intubate programme-control, so that optionally Jiang Kou, left nostril and right respiratory gas sample tube 236,238 and 240 can be operatively connected with pressure transducer 158 one at a time.Use with Figure 23 in other structures of valve, the design of different valve and/or the connection of different valve of the different numbers that show can expect for a person skilled in the art.In one modification, medical actuator system 154 also comprises at least one capnometer 230 and 234, wherein at least one valve 242,244 restrain with 246 and the intubate programme-control so that operationally Jiang Kou, left nostril and right respiratory gas sample tube 236,238 are connected with 234 with at least one capnometer 230 with 240.In one application, at least one capnometer 230 and 234 comprises nose capnometer 230 that receives breathing gas sampling input from two nostrils of patient and the mouth capnometer 234 that receives from the breathing gas sampling input in patient oral cavity.In a kind of executive mode, a nose capnometer 230 and a mouthful capnometer 234 are members of operation room unit (operation room unit 200 for example previously discussed).Should be noted in the discussion above that for the sake of clarity being connected among Figure 23 between connection between processor 174 and capnometer 230 and 234 and processor 174 and at least one valve 242,244 and 246 is removed.Being provided with that other does not show, adopt two or three pressure transducers.

In other structure that does not show of the medical actuator system that adopts intubate warning user possibility problem, each valve 242,244 and 246 of Figure 23 (also have in an example sealing any mobile off-position from valve) is substituted by diverter, described diverter with the related breathing gas sample tube be divided into one of relevant capnometer connection be connected with pressure transducer another.Employing in a kind of variation, one, two or three pressure transducers and/or one, two or three capnometers.Should be noted in the discussion above that in a kind of expansion the best that the capnometer that is identified in the carbon dioxide of patient's aerofluxus in breathing from the strong pressure signal of breathing the position uses in measuring is breathed the position.

In an example, the advantage of medical actuator system 154 comprises the possible position of automatic warning user intubate 156 and need not the mechanical switch that adopts reliability relatively poor, and the oral cavity that is included as the patient is breathed and nose breathing provides baseline pressure mensuration.In one application, if patient's preferred pneumostome has changed thereby the oxygen gas flow rate that arrives the patient who carries out medical surgery increases or when reducing, described baseline pressure is measured the mensuration that is used to afterwards.

The detailed description of a kind of specific implementations of following pictorialization Fig. 1-18.Should be noted that any part of this specific implementations all rises in the expression of the embodiment of any previously described Fig. 1-18 (for example comprise and waiting).In this specific implementations, cannula assembly 145 is oxygen (term " oxygen " comprises the air that is rich in oxygen) delivery cannula assemblies, more specifically oxygen supply is given patient 10 and is collected the cannula assembly 145 (showing at Fig. 1) that the mouth and nose that are used for analyzing are breathed the discharge sample.Mouth/nasal intubation 351 allows to measure end-tidal carbon dioxide (the end-tidal CO from oral cavity and nasal cavity two places ₂Gas) (term " carbon dioxide " refers to carbonated gas), and from the carbon dioxide gas pressure of bonded nasal cavity.

With oxygen is different with the intubate that cloud is provided to the prior art outside oral cavity and the nasal cavity, mouth/nasal intubation 351 provides the Oxygen Flow that is directed in oral cavity and the nasal cavity.Cannula assembly 145 comprises the nose pressure sensor tube, and it provides a signal to the oxygen controller in exhalation process, reducing flow of oxygen speed, thereby prevents the dilution of end-tidal gaseous sample, has increased the accuracy of measuring.Intubate 145 allows dependent/non-dependent mouth, nose capnometer to measure, and this is with different with the capnometer intubate of the prior art of realization average measurement in conjunction with sampling.The present invention also comprises the integrated component of adapter 363 as intubation system, helps being easy to connecting bed side monitoring means (BMU) 300 and removing from it.Intubate 145 also requires produce the transmission of the audible instructions of response from dynamic response monitor (ARM) for patient 10 provides.

In a kind of structure, mouth and nose intubate 351 is made by the flexible material that is easy to deformation and cosily be engaged on patient 10 the face.This has guaranteed that patient 10 is comfortable and zest has been minimized.

Cannula assembly 145 (showing in Fig. 1) is to give the integrated monitor of downern and the part of calm induction system (SDS) with secured fashion in surgical operation.This system uses drug conveying algorithm and intravenous fluids peristaltic pump to reach and to keep the variable bit rate infusion delivery medicine of the sedation effect of needs.All drug conveying are undertaken by operation room unit (PRU) 200, and it may change with the drug dose that bed side monitoring means (BMU) 300 makes nursing group needing can carry out from any position.

As used herein, term " near-end " refers to the position of the device of the most approaching use cannula assembly on the mouth/nasal intubation assembly, thereby the patient's 10 who is used apart from cannula assembly distance farthest.On the contrary, term " far-end " refers on the mouth/nasal intubation assembly the position away from the device that uses cannula assembly, thereby near patient 10.

As Figure 1-3, mouth/nasal intubation 351 is set to cosily be engaged on the upper lip between patient's 10 noses and the oral cavity.Mouth/nasal intubation 351 also provides the monitoring of patient's 1 breathing simultaneously as the no mask conveyer device that is used to patient's 10 supply oxygens.Mouth/nasal intubation 351 is connected with one group of pipe fitting that is used for gaseous sample collection, sound and oxygen delivery, and comprise that help is connected to patient 10 frenulum 361, permission sends to patient 10 receiver 362 with acoustic information, and is used for being connected to safely a BMU adapter 363 of side monitoring means (BMU) 300.

Referring to Fig. 1 and 6, cannula assembly 145 comprises far distance port nasal intubation 351 receivers 362 and proximal connector 363.The sample of being discharged by patient 10 arrives adapter 363 by mouth and nose intubate 351 collect and flow through autonomous channel and tube chamber.Adapter 363 removably connects with bed side monitoring means (BMU) 300.Gas (oxygen and carbon dioxide) then through the umbilicus cable come/from the path of operation room unit (PRU) 200.The capnometer system comprises two capnometer in PRU200.Particle and hydrophobic filter are arranged on intubate adapter 262 inside.Oral chamber 422 and nasal cavity chamber 412 are designed to stop from patient's 10 expiration discharges concentrating to avoid damaging capnometer of gas.Nose presses transducer 47 process umbilicus cables that patient 10 respiration information is offered operation room unit (PRU) 200.

As shown in Figure 4, mouth and nose part 351 is made by soft and resilient material, such as polyurethane, silicon or some other elastomers, and the general molded or fluid thermal die casting mold structure by injection moulding.Intubate lid 368 generally is the platform that other part is supported in hollow cube and conduct.Mouth and nose part 351 profiles are set to adapt to easily patient's anatomical features.Mouth and nose intubate 351 comprises the adhesive pad 366 that is arranged on intubate wing 367 1 sides on the patient 10, and mouth and nose part 352 cosily can be adhered to and is connected in the position on patient's 10 faces.Intubate lid 368 comprises nose pin 422 and mouthful pin 369.Intubate main body 18 comprises nose pin 364 and 365 and mouthful pin 370 and 371.

Fig. 4 and 6-9 show intubate lid 368 and comprise two independently gas circulation, and one is used to collect the carbon dioxide that mouth and nose breathe out and is used for capnometer and pressure analysis, second nose and oral cavity that is used for providing a supply of oxygen to patient 10.Fig. 8 has shown mouth/nasal intubation carbon dioxide sampling circulation cutaway view.Carbon dioxide sampling circulation comprises that left side and the right side nasal cavity good to eat sample that circulates circulates, and they are in inner molded and cover 268 inside in intubate and interconnect.The circulation of carbon dioxide left side comprises with interconnective left pin passage 375 of angle to the right and left passage 377, plays a part to collect carbon dioxide sample from left nostril of the patient 10.Left side sample cell 354 (Fig. 1) is inserted into and is fixedly attached to assigns to two chambers left passage 377 of (showing) with the carbon dioxide sample volume in Fig. 2-3 and 6: left pressure chamber 359 and left sample cavity 360.In addition, the circulation of carbon dioxide right side comprises with interconnective right pin passage 374 of angle to the right and right passage 376, plays a part to collect carbon dioxide sample from right nostril of the patient 10.Right side sample cell 352 (Fig. 1) is inserted into and is fixedly attached to assigns to two chambers right passage 376 of (showing) with the carbon dioxide sample volume in Fig. 2-3 and 6: right pressure chamber 357 and right sample cavity 358.This layout basically with the mouth pin passage 379 that comprises in mouthful pin 369,371 and 370; The oral cavities circulation that mouth passage 378 is arranged in the intubate lid 368 is identical.Mouthful pin passage 379 and mouthful passage 378 interconnect and from patient 10 oral collection carbon dioxide sample.

Shown in Fig. 7-9, second gas circulation arrives oxygen delivery near patient 10 the nose and oral cavity.Fig. 9 has shown the cutaway view of mouth/nasal intubation 351.Oxygen channel 387 is communicated with chamber 384 fluids that intubate is covered in 368.Oxygen room 384 has three openings: first opening that is connected with near the oxygen pin passage 381 of the delivering oxygen oral cavity, with second opening that oxygen delivery is communicated with to the right channel 385 in the right nostril; With three opening of oxygen delivery to left side cavity passage 386.

Shown on Fig. 4, nose oxygen pin 422 is installed in pin 364 and 365 tops.Pin 422 has conical in shape and coaxial being engaged in around nose pin 364 and 365.Pin 422 comprises some holes, and permission flows near patient 10 the nasal cavity from the oxygen in the intubate lid 368.

Port system comprises the mouth pin 369 as the integrated component of mouth and nose intubate 351, slidably is installed in slip pin 371 and EGD (esophageal-gastric-duodenoscopy) pin extension 370 on the pin 369.Mouthful pin system by two independently passage forms: be used for the oxygen pin passage 381 of oxygen supply and be used for mouthful pin passage 379 that carbon dioxide is collected.Slip pin 371 is slidingly mounted on pin 369 tops, forms " L " shape and allows crooked to adapt to different patients 10.Pin 369 is extensible and can bounce back, and is easy to be positioned at the place ahead, oral cavity.The 3rd part that comprises mouthful pin system is detachably/can connect pin extension EGD (esophageal-gastric-duodenoscopy) pin 370, and it is designed to be slidingly mounted on the slip pin 371 with in the oral cavity that arrives patient 10.EGD pin extension 370 is manufactured to attached on the pin 371 but be easy to be pulled down by the user.Transfer of gas and collection in the oral cavity have been improved in EGD extension 370, if but remove easily again and abandon when not using.

As shown in Figure 1, the pipe fitting group is included in two the outstanding pipes 352 and 354 that are used for transporting carbon dioxide nose sample, each pipe fitting group contains two loculuses, pipe 355 is used to transport carbon dioxide mouth sample, and audio frequency pipe 356 and oxygen hose 353 arrive cell 384 (showing) with oxygen delivery in Fig. 7-9.Pipe can be bought from the market, and preferably the polrvinyl chloride structure by flexible plastic such as mold pressing forms.Each mold pressing pipe 352 and 354 transports the carbon dioxide from right side and left nare respectively.Sample cell 352 is connected with intubate lid 368 near oxygen hose 353 on the right side.Sample cell 354 is connected with intubate lid 368 near oxygen hose 355 on the left side in similar the setting.

Referring now to Fig. 2 and 3,, right atrial pressure chamber 357 and right side sample cavity 358 are arranged in pipe 352 and the carbon dioxide sample that transports from right naris is used for pneumatic and the capnometer analysis.In same form, left pressure chamber 359 and left sample cavity 360 are arranged in the pipe 354 carbon dioxide samples that transport from left nostril.In a kind of the setting, pipe 352 is connected with oxygen hose 353, manages 354 and is connected with mouth sample cell 355 in an identical manner.If desired, to be designed so that pipe is easy to separated for the connection between the pipe.Independently audio frequency pipe 356 is connected with receiver 362 and is used for the ear of transfer voice to patient 10.

As shown in figure 13, mouth/nasal intubation adapter 363 comprises four members, and they form inner room and passage when fitting together.Described member is outlet outer housing 394, hydrophobic filter 395, liner 396 and a backboard 423.Described member is kept together by the interior latch 403 on the otch 404 in fastening and being locked in.

Referring to Figure 10-13 and 15-18, outlet outer housing 394 and backboard 423 are made by the mold pressing rigid thermoplastic material, and liner 396 is made by elastic flexible material.Being included in outlet in the outer housing 394 is to be used to slough mouthful and the moist room 411 and 412 of the dampness of nose carbon dioxide gas sampled.Outlet outer housing 394 comprises that clamper buckles 388, conveniently is used for safely connector assembly being connected to BMU interface adapter (showing at Fig. 1).Left and right nose carbon dioxide is passing through capnometer exit passageway 417 (showing) combination in groove 415 afterwards in Figure 16-18.(see figure 6) is preferably carried out in the analysis of nose capnometer on bonded gaseous sample in PRU200.Pass manometer tube 424 (Figure 12) afterwards at carbon dioxide, the pressure analysis is also carried out on bonded gaseous sample.

The analysis of mouthful capnometer is carried out on the carbon dioxide sample that gas has been obtained after the (see figure 6) in through port exit passageway 416 and inlet port groove 410 and the moist room 411.Groove 410 and 415 keeps sloughing the hydrophobic filter 395 of dampness and allowing it to be discharged in moist room 411 and 412, prevents other sensing unit of dampness damage capnometer system.

Referring to Fig. 1 and 10-13, the distal face of outlet outer housing 394 provides adapter for all intubate pipe fittings.The distal face of outer housing 394 comprises the oxygen hose opening 390 as the jointing of pipe 353, audio frequency tube opening 389 as pipe 356 jointing, the right side tube opening 392 that holds sample cell 352 connects the left side tube opening 393 of sample cell 354 and the mouth tube opening 391 of utensil receiving opening sample cell 355.All jointings are configured such that with cooperating pipe fitting to form and do not leak sealing.Right side and left side nose pressurized carbon dioxide solenoid 418 (seeing Figure 16) all be arranged on groove 420 in pressure chamber opening 421 be connected.

Preferably shown in Figure 13 and 15, liner 396 is clipped between outlet outer housing 394 and the backboard 423.Its function is to form the inner passage and separate independently stream.It also connects hydrophobic filter 395.Hydrophobic filter 395 is also kept by filter otch 419 and the pump 413 that is arranged on the proximal end face that exports outer housing 394.Hydrophobic filter 395 can be bought from the market, and has particle obstruction and hydrophobic feature.Backboard 423 comprises some ports that are connected with adapter on the BMU300, comprises audio port 398, oxygen port 399, mouthful port 400 and pressure port 401.Adapter pin 397 is used to guide being connected between the adapter on intubate adapter 363 and the BMU300.

Should be noted that intubate 351 ', adapter 363 and receiver 362 all are that single patient uses (SPU) article in a kind of detailed description of specific implementation mode of embodiment of Fig. 1-18.

Drug delivery cassette component

A second aspect of the present invention relates to drug delivery cassette component 251 or its member, perhaps can be used for drug delivery cassette component 251, its embodiment shows that in Figure 24-40 it is used in the embodiment of the operation room unit (PRU) 200 of reality in Figure 41-57 in one implementation.First kind of performance of the embodiment of Figure 24-40 is drug delivery cassette component 251, comprises Rule 269, pipe fitting 277 and 259 and drug delivery cassette mainboard 253.Pipe fitting 277 and 259 has medicine receiving terminal that can be connected with medicine bottle 250 fluids that contain medicine and the drug conveying end that is communicated with Rule 269 fluids.Technical term " but fluid connection " comprise directly that fluid connects and indirectly fluid be connected, technical term " fluid connection " comprises that direct fluid connection is connected with indirect fluid.Box mainboard 253 has position, Rule base portion 271.Rule 269 can be with respect to base portion 271 dismounting of position, Rule.But position, Rule base portion 271 has position, deflection Rule pick off crossbeam 275, and it can be configured to be pulled down Shi Qike when Rule 269 from position, Rule base portion 271 and be configured to not deflection by Rule 269 deflections when Rule 269 is connected with position, Rule base portion 271.In a kind of structure, position, Rule base portion 271 is also as T position base portion 271, and in a kind of structure, position, Rule pick off crossbeam 275 is also as T position pick off crossbeam 275.Other structure can be expected for a person skilled in the art.

In an example of first kind of performance of the embodiment of Figure 24-40, box mainboard 253 can be with respect to operation room unit (PRU) 200 (showing in Figure 41-57) dismounting of the built-in Rule optical sensor 266 (seeing Figure 44) that one of has in position, Rule pick off crossbeam 275 that is set to only perception deflection and position, the undeflected Rule pick off crossbeam 275.In a kind of variation, operation room unit 200 also conducts drugs to the patient through pipe fitting according to built-in Rule optical sensor 266 control medicines flowing in pipe fitting 277 and 259 of perception or position, not perception Rule pick off crossbeam 275 with air cleaning pipe fitting 277 and 259 at least in part.Other example can be expected for a person skilled in the art.

The bonded extensive description of a second aspect of the present invention (its drug delivery cassette component embodiment shows in Figure 24-40) and a third aspect of the present invention (its operation room unit embodiment shows in Figure 41-57) of discussing later is drug conveying assembly (for example, drug delivery cassette component 251 and an operation room unit 200).In a kind of performance of this combination, drug conveying assembly (for example 251 and 200) comprises pipe fitting (for example 277 and 259), storing position (for example position, Rule base portion 271), pump (for example seeing 220 among Figure 41) and pick off (for example built-in Rule pick off 226 is seen Figure 44).Pipe fitting (for example 277 and 259) has the medicine receiving terminal that can be connected with the medicine bottle that contains medicine (for example 250) fluid and has drug conveying end parts (for example Rule 269).When the drug conveying end parts of pipe fitting was not communicated with patient's drug conveying, storing position (for example 271) was suitable for storing releasedly the drug conveying end parts (for example 269) of pipe fitting (for example 277 and 259).When pipe fitting (for example 277 and 259) is operably connected to pump (for example 220), pump (for example 220) control medicine flowing in pipe fitting (for example 277 and 259), air cleaning pipe fitting (for example 277 and 259) also conducts drugs to the patient through pipe fitting (for example 277 and 259).Whether pick off (for example 226) has outlet and is set to the drug conveying end parts of perception pipe fitting (for example 277 and 259) (for example 269) and exist at storing position (for example 271).

It should be noted that, in the example of broadly described combination, the drug conveying end parts of pipe fitting has and is roughly one to four inch length and comprises any end fitting (for example Rule 269) that self is connected with the drug conveying end parts of pipe fitting (for example 277 and 259) (for example 269).In one application, whether the drug conveying end parts of the direct perception pipe fitting of pick off (for example 277 and 259) (for example 269) exists in storing position (271).In another kind is used, pick off (for example 226) by perception the drug conveying end parts of pipe fitting (for example 277 and 259) (for example 269) in storing position (for example 277) existence and do not exist between change the position another kind of member (for example position, Rule pick off crossbeam 275) existence and/or do not exist, the drug conveying end parts of perception pipe fitting (for example 277 and 259) (for example 269) exists and/or does not exist indirectly.Be that described member is not limited to the example of the particular elements found in the round parentheses after the member with being to be understood that.Therefore, other example of pick off can be used to such as but not limited to another kind of optical pickocff, sonac, proximity transducer or electromagnetic transducer.Similarly, the example of storing position etc. can be used, and delivery system need also to be not limited to drug delivery cassette component and/or operation room unit, understands as those skilled in the art.

In a kind of implementation of drug conveying assembly (for example 251 and 200), only when the drug conveying end parts of being determined pipe fitting (for example 277 and 259) by the output of pick off (for example 226) (for example 269) is stored in the storing position (for example 271), pump (for example 220) air cleaning pipe fitting (for example 277 and 259).This helps prevent when the drug conveying end parts of pipe fitting (for example 77 and 259) (for example 269) when being communicated with patient's fluid, the cleaning (for example air cleaning) that causes because of carelessness of pipe fitting (for example 277 and 259).

In the identical or different implementation of drug conveying assembly (for example 251 and 200), only when the drug conveying end parts of pipe fitting (for example 277 and 259) (for example 269) is determined to be stored in the storing position (for example 271) by the output of pick off (for example 226), can be not in pipe fitting (for example 277 and 259) operation be connected with pump (for example 220).This helps prevent medicine to flow freely among the patient or in the environment.In a kind of variation, pump case door (for example 201) relies on the pipe fitting that connects on pump (for example 220) clamp operation (for example 277 and 259), pumping action is needed for drug flow, and drug flow is not closed when pump (for example 220) has pump moving.In variation, pump case door (for example 201) is locked and can not be opened with the pipe fitting of removing clamping (for example 277 and 259), unless the drug conveying end parts of pipe fitting (for example 277 and 259) (for example 269) is determined to be stored in the storing position (for example 271) by the output of pick off (for example 226).

Second kind of performance of the embodiment of Figure 24-40 is drug delivery cassette component 251, comprises drug delivery cassette mainboard 253.Medicine bottle 250 can be connected with box mainboard 253.Box mainboard 253 has deflectable medicine bottle position pick off crossbeam 267, and it can be configured to by medicine bottle 250 deflections when medicine bottle 250 is connected with box mainboard 253, and it can be configured to not deflection when medicine bottle 250 is not connected with box mainboard 253.In a kind of structure, medicine bottle position pick off crossbeam 267 also refers to follow closely pin pick off crossbeam 267.Other structure can be expected for a person skilled in the art.

In an example of second kind of performance of the embodiment of Figure 24-40, box mainboard 253 can be with respect to operation room unit (PRU) 200 (showing in Figure 41-57) dismounting of the built-in medicine bottle optical sensor 228 (seeing Figure 44) that one of has in the medicine bottle position pick off crossbeam 267 that is set to only perception deflection and the undeflected medicine bottle position pick off crossbeam 267.In a kind of variation, the drug flow that operation room unit 200 is controlled from medicine bottle according to the built-in medicine bottle optical sensor 228 of perception or not perception medicine bottle position pick off crossbeam 267 at least in part.

In the identical or different example of second kind of performance of the embodiment of Figure 24-40, medicine bottle 250 comprises medicine bottle sealing member 42, and drug delivery cassette component 251 also comprises the nail pin 261 with nail needle point 296 and nail pin agnail 184.When medicine bottle 250 was connected with box mainboard 253, medicine bottle sealing member 42 kept by 296 perforation of nail needle point and by nail pin agnail 184, and medicine bottle position pick off crossbeam 267 relies on nail pin agnail 184 upwards to promote medicine bottle 250.As understood by one of ordinary skill in the art, described upwards promotion has reduced drug waste.Other example can be expected for a person skilled in the art.

The third performance of the embodiment of Figure 24-40 is a drug delivery cassette component 251, comprises drug delivery cassette nail pin 261.Medicine bottle 250 can be connected with nail pin 261.Medicine bottle 250 comprises medicine bottle sealing member 42.Nail pin 261 has nail needle point 296 and nail pin agnail 184.When medicine bottle 250 was connected with nail pin 261, medicine bottle sealing member 42 kept by 296 perforation of nail needle point and by nail pin agnail 184.

The 4th kind of performance of the embodiment of Figure 24-40 is drug delivery cassette component 251, comprises Rule 269, drug delivery cassette nail pin 253, pipe fitting 277 and 259 and drug delivery cassette mainboard 253.Nail pin 261 comprises medicine bottle sealing member perforation nail needle point 296.Pipe fitting 277 and 259 has and can be connected medicine receiving terminal that also can be connected with its fluid and the drug conveying end that is communicated with Rule 269 fluids with nail pin 261 fluids.Nail pin 261 can be with respect to 253 dismounting of box mainboard.This allows only will follow closely pin 261 and is arranged in the sharp keen article returnable, as understood by one of ordinary skill in the art, reduces sharp keen waste product volume and disposal cost.

The 5th kind of performance of the embodiment of Figure 24-40 is drug delivery cassette component 251, comprises Rule 269, pipe fitting 277 and 259 and drug delivery cassette mainboard 253.Pipe fitting 277 and 259 has medicine receiving terminal that can be connected with medicine bottle 250 fluids that contain medicine and the drug conveying end that is communicated with Rule 269 fluids.Box mainboard 253 has position, Rule base portion 271.Rule 269 can be with respect to base portion 271 dismounting of position, Rule.Rule 269 has and is set to the drip chamber 273 of collecting the medicine in any discharge Rule 269 when Rule 269 is connected with position, Rule base portion 271.In a kind of structure, position, Rule base portion 271 is also as T position base portion 271.Other structure can be expected for a person skilled in the art.In an example of the 5th kind of performance of the embodiment of Figure 24-40, drug delivery cassette component 251 also comprises the drug absorption pad 273 ' that is arranged in the drip chamber 273.Other example can be expected for a person skilled in the art.

The 6th kind of performance of the embodiment of Figure 24-40 is drug delivery cassette component 251, comprises Rule 269 and pipe fitting 277 and 259.Pipe fitting 277 and 259 comprises coil pipe 259 and the flexible pipe 277 that fluid links together.Flexible pipe 277 has the medicine receiving terminal that can be connected with medicine bottle 250 fluids that contain medicine, and coil pipe 259 has the drug conveying end that is communicated with Rule 269 fluids.Coil pipe 259 can be extended by the user.In an example of the 5th kind of performance of the embodiment of Figure 24-40, coil pipe 250 comprises a plurality of pipeloops, and wherein adjacent pipeloop can discharge and bond together.This layout allows to support only pulls out the length that is used for the required coil pipe of patient 259, thereby improved pipe fitting management is provided.In a kind of variation, adjacent pipeloop heat bonding together.In another kind changed, the radiation in the sterilization process can discharge the adjacent pipeloop of coil pipe 259 and bond together.In identical or different example, coil pipe 259 has the diameter littler than flexible pipe 277.This has reduced medicine and has used the waste of back residue medicine in pipe fitting 277 and 259 and accelerated removing of air in the beginning purification process.Other example can be expected for a person skilled in the art.

The 7th kind of performance of the embodiment of Figure 24-40 is to comprise the drug delivery cassette component of drug delivery cassette mainboard 253 251, described drug delivery cassette mainboard 253 removably connects with the operation room unit 200 of calm induction system 100 (the perhaps medical actuator system 100 ' of other type), and comprises peristaltic pump cut-out 254.In an example of the 7th kind of performance of the embodiment of Figure 24-40, drug delivery cassette component 251 also comprises drug conveying flexible pipe 277, it has the generally linear part that is connected with mainboard 253 and across peristaltic pump cut-out 254, wherein, when mainboard 253 was connected with operation room unit 200, the pump that the part of flexible pipe 277 is operably connected to the drug conveying peristaltic pump of operation room unit 200 referred to.

The 8th kind of performance of the embodiment of Figure 24-40 is to comprise the drug delivery cassette component of drug delivery cassette mainboard 253 251.Mainboard 253 has top left part, top right side part, bottom left-hand section and right side, bottom part.Box mainboard 253 removably connects with the operation room unit 200 of calm induction system 100 (the perhaps medical actuator system 100 ' of other type), and mainboard 253 comprises the peristaltic pump cut-out 254 that is arranged between top left side and the top right side part.Mainboard 253 has the inner air tube pick off cut-out 255 between the top right side of being arranged on part and right side, the bottom branch.

In an example of the 8th kind of performance of the embodiment of Figure 24-40, drug delivery cassette component 251 also comprises drug conveying flexible pipe 277, it has the generally linear first that partly is connected with the top left part of mainboard 253 and top right side and across peristaltic pump cut-out 254, and has the generally linear second portion that is connected with right side, bottom part with the top right side part of mainboard 253 and across inner air tube pick off cut-out 255.When mainboard 253 is connected with operation room unit 200, the pump that the first of flexible pipe 277 is operably connected to the drug conveying peristaltic pump of operation room unit 200 refers to that the second portion of flexible pipe 277 is operably connected to the inner air tube pick off of operation room unit 200.

In the identical or different example of the 8th kind of performance of the embodiment of Figure 24-40, the lower left side of mainboard 253 part is extended down lower right sidepiece branchs of mainboard 253, limits the pump door lock cut-out of the right side that extends to the lower left side part and extension under lower right sidepiece branchs of mainboard 253.

In a kind of application of any above-mentioned performance of Figure 24-40, comprise their example etc., box mainboard 253 can be directly connected to operation room unit (PRU) 200 (showing) in Figure 41-57.Other application can be expected for a person skilled in the art.

As understood by one of ordinary skill in the art, any or the multiple above-mentioned performance of the embodiment of Figure 24-40, comprise their example etc., can with any other one or more above-mentioned performance of the embodiment of Figure 24-40, comprise their combinations such as example.

The detailed description of a kind of specific implementation mode of the embodiment of following pictorialization Figure 24-40.Should be noted in the discussion above that any part of this specific implementation mode rises in the expression of the embodiment of any previously described Figure 24-40 (comprising its example etc.).In this specific implementation mode, drug delivery cassette component 251 is used in combination with drug conveying infusion pump assembly 220.In this implementation, drug delivery cassette component 251 is will be to the part of the integrated patient-monitoring of giving downern and calm induction system (SDS) 100 (showing in Figure 41) in simple operation process.This system uses drug conveying algorithm and venous transfusion wriggling (perhaps other type) pump 220 (seeing Figure 41) with drug delivery cassette component 251, adopts the variable velocity infusion delivery medicine of the sedation effect that reaches and needing to keep.

Here, term " near-end " refers to the position of the device of the most approaching use drug delivery cassette component 251 on the drug delivery cassette component 251, thereby the patient's 10 of distance use drug delivery cassette component 251 distance farthest.On the contrary, term " far-end " refers on the drug delivery cassette component 251 the position away from the device that uses drug delivery cassette component 251, thereby near patient 10.

Shown in Figure 24-26, box 251 comprises box mainboard 253, it is cast by thermoplastic in an example, has the planar rectangular shape of being generally, its angle is level and smooth round angle, and rectangle cut-out 254 and 255 is designed to allow be connected with peristaltic pump 220 (seeing Figure 41) and sensor component thereof (for example show among Figure 44 226 and 228).In one application, box 251 comprises mainboard 253 and member, is the member that single patient uses, and is disposable.Box mainboard 253 comprises and being generally at the smooth thin end, and it is designed to have support fluid communicating pipe 277 and 259, the molded part in reducer 281, nail needle system 272 and commercially available Rule 269.Nail needle system 272 comprises nail pin medicated cap 263, nail pin 261, blow vent filter 295 and nail pin elbow 265.

Refer again to Figure 24-26, box mainboard 253 has end face 252 and bottom surface 260, and they keep being assembled into the connecting elements of box 251.Box mainboard 253 has peristaltic pump cut-out 254 on near-end one side.Inner air tube pick off cut-out 255 and tube passage 258 are operated by rotary motion openings on a side of mainboard 253.Visual arrow 289 is general central molded relieves at mainboard 253, and arrowhead indication box 251 is inserted into user's direction.Collimating aperture 287 is the circular opens by mainboard 253, is used for helping customer location and aims at box 251 at pump 220 (seeing Figure 41).

Shown in Figure 24-26, box mainboard 253 comprises that on the end face 252 one strengthens the parallel enhancing groove 286 on rib 256 and the bottom surface 260 in a kind of structure, with the hardness of the plastic molded construction 253 that increases contiguous pump cut-out 254 and inner air tube pick off cut-out 255.Be in the purpose of handling and using, strengthen rib 256 and strengthen groove 286 helping to make mainboard 253 hard.Strengthen rib 256 and strengthen groove 286 integrally moulded as the part of box mainboard 253.

Shown in Figure 24 and 26, box mainboard 253 has: the coil pipe pedestal 257 that (a) is designed to keep coil pipe 259; (b) the T-position pedestal 271 in maintenance Rule 269; (c) hold the nail pin base 262 of following closely needle system 272.Box mainboard 253 also comprises holder handle 285.

As shown in figure 26, holder handle 285 is integration sections of box mainboard 253, extends to make things convenient for user's handling from the distal side.The shape of holder handle 285 is set to have level and smooth round angle, makes it be easy to cosily be held.Parallel rib 190 forms on holder handle 285, is inserting or is being used to secure grip that not slidingsurface (seeing Figure 41) is provided reliably when pump 220 is removed box 251.

Shown in Figure 24 and 26, the delivery system that is installed on the box 251 comprises the assembling flexible pipe that one group of fluid is communicated with.The pipe group comprises (a) coil pipe 259 and (b) flexible pipe 277.Drug system also comprises: (c) reducer 281; (d) be installed in the nail needle system of following closely on the pin base 262 272; (e) be installed in commercially available Rule 269 on the T position pedestal 271.For the purpose of handling and transporting, in a kind of structure, all parts all detachably are installed in the position.

Shown in Figure 25 and 26, pipe 277 is made such as commercially available pvc by the transparent flexible plastics, and has constant inner and outer diameter section.Pipe 277 is made by flexible elastic material, allows also to be engaged in the intermediate plate 279 through passage 258 is crooked.Pipe 277 generally assembles according to the box outline.Box 251 utilizes intermediate plate 279 and spike wall retainer 291 to provide the path with guiding and for managing 277, keeps its profile diameter constant and by passage 258 usually around the angle of box 251.In a kind of structure that does not show, spike wall retainer 291 is replaced by one or more additional intermediate plates 279.

Shown in Figure 25 and 26, pipe 277 is parts of medicinal fluid connected system, and is connected with (a) nail pin elbow 265 with an end, and the other end is connected with (b) reducer 281.Pipe 277 is connected in the nail pin elbow 265 on the bottom side of box 251.Manage 277 then and forward the horizontal of box 251 to, extend through tube passage 258 from box bottom side 260.The opposite end of pipe 277 is connected with the reducer 281 on box 251 top sides.Manage 277 and freely extend through cut-out 254 and 255.Pipe 277 passes air inlet pipe cut-out 255 and peristaltic pump cut-out 254.

Shown in Figure 24,26 and 29, flexible pipe 277 is remained in the position by the molded intermediate plate 279 that is arranged on the box top 252.Intermediate plate 279 has alternative opening and helps pipe 277 to aim at and be connected in the position and can not twist.Intermediate plate 279 is generally and manages the arc of 277 external diameter coupling.Clip openings 270 and 276 is the results that form the manufacturing process of intermediate plate.Double grip-pieces 280 is connected reducer 281 on the box mainboard 253.In a kind of structure, double grip-pieces 280 is constructed to only have a space (as shown in figure 29) between them, and reducer 281 is firmly connected and the grappling tube system.Intermediate plate 280 also has the arcuate shape of mating with the outside of reducer 281 body profile.Double grip-pieces 280 remains on both wings on the main body of the reducer 281 that is limited in the fixed position, prevents to slide in processing or the use.Reducer 281 has smooth bottom, box mainboard 253 has reducer positioning rib 40 and (sees Figure 29, but for the sake of clarity from Figure 26, save), described reducer positioning rib also can help reducer to remain in the position when reducer 281 is connected by double grip-pieces 280.In an example, being connected to after the peristaltic pump 220 of being realized by intermediate plate 280, pipe 277 keeps firmly and is in line.

Shown in Figure 26 and 29, spike wall retainer 291 forms on box top 252, when limited pipe 277 is advanced around the angle it is caught and keeps.Distance between the wall makes the slight interference between its formation and the pipe 277, helps holding tube 277.As previously mentioned, in a kind of structure that does not show, spike wall retainer 291 is replaced by one or more other intermediate plates 279.

As shown in figure 26, reducer 281 is parts of fluid communication, and is installed on the proximal part of box 251.In a kind of structure, it is made by the transparent thermoplastic material, and comprises the entrance and exit that fluid is communicated with, and entrance and exit is each other in approximate angle to the right.The arrival end of reducer 281 is greater than the port of export.The port of export is suitable for being connected to IV (intravenous) coil pipe 259, and arrival end is suitable for being connected to flexible pipe 277.Reducer 281 main bodys are generally the cylinder form with two molded wings, keep it to be fixed in the position on the intermediate plate 280 to be installed to.Reducer 281 also helps pipe assembly coil pipe 259 that diameter is littler and the bigger flexible pipe 277 of diameter to be connected in the position.

Shown in Figure 26 and 27, coil pipe 259 is made by transparent IV pipe, and the pvc that can buy from the market for example is with its manufacturing and be assembled into to be biased to and be substantially columniform spiral, as with the minimized mode of overall size and make things convenient for the user to grasp and handle.In a kind of structure, when not coiling and extending to its greatest length, coil pipe 259 length overalls are approximately 8 feet.The user is extended coil pipe 259 between box 251 and patient this may be enough length.In a kind of structure, coil pipe 259 is stored on the box 251 with the form of the semi-cylindrical base 257 that is designed to prevent in box 251 shipment and during being installed in pump 220 move.One end of coil pipe 259 is fixed to reducer 281, and the other end is connected to Rule 269.During use, the clinician removes Rule 269 from T position base 271, Rule 269 is broken away from second Rule intermediate plate 297 with first Rule intermediate plate 274 be connected, and spurs and make coil pipe 259 to open until reaching the patient as required.Should be noted in the discussion above that it is minimum that pipe 259 interior stream is compared with flexible pipe 277,, and when beginning to purify, quicken removing of air so that the waste medicine that is retained in after it is used in the pipe fitting is minimum.

As Figure 24,27 and 29-31 shown in, T position pedestal 271 is designed to detachably catch Rule 269.T position pedestal 271 also comprises the built-in crossbeam 275 of deflection, and its contact Rule 269 when Rule 269 is fixed in the position causes crossbeam 275 deflections and is connected with optical sensor 226 on the operation room unit (PRU) 200 (in Figure 41-57 show).T position pedestal 271 further comprises as the open drip chamber 273 of catching and comprise the container that medicine overflows at pipe in the cleaning course.T position pedestal 271 has built-in wall, forms the base (as shown in figure 35) of band hypotenuse on box top 252.T position pedestal 271 has two built-in molded intermediate plates.First Rule intermediate plate 274 is connected Rule 269 securely with second Rule intermediate plate 297.T position pedestal 271 comprises thin pylon 278.Rule 269 is arranged on the top of T position pylon 278 with the angle that tilts, and excess drug is overflowed direct in the chamber 273.

Shown in Figure 27 and 29, drip chamber 273 is integration sections of T position pedestal 271, and it is the molding part of box mainboard 253 in an example.Drip chamber 273 is arranged on the middle section of box mainboard 253 usually.Drip chamber 273 is generally rectangle, and an one wall meets T position pylon 278, and its size is set to comprise the designated volume of total medicine bottle 250 (seeing Figure 22) capacity.Drip chamber 273 plays the effect of overflowing of preventing in the pencil overflow process, and plays the effect of catching any left drug after box uses.In a kind of variation, drip chamber 273 comprises absorption pad 273 ' to absorb the medicine of all discharges.

Shown in Figure 25-27 and 29-31, pick off crossbeam 275 parts as box mainboard 253 in T position are molded, and as cantilever beam, and the pivoting point of crossbeam 275 is based upon in the distally of the box 251 on the end face of T position pylon 278.In a kind of structure, the free suspended end of crossbeam 275 extends through the central longitudinal opening (as shown in figure 31) that box bottom surface 266 enters T position pedestal, is connected with built-in T position optical sensor 226 on being arranged on PRU200.The free suspended end 275 of crossbeam 275 generally is designed to " T " font.A point of " T " contacts with Rule 269.When Rule 269 is connected in the pedestal 271, crossbeam 275 deflections, and another T point blocks the light beam of built-in optical T position pick off 226.This is that PRU200 (showing in Figure 41-57) Rule 269 is in the position, and the medication tube cleaning can be performed.

Shown in Figure 26 and 27, Rule 269 can be bought from the market, and is known at medical domain.It is made by rigidity plastics.In a kind of structure, Rule 269 is "T"-shaped shape, and all three lower limbs of ' T ' all have the inner chamber that fluid is communicated with.A T lower limb connects coil pipe 259.Another T lower limb contains the needleless port that can be connected with IV Rule part.Last " T " lower limb has dismountable dust cover.

As Figure 26,28 and 32-34 shown in, nail pin base 262 has with angle slightly and is molded in band grooved area in the box mainboard 253, make when nail pin 261 is assembled in the mainboard 253, when box 251 is placed in the pump 220 of PRU200 (in Figure 41-57, showing) follow closely pin 261 vertical orientation substantially.When preventing on nail pin 261, the upright position of nail pin 261 helps medicine bottle 250 correct and be emptied completely.Nail pin base 262 has the upstanding wall that holds the nail pin wing 197.Nail pin base 262 bottoms comprise two upwardly extending guide pins 299 and two windows 292, help to aim at nail needle assembly 261.The middle section of nail pin base 262 has semi-cylindrical base 199 to hold air vent axle sleeve 177.Air vent sleeve base 199 generally forms ladder so that hollow spike pin 261 is remained in the position on circular contour.There is circular window in central authorities in nail pin base 262 bottoms, are used for inserting nail medicine administered by injection thing axle sleeve 185.In the centre of nail pin base 262 is the cut-out of nail pin pick off crossbeam 267 in a longitudinal direction, and it is smooth arcuate shape.Nail pin pick off crossbeam 267 is fixed on the nearside of nail pin base 262, and is cantilever beam.

Shown in Figure 29-34,267 (showing in Figure 30) of cantilever nail pin pick off crossbeam are the integration sections of box mainboard 253.Least significant end at nail pin crossbeam 267 is to follow closely pin fin 290 down, and it is set to link to each other with the optical bottle position sensor 228 that is arranged on PRU200 pump 220 (showing) in Figure 41.Last nail pin fin 288 is arranged on along second fin in the centre position of crossbeam 267, and orientates as with medicine bottle 250 and be connected when medicine bottle 250 prevents on nail pin 261.When nail pin 261 when correctly being assembled on the box mainboard 253, on follow closely pin fin 288 and extend through window 198 on the nail pin wing 297.In being in the position of the pump 220 on the PRU200, case assembly 251 (in Figure 41-57, shows) and medicine bottle 250 when preventing on nail pin 261, bottle graft touches nail pin fin 288 and causes the 267 abundant deflections of nail pin pick off crossbeam, causes that the optical bottle position sensor 288 on following closely pin fin 290 and be positioned at PRU down is connected.This correctly is in the position for PRU200 indication medicine bottle 250, the pencil cleaning can be performed, and make PRU200 pump 220 can conduct drugs to the patient.

As Figure 24,26 and 32-34 shown in, nail needle system 272 comprises nail pin medicated cap 263, nail pin 261 and nail pin elbow 265.Nail pin medicated cap 263 firecrackers protection clinician is not stabbed by nail needle point 296 because of carelessness.Nail pin medicated cap 263 is detachably connected on the top of nail needle point 296 by blocking mechanism.Nail pin elbow 265 detachable spirals connect (Rule locking) on medicine axle sleeve 185.Nail pin elbow 265 will be followed closely pin 261 and be connected safely on the box mainboard 253.The nail pin elbow that is not connected with medicine axle sleeve 185 spirals 265 allows nail pins 261 to be easy to pull down from box mainboard 253, and nail pin 261 can correctly be arranged in the sharp keen article container, total waste product volume is minimized, and saved disposal cost for the user.

Shown in Figure 32-34, nail pin 261 forms by rigid thermoplastic material is molded, and contains and two parallel substantially inner chambers of length of following closely pin 261.Nail pin 261 is generally cylindrical, has puncture tip 296 and as the nail pin wing 197 of pedestal of nail needle point 296.Nail pin 261 comprises nail pin agnail 184, and it can prevent that medicine bottle 250 is from following closely slippage on the needle point 296.Nail needle point 296 comprises first inclined-plane 186 and second inclined-plane 187.First inclined-plane 186 comprises the medicine opening that is communicated with pencil chamber 195 fluids.Equally, second inclined-plane 187 comprises the air bottle opening that is communicated with 196 inducing QIs of aerofluxus vestibule.During use, medicine bottle sealing member 42 keeps by 296 punctures of nail needle point and by nail pin agnail 184.

Shown in Figure 26 and 32-34, pencil chamber 195 fluid between nail needle point 296 and drug channel 294 is communicated with.Being medicine axle sleeve 185 outside the drug channel 294, is the helical 193 that is used for connected nail pin elbow 265 on the outside of medicine axle sleeve 185.Ventilation vestibule 194 is communicated with air vent passage 293 fluids.It outside the air vent passage 293 air vent axle sleeve 177.Ventilation vestibule 194 is used to compensate the air pressure in the medicine bottle 250, allows fluid to flow to the medicine pipe fitting through medicine tube chamber 195 from medicine bottle 250 by action of gravity.In a kind of structure, the air vent filter 295 (as shown in figure 26) that existence can be bought from the market, it is fastened in the air vent axle sleeve 177.In general, air vent filter 295 has cylinder form, on the one side fine mesh is arranged.Air vent filter 295 is permeable gas passages along either direction through air vent 293, comprises air, but has got rid of fluid and the solid material passage along the either direction of air vent passage 293.

Shown in Figure 26,28,32-40, nail pin 261 has the flat wing 197 pedestals, and it is designed to be generally trapezoidal plate, has level and smooth fillet.The support that the flat thin shape of the nail pin wing 197 makes things convenient for the user to handle and is formed for following closely pin medicated cap 263.Two nail pin windows 191 and nail pin pedestal window 292 mechanism that bottle centers consistent and that be used for following closely pin 261 and PRU200 aims at.In the time of on will following closely pin 261 insertion boxes 251, the nail pin is aimed at window 298 and is used for aligning and passes through to follow closely needle pin 299 combinations, aims on nail pin base 262 and follows closely pin 261.

Shown in Figure 32-40, nail pin 261 comprises the snap lock 189 on the nail pin wing 197 tops.Snap lock 189 is by the nail pin wing 197 whole formation.Snap lock 189 is locked 284 with the nail pin on being positioned at nail pin medicated cap 263 and is connected, and will follow closely pin medicated cap 263 and be limited on the nail pin 261.

Shown in Figure 24 and 32-40, the safety guard of nail needle system 272 is made and be to nail pin medicated cap 263 by rigid thermoplastic material.Nail pin medicated cap 263 comprises the covering 176 of hollow body, is used for covering nail needle point 296.Nail pin chamber 181 generally has rectangular shape, convenient nail pin medicated cap 263 assemblings on nail needle point 296.Nail pin medicated cap 263 comprises that medicated cap handle 182 is beneficial to the user and grips easily.Each side of medicated cap handle 182 is provided with clamper rib 178.Locking mechanism comprises nail pin lock 284 and integrated two support arms, the first arm 179 and second arm 180 that covers on 176 both sides that be molded in.Nail pin lock 284 have spring-like character and can deflection with cover 176 spool vertical.When nail pin medicated cap 263 was assembled on the nail needle point 296, lock 284 caused that by snap lock 189 deflections that are positioned on the nail pin 296 lip 183 is locked on the edge of snap lock 189.The first arm 179 and 180 anti-non-magnetic shim pin medicated cap 263 perks of second arm.Shown in Figure 24,26,28-31, box mainboard 253 comprises two lid connection ribs 38, with removing to be fastened and connected and be provided to box mainboard 253 between the medicated cap handle 182 of nail pin medicated cap 263.The brisk power that makes progress rapidly on the medicated cap handle 182 will cause that nail pin medicated cap 263 discharges from nail pin 261 and lid connection rib 38.

Shown in Figure 25 and 26, nail pin elbow 265 is made by rigid thermoplastic material, generally has cylinder form, has two openings that connected by internal fluid channels 264.An opening of fluid passage 264 is connected with pipe 277.Another opening of passage 264 be arranged on drug channel 294 fluids of nail in the pin 261 and be communicated with, allow medicine by action of gravity from the bottle of binding pin through medicament lumen 195, manage in 277 through also flowing to.Nail pin elbow 265 comprises the inner loop of being with helical, allows nail pin elbow 265 to removably connect and follows closely needle shaft cover 185 (seeing Figure 33).When nail pin 261 correctly was assembled on the box mainboard 253, nail pin elbow kept nail pin 261.

Drug delivery cassette 251 is that single patient uses (SPU) and manual load in operation room unit (PRU) the 200 pump kit platform 219 of (showing in Figure 41-57).Pump kit platform 219 has hinged door, is used to rely on peristaltic pump 220 to push box 251.Box 251 contains the intravenous pipe fitting that is connected with patient's conduit.

Operation room unit

A third aspect of the present invention relates to operation room unit 200 or its member or can be by the member of its use, and the embodiment of described operation room unit shows in Figure 41-57.First kind of performance of the embodiment of Figure 41-57 is drug conveying infusion pump assembly 220, comprises drug conveying infusion pump shell 239, drug delivery cassette component 251 (its embodiment has gone through in front and shown in Figure 24-40) and pump case door 201.Drug delivery cassette component 251 can be connected and have medicine bottle nail pin 261 (seeing Figure 32) with infusion pump shell 239.Pump case door 201 is connected with infusion pump shell 239, has the position of opening the door and close the door, and has medicine bottle and aim at and to refer to 44.Medicine bottle is aimed at and to be referred to that 44 are positioned at central authorities and aim at the medicine bottle 250 of different-diameter: when case assembly 251 is connected with infusion pump shell 239; When pump case door 201 is in the position of closing the door; And, aims at when combining with nail pin 261 between referring to 44 medicine bottle 250 when being inserted into medicine bottle.

In a kind of structure of first kind of performance of the embodiment of Figure 41-57, medicine bottle is aimed at and is referred to that 44 are positioned at central authorities and aim at ten and 20 cubic centimetres the medicine bottle 250 that has various outer diameter and have identical or different length.In a kind of variation, the finger 44 that is positioned at medicine bottle central authorities is made up of two elasticity concave surfaces and relative finger basically.In identical or different structure, the pump case door 201 rotatable infusion pump shells 239 that are connected to also can open the door and close the door and rotate between the position.Other structure and variation can be expected for a person skilled in the art.

In an example of first kind of performance of the embodiment of Figure 41-57, when pump case door 201 was in opening position, case assembly 251 can be with respect to 239 dismounting of infusion pump shell.In identical or different example, drug conveying infusion pump assembly 220 also comprises being arranged in the infusion pump shell 239 and having pump and refers to 229 drug conveying peristaltic pump 232.In this example, when case assembly 251 is connected with infusion pump shell 239 and pump case door 201 when being in opening position, case assembly 251 is operably connected to pump and refers to 229.

In a kind of application of first kind of performance of the embodiment of Figure 41-57, drug conveying infusion pump assembly 220 is parts of the operation room unit (PRU) 200 of calm induction system (SDS) 100 (the perhaps medical actuator system 100 ' of other type), and wherein SDS 100 (the perhaps medical actuator system 100 ' of other type) also has bed a side monitoring means (BMU) 300 and a umbilicus cable 160.In this was used, BMU300 had and is used for receiving first group of junction point of patient's input and second group of junction point of the patient parameter that is used to export from the patient-monitoring connector, and has the display screen that is used to show patient parameter.In this was used, PRU200 was used and is used for receiving patient parameter and having the display screen that is used to show patient parameter from BMU 300 in the medical operating process.In this was used, umbilicus cable 160 was used to from BMU 300 to PRU 200 transmission patient parameters.

Second kind of performance of the embodiment of Figure 41-57 is the combination of drug conveying infusion pump assembly 220 and drug delivery cassette component 251, comprises drug conveying infusion pump shell 239, drug delivery cassette component 251, pump case door 201 and pump case door lock 205/222.Case assembly 251 can be connected and have medicine bottle nail pin 261 with infusion pump shell 239, have Rule 269, and have the drug delivery cassette mainboard 253 that comprises position, Rule base portion 271.Rule 269 can be with respect to base portion 271 dismounting of position, Rule.Pump case door 201 is connected with infusion pump shell 239, and has and open the door and close the door the position.When case assembly 251 was connected with infusion pump shell 239, when Rule 269 was connected with position, Rule base portion 271, pump case door lock 205/222 was opened pump case door 201.

In a kind of implementation of second kind of performance of the embodiment of Figure 41-57, lock 205/222 comprises pump door lock 205 and is operably connected to the door lock solenoid 222 of pump door lock 205.Other implementation can be expected for a person skilled in the art.Should be noted in the discussion above that when Rule 269 turned back to position, Rule base portion 271 when medical operating finishes, pump case door 201 can be opened to remove case assembly 251.

The third performance of the embodiment of Figure 41-57 is calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprises capnometer 140 and 202 and barcode reading instrument assembly 455.Capnometer 140 and 202 is suitable for directly or receives breathing gas from the intubate 351 ' that can use at the facial disposable single patient of patient indirectly.Barcode reading instrument assembly 455 is suitable for reading the bar code of the packing that contains intubate 351 ' and/or the bar code of intubate 351 '.

The third performance of another of the embodiment of Figure 41-57 is calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprises drug conveying infusion pump shell 239 and barcode reading instrument assembly 455.Drug conveying infusion pump shell 239 is suitable for holding the drug delivery cassette component 251 that single patient uses.Barcode reading instrument assembly 455 is suitable for reading the bar code of the packing that contains drug delivery cassette component 251 and/or the bar code of drug delivery cassette component 251.

The embodiment of Figure 41-57 another the third the performance in, drug delivery cassette component 251 is suitable for holding the medicine bottle 250 of the single patient use that contains medicine (such as but not limited to downern), the bar code that barcode reading instrument assembly 455 is suitable for reading the bar code of medicine bottle 250 and/or contains the packing of medicine bottle 250.

In a kind of uses of the third performance of another the third performance of the embodiment of Figure 41-57 and another the third performance, operation room unit 200 uses barcode reading instrument 255 to prevent the repeatedly use of drug delivery cassette component 251, intubate 351 ' and medicine bottle 250 in single patient use article such as the operation room unit 200.In another kind used, operation room unit 200 used barcode reading instrument assembly 455 that the article that single patient uses are equipped with to particular patient.Other use can be expected for a person skilled in the art.

The 4th kind of performance of the embodiment of Figure 41-57 is calm induction system 100 (the perhaps calm induction system 100 ' of other type), comprise bed side monitoring means 300, based on the operation room unit 200 and the umbilicus cable 160 of microprocessor based on microprocessor.Bed side monitoring means 300 has the first group of junction point that is used for receiving from the patient-monitoring connector patient's input, and have second group of junction point, and has the display screen that is used to show at least a portion patient output according to the output patient output signal of the input signal that receives.The drug conveying that has operation room unit 200 Control Component 220 ' (the perhaps medical actuator 220 of other type ") that flows, and have the master controller 204 that has the memorizer that comprises patient-monitoring and medical actuator scheduler program (the perhaps patient-monitoring of other type and medical actuator scheduler program).Described program is operably connected to the program input according at least a portion patient output at least in part, and this program is controlled the drug conveying Control Component 220 ' (the perhaps medical actuator 220 of other type ") that flows according to program input control and/or suggestion user at least in part.Umbilicus cable 160 has with second group of junction point of bed side monitoring means 300 and is connected or attachable first end, and has and can be connected with operation room unit 200 or attachable second end.At least one of first and second ends of umbilicus cable 160 can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.Operation room unit 200 comprises network (Ethernet) and/or the modem connector 471/470 that is operably connected to master controller 204.

In a kind of setting of the 4th kind of performance of the embodiment of Figure 41-57, drug flow Control Component 220 ' comprises drug conveying infusion pump assembly 220, such as peristaltic pump component.In a kind of variation of this setting, medicine is transported to the patient through IV.Being provided with that another kind does not show, the drug conveying Control Component that flows comprises gaseous medication gas flow controller.In a kind of variation of this setting, gaseous medication is that oxygen and/or non-carrier of oxygen also are transported to the patient through cannula assembly.

In a kind of utilization of the 4th kind of performance of the embodiment of Figure 41-57, Ethernet and/or modem connector 471/470 are used for updating stored in the remote software of program of memorizer of the master controller 204 of operation room unit 200, such as patient-monitoring and medical actuator scheduler program (the perhaps patient-monitoring of other type and medical actuator scheduler program).Term " memorizer " comprises the memorizer of all master controllers 204, comprises the memorizer of the processor plate 452 of the memorizer of all system's input/output boards 451 and master controller in an example.In identical or different utilization, the master controller 204 use Ethernet of operation room unit 200 and/or modem connector 471/470 send to remote computer with patient data and are used for the date processing purpose.Other utilization can be expected for a person skilled in the art.In a kind of structure, operation room unit 200 only has Ethernet adapter 471, and does not have modem connector 470.In not isostructure, only there is modem interface 470, and do not have Ethernet interface 471.In the another kind structure, Ethernet and modem interface 471 and 470 all exist.In a kind of realization of the 4th kind of performance of the embodiment of Figure 41-57, operation room unit 200 comprises monitor display 442, is used to show the state of the mobile Control Component 220 ' of input of at least a portion program and drug conveying (the perhaps medical actuator 220 of other type ").

The 5th kind of performance of the embodiment of Figure 41-57 is calm induction system 100 (the perhaps calm induction system 100 ' of other type), comprise bed side monitoring means 300, based on the operation room unit 200 and the umbilicus cable 160 of microprocessor based on microprocessor.Bed side monitoring means 300 has the first group of junction point that is used for receiving from the patient-monitoring connector patient's input, and have second group of junction point, and has the display screen that is used to show at least a portion patient output according to the output patient output signal of the input signal that receives.The drug conveying that has operation room unit 200 Control Component 220 ' (the perhaps medical actuator 220 of other type ") that flows, and have the master controller 204 that has the memorizer that comprises patient-monitoring and medical actuator scheduler program (the perhaps patient-monitoring of other type and medical actuator scheduler program).Described program is operably connected to the program input according at least a portion patient output at least in part, and this program is controlled the drug conveying Control Component 220 ' (the perhaps medical actuator 220 of other type ") that flows according to program input control and/or suggestion user at least in part.Umbilicus cable 160 has with second group of junction point of bed side monitoring means 300 and is connected or attachable first end, and has and can be connected with operation room unit 200 or attachable second end.At least one of first and second ends of umbilicus cable 160 can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.The master controller 204 of operation room unit 200 comprises health level seven application protocols (Health Level Seven application protocol), is transferred to and/or from remote computer to send and/or to receive through the electronics mode.

In a kind of utilization of the 5th kind of performance of the embodiment of Figure 41-57, health level seven application protocols are used for economically patient data being sent to remote computer and are used for the date processing purpose.In identical or different utilization, health level seven application protocols are used for receiving economically the remote server (such as moving remote diagnosis procedures thereon) of operation room unit 200.Other application can be expected for a person skilled in the art.

The 6th kind of performance of the embodiment of Figure 41-57 is calm induction system 100 (the perhaps calm induction system 100 ' of other type), comprise bed side monitoring means 300, based on the operation room unit 200 and the umbilicus cable 160 of microprocessor based on microprocessor.Bed side monitoring means 300 has the first group of junction point that is used for receiving from the patient-monitoring connector patient's input, and have second group of junction point, and has the display screen that is used to show at least a portion patient output according to the output patient output signal of the input signal that receives.The drug conveying that has operation room unit 200 Control Component 220 ' (the perhaps medical actuator 220 of other type ") that flows, and have the master controller 204 that has the memorizer that comprises patient-monitoring and medical actuator scheduler program (the perhaps patient-monitoring of other type and medical actuator scheduler program).Described program is operably connected to the program input according at least a portion patient output at least in part, and this program is controlled the drug conveying Control Component 220 ' (the perhaps medical actuator 220 of other type ") that flows according to program input control and/or suggestion user at least in part.Umbilicus cable 160 has with second group of junction point of bed side monitoring means 300 and is connected or attachable first end, and has and can be connected with operation room unit 200 or attachable second end.At least one of first and second ends of umbilicus cable 160 can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.Operation room unit 200 comprises the printer 454 that is operably connected to master controller 204.

In a kind of utilization of the 6th kind of performance of the embodiment of Figure 41-57, printer 454 is used to set up the printing patient record that the patient carries out the effect of calm induction system 100 (the perhaps medical actuator system 100 ' of other type) during the medical operating.In an example of the 6th kind of expression of the embodiment of Figure 26-52, operation room unit 200 comprises operation room unit control station 444, the control station 444 drug conveying Control Component 220 ' (the perhaps medical actuator 220 ' of other type) that flows wherein, master controller 204 and printer 454.In a kind of structure, printer 454 is thermo printers.

The 7th kind of performance of the embodiment of Figure 41-57 is calm induction system 100 (the perhaps calm induction system 100 ' of other type), comprise bed side monitoring means 300, based on the operation room unit 200 and the umbilicus cable 160 of microprocessor based on microprocessor.Bed side monitoring means 300 has bed side monitoring means master controller 301 (the seeing Figure 62) that comprise first program.First program is carried out the following step: the patient sends requirement to non-sedating, requires to make non-sedating patient response; The patient responds received signal based on non-sedating; And according to the time difference of sending between requirement and the received signal patient is calculated the non-sedating response time at least in part.Operation room unit 200 has the operation room unit master controller 204 that contains second program.Second program is carried out the following step: will require to send to calm patient for calm patient's response by bed side monitoring means 300; Pass through bed side monitoring means 300 received signals based on calm patient's response; Calculate calm response time for calm patient, and the response time between non-sedating and the calm response time is poor.Umbilicus cable 160 has with second group of junction point of bed side monitoring means 300 and is connected or attachable first end, and has and can be connected with operation room unit 200 or attachable second end.At least one of first and second ends of umbilicus cable 160 can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.

In an example of the 7th kind of performance of the embodiment of Figure 41-57, operation room unit 200 has drug conveying infusion pump assembly 220.Drug conveying infusion pump assembly 220 is controlled according to the response time difference at least in part by operation room unit master controller 204.In identical or different example, calm induction system 100 comprises the cannula assembly 145 that can be arranged on patient's face and have breathing gas probe tube 354,352 and 355 (see figure 1)s.Breathing gas probe tube 354,352 and 355 (see figure 1)s can be connected to a side monitoring means 300.Operation room unit 200 comprises the capnometer 202 and 140 with capnometer output signal, and umbilicus cable 160 is operably connected to breathing gas probe tube 354,352 and 355 and capnometer 202 and 140.Drug conveying infusion pump assembly 220 to small part is controlled by the capnometer output signal.

In a kind of utilization of the 7th kind of performance of the embodiment of Figure 41-57, bed side monitoring means 300 uses audio frequency receiver 362 (see figure 1)s to provide extruding from dynamic response monitor (ARM) receiver (handpiece for example as the patient, it comprises the vibrator that also requires from patient's response in a kind of explain) requirement, to calculate patient's response time.This requirement is also sent by the bed side monitoring means 300 of operating room before being arranged in, to calculate the non-sedating response time.When the patient carried out calmness in operating room, this requirement was sent by operation room unit 200 (and process umbilicus cable 160 is transferred to a side monitoring means 300), to calculate the calm response time in the whole surgery.This requirement is also sent to propose the YES/NO problem by the bed side monitoring means 300 of back in the operating room, and multiple selection problem is inquired or other described prompting/answer interaction based on the response of time, and carries out patient's evaluation in conjunction with other monitoring parameter.An example can be that a basket/activity showed cognition and motor function before the patient leaves.Further example can be if monitoring level of response and warn suitable medical worker when not reaching a certain setting threshold in the suitable time period.

An example can be to utilize the ARM receiver 342 that replaces call button again.Operating room or back operating room before though the patient is in, long-time extruding or rapid extruding can be detected as the requirement for relief by BMU 300 on ARM receiver 342.BMU 300 writes down this requirement then, and it is recorded on the BMU GUI 212 (seeing Figure 60) and with suitable color or irradiation luminous 208 of flicker scheme (seeing Figure 60).

An example is to detect low breathing rate, apnea state or low SpO again ₂And these situations are conveyed to the patient.Audio request can take place in BMU 300, and such as by audio frequency receiver 362 " deep breathing " being sent to the patient, the instruction patient deeply breathes.If patient's breathing rate does not increase, this requirement can repeat by predetermined time interval.In addition, this requirement can the first nominal volume level be provided at first, and subsequent request provides with second volume level higher than described first volume level.If the patient does not respond to this requirement and breathes, alarm will be warned the nursing group of status of patient.When other condition guarantees that specific patient responds, can give the patient with the audio request of other similar type.

The 8th kind of performance of the embodiment of Figure 41-57 is calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprise operation room unit master controller 204, it contains the oxygen delivery program of carrying out the following step: from carry out abirritative patient received pulse blood oxygen measured signal and to small part according to the pulse oximetry calculated signals oxygen flow speed that receives, wherein the oxygen flow rate controlled calculated of operating room master controller 204 flow to patient's oxygen.

In the 8th kind of performance of the embodiment of Figure 41-57, the oxygen flow speed that arrives the patient is variable and at least in part according to the patient's blood oxygen level from the pulse blood oxygen amount signal that receives.It should be noted that term " oxygen " comprises the air that is rich in oxygen when describing the oxygen conveying.

First kind of extension of the 8th kind of performance of the embodiment of Figure 41-57 is calm induction system 100 (the perhaps calm induction system 100 ' of other type), comprise the calm induction system operation room unit of describing in the chart as the front 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprise a side monitoring means 300, and comprise umbilicus cable 160.Umbilicus cable 160 has and being connected or attachable first end of bed side monitoring means 300, and has and can be connected with operation room unit 200 or attachable second end.At least one of first and second ends of umbilicus cable 160 can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.When umbilicus cable 160 is connected with bed side monitoring means 300 with operation room unit 200, arrive operation room units 200 from patient's pulse blood oxygen amount signal through bed side monitoring means 300 and through umbilicus cable 160, flow through umbilicus cable 160 and bed side monitoring means 300 of Oxygen Flow arrives patients.

The 9th kind of performance of the embodiment of Figure 41-57 is medical science oxygen therapy apparatus, comprises oxygen therapy collector 206, the current limiter 489 of mouth of pipe fixed size and the current limiter 480 of mouth of pipe size variable with oxygen therapy stream., the oxygen therapy stream is connected to the flowing path outlet that is positioned at the disposable intubate 351 ' on patient's face but but comprising stream inlet and fluid that fluid is connected to the pressurised oxygen source of the gas.The current limiter 489 of mouth of pipe fixed size is arranged on the stream downstream of stream inlet, and the current limiter 480 of mouth of pipe size variable is arranged on the stream downstream of the current limiter 489 of mouth of pipe fixed size.

In an example of the 9th kind of performance of the embodiment of Figure 41-57, medical science oxygen therapy apparatus also is included in the high side pressure pick off 487 that the primary importance place between the current limiter 489 that is arranged on stream inlet and mouth of pipe fixed size is communicated with the stream fluid, and is arranged on entry position between the current limiter 489 of primary importance and mouth of pipe fixed size and locates and be arranged on exit position between mouth of pipe fixed size current limiter 489 and the mouth of pipe size variable current limiter 480 and locate the differential pressure pickup 479 that is communicated with the stream fluid.The mouth of pipe size of the current limiter 480 of mouth of pipe size variable is relevant with pressure reduction with mensuration pressure and be used to control flow velocity, and this is the common technology that those skilled in the art grasp.In identical or different example, mouth of pipe size variable current limiter 480 is mouth of pipe size variable solenoids.In one application, oxygen therapy collector 206 is sub-components of the operation room unit 200 of calm induction system 100 (the perhaps medical actuator system 100 ' of other type).

The tenth kind of performance of the embodiment of Figure 41-57 is calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprises the operation room unit master controller 204 that contains the oxygen therapy program.Described program is carried out the following step: when the patient is confirmed as through oral inhalation and aerofluxus, arrive at least one breathing gas delivery port pin 369 of the cannula assembly 145 that is operably connected to the patient with predetermined first rate control "/371 " oxygen delivery; When the patient is confirmed as being confirmed as when air-breathing through respiratory and as the patient, arrive at least one breathing gas conveying nose pin 422 '/422 of the cannula assembly 145 that is operably connected to the patient with predetermined second rate controlled " oxygen delivery; And be confirmed as through respiratory and when the patient is confirmed as exhaling as the patient, arrive at least one breathing gas conveying nose pin 422 '/422 of the cannula assembly 145 that is operably connected to the patient with predetermined third speed control " oxygen delivery.Second speed is greater than third speed.

In an example of the tenth kind of performance of the embodiment of Figure 41-57, when oxygen therapy speed was controlled to one of breathing gas delivery port or nose pin, oxygen always flow to all breathing gas delivery ports and nose pin when flow of oxygen.

In a kind of realization of the tenth kind of performance of the embodiment of Figure 41-57, the oxygen therapy program is also carried out and is measured the step of patient through nose or oral cavity breathing, and, if through respiratory nasal, also at least in part according to carrying out the step of determining that the patient sucks or breathes out from the nasal pressure reading of the sampling breathing gas that obtains by a breathing gas sampling nose pin 364 and 365 of cannula assembly 145 at least.

First kind of the tenth kind of performance of the embodiment of Figure 41-57 substitutes is medical actuator system 200 ' (such as calm induction system operation room unit 200 '), comprises the operation room unit master controller 204 that contains the oxygen therapy program.Described program is carried out the following step: when the patient is confirmed as through oral inhalation and aerofluxus, arrive at least one breathing gas delivery port pin 369 of the cannula assembly 145 that is operably connected to the patient with predetermined first rate control "/371 " oxygen delivery; When the patient is confirmed as being confirmed as when air-breathing through respiratory and as the patient, arrive at least one breathing gas conveying nose pin 422 '/422 of the cannula assembly 145 that is operably connected to the patient with second rate controlled that changes " oxygen delivery; And be confirmed as through respiratory and when the patient is confirmed as exhaling as the patient, arrive at least one breathing gas conveying nose pin 422 '/422 of the cannula assembly 145 that is operably connected to the patient with the third speed control that changes " oxygen delivery.The patient has the blood oxygen saturation percentage ratio of variation, and first, second depends on blood oxygen saturation percentage ratio with third speed.

In first kind of alternate a kind of realization of the tenth kind of performance of the embodiment of Figure 41-57, for the blood oxygen saturation percentage ratio that is higher than predetermined high percentage ratio, second speed is fixed low rate, and for the blood oxygen saturation percentage ratio that is lower than predetermined low percentage ratio, second speed is fixed low rate.In a kind of variation, along with blood oxygen saturation percentage ratio is reduced to predetermined low percentage ratio from predetermined high percentage ratio, second speed repeatedly arrives fixedly two-forty from fixing low rate increase.In one modification, for identical blood oxygen saturation percentage ratio, the second speed ratio third speed height.In one implementation, be zero at predetermined high percentage ratio place third speed.In identical or different implementation, the first rate corresponding with the oxygen-saturated particular percentile of blood is the arithmetic average with corresponding second and the third speed of the oxygen-saturated particular percentile of blood.In identical or different implementation, when blood oxygen saturation percentage ratio is higher than but when being not less than predetermined high percentage ratio, the oxygen therapy program is accepted the user and is imported and raise but never reduce than the fixing second high speed of low rate.In a kind of variation, when blood oxygen saturation percentage ratio is higher than but when being not less than predetermined high percentage ratio, the oxygen therapy program is accepted the user and is imported and raise but never reduce than the fixing high third speed of low rate.

In first kind of alternate example of the tenth kind of performance of the embodiment of Figure 41-57, for about 96% predetermined high percentage ratio, second speed is roughly 2 Liter Per Minutes, third speed is 0 Liter Per Minute, for about 84% predetermined low percentage ratio, second speed is roughly 15 Liter Per Minutes, and third speed is 2 Liter Per Minutes.In this example, when blood oxygen saturation percentage ratio substantially 88% between 96% the time, second speed is roughly 8 Liter Per Minutes, third speed is 2 Liter Per Minutes, when blood oxygen saturation percentage ratio substantially 84% between 88% the time, second speed is roughly 12 Liter Per Minutes, and third speed is 2 Liter Per Minutes.The advantage of this example and benefit comprise with oxygen therapy speed be based upon on the basis of patient's oxygen saturation level, provide higher oxygen therapy speed for having the oxygen-saturated patient of low blood, provide lower oxygen therapy speed for having the saturated patient of high oxygen pressure simultaneously.In this example, flow rate can be associated with main patient with nasal respiration.If mainly with mouth breathing (pressing signal to indicate by lacking nose), flow rate can be an arithmetic average air-breathing and that exhale to the patient for every kind of blood oxygen fragment.

Second kind of the tenth kind of performance of the embodiment of Figure 41-57 substitutes is medical actuator system 200 ' (such as calm induction system operation room unit 200 '), comprises the operation room unit master controller 204 that contains the oxygen therapy program.Described program is carried out the following step: when the patient is confirmed as being confirmed as when air-breathing through respiratory and as the patient, arrive at least one breathing gas conveying nose pin 422 '/422 of the cannula assembly 145 that is operably connected to the patient with the first rate control that changes " oxygen delivery; When the patient is confirmed as through respiratory and when the patient is confirmed as exhaling, arrive at least one breathing gas conveying nose pin 422 '/422 with the nostril oxygen therapy flow rate control of exhaling " oxygen delivery.The patient has the blood oxygen saturation percentage ratio of variation, and the air-breathing oxygen therapy flow rate in nostril is variable bit rate, and it depends on blood oxygen saturation percentage ratio.

In second kind of alternate a kind of realization of the tenth kind of performance of the embodiment of Figure 41-57, the air-breathing oxygen therapy flow rate in nostril is a variable bit rate, it depends on blood oxygen saturation percentage ratio, and speed is cured by oxygen therapy in the about nostril expiration of the air-breathing oxygen therapy speed in nostril for identical blood oxygen saturation percentage ratio.

The 11 kind of performance of the embodiment of Figure 41-57 is medical science oxygen therapy apparatus, comprises oxygen therapy collector 206.Oxygen therapy collector 206 has oxygen therapy stream and the oxygen sampling stream that can be connected with oxygen therapy stream fluid., the oxygen therapy stream is connected to the flowing path outlet that is positioned at the disposable intubate 351 ' on patient's face but but comprising stream inlet and fluid that fluid is connected to the pressurised oxygen source of the gas.Oxygen sampling stream comprises the oxygen sensor 482 that detects oxygen-depleted gas.

In an example of the 11 kind of performance of the embodiment of Figure 41-57, oxygen sample collector 481 is connected the oxygen stream of taking a sample with oxygen therapy stream fluid.In one implementation, the detection of 482 pairs of anoxias of oxygen sensor (hypoxia) gas is used to send user's warning to check source of oxygen.In a kind of utilization, oxygen therapy collector 206 is sub-components of the operation room unit 200 of calm induction system 100 (the perhaps medical actuator system 100 ' of other type).

The 12 kind of performance of the embodiment of Figure 41-57 is calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprises operation room unit master controller 204 and capnometer 140 and 202.Capnometer 140 and 202 has can be directly or receive capnometer gas input from the breathing gas of the intubate 351 ' that can disposable mode places patient's face indirectly.Capnometer 140 and 202 also has the capnometer signal output that is operably connected to operation room unit master controller 204.Operation room unit master controller 204 is at least in part according to the output of the capnometer signal of capnometer 140 and 202, sends that capnometer 140 is connected with 202 fluids and/or the user that do not have fluid to be connected to intubate 351 ' warns.

In the example of the 12 kind of performance of the embodiment of Figure 41-57, the capnometer input derives from the breathing gas of intubate 351 ' through bed side monitoring means 300 indirect receptions between two parties.Bed side monitoring means 300 can be connected and connect or can be connected to first end of umbilicus cable 160 with intubate 351 '.Umbilicus cable 160 have second end that connects or can be connected to operation room unit 200.At least one of first and second ends can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.Typically, in this example, the umbilicus cable 160 that is removed will be warned responsible for the most users from capnometer 140 and the 202 operation room unit master controllers 204 that are connected with intubate 351 ' fluid.In a kind of utilization, if capnometer (that is to say based on the rising and the decline of capnometer output, the rising and the reduction of the carbon dioxide levels of measuring by capnometer 140 and 202) effective breathing rate of indication patient, operation room unit master controller 204 determines that capnometers 140 are connected with intubate 351 ' fluid with 202.

The 13 kind of performance of the embodiment of Figure 41-57 is calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprises calm induction system operation room unit control station 444 (the perhaps operation room unit of medical actuator system control station 444 ' of other type) and capnometer sub-component 140/202 and 141/142 with control desk fan 456.Control desk fan 456 make air movement enter, through operation room unit control station 444 (perhaps 444 ') and from wherein discharging.Capnometer sub-component 140/202 and 141/142 has capnometer gas feed and capnometer gas outlet.Capnometer sub-component gas outlet is arranged to make gas can be entrained with the air that control desk fan 456 removes and leaves capnometer sub-component gas outlet.

In the example of the 13 kind of performance of the embodiment of Figure 41-57, capnometer sub-component 140/202 and 141/142 has capnometer 140 and 202 and the capnometer pump 141 and 142 that operationally is connected with 202 with capnometer 140.In a kind of structure of this example, gas flows to capnometer from the gas feed of capnometer sub-component, flows to the capnometer pump and flows to capnometer sub-component gas outlet.In the another kind structure of this example, gas flows to the capnometer pump from the gas feed of capnometer sub-component, flows to capnometer and flows to capnometer sub-component gas outlet.Make gas be that by the benefit that fan is discharged to the outside described exit gas is littler to the possibility of pollution of capnometer calibration from capnometer sub-component gas outlet.In a kind of the setting, calibration gas and control desk fan air are sucked into the front of control station and discharge from the control station back.

A kind of extension of the 13 kind of performance of the embodiment of Figure 41-57 is calm induction system 100 (the perhaps calm induction system 100 ' of other type), comprise the calm induction system operation room unit of describing in the chart as the front 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprise a side monitoring means 300, and comprise umbilicus cable 160.Umbilicus cable 160 has and being connected or attachable first end of bed side monitoring means 300, and has and can be connected with operation room unit 200 or attachable second end.At least one of first and second ends of umbilicus cable 160 can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.

The 14 kind of performance of the embodiment of Figure 41-57 is calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprise operation room unit master controller 204, capnometer 140 and 202, oxygen collector 206 and downside pressure sensor 488.Capnometer 140 and 202 has can be directly or receive capnometer gas input from the breathing gas of the intubate 351 ' that can disposable mode be positioned at patient's face indirectly, also has the capnometer signal output that is operably connected to operation room unit master controller 204.Oxygen collector 206 has the oxygen therapy stream, but comprises the stream inlet that is connected to the pressurised oxygen source of the gas with series connection form fluid, but current limiter 489 and 480 and fluid be connected to the flowing path outlet of intubate 351 '.Downside pressure sensor 488 is communicated with the flowing path outlet fluid, is arranged on the downstream of any oxygen collector current limiter 489 and 480, and has the low side pressure signal output that is operably connected to operation room unit master controller 204.Operation room unit master controller 204 is at least in part according to the low side pressure signal output of output of the capnometer signal of capnometer 140 and 202 and downside pressure sensor 488, sends that capnometer 140 is connected with 202 fluids and/or the user that do not have fluid to be connected to intubate 351 ' warns.

In the example of the 14 kind of performance of the embodiment of Figure 41-57, the capnometer input derives from the breathing gas of intubate 351 ' through bed side monitoring means 300 indirect receptions between two parties, described bed side monitoring means 300 can be connected and connect or can be connected to first end of umbilicus cable 160 with intubate 351 ', and described umbilicus cable 160 has second end that connects or can be connected to operation room unit 200.The flowing path outlet of oxygen collector 206 is connected to intubate 351 ' by bed side monitoring means 300 and umbilicus cable 160 indirect fluids.At least one of first and second ends can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.

The 15 kind of performance of the embodiment of Figure 41-57 is calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprise operation room unit master controller 204, capnometer 140 and 202 and capnometer pump 141 and 142.Capnometer 140 and 202 has can be directly or receive capnometer gas input from the breathing gas of the intubate 351 ' that can disposable mode places patient's face indirectly.Capnometer 140 and 202 also has the capnometer signal output that is operably connected to operation room unit master controller 204.Capnometer 140 and 202 operationally with capnometer 140 and 202 and by operation room unit master controller 204 control.According to the capnometer signal output of capnometer 140 and 202, decision capnometer 140 is connected with 202 fluids and/or does not have fluid to be connected to intubate 351 ' operation room unit master controller 204 at least in part.When capnometer 140 and 202 not is not connected with intubate 351 ' fluid, operation room unit master controller 204 time delays or the not free cut- out capnometer pump 141 and 142 that postpones.In a kind of utilization, during the time period that intubate is not used, capnometer pump 141 and 142 close and avoid during the described time period airborne pollutant, impurity etc. to pollute capnometers 140 and 202.

In the example of the 15 kind of performance of the embodiment of Figure 41-57, the capnometer input derives from the breathing gas of intubate 351 ' through bed side monitoring means 300 indirect receptions between two parties.Bed side monitoring means 300 can be connected and connect or can be connected to first end of umbilicus cable 160 with intubate 351 '.Umbilicus cable 160 has second end that connects or can be connected to operation room unit 200.At least one of first and second ends can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.

The 16 kind of performance of the embodiment of Figure 41-57 is calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprise operation room unit master controller 204, capnometer 140 and 202 atmosphere pressure sensors 46.Capnometer 140 and 202 has can be directly or receive capnometer gas input from the breathing gas of the intubate 351 ' that can disposable mode places patient's face indirectly.Capnometer 140 and 202 also has the capnometer signal output that is operably connected to operation room unit master controller 204.Atmosphere pressure sensor 46 has the atmosphere pressure sensor signal output that is operably connected to operation room unit master controller 204.Operation room unit master controller 204 uses the atmosphere pressure sensor signal output of atmosphere pressure sensor 46 at least to determine whether calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type) has moved to the reposition with difference in height bigger than predetermined height difference.When calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type) when having moved to the reposition of the reposition with difference in height bigger than predetermined height difference, operation room unit master controller 204 sends capnometer calibration user warning.

In the example of the 16 kind of performance of the embodiment of Figure 41-57, the capnometer input derives from the breathing gas of intubate 351 ' through bed side monitoring means 300 indirect receptions between two parties.Bed side monitoring means 300 can be connected and connect or can be connected to first end of umbilicus cable 160 with intubate 351 '.Umbilicus cable 160 has second end that connects or can be connected to operation room unit 200.At least one of first and second ends can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.

The 17 kind of performance of the embodiment of Figure 41-57 is calm induction system operation room unit 200 (the perhaps operation room unit of medical actuator system 200 ' of other type), comprises operation room unit master controller 204 and oxygen collector 206.Intubate 351 ' can be arranged on patient's face and have the breathing gas sample output that is operably connected to operation room unit master controller 204.Oxygen collector 206 has the flowing path outlet that can be connected with intubate 351 ' fluid, and has the mouth of pipe size variable current limiter 480 that is operably connected to and is arranged on the flowing path outlet upstream.Operation room unit master controller 204 uses the time of intubate 351 breathings of setting at least for the first time based on the definite patient of breathing gas sample output of intubate 351 ', and opens mouth of pipe size variable current limiter 480 when the patient is determined the intubate 351 ' breathing that the first time, use was provided with.

In a kind of realization of the 17 kind of performance of the embodiment of Figure 41-57, the breathing gas sample output of intubate 351 ' is operably connected to operation room unit master controller 204 through pressure transducer (pressing transducer 47 such as nose) and/or through capnometer 140 and 202.In identical or different realization, mouth of pipe size variable current limiter 480 is solenoids of mouth of pipe size variable.

In a kind of application of any above-mentioned performance of the embodiment of Figure 41-57, comprise its example etc., operation room unit 200 can be directly connected to a side monitoring means 300.Other application can be expected for a person skilled in the art.

As skilled in the art to understand, in any or multiple above-mentioned performance of the embodiment of Figure 41-57, comprise that its example etc. can comprise that its example etc. combines with any or multiple above-mentioned performance of the embodiment of Figure 41-57.

In alternate embodiments, shown in Figure 58, operation room unit 50 comprises energy delivery medical actuator 52.The performance of the embodiment of Figure 58 is a medical actuator system 54, comprises the microprocessor based on bed side monitoring means 56, based on the microprocessor and the umbilicus cable 58 of operation room unit 50.Bed side monitoring means 56 has the first group of junction point 60 that is used for receiving from the patient-monitoring connector patient's input, and have second group of junction point 62, and has the display screen 64 that is used to show at least a portion patient output according to the output patient output signal of the input signal that receives.Operation room unit 50 has energy delivery medical actuator 52, and has a master controller 66 that has the memorizer that comprises patient-monitoring and medical actuator scheduler program, described medical actuator scheduler program is operably connected to the program input according at least a portion patient output at least in part, and this program is at least in part according to program input control and/or suggestion user energy delivery medical actuator 52.Umbilicus cable 58 has with second group of junction point of bed side monitoring means 56 and is connected or attachable first end, and has and can be connected with operation room unit 50 or attachable second end.At least one of first and second ends can be pulled down from corresponding bed side monitoring means 56 or operation room unit 50.In an example, energy delivery medical actuator 52 comprises that at least one is suitable for that the time variation magnetic field is transported to the patient and makes the patient have the magnetic flux generator 68 of sedation effect.In a kind of variation, at least one magnetic flux generator 68 comprises coil 70.

Figure 59 has shown the embodiment of medical actuator subsystem 306.First kind of performance of the embodiment of Figure 59 is medical actuator subsystem 306, comprises drug delivery pipe 308, pressure transducer 324 and memorizer 326.The medicine 328 that drug delivery pipe 308 is suitable for having the controlled variable flow velocity is included in wherein and it is disposable, so that conduct drugs to patient 336.Pressure transducer 324 has output signal 338 and is suitable for the internal pressure of perception drug delivery pipe 308.Memorizer 326 comprises the obstruction program, and it is operably connected to the output signal 338 of pressure transducer 324 when operation on processor 344.The obstruction program has the variable pressure warning value of setting, and the user of the drug delivery pipe 308 that warning is blocked when the output signal 338 of pressure transducer 324 surpasses the variable pressure warning value of setting.The obstruction program directly or indirectly changes the variable pressure warning value of setting according to the controlled variable flow velocity of medicine 328 at least in part.

Term " obstruction " comprises partial blockage and total blockage.The cause of blocking drug delivery pipe 308 includes but not limited to: bending, distortion, extruding and/or chock tube.In a kind of operation of first kind of performance of the embodiment of Figure 59, medicine 328 is the medicines that pump into, and it pumps into the controlled variable flow velocity.In this operation, when drug delivery pipe 308 got clogged, the contact of medicine 328 pumped into the internal pressure that has increased drug delivery pipe 308.Should be noted in the discussion above that as understood by one of ordinary skill in the art, is that indirect controlled variable flow velocity based on medicine changes the variable pressure warning value of setting based on appointment or the actual pump speed change variable pressure warning value of setting.In a kind of the setting, because the increase medicament flow rate has increased the internal pressure of the pipe that does not have obstruction, the variable pressure warning value of setting always is set to the non-sealed tube internal pressure that is higher than (being scheduled volume in an example) corresponding with existing given flow rate (perhaps corresponding with existing appointment or actual pump speed).

In a kind of executive mode of first kind of performance of the embodiment of Figure 59, when the controlled variable flow velocity is lower than predetermined value, the obstruction program is set at fixing low the setting with the variable pressure warning value of setting, when the controlled variable flow velocity equaled or is higher than predetermined value, the obstruction program was set at fixing high the setting with the variable pressure warning value of setting.In different executive modes, no matter whenever the controlled variable flow velocity changes, and the obstruction program all changes the variable pressure warning value of setting.Other executive mode can be expected for a person skilled in the art.

In a kind of realization of first kind of performance of the embodiment of Figure 59, drug delivery pipe 308 is drug delivery pipes.In the difference that does not show realized, drug delivery pipe was a pneumatic tube, and its Chinese medicine is a gaseous medication.As previously mentioned, oxygen (that is to say, be rich in the air of oxygen) is the example of nonrestrictive gaseous medication.

In a kind of structure of first kind of performance of the embodiment of Figure 59, pressure transducer 324 comprises pressure-sensitive importation 346, and drug delivery pipe 308 has atresia lateral surface part 348.In this structure, the importation 346 of pressure transducer 324 is configured to contact with the atresia lateral surface part 348 of drug delivery pipe 308.Other pressure transducer and/or drug delivery pipe type and structure can be expected for a person skilled in the art, include but not limited to the pressure transducer input that is communicated with the medicinal fluid of drug delivery pipe inside.

In a kind of realization of first kind of performance of the embodiment of Figure 59, memorizer 326 and processor 344 are members of the master controller of operation room unit (master controller 204 of for example aforementioned operation room unit 200).In a kind of variation, memorizer 326 also comprises the drug conveying algorithm, and for example above-mentioned dosage control device (Dosage Controller) is algorithm (DC), and it measures the controlled variable flow velocity when operation on processor 344.In one modification, the controlled variable flow velocity comprises zero flow velocity, fixedly keeps flow velocity and higher fixed pellets flow velocity.Other is revised, changes and realizes can expecting for a person skilled in the art.

In a kind of application of first kind of performance of the embodiment of Figure 59, medical actuator sub-component 306 also comprises the infusion pump 350 that is suitable for accepting the controlled variable flow velocity.Infusion pump 350 has peristaltic pump and refers to 372.Peristaltic pump refers to that 372 are configured to interact with drug delivery pipe 308, and controlled being made as pumps into medicine 328 under the controlled variable flow velocity.

Second kind of performance of the embodiment of Figure 59 is medical actuator subsystem 306, comprises drug delivery pipe 308, pressure transducer 324 and memorizer 326.The medicine 328 that drug delivery pipe 308 is suitable for having the controlled variable flow velocity is included in wherein, and is disposable, giving patient 336 with drug conveying, and comprises atresia lateral surface part 348.Pressure transducer 324 has output signal 338 and comprises and be arranged to the pressure-sensitive importation 346 that contacts with the atresia lateral surface part 348 of drug delivery pipe 308.Memorizer 326 comprises the obstruction program, and it is operably connected to the output signal 338 of pressure transducer 324 when operation on processor 344.The obstruction program has the variable pressure warning value of setting, and the user of the drug delivery pipe 308 that warning is blocked when the output signal 338 of pressure transducer 324 surpasses the variable pressure warning value of setting.The obstruction program directly or indirectly changes the variable pressure warning value of setting according to the controlled variable flow velocity of medicine 328 at least in part.

The third performance of the embodiment of Figure 59 is a medical actuator subsystem 306, comprises drug delivery pipe 308, pressure transducer 324 and blocks alarm unit 380.The medicine 328 that drug delivery pipe 308 is suitable for having the controlled variable flow velocity is included in wherein, and it is disposable, so that conduct drugs to patient 336.Pressure transducer 324 has output signal 338 and is suitable for the internal pressure of perception drug delivery pipe 308.Blocking alarm unit 380 is operably connected with the output signal 338 of pressure transducer 324, and has the variable pressure warning value of setting, the user of warning obstruction drug delivery pipe 308 when the output signal 338 of pressure transducer 324 surpasses the variable pressure warning value of setting.Block alarm unit 380 to the direct or indirect controlled variable flow velocity of small part and change the variable pressure warning value of setting based on medicine 328.In an example, block alarm unit 380 and comprise previously described operation room unit master controller (all master controllers as described above 204) memorizer 326 and processor 344, and (such as operation room unit monitor 441, as shown in figure 48) pop-up window on is warned the user to pass through monitor.In the example that another kind does not show, block the processor that alarm unit does not relate to the operation room unit master controller.

The 4th kind of performance of the embodiment of Figure 59 is drug conveying infusion pump subsystem 382, comprises that drug delivery pipe 308, peristaltic pump refer to 372, pressure transducer 324 and block alarm unit 380.The medicine 328 that drug delivery pipe 308 is suitable for having the controlled variable flow velocity is included in wherein, and it is disposable, so that conduct drugs to patient 336.Peristaltic pump refer to 372 be configured to interact with drug delivery pipe 308 and can controlled flow speed control to the pumping of medicine 328.Pressure transducer 324 has output signal 338 and is suitable for the internal pressure that the perception peristaltic pump refers to the drug delivery pipe 308 in 372 downstreams.Blocking alarm unit 380 is operably connected with the output signal 338 of pressure transducer 324, and has the variable pressure warning value of setting, the user of warning obstruction drug delivery pipe 308 when the output signal 338 of pressure transducer 324 surpasses the variable pressure warning value of setting.Block alarm unit 380 and fully directly change the variable pressure warning value of setting based on the controlled variable flow velocity of medicine.

In a kind of executive mode of the 4th kind of performance of the embodiment of Figure 59, drug delivery pipe 308, peristaltic pump refer to 372, pressure transducer 324 and to block alarm unit 380 are members of the operation room unit of medical actuator system (operation room unit 200 of all medical actuator systems 100 ' as described above).In an example of the 4th kind of performance of the embodiment of Figure 59, block alarm unit 380 and comprise previously described operation room unit master controller (all master controllers as described above 204) memorizer 326 and processor 344, and (such as operation room unit monitor 441, as shown in figure 48) pop-up window on is warned the user to pass through monitor.In the example that another kind does not show, block the processor that alarm unit does not relate to the operation room unit master controller, and under the situation that lacks aforementioned operation room unit 200 independent operation.

Executive mode, utilization and the structure etc. of first kind of performance that it should be noted that the embodiment of Figure 59 all can be equal in second to the 4th kind of performance of the embodiment that is applicable to Figure 59 any one or a plurality of or whole.In an example of all performances of the embodiment of any one or more or whole Figure 59, the patient 336 who accepts medicine 328 can change better and control by having the blockage pressure value of setting of reporting to the police based on the controlled variable flow velocity of medicine 328.Better control be implemented be because, for the given flow rate of medicine, compare with using traditional fixing higher blockage pressure value of setting of reporting to the police, response time and any pill of obstruction made up and will be minimized.It is also to be noted that, described traditional warning value of setting must be higher than the highest actual flow velocity of corresponding medicine (it is used at least), because the internal pressure of not blocking drug delivery pipe is along with the actual flow velocity of medicine increases and increases, as understood by one of ordinary skill in the art.It should also be noted that, described high conventional fixed warning value of setting can be more permanent for low controlled flow velocity, so that produce enough internal pressures in blocking drug delivery pipe, causes to block and report to the police, and in case described high internal pressure is released, the bolus of medicine will be delivered to the patient simultaneously.

Following chart has been showed a kind of detailed description of specific implementation of the embodiment of Figure 41-57.Should be noted in the discussion above that any part of this specific implementation can join in the aforementioned performance of the embodiment of Figure 41-57 (comprising its example etc.) any one.In this was realized, PRU 200 was the main interfaces between the nursing Team Member of SDS 100 and responsible administration.PRU200 is provided in the operating room and uses.PRU 200 connects BMU 300 by umbilicus cable 160.PRU 200 is by BMU 300 and the nose capnometer module 140 and the input of mouthful capnometer module 202 acceptance from all physiological signals that are positioned among the PRU 200.PRU 200 accepts user's input parameter, such as patient data, drug dose rate index and alarm trigger setting.PRU 200 handles these physiological signals and user's input parameter; Show the derivative of physiological signal, these signals and be used for the relevant alarm condition that the user observes; And according to the algorithm execution drug conveying and the oxygen stoichiometry that drive by these signals.

Dosage control device (DC) is by the drug conveying algorithm of PRU 200 utilizations and is the enhancing of close rate control (DRC).Described enhancing comprises the algorithm ability of calculating suitable loading dosage based on the drug labelling criterion.For given maintenance speed, DC calculates suitable loading dosage, allows the rapid realization of sedation effect when medical operating begins.

PRU 200 comprises the interactive software that is become the monitoring shell, and its monitoring also shows status of patient and makes the decision of arranging about status of patient and consequent drug conveying.The monitoring shell utilizes algorithm to quantize status of patient, controls rate of drug delivery and oxygen therapy speed, and shows the alarm to the user.The monitoring shell utilizes the broad array of input parameter, comprises DC data, patient physiological Monitoring Data, patient's physical data and alarm trigger setting.Condition is corrected subsequently if described unfavorable patient is calm, and the monitoring shell reduces or stop drug conveying in the warning user.According to pharmacology's principle of using, the drug dose rate is based on user's input parameter, such as recommended dose rate and weight in patients, and based on the decision of software.Oxygen transfer rate is based on user's input parameter and patient physiological Monitoring Data, such as oxygen saturation level.

PRU 200 shows in conjunction with the intuition display screen that is called as PRU graphic user interface (PRU GUI) 210.PRU GUI 210 shows status of patient according to physiological parameter and warning/warning; It also shows the functional situation of internal sensor and operating data.PRU GUI 210 also provides simple intuitive manner for user's input parameter such as patient data, drug dose rate and alarm trigger level.The part of PRU GUI 210 is a PRU function warning box 249, allows the user by green, the yellow and red general situation of concluding the patient rapidly.PRU function warning box 249 utilizes algorithm computation and shows the rough extensively patient's states of definition.

Except DC, monitoring shell and PRU GUI 210, PRU 200 is in conjunction with the operation of other software-driven.These operations comprise monitoring function and facilitating functions.Facilitating functions comprises rising automatically annotates (auto-prime), and it provides automatic infusion tube 224 notes when the medicine bottle 250 of box 251 has been installed among the PRU 200.The infusion tube that comprises monitoring function plays the notes interlocking, and it allows 224 notes of infusion tube when Rule 269, T position is connected with the T position base portion 271 of box 261.Monitoring function also comprises when being connected to patient delivering oxygen and carry medicine when PRU identification that box 251 is not utilized in PRU as the front.

PRU 200 comprises not brief power supply supply (UPS) 214, PRU control station 444 and PRU monitor 441.These article are stacked so that describe and rest on the SDS cart balance 101 usually or on user's oneself the palm.

UPS 214 changes into low-voltage power with AC wall plug receptacle electric power, the electric energy that provides all to be utilized by PRU control station 444.The major part that is fed into the UPS 214 of PRU control station 444 is utilized by PRU control station 444, and dump power is fed into PRU monitor 441 and BMU 300 through PRU control station 444 simultaneously.UPS 214 also has the standby subsystem of rechargeable battery, and it is utilized as the interim power supply that is called automatically by UPS 214 when existing interruption of AC wall plug power supply rather than process ac power cable to provide.UPS 214 also connects for PRU control station 444 provides ground connection electrical ground.There is means of communication between UPS 214 and the PRU control station 444, transmits the information of the battery condition of relevant power condition and correlated parts.The low-tension supply line that electric power, communication and ground connection are connected by being called as UPS output cable 490 is transferred to PRU control station 444, thereby described cable and UPS 214 integrate and make the UPS output cable adapter 491 that is arranged on these UPS 214 output cables 490 ends be inserted into PRU control station 444.

UPS 214 comprises outer ac power cable, general AC/DC power module 501, and UPS electric power is handled circuit board 502 and UPS rechargeable battery pack 503.UPS 214 has the on/off switch 504 that is arranged on outside the UPS, shows the UPS power condition indicator 505 of power condition and the UPS battery status indicator 506 of pilot cell charge condition.

UPS 214 also comprises the cooling fan 507 that is arranged on UPS cabinet 508 back.Seat ring 509 is connected to UPS cabinet 508 and UPS top cover 473, UPS top E-PAC before ornamental ^TM474 and bottom E-PAC ^TMThe 475th, play the protection all UPS internals effects foaming structure.

UPS 214 comprises circuit, allows in flow of electrical power UPS output cable adapter 491 to be removed from PRU control station 444, helps prevent simultaneously to electrically contact igniting or to the excessive electric stress of adapter.UPS output cable adapter 491 also comprises guarantees that ground connection connects the parts that contact is first contact made in-PRU the connection procedure at UPS-, and is at the parts that disconnect the last contact of opening during connecting.

PRU monitor 441 arrives PRU 200 in conjunction with colored PRU monitor display 442, PRU monitor touch screen 443 user cross sections and PRU monitor speaker 458 and 459 for the user provides the interface.PRU monitor 441 is placed in PRU control station 444 tops.PRU monitor 441 provides electric power to be connected with ground connection by PRU control station 444.Video and audio signal is also provided by PRU control station 444.PRU monitor 441 sends PRU monitor touch screen 443 signals to PRU control station 444.

PRU monitor 441 is electrically connected with PRU control station 444 by the PRU monitor cable that is inserted into PRU control station 444 rear portions.This cable provides means of delivery for electric power, ground connection connection, video, audio frequency and PRU monitor touch screen 443 signals.PRU monitor cable connector 463 also comprises guarantees that ground connection connection contact is first parts of being made in the connection procedure that contact, and is the parts that disconnect the last contact of opening during the connection.

PRU control station 444 is that the central authorities of SDS 100 are calculated and the processing controls source.PRU control station 444 also contains specific function, comprises medication infusion; Patient's carbon dioxide analysis of being undertaken by capnometer; Auxiliary oxygen flow control; The bar code of box 251, the mouth/nasal intubation 145 and medicine bottle 250 bar code labels that are arranged on article or its packing are read; The patient data hard copy printout; With, in SDS 100, communicate by letter; With communicating by letter and electric power control/management of external source.

PRU control station 444 comprises PRU power management plate 453, pru processor plate 452, system I/O plate 451, barcode reading instrument assembly 455.PRU printer 454, IV (intravenous) pump module 220, oxygen collector 206, control knob and illumination indicator, external user connector and PRU control desk fan 456.All these article all are enclosed in the single casing screen board.The pru processor plate 452 and the I/O of the system plate 451 that link together with the flexible circuit bunch are called as PRU master controller 204.

PRU electrical management plate 453 is accepted UPS 214 electric power and is entered PRU control station 444 and convert it into some low pressure regulation and control outputs, is used by PRU 200 and BMU 300.In an example, these adjustment signals comprise 5V (volt), 12V and 15V.

Pru processor plate 452 provides the basic calculating source for SDS 100, and is one of basic calculating source that is used for the signal I/O.The main body of SDS 100 softwares comprises DC and monitoring shell, is retained in the nonvolatile memory that is arranged on the pru processor plate 452.Pru processor plate 452 comprises CPU (CPU), RAM memorizer, chip disk (disc-on-chip) memorizer and digital I/O, Simulation with I/O, video and voicefrequency circuit sorting.

The flexible circuit bunch provides interconnecting between about 100 kinds of signal input/output lines of pru processor plate 452 and the I/O of the system plate 451.It comprises the flexible printed circuit board of the multidimensional that contains about 10 adapters.

System I/O plate 451 is multifunction circuit boards, it is integrated and handle from the signal that is arranged on the most circuit in the PRU control station 444, comprise pru processor plate 452, IV pump module 220, PRU printer 454, barcode reading instrument module 455, and the difference of 451 function circuits on one's body of the I/O of system plate.It also handles the signal that relates to other source outside the PRU control station 444, such as the signal from UPS 214, BMU 300 and PRU monitor 441.

System I/O plate 451 has and resides in originally on one's body circuit of plate.System I/O plate 451 also comprises installation module onboard, such as nose capnometer module 140 and mouthful capnometer module 202 and flash memory module 466.

The most I/O of system plate 451 functional circuits are described in following chart.

Flash memory module 466 is that removable user is come-at-able, and in order to revise the software that is used for system's operation, it provides upgrading SDS 100 internal memories.

Have nose capnometer module 140 and mouthful capnometer module 202, they are installed on the I/Q of the system plate 451 and become its part.Nose capnometer module 140 monitoring patients' combination nose is exhaled.Mouth capnometer module 202 monitoring patients' mouth is exhaled.Each capnometer module 140 and 202 all comprises the suction pump control circuit, control and the 451 independent suction pumps that are provided with controlled sample flow rate attraction patient sample of the I/Q of system plate.Each capnometer module 140 and 202 all comprises monitors sample cell pressure is also managed atmospheric pressure compensation CO 2 measuring per sample with the working sample pipe choking sample cell pressure transducer.Two capnometer modules 140 and 202 all have their software, and automatic calibration is provided when needs, communicate by letter with PRU master controller 204 and have other function.Have the first and second capnometer I/Q circuit, they remain on the I/Q of the system plate 451 and as each capnometer module 140 and 202 and pru processor plate 452 between the interface.A function of this circuit is to require control to arrive the electric power of the motor of capnometer module 140 and 202 electrical equipments and capnometer pump 141 and 142 according to pru processor plate 452.

Built-up circuit is arranged on the I/Q of the system plate 451 and the electric power that is applied to PRU umbilicus cable electrical socket 461 control is provided fast.This circuit helps prevent because sparking that other charged socket of connection/disconnection causes and disconnection supply to the umbilicus cable 160 adapter pins that may expose in the disconnection process electric power.

BMU status circuit 600 similar status circuit collaborative works among PRU status circuit 510 and the BMU 300, thus two status circuits 510 and 600 all pass through notochord 160 means of communication interactions.PRU status circuit 510 in the PRU control station 444 provides instrument for PRU control station 444 so that know whether umbilicus cable 160 is inserted among the BMU 300 and whether BMU 300 is supplied to energy or is cut off.This status information is utilized by PRU control station 444.For example, if if PRU 200 disconnects and BMU 300 connects, then BMU300 is connected to PRU 200 and PRU 200 connects himself automatically through umbilicus cable 160.It is the communication warning that prevents that umbilicus cable 160 is relevant with the purpose disconnection of umbilicus cable 160 that the another kind of state condition uses.Another task of state condition among the PRU 200 is to help control so that the exposure pin of the umbilicus cable 160 that helps to avoid electric power to be applied to and be not inserted into when electric power is applied to PRU umbilicus cable electrical socket 461.

IV pump control circuit power is according to controlling IV pump module 220 from pru processor plate 452 with from the various requirement of interlock such as monitoring control devices module 467 circuit.Also being included in this circuit is to stop medicine button 497, and it forces the electric power that supplies to IV pump module 220 to be cut off and the situation of this button is communicated by letter with pru processor plate 452.Also being included in this circuit is pump door button 496, and its situation with this button is communicated by letter with pru processor plate 452 and assisted the door lock solenoid 222 of control non-locking pump door 201.Another function of this circuit is that the signal(l)ing condition with IV pump motor encoder is transferred to pru processor plate 452.

PRU power button circuit monitoring is communicated by letter this button state with pru processor plate 452 power button 495.PRU power button circuit also comprises LED indicator driver circuit, trim current is provided to the LED indicator that is in the PRU power state indicator 498 in the standby mode that produces variable luminous indication between standby period simultaneously.In the time of in being in the connection pattern, this circuit drives the LED indicator of PRU power state indicator 498 with follow current.

The PRU printer circuitry is provided for the controlled electric power of electric insulation of PRU printer 454, and the electric insulation communication between pru processor plate 452 and the PRU printer 454 also is provided.The barcode reading instrument circuit also provides the communication interface of barcode reading instrument module 455 to pru processor plate 452 for barcode reading instrument module 455 provides controlled electric power.The control of PRU fan control circuit arrives the electric power of PRU control desk fan 456.This circuit can detect the PRU control desk fan 456 of slow operation or installation, gives the alarm to pru processor plate 452 then.

The PRU temperature sensor circuit comprises the internal temperature of heat sensor and monitoring PRU control station 444 and the signal processing of temperature data is provided for pru processor plate 452.This heat sensor is installed on the system I/Q plate 451 that can effectively monitor the thermal conditions in the PRU control station 444 together with relevant support circuit.

Monitoring control devices module 467 is monitoring circuits that the transmutability of monitoring PRU master controller 204 reaches the relevant software programs of moving.If monitoring control devices module 467 detects unwanted PRU master controller 204 functions (comprise according to too frequently or not frequent processor activity), monitoring control devices module 467 will be notified the pru processor plate of this state, and monitoring control devices module 467 made IV pump module 220 lose ability direct action and turn off most functions in the very short time period.Can detect in monitoring control devices module 467 under the situation of incident, monitoring control devices module 467 is also with as the interim sounding of buzzer that is arranged on the I/Q of the PRU system plate 451, as the instrument of informing the undesirable state of user.

PRU monitor control circuit controls to the electric power of PRU monitor 441.It is by 452 controls of pru processor plate, and circuit has the function of restriction electric current.The PRU audio-frequency amplifier circuit comprises two audio-frequency amplifier circuits, receives from the low-level audio frequency of pru processor plate 452 and amplifies these signals.These amplifying signals are used to drive two PRU monitor speakers 458 and 459 in the PRU monitor 441.The monitor control circuit comprises the conveying of PRU monitor speaker interlocking signal to pru processor plate 452, assists in ensuring that only running when PRU monitor speaker 458 and 459 is connected to PRU control station 444 of SDS 100.

Modulation circuit is communicated with non-SDS device through telephone wire for SDS 100 provides instrument.This circuit is carried out insulated return.The Internet circuit is communicated with non-SDS device through the Internet line for SDS 100 provides instrument.This circuit is carried out insulated return equally.

The circuit at interface is provided between UPS order wire and pru processor plate 452 during PRU UPS communication interface.

Auxiliary oxygen control circuit board provides baseband signal to handle the interface between pru processor plate 452 and assistant oxygen pressure force transducer.Described pick off comprises oxygen sensor 482, high side oxygen pressure sensor, downside oxygen pressure sensor and differential pressure pickup.In these pick offs one, the differential pressure pickup physical positioning is near the system I/Q plate 451 this circuit, and other pick off of enumerating is positioned on the oxygen collector 206.Auxiliary oxygen control circuit also provides the circuit signal that drives mouth of pipe size variable (VSO) current limiter 480 (such as the VSO solenoids), regulates auxiliary oxygen flow.Included part is the electric control of VSO current limiter 480 and the signal processing interface between pru processor plate 452 and the VSO current limiter 480.Another task of auxiliary oxygen control circuit is according to the requirement control oxygen sampling solenoid of accepting from pru processor plate 452.

System I/Q plate 451 functional circuits of Tao Luning are electric voltage observation circuits at last.Electric voltage observation circuit is at pru processor plate 452 and keep between the various supply voltages on the I/Q of the system plate 451 again the interface is provided, so that monitor these voltages and determine whether they are in ideal range.

In PRU control station 444, be provided with nose capnometer pump 141, its vertically but not with nose capnometer module 140 physical bond.In PRU control station 444, be provided with a mouthful capnometer pump 142, its vertically but not with mouth capnometer module 202 physical bond.

Barcode reading instrument assembly 455 comprises the self-contained barcode reading instrument module 464 that is installed on the metal framework that comprises mirror.Metal framework is installed in the enclosure of PRU control station 444, along allow the bar code laser beam through the open window projection of the surgery of PRU control station 444 with shine on the zone outside the PRU control station 444 towards.The bar code that the user will be contained the packing of mouth/nasal intubation 145 or box 251 or medicine bottle 250 is arranged in the reading range of activity bar font code reading apparatus module 464 laser beams.Barcode reading instrument module is read bar code then.

PRU printer 454 comprises thermal printer head, the paper feed mechanism, and printer driver plate box PRU prints gate 460.This assembly utilizes electric insulation part to be installed on the shell of PRU control station 444, helps to be provided to the electric insulation inlet of printer paper roller.

IV pump module 220 provides the drug efflux pump of PRU control station 444 moving function.IV pump module 220 is accepted replaceable box 251.IV pump module 220 closes 277 wriggling massage propelling metering medicaments through flexibility by box 251.IV pump module 220 detects the existence in commercially available Rule 269, T position of each jack that places box 251, also detects the medicine bottle 250 on each jack that is placed in box 251.IV pump module 220 comprises the obturation that a plurality of parts such as inner air tube detects box stream downstream.The another kind of function city pump door 201 and the controlled of pump door 201 of IV pump module 220 are opened.

IV pump module 220 comprises IV pump case 239, it is connected with inner air tube pick off 225 with pump door 201, pump door lock 205 and pump door rising mechanism 207, IV pump assembly 232, pump panel 233, optical sensor plate.IV pump assembly 232 comprises that IV pump motor, pump refer to mechanism, pump motor encoder, downstream IV pressure transducer 223 and IV pump sensor board.Optical sensor plate 227 has T position pick off 226 and bottle pick off 228.These two pick offs are outstanding to pass near the pump kit platform 221 IV pump case 239, they and the associated mechanisms interaction of the replaceable box of laying 251 at this place.The optical sensor plate also has door lock solenoid 222, its Pressing pump door lock 205 discharges pump door 201 when activateding, thereby pump door 210 is raise by pump door rising mechanism 207, and proceed to open position to expose kit platform 221 and to allow the user to select box 251 to install or remove.

Oxygen collector 206 is auxiliary oxygen transport subsystem basic building blocks of PRU control station 444.Oxygen collector 206 provides flow of oxygen, flow of oxygen control, oxygen purity assessment box oxygen to cross the inferior path that discharges.It is installed in the rear portion of PRU control station 444.

Oxygen collector 206 comprises the collector (enumerating according to the order of sequence) that is equipped with the following article that meet with the oxygen of importing: the oxygen input connector 484 that is positioned at the outside, the high side pressure relief valve 485 boxes air vent of being correlated with, high side pressure pick off 487, oxygen steering gear 492, fixed current limiter 489, VSO current limiter 480, downside pressure sensor 488, downside pressure sensor relief valve 486 and oxygen master delivery outlet.The assist gas path comprises oxygen sample solenoid 481, oxygen sensor 482 and oxygen sensor outlet 483.Also be useful on make fixed current limiter 489 every side to the vertical outlet of air pressure that is arranged on the differential pressure pickup 479 on the I/Q of the system plate 451.Oxygen collector 206 has oxygen out connector 484, and its back from PRU control station 444 is outstanding, makes the user connect external auxiliary oxygen source.

Oxygen collector 206 has the stream of intercepting oxygen sample.The oxygen sample is by oxygen sample solenoid gate, allows auxiliary oxygen flowing by the oxygen sensor 482 that connects temporarily.Oxygen collector 206 has oxygen sensor outlet 483, allows sampled gas to discharge from oxygen collector 206.

Oxygen collector 206 utilizes high side pressure relief valve 485, and it discharges the not too high pressure that provides in described pressure protect oxygen high pressure path by the outlet through high side pressure relief valve 485.Oxygen collector 206 utilizes low side pressure relief valve 486, and it discharges described pressure protect oxygen low pressure path by the outlet through low side pressure relief valve 486 and exceeds output pressure.

Oxygen steering gear 492 makes manual operating valve, and through come-at-able oxygen steering gear handle 493 operations from the outside.This oxygen steering gear 492 can be set at the normal position, thus the adjusting stream orientation that makes auxiliary oxygen flow only pass through SDS 100 systems.Oxygen steering gear 492 can be alternative the SDS system that is set to bypass position, thereby the adjusting flow path that makes auxiliary oxygen flow no longer pass through SDS 100 systems.On the contrary, it directly flow to oxygen outlet 494 of band agnail that can be approaching from the outside specially, and described oxygen outlet 494 provides the convenient tool that is connected to the SDS bypass oxygen delivery device that the user provides for the user.

PRU control station 444 provides direct tool to be used for through PRU power button 495, to stop the user input of medicine button 497 and pump door button 496.PRU power button 495 allows PRU 200 to be placed with standby or ready state.Stopping medicine button 495 allows the user to suspend drug conveying by being cut to IV pump module 220.When not having box 251 to be installed in the IV pump module 220 or exist and commercially available Rule 269, T position when being installed in the box 251 when box 251, pump door button 496 allows users to open pump door 201.

PRU control station 444 provides the state indication by two kinds of irradiation indicators for the user.One in these indicators is the PRU power state indicator 498 that integrates with PRU power button 495.This indicator has the cyclic swing briliancy in the time of in being in standby mode, has continuous briliancy in ready mode.Another indicator is the pump door locked indicator 499 that integrates with pump door button 496, and it brightens when pump door 201 is locked.It does not brighten when the pump door does not have when locked.

PRU control station 444 has a plurality of external users can be near adapter.Be positioned at PRU umbilicus cable electric-connected socket 461 on PRU control station 444 front panels and be used to provide convenience with the adapter that is electrically connected of umbilicus cable 160.It utilizes various pin height to provide the heat conversion and the pin of need not degrading.The pneumatic socket 462 of PRU umbilicus cable that is decided to be on the front panel of PRU control station 444 provides a plurality of pneumatic connection that connects umbilicus cable 160 easily simultaneously, comprises being used for the exhale pneumatic path of sample of oxygen delivery and patient.The modulation adapter 470 that is positioned on the rear board of PRU control station 444 is adapters of RJ11 type, for the user provides and being connected of external telephone wire.The Internet connection device 471 that is positioned on the rear board of PRU control station 444 is adapters of RJ45 type, for the user provides and being connected of external the Internet line.The PRU electric connector 465 that is positioned on the rear board of PRU control station 444 is to provide the adapter that PRU control station 444 is connected with UPS output cable adapter 491 for the user.

PRU control station 444 has the fan that is called as PRU control desk fan 456.PRU control desk fan 456 provides the heat cooling of the member that is arranged on PRU control station 444 inside.PRU control desk fan 456 also is provided for diluting the sharp draft equipment of PRU control station 444 of the instrument of any auxiliary oxygen that enters PRU control station 444 that may exist, thereby helps oxygen concentration is remained in the scope that needs.

The internals of PRU 200 is interposed between top PRU foam holder 447 and the bottom PRU foam holder 448.In an example, PRU foam holder 447 and 448 is formed by the known rigid foams structure of electronics industry, as E-PAC ^TMThe chassis.At E-PAC ^TMGroove that strategy upward is provided with in the chassis and cavity are caught effectively and are kept the pc plate safely, pump, LCD, speaker and other member.The shell of PRU 200 forms by rigidity molded thermoplastic material (for example ABS) structure and comprises taking over a business top dark slide 446 and front diaphragm 450.Chassis 449 is formed and is formed the part of the shell of PRU 200 by the sheet metal structure.Casing component keeps together with the fastening part and the screw of inner molding.Taking over a business 445 is designed to be easy to remove to enter PRU 200.

The PRU/BMU interface

A fourth aspect of the present invention relates to the interface of the operation room unit (PRU) 200 and the bed side monitoring means (BMU) 300 of calm induction system 100 (the perhaps medical actuator system 100 ' of other type), and its embodiment shows in Figure 41-57 and 60-62.The performance of the embodiment of Figure 41-57 and 60-62 is calm induction system 100 (the perhaps medical actuator system 100 ' of other type), comprise bed side monitoring means 300 (its embodiment shows) in Figure 41 and 60-62 based on microprocessor, based on the operation room unit 200 (its embodiment shows in Figure 41-57) of microprocessor and umbilicus cable 160 (its embodiment Figure 41,42 and 60-62 in show).Bed side monitoring means 300 has a side monitoring means master controller 301, have the first group of junction point that is used for receiving patient's input from the patient-monitoring connector, and have second group of junction point, and has the display screen that is used to show at least a portion patient output according to the output patient output signal of the input signal that receives.The drug conveying that has operation room unit 200 Control Component 220 ' (the perhaps medical actuator 220 of other type ") that flows, and have operation room unit master controller 204.The operation room unit master controller has the memorizer that comprises patient-monitoring and medical actuator scheduler program (the perhaps patient-monitoring of other type and medical actuator scheduler program).Described program is operably connected to the program input according at least a portion patient output at least in part, and/or controls the drug conveying Control Component 220 ' (the perhaps medical actuator 220 of other type ") that flows according to program input control suggestion user at least in part.Umbilicus cable 160 has with second group of junction point of bed side monitoring means 300 and is connected or attachable first end, and has and can be connected with operation room unit 200 or attachable second end.At least one of first and second ends can be pulled down from corresponding bed side monitoring means 300 or operation room unit 200.When umbilicus cable 160 was connected with operation room unit 200 and bed side monitoring means 300, operation room unit master controller 204 and bed side monitoring means master controller 301 were operatively coupled on together.

In a kind of setting of the performance of the embodiment of Figure 41-57 and 60-62, drug flow Control Component 220 ' comprises drug conveying infusion pump assembly 220, such as peristaltic pump component.In a kind of variation of this setting, medicine is transported to the patient through IV.Being provided with that another kind does not show, the drug conveying Control Component that flows comprises gaseous medication gas flow controller.In a kind of variation of this setting, gaseous medication is that oxygen and/or non-carrier of oxygen also are transported to the patient through cannula assembly.

In an example of the performance of the embodiment of Figure 41-57 and 60-62, operation room unit 200 has independent operation room unit (PRU) identifier, and a bed side monitoring means 300 has independent bed side monitoring means (BMU) identifier.The operation room unit master controller 204 of operation room unit 200 is write the electronics history (electronic history) of a side monitoring means 300 based on Independent B MU identifier when being connected with operation room unit 200.In a kind of variation, identifier is retained in the master controller of PRU and BMU, works out electronics history when BMU is connected with PRU automatically.In a kind of extension, calm induction system 100 also comprises drug delivery cassette component 251 and the cannula assembly 145 of single patient use and the medicine 250 that single patient uses that single patient uses.Drug delivery cassette component 251 has independently box identifier, and is operably connected to the mobile Control Component 220 ' of drug conveying of operation room unit 200.Cannula assembly 145 has independently, and the intubate identifier also can be connected to a side monitoring means 300.Medicine bottle has independently the bottle identifier and is operably connected to drug delivery cassette component 251.The operation room unit master controller 204 of operation room unit 200 is based on independent box and intubate and bottle electronics history that identifier (SPU identifier) is write drug delivery cassette component 251 and cannula assembly 145 and medicine 250.

In another performance of the embodiment of Figure 41-57 and 60-62, operation room unit 200 is downloaded has independent operation room unit (PRU) identifier, and a bed side monitoring means 300 has independent bed side monitoring means (BMU) identifier.When being connected with operation room unit 200, the operation room unit master controller 204 of operation room unit 200 is based on the electronics history of Independent B MU identifier editor bed side monitoring means 300.

In another performance of the embodiment of Figure 41-57 and 60-62, medicine kit assembly 251 independent box identifiers are to contain the unique bar code of sterilization packaging of medicine kit assembly 251 and/or the bar code on the medicine kit assembly 251.The independent cannula assembly identifier of cannula assembly 145 is to contain the unique bar code of sterilization packaging of cannula assembly 145 and/or the bar code on the cannula assembly 145.The independent bottle identifier of medicine bottle 250 is to contain the unique bar code of sterilization packaging of medicine bottle 250 and/or the bar code on the medicine bottle 250.Use barcode reading instrument 455 to read unique identifier at PRU 200 places.

In a kind of realization of the performance of the embodiment of Figure 41-57 and 60-62, when bed side monitoring means 300 was connected with operation room unit 200, the electronics history of box, intubate and bottle identifier was passed to BMU 300.BMU 300 revises the electronics history of its SPU identifier, makes the SPU of previous use can not be used to this BMU use once more.In another was realized, BMU 300 also duplicated the electronics history of its SPU identifier.This is particularly useful in the surgical site with a plurality of BMU and PRU still less.The identifier cross replication has also prevented the repeatedly use of the SPU on the different PRU in the surgery suite between BMU and the PRUSPU.

In a kind of realization of the performance of the embodiment of Figure 41-57 and 60-62, when bed side monitoring means 300 was connected with operation room unit 200, the bed side monitoring means master controller 301 of anastomosing bed side monitoring means 300 opened the operation room unit 200 of cutting out.In identical or different realization, when bed side monitoring means 300 was connected with operation room unit 200, the operation room unit master controller 204 of anastomosing operation room unit 200 opened the bed side monitoring means 300 of cutting out.In a kind of variation, when PRU 200 or BNU 300 are switched on, upwards guiding (boot up) of its master controller 204 and 301.

In a kind of explanation of the performance of the embodiment of Figure 41-57 and 60-62, bed side monitoring means 300 shows patient-monitorings and is not connected with operation room unit 200, and when operation room unit master controller 204 detects in the operation room units 200 some and fails demonstration patient-monitoring and being connected with operation room unit 200.In identical or different explanation, when some failure was detected in continuous bed side monitoring means 300 and/or operation room unit 200, operation room unit master controller 204 cut out drug conveying infusion pump assembly 220.

In a kind of execution of the performance of the embodiment of Figure 41-57 and 60-62, umbilicus cable 160 comprises the electric power supply line, when umbilicus cable 160 and bed side monitoring means 300 disconnect when being connected and/or umbilicus cable 160 when being connected with operation room unit 200 disconnections, 204 disconnections of operation room unit master controller supply to the electric power supply line of umbilicus cable 160.In a kind of variation, a bed side monitoring means 300 comprises a side monitoring means battery 303, and be that a bed side monitoring means battery 303 is powered from the electric power of operation room unit 200 through the electric power supply line of umbilicus cable 160.

Bed side monitoring means

A fifth aspect of the present invention relates to a side monitoring means (BMU) 300 or its member or by the member of its use, its embodiment Fig. 6,41 and 60-62 in show.Fig. 6,41 and first kind of performance of the embodiment of 60-62 be patient's checkout gear independently, comprise mouth/nasal intubation 145, be used to receive from first group of junction point of the input signal of patient-monitoring connector and be used to receive the adapter 151 of auxiliary oxygen supply 152.

Fig. 6,41 and second kind of performance of the embodiment of 60-62 be the BMU300 that accepts patient's user input and surgical data, comprise garaph user interface 212.In this application, in assembling, the surgical procedures or in the postoperative rehabilitation process, BMU 300 can be used to input and show patient parameter (such as physiological parameter) before art.

Fig. 6,41 and the third performance of the embodiment of 60-62 be the BMU 300 that audible instructions is offered patient 10, comprise ARM module 340, export through the audition of mouth/nasal intubation 145 and receiver 135 vibration receivers 342 and input rope 150.

In a kind of execution of the third performance, BMU 300 provides audible instructions through receiver 135 for patient 10 in the assembling process before art, and such as " extruding left hand ", and the monitoring response time is to set up the baseline response rate.In a kind of explanation of this execution, intubate 145 is carried audible instructions and is offered patient 10, requires for the response from dynamic response monitor (ARM) 340.

Fig. 6,41 and the 4th kind of performance of the embodiment of 60-62 be and the bonded BMU300 of operation room unit, comprise mouth/nasal intubation 145, be used to receive first group of junction point from the input signal of patient-monitoring connector, with the second group of junction point that is used to export patient parameter, and has the display screen that is used to show patient parameter.In a kind of execution of the 4th kind of performance, umbilicus cable 160 is connected with BMU umbilicus cable connector 151 (in the place that is connected to auxiliary oxygen supply 152) and patient parameter is transferred to PRU 200 from BMU 300.In a kind of explanation, BMU 300 is along with patient 10 advances to field of operation.Umbilicus cable 160 is connected BMU with PRU210 and all patients are imported data to BMU 300 and parameter (comprising the reading of physiological parameter and carbon dioxide) downloads to PRU 210.PRU 210 begins oxygen delivery to patient's (if desired) through rope 160.

Fig. 6,41 and the 5th kind of performance of the embodiment of 60-62 in, user's input of BMU 300 monitoring patient parameters and comprise patient information on the garaph user interface 212 between convalescence after surgery.In this was used, between convalescence, BMU 300 can be used to show patient parameter (such as physiological parameter) after surgery, oxygen supply is provided if necessary and allowed the situation of medical worker's assess patient 10 before discharging.In a kind of execution of the 5th kind of performance, BMU 300 comprises the light-emitting section 208 of many LED, so that the medical worker is easy to observe.Light-emitting section 208 can change into different-format with status of patient, and such as green light, light, passage of scintillation light and steady-state light glow and turn to be yellow.

In second kind of execution of the 5th kind of performance, BMU 300 utilizes ARM module 340 and ARM mobile phone 342 inquiry patients and write down time-based response and answer automatically, and should respond to combine with other monitoring parameter and carry out patient evaluation.

The detailed description of a kind of specific implementation of the embodiment of the following passage displayed map 6,41 and 60-62.Any part that should be noted in the discussion above that this specific implementation all can be added to any Fig. 6,41 and the aforementioned performance (comprising its example etc.) of the embodiment of 60-62 in.In this was realized, BMU 300 provided the monitoring of physiological parameter in all operation phase process.When BMU in operating room 300 when umbilicus cable 160 is connected with PRU 200, the BMU300 monitored physiological parameter shows on PRU 200.BMU 300 comprises BMU master controller 301, and it is for being used for unitary computer.BMU master controller 301 comprises hardware and software.Hardware comprises the interface members of communicating by letter with patient monitor.This communication comprises the reception patient data, monitors running status and sends routine request to module.Software processes is used for showing at the visual display monitor from the data that patient monitor receives.Software comprises the driver that is used for visual display monitor, touch screen, speaker, ARM function, internal memory and printer.BMU 300 is designed to keep together with the patient in the whole surgery flow process of the Zhongdao recovery room of operating room in the past operating room.

BMU 300 comprises electrocardiogram (ECG) module 330, the software that it comprises electronics and be used to handle patient's signal when being supplied through ECG pad 332 and ECG 334.ECG pad 332 and ECG 334 is that medical domain is known.An example of ECG module 330 can be available from Mortara Instrument, Inc., Milwaukee, WI, Model M12A.Result data from this module is sent to BMU master controller 301 then, is used for the demonstration of physiological parameter (heart rate and waveform).

BMU 300 also comprises non-intruding blood pressure (NIBP) module 320.NIBP module 320 comprises NIBP pump 322.An example of NIBP module 320 can be available from SunTech MedicalInstruments, Inc., Morrisville, NC, Model MC2619045.Non-intruding blood pressure (NIBP) module 320 comprises electronic component, software, the pump and the valve of non-intruding blood pressure (NIBP) module 320 cufves 321 that are used to expand.The NIBP cuff is known at medical domain.Electronic component is handled the information that receives by NIBP cuff 321 with software.Blood pressure data (systolic pressure, diastolic pressure) is sent to BMU master controller 301 then as a result.

Pulse blood oxygen amount (SpO ₂) module 310 also is comprised among the BMU 300.An example of pulse blood oxygen amount 310 can be available from Dolphin Medical, Inc., Hawthorne, CA, Model OEM701.Pulse blood oxygen amount module 310 comprises electronic component and is used to handle the software of the patient information that receives by reusable pulse blood oxygen amount probe 311.An example of pulse blood oxygen amount probe 311 can be available from Dolphin Medical, Inc., and Hawthorne, CA, Model 210.The data (pulsation rate, the SpO that produce ₂And waveform) is sent to BMU master controller 301.

Also be positioned among the BMU 300 is from dynamic response monitor (ARMA) module 340.ARM module 340 comprises ARM loudspeaker assembly 341.At intra-operative, comprise that the ARM module 340 of hardware and software provides audition and tactual stimulation for the patient simultaneously through receiver 135 and vibration ARM mobile phone 342.ARM mobile phone 342 ergonomic design are to remain in the palm in the hands that cosily is engaged in the patient and by clamping belt.This stimulation continues to reach the regular time section, perhaps responds by extruding ARM mobile phone 342 up to the patient, and the switch that activates in the mobile phone also transmits a signal to ARM module 340.ARM auditory stimulus is the slight vibration of requirement (" please push your hands ") and ARM mobile phone 342.If the patient can not respond, then more instant audition requires to be repeated (" pushing your hands ") and increases oscillation intensity, comprises the increase of audition amount.If the patient can not respond once more, even more instant audition requires to be repeated (" to push your hands now! "), and (for the last time) increases oscillation intensity for the third time.If the patient can not push ARM mobile phone 342 in this program process, then the patient is considered to not response.If the patient can not respond in the set time section, action of monitoring shell and warning nursing group.

Mouth/nasal intubation 145 connects the patient with an end that comprises three sample taps, and a sample tap is used for left nostril, and one is used for right nostril, and one is used for the oral cavity.Patient end also comprises nose and mouthful outlet that is used to cure by oxygen therapy.The other end of mouth/nasal intubation 145 is connected with BMU 300 through intubate connector board 304.Intubate connector board 304 also will be connected with BMU 300 fluids from the output of mouth/nasal intubation 145.Intubate connector board 304 also is connected BMU 300 with output from mouth/nasal intubation 145.Pressure transducer (in an example its for nose pressure transducer 47) is set in BMU 300, air-breathing and it plays detection effect and communicates by letter to control flow of oxygen with PRU 200 when exhaling as the patient.Mouth/nasal intubation 145 also comprises receiver 135, and it requires acoustic response to be transferred to the patient from ARM module 340.

Power button 318 is arranged on the face of BMU 300, and green light when BMU 300 connects electric power is sent the pulse green glow when BMU 300 is in standby mode.BMU 300 comprises user interface, will relay to the user and allows user's input information and require control system from physiological monitor and the accumulative information of pick off.BMU graphic user interface (GUI) 212 comprises the printing opacity lamp box LCD visual display monitor with the touch screen that is used for user's input and has the warning system of Voice ﹠ Video member.Be used for providing the speaker of audible indicator to be positioned at the face of BMU 300 to the user.Light-emitting section 208 is positioned on the top of BMU 300, is made by translucent thermoplastic plastics (for example Merlon), and is indicated by the vision that 203 of LED provides illumination one that alarm condition is provided.Light-emitting section 208 is for particularly useful for the medical personnel of the information transmission in the postoperative chamber that many patients can be existed by surgical operation rehabilitation and many BMU.When patient physiological intersects with warning and alert threshold, character display indication alarm condition.After visual detector, BMU comprises the different audition intonation that are used to report to the police.For example when BMU 300 do not detect any when undesired light-emitting section 208 can show or dodge green glow, perhaps when taking place to report to the police, show or dodge gold-tinted, perhaps demonstration or sudden strain of a muscle HONGGUANG when alarm takes place.And light-emitting section 208 can change color, intensity and flicker circulation describe to ventilate magnitude and/or state.Light-emitting section 208 also can comprise letter, numeral or alphanumeric display.Described demonstration can provide the heart beating breathing rate or the alert details of extra details such as per minute.

Independent thermal printer can be used to form the hard copy log of tranquilizing system.Printer port 218 is arranged on the side of BMU 300 and is used to connect remote printer.BMU 300 can be by utilizing BMU battery 303 or moving under the power supply of internal cell through external a/c power adapter.And, when they connect in operating room, the electric power that BMU 300 receives from PRU 200.Oxygen adapter 152 and pipe fitting group can be connected between BMU 300 and standard oxygen wall outlet or oxygen tank, when BMU 300 is not connected to PRU 200 (the preceding and postoperative of art typically) through umbilicus cable 160, be provided to the patient through BMU300 easily to allow oxygen.

See preferably shown in Figure 62 that the internals of BMU 300 is folded between foam top holder 312 and the bottom foam holder 313.In an example, foam holder 312 and 313 is made of as E-PAC the known rigid foams of electronics industry ^TMThe chassis.At E-PAC ^TMThe groove that strategy go up to be provided with in the chassis is caught effectively with the chamber and is connected pc plate, pump, LCD, speaker and other member safely.The shell of BMU 300 is made of rigidity molded thermoplastic plastics (for example ABS) and comprises bottom 314, and is anterior 315, back 316 and top 317.Described mould component is used the fastening part of molding therein to close screw and is kept together.Shell top 317 is designed to be easy to remove so that near battery 303.

Calm induction system

Referring to Figure 63-76, the following passage has been showed a kind of combination of the specific examples of aforementioned aspect of the present invention, and it is a calm induction system (SDS) 100, is integrated monitoring and delivery system, and makes patient's abirritative instrument during being provided at medical surgery.SDS 100 uses the drug conveying algorithm that is called as dosage control device (DC) and amedrop 220 to reach rapidly and to keep the pace of change infusion of required sedation effect to carry medicine.It can make doctor/nurse's (not being the anaesthetist) nursing group, and they think that the dosage rate that can keep required sedation effect regulates patient's level of sedation by simple input.DC calculates suitable loading dosage based on the criterion in the drug labelling, can reach the sedation effect that is used for given maintenance speed rapidly.

SDS 100 comprises four kinds of daily physiological monitors.They are the pulse blood oxygen amounts 110 that are used to monitor the oxidation of patient's tremulous pulse, non-intruding shape blood pressure (NIBP) 120 and be used to monitor the dynamic (dynamical) electronics electrocardiogram of patient's heart pad (ECG) 332 and be used to measure the active capnometer 140 of patient respiratory and 202.In addition, SDS 100 has from dynamic response monitor (ARM) 150 to help the level of sedation of nursing group assess patient.All five kinds of monitors and DC integrate by being called the software module of monitoring shell.Monitoring shell view remains on required level of sedation with the patient.It monitors status of patient, keeps the notified patient's states of nursing group, if stop drug conveying when detecting unwanted sedation immediately.In some cases, in case when patient's states is returned to required sedation, the monitoring shell will restart drug conveying, but carry with the maintenance rate that reduces.If this inertia is permitted by unwanted sedation, then monitor shell and will not restart infusion.On the contrary, after described situation, it requires nursing group member intervention to restart drug conveying.Operation room unit (PRU) graphic user interface (GUI) 210 and bed side monitoring means (BMU) graphic user interface 212 during the integrated component of monitoring shell; Each shows the biological value of monitoring so that nursing group can be determined the mode of patient's states easily.GUI also is designed to regulate the effective tool of patient's level of sedation to nursing group by changing maintenance rate.

SDS 100 is designed to provide the continuous blood dynamic monitoring of the patient in art cup, operating room and rehabilitation (postoperative) chamber.It comprises two master units, and they are side monitoring means (BMU) 300 and operation room unit (PRU) 200.BMU 300 is connected with patient in the art cup and keeps together with the patient in whole rehabilitation.BMU 300 control impuls blood oxygen amount modules 310, NIBP module 320, ECG module 330 and ARM module 340.In case be connected with the patient, its monitoring also shows patient's tremulous pulse saturation, arterial pressure and heart rate.Auxiliary oxygen (comprising the air that is rich in oxygen) can be transferred through BMU 300 and mouth/nasal intubation 145 at this moment.When the patient was shifted onto in the operating room with wheelchair, BMU 300 pneumaticly was connected with PRU 200 with the umbilicus cable 160 of electric wire by comprising.At intra-operative, umbilicus cable 160 allows patient physiological data and the patient respiratory gas of PRU200 reception from BMU 300.In addition, umbilicus cable 160 allows oxygen is transported to the patient from PRU 200.

PRU 200 is increased to capnometer in the system, and monitoring also shows patient respiratory speed and end-tidal carbon dioxide.The ARM monitoring activated and patient's response is displayed to nursing group.As long as PRU 200 detects respiratory activity (from capnometer), just start and force oxygen therapy.All drug conveying are carried out by PRU 200, because amedrop 220, DC and monitoring shell.All be connected and provide virtual value and oxygen to be transported to the patient up to all monitors, infusion of drug just can be activated and.PRU 200 is responsible for the nursing group member of calm administration and the main interface between the SDS100.It comprises the GUI 210 that shows status of patient and the convenient patient of adjusting level of sedation.

Referring now to Figure 42 and 43,, PRU 200 provides the member of the system of following function: the detection of physiological parameter and demonstration; User's input of patient data; User's input of dosage rate; And the hardware and software that is used for drug conveying at intra-operative.PRU 200 is designed in keeping operating room and is the mechanism of drug conveying.

In PRU 200, be provided for monitoring from patient oral cavity and nasal cavity region in front two capnometers 140 and 202 to the carbon dioxide sampling.Software monitoring respiratory activity, and the stronger position of respiratory activity is displayed to the user.The biosensor analysis sample, data (the breathing rate EtCO of generation ₂And respiratory waveform) is sent to PRU master controller 204.

Calm induction system 100 is used for during medical surgery tranquilizer being flowed to the patient.The amount that is fed to patient's tranquilizer is determined by the level of patient's response of ARM system 340 mensuration.In alternate embodiments, the painful level that the patient stands determines to flow to the amount of patient's tranquilizer.Patient suffering's level can be represented by physiological parameter, such as the heart rate and/or blood pressure and/or the cerebral activity that increase.Calm induction system 100 comprises by ECG monitor monitors heart rate and the ability by NIBP monitor monitors blood pressure.EEG (E.E.G) monitor randomly offers the cerebral activity of calm induction system 100 with the monitoring patient.Calm induction system 100 is explained the assessment output from ECG, NIBP and/or EEG thus, as the indication of patient experience misery or pressure and regulate drug conveying with managing patient better.For example, if ECG, NIBP and/or EEG monitor increase predetermined threshold value, for example increase by 20% in the section at the fixed time, calm induction system 100 will increase the medicine stream of giving the patient or notify the doctor to increase medicine.Other monitored physiological parameter is in the scope of this embodiment, and this is also to it will be appreciated by those skilled in the art that.

Referring to Figure 42 to 47, infusion pump 220 is arranged on the anterior of PRU 200 and drug conveying is provided.Replaceable box 251 is connected with pump 220.Box 251 keeps medicine bottle 250, and medicine is fed to the patient from medicine bottle.Box 251 comprises a base plate that keeps bottle nail pin 261, infusion pipe fitting 277 and 259 and Rule, T position adapter 269 of being arranged on the patient end place of infusion pipe fitting.As shown in figure 44, the pump door 201 on the PRU 200 is opened accepting box 251, and when closing box 251 and pump 220 is connected in the appropriate location.T position pick off 226 is the transducers of the optical type devices in the pump 220 that is provided with, and is used for the signal PRU master controller 204 that T position 269 exists when mounting box 251.The pick off that is arranged on another optical type in the pump 220 is a bottle pick off 228.It is used to the signal PRU master controller 204 that medicine bottle 250 exists.Inner air tube pick off 225 is Vltrasonic devices, and it is across short-movie of pipe fitting 277 and detect the air that pumps from medicine bottle through pipe fitting 277 or the existence of bubble.The obstruction detector 223 that is arranged in the pump 220 is little pressure transducers, and it relies on pipe fitting 277 to leave standstill and survey the increase that shows the pipe fitting internal pressure that may block in the infusion tube part 259.Pump refers to that 229 are connected with the fragment that is set to the vertical pipe fitting 277 in the top of box 251, and their peristaltic pump effect is given the patient through managing 277 and 259 pumps from medicine bottle 250.Pump 220 by with electronic circuit board that PRU master controller 204 is connected on software-driven.

Figure 45 also shows the tram of box 251 in the pump 220 and shows that pump door 201 opens.Figure 46 shows box 251 in the pump 220, the door 201 of closing and is set at medicine bottle 250 in the position on the bottle nail pin 261.Figure 47 shows the box 251 that is inserted in the pump 220, door 201 of closing and the medicine bottle 250 that is arranged on the bottle nail pin 261.

Refer again to Figure 42 and 43, being arranged among the PRU 200 is oxygen therapy module 206, flows to patient's oxygen in its control of intra-operative.Oxygen therapy module 206 comprises pick off, flow control apparatus and the pipe fitting that provides for oxygen therapy.A mensuration in the pick off enters the oxygen concentration in the pipeline of PRU200, and if oxygen concentration is lower than predeterminated level, then oxygen is carried and is not allowed to and information is displayed to the user.This partial view helps prevent the gas delivery different with oxygen to give the patient.

PRU graphic user interface (GUI) 210 allows PRU 200 to relay to the user from the information of physiological detection device and pick off collection, and allows user's input information and instruction.PRU graphic user interface 210 comprises the visual display monitor with the touch screen that is used for user's input and has the warning system of Voice ﹠ Video member.In addition, printer is used to set up the hard copy log of calm information.When the patient physiological mensuration of monitoring was arranged in required parameter, the alarm box zone of monitor showed green.As breathing rate or oxygen saturation (SpO ₂) when being positioned at outside the required state first amount, their state rods are separately indicated first alert if by it being shown as yellow.When these identical physiological parameters were positioned at outside the required state higher second amount, their state rods separately were by with its shown in red second alert if of indicating.Except the vision indication, SDS 100 comprises different audition intonation, is used for different warning level (promptly yellow or red).

PRU 200 is by multiple power source (UPS) 214 power supplies, and it becomes constant dc voltage with available a/c voltage transitions.This voltage is provided to all modules among the SDS 100.UPS214 also comprises the battery by back-up system power supply, allows the user under the situation of outage system's service time of several minutes.

PRU 200 comprises PRU master controller 204, and it has the hardware and software module.Software comprises and is used for the interface members of communicating by letter with all patient monitor.This communication comprises the reception patient data, monitors operation conditions, and routine is required to send to module.Software is also handled the data that received by patient monitor, is used for showing on the video display units monitor.Software comprises and is used for display, touch screen, speaker, internal memory, printer, ARM function, the driver of the network port, external video display units, internal sensor and infusion pump 220.

Interaction and the function of operating software control SDS 100.By the monitoring shell, software is made suitable decision based on it from the information that user's input, various internal sensor and patient monitor receive.If patient's states reach with than required calmness (for example low breathing rate or the low oxygen saturation) level outside the required restriction of the relevant state of deep level more, software is taked suitable action warning user and is reduced or stop administration.Software is also based on carrying out drug conveying by the close rate of user's indication.The infusion pattern is based on pharmacology's principle and use weight in patients to calculate the infusion rate of medicine with required dosage.

Convenient as the user, when effective drug delivery cassette and medicine bottle were loaded in the infusion pump 220, SDS 100 comprised automatic filling patient infusion line 224.As the monitoring part, along with box 251 is installed in the infusion pump 220, sensor is installed in the existence of the T position adapter on the drug delivery cassette 251.When the T position is detected when being connected to drug delivery cassette, SDS pours into infusion line 224.

The following passage illustrates the specific examples of some SDS 100 functional subsystems, and they comprise the member of one or more aforementioned aspects of the present invention, and a kind of aforementioned combination of the specific examples of these aspects.

Oxygen conveying function subsystem accept the to do for oneself auxiliary oxygen of the standard external source that the user provides and its is disperseed to the patient with the controlled flow pattern, described controlled flow pattern is subjected to the influence of patient's breathing patterns.As patient during basically by nasal respiration, oxygen is in higher flow velocity in breathing process, and oxygen is in lower flow velocity in exhalation process.As patient during substantially with mouth breathing, oxygen is without interruption.Flow velocity can be input to PRU GUI 210 by the user and regulate.Oxygen is transported to the patient by the special mask shape mouth/nasal intubation 145 partly that comprises the mouth/nose region that is fixed to patient's face.

Press the algorithm of influence in PRU control station 444, to control oxygen flow according to being subjected to patient's nose.Be directed to and supply to BMU300 by the oxygen flow of PRU control station 444 metering through umbilicus cable 160.The replaceable so-called mouth/nasal intubation 145 that BMU 300 is connected the oxygen guiding with BMU 300 single uses.Mouth/nasal intubation 145 is given the patient through its oxygen hose 353 with oxygen delivery, and through two nose oxygen pins 422 and a mouth pin 369 oxygen is distributed to patient's nose and port area.

The oxygen therapy functional subsystem has multiple auxiliary oxygen correlation function, and they reside in the PRU control station 444 basically.These functions comprise that the auxiliary oxygen supply of checking does not have anoxia and is not in the instrument that oxygen content is lower than the oxygen content in the atmosphere.Under the situation of measuring oxygen-depleted gas, PRU control station 444 will be cut to patient's gas delivery and warn the user.Another auxiliary oxygen function is to rely on the auxiliary oxygen protection of irreversible high pressure that obtains from user's auxiliary oxygen source, and its pressure through overvoltage discharges ejection and alleviates.Another kind of auxiliary oxygen function is to rely on than the auxiliary oxygen protection of the irreversible high pressure in the Low Pressure Oxygen stream, its its discharge ejection through the pressure of overvoltage and alleviate.Terminal A 161 of the pneumatic cable connector of umbilicus that the disconnection that another kind of auxiliary oxygen function is PRU control station 444 or BMU300 place connects or the detection of the terminal B 162 of the pneumatic cable connector of umbilicus, the perhaps detection of the mouth/nasal intubation 145 that is connected with the disconnection of BMU 300.When very moment/nasal intubation 145 was connected with BMU 300 disconnections, oxygen just was not transported to required patient position.The observation that this disconnection connects by the accidental pressure level of measuring in 444 pairs of oxygen therapy of the PRU control station path detects.When separating by resolution, oxygen therapy is stopped automatically by PRU control station 444, is solved by the user up to separating.Another kind of auxiliary oxygen function is the manual oxygen valve that is called as oxygen steering gear 492 at PRU control station 444 rear portions.Oxygen steering gear 492 allows user's auxiliary oxygen of manual steering input easily, and alternatively leading away from PRU control station 444 inside and with described oxygen source is called as the SDS bypass oxygen source accessory of the oxygen outlet 494 of being with agnail.The oxygen outlet 494 permission users of band agnail near oxygen, are used as the replace oxygen care appliances through SDS 100, such as being used by the bypass of SDS system.

The oxygen collector 206 that is arranged in the PRU control station 444 is the metal structures that contain the inner hollow path, it provides effective parts, to assist oxygen to be transported to or through peroxide related assays and control device, described device is installed to oxygen collector 206 or is not installed to oxygen collector 206 but vertical with oxygen collector 206.Auxiliary oxygen is connected to the connection on the oxygen collector 206 that is called as oxygen input connector 484 by the user, it is arranged on the rear portion of PRU control station 444.This input oxygen has it by the pressure that high side pressure sensor 487 is measured, and described high side pressure sensor is arranged on the oxygen collector 206, monitors high lateral pressure also with this direct data PRU master controller 204.The oxygen of this input also is directed to the high lateral pressure relief valve 485 that is arranged on the oxygen collector 206, and excessive pressure is discharged in the ambient atmosphere.The oxygen of this input also leads except that the oxygen sample solenoid 481 of all normally closing between sampling date.For possible anoxia content, no matter when PRU control station 444 is checked the oxygen of importing, and oxygen sample solenoid 481 all is opened temporarily.The Oxygen Flow of this guiding input blows out and is discharged to the ambient atmosphere from oxygen collector 206 subsequently from the auxiliary air passage by oxygen sensor 482.Before or after the oxygen sampling of input, PRU master controller 204 compares the oxygen content of the surrounding air of this sample and surrounding air oxygen concentration after measured.If the oxygen sample of input has higher oxygen content, it is anoxybiotic and be allowed to be utilized by SDS 100 that the auxiliary oxygen that then is connected to PRU control station 444 is considered to right and wrong.

The basic gas circuit of oxygen of input continues to enter oxygen steering gear 492.The oxygen steering gear 492 normal oxygen that allow pass through along basic gas circuit.But if oxygen steering gear handle 493 is in the SDS system bypass position, oxygen directly leaves basic gas circuit on the contrary and directly enters as the outside delivery outlet 478 of the oxygen of current limiter.Oxygen arrives the external nozzles that is called as the oxygen outlet 494 of being with agnail then.Basic oxygen road proceeds to fixed current limiter 489, and it is single size mouth, controlled oxygen restriction is provided and produces the pressure reduction that passes this interruption-forming, and described pressure reduction is proportional with the flow velocity through fixed current limiter 489.As what observe on every side of fixed current limiter 489, pressure reduction is described the oxygen flow speed in the basic gas circuit; Thereby flow velocity is transported to the pipe that is arranged on the differential pressure pickup 479 on system's I/O (I/Q) plate with these two kinds of pressure and is simply measured through a pair of.Pressure-gradient transducer 479 presses data to be provided to PRU master controller 204 oxygen.PRU master controller 204 is measured the implicit oxygen flow speed of passing through fixed current limiter by math equation and tabulation related data.

Oxygen passes fixed current limiter 489 and enters voltage-sensitive mouth (VSO) solenoid (being called VSO solenoid 480), and described voltage-sensitive mouth solenoid has and the proportional mouthful of size of voltage that is applied on its actuator coil.The variable airflow limitation of VSO comprises and cuts off Oxygen Flow in due course fully for PRU control station 444 provides control to oxygen gas flow rate.VSO solenoid 480, is utilized to comprise that the hardware/software feedback circuit of differential pressure pickup 479 operates according to the oxygen control algolithm by PRU master controller 204.The output of VSO solenoid 480 is directed to the low side pressure of monitoring and this direct data is arrived the downside pressure sensor 488 of PRU master controller 204.

Basic gas circuit continues by being discharged to low side pressure relief valve 486 in the ambient atmosphere to excess pressure.Oxygen is discharged oxygen collector 206 at the accessory place with connected flexible pipe.To the flow oxygen of control of this flexible pipe is transported to the pneumatic socket 462 of PRU umbilicus cable in the place ahead that is arranged on PRU control station 444.A passage of the pneumatic socket 462 of PRU umbilicus cable is exclusively used in oxygen and carries.Umbilicus cable 160 is connected to the pneumatic socket 462 of PRU umbilicus cable by the user.The mobile oxygen of control is along the oxygen line transportation of umbilicus cable 160 through umbilicus cable 160 inside, and is transported to BMU 300 at the other end of umbilicus cable 160.

Capnometer functional subsystem (CFS) provides carbon dioxide level, the end-tidal carbon dioxide (EtCO that measures and show patient's exhalation ₂) and the instrument of breathing rate (RR).This CO ₂The CO of related data on the basis of breathing, to revise ₂Chart, EtCO ₂The form of value and RR value shows on the PRU screen.The patient that CFS collects nose and the oral area position sample of breathing out, monitoring patient nose expiration speed, analyze the carbon dioxide content of expiration sample, select the strongest carbon dioxide data (no matter it is nasal cavity or oral cavity) according to algorithm, showing then has most force data also with the differentiate on the PRU monitor of these data.

The miscellaneous function of CFS comprises the detection of the expiration sample air pipeline of obstruction or partial blockage, filtration is invaded with the air-borne dust particle of avoiding influencing determination sensor, the water condensation of sloughing from the sampling air precipitates with the expansion capacity, and reduces the sampling air humidity to avoid fluidic precipitation in the determination sensor.

Intubate has two nose expiration sample port, promptly is inserted into a left side and the right nostril port in patient nostril.Each sample port has self the special-purpose sample line that extends to intubate SPU (single patient use) adapter.Intubate SPU connector body is connected to the sample path of these two pipes in the single sample path with two kinds of sample mix.In this point, the precipitation that the special-purpose dehydrator of single nose is used to separate existence.Bonded nose sample is directed to nose expiration sample output place of SPU intubate adapter.Also have two extra pipes that distribute from left and right sides nose sample port, with the pressure transmission of these two ports to intubate SPU adapter.These two pressure signals are transferred to the output of SPU adapter discretely and they are not bonded to each other.

Intubate has a mouth expiration sample port that is positioned at the front, oral cavity.This sample port has self the special-purpose sample line that extends to intubate SPU adapter.In this point, the precipitation that mouthful special-purpose dehydrator is used to separate existence.The mouth sample is directed to mouth expiration sample output place of SPU intubate adapter.

BMU intubate adapter is accepted intubate SPU adapter and relevant nose/mouth expiration sample and nose pressure signal.Nose expiration sample is transferred and is directed at the pneumatic socket of BMU umbilicus place as the single pneumatic pipeline in this adapter through pipe fitting by BMU.Mouth expiration sample is transferred and is directed at the pneumatic socket of BMU umbilicus place as the single pneumatic pipeline in this adapter by BMU.Nose pressure sample ends at nose pressure transducer place in the BMU.The nose pressure sensor signal is measured by the BMU expansion oplate, and it arrives PRU control station 444 with relevant umbilicus cable with nose pressure signal transfer of data through BMU umbilicus electric connector.

Mouth and nose expiration sample are through mouth in the umbilicus cable and the transportation of nose transport line.These samples are transported to the pneumatic socket of PRU umbilicus, and it is transferred to PRU control station 444 inside with these expiration samples.

Nose expiration sample enters then and prevents that air-borne dust particle and water droplet from further entering in the hydrophobic filter in the system.Filtering expiration sample is supplied to nose capnometer module through pipe fitting.When the expiration sample during by the capnometer carbon dioxide sensor nose capnometer it is carried out CO 2 measuring.The nose capnometer is OEM (original device manufacturing) device, is made part number CO2WAF by Cardio Pulmonary Technology Inc.It comprises infrared (IR) pick off, control electronic installation, pressure transducer and gas container.Expiration sample discharge nose capnometer module and process pipe fitting are to the E-PAC that is arranged in the PRU control station 444 ^TM Nose capnometer pump 141 in the chassis.Nose capnometer pump 141 provides vacuum, and sample is advanced to the PRU control station 444 from intubate.Nose capnometer pump 141 is by the control of nose capnometer module controls electronic installation, and this control electronic installation is controlled and gas flow modulation is arrived the target flow velocity.Nose expiration sample by nose capnometer pump 141 then by pipe fitting to the outlet that is arranged in the PRU control station 444.Gas is diluted by the air that PRU control desk fan circulation PRU control station 444 surrounds herein.

Mouthful expiration sample enters then and prevents that air-borne dust particle and water droplet from further entering in the hydrophobic filter in the system.Filtering expiration sample is supplied to a mouthful capnometer module through pipe fitting.When the expiration sample during by the capnometer carbon dioxide sensor mouth capnometer it is carried out CO 2 measuring.The mouth capnometer is OEM (original device manufacturing) device, is made part number CO2WAF by Cardio Pulmonary Technology Inc.It comprises infrared (IR) pick off, control electronic installation, pressure transducer and gas container.Expiration sample outlet capnometer module and process pipe fitting are to the E-PAC that is arranged in the PRU control station 444 ^TM Mouth capnometer pump 142 in the chassis.Mouth capnometer pump 142 provides vacuum, and sample is advanced to the PRU control station 444 from intubate.Mouth capnometer pump 142 is by the control of mouth capnometer module controls electronic installation, and this control electronic installation is controlled and gas flow modulation is arrived the target flow velocity.Mouthful expiration sample through port capnometer pump 142 then by pipe fitting to the outlet that is arranged in the PRU control station 444.Gas is diluted by the air that PRU control desk fan circulation PRU control station 444 surrounds herein.

The nose pressure subsystem detects patient's nose breath pressure, and when the patient considered to be in nasal respiration pattern or mouth breathing pattern, corresponding pressure data was used to determine in the nose pressure algorithm.

The intubate main body has two nose piezometry passages that are used for each nostril.The pressure that centers on by each nasal passage of intubate main body by two independently gas line be transported to the intubate adapter that is connected to each BMU socket by the user.These two gas lines single gas pressure signal as intubate adapter place combined together.Single nose pressure signal is transferred among the BMU.This nose pressure is transported to the BMU pressure transducer that is arranged on BMU inside by single pipe.The BMU determination of pressure sensor is directed to the relevant nose pressure of intubate main body and converts this simulated pressure to the signal of telecommunication, and this signal of telecommunication is handled by the BMU expansion oplate and is transported to master controller among the PRU through the umbilicus cable.

The PRU master controller utilizes algorithm to analyze pressure signal, produce synchronizing signal thus, the synchronous prompting relevant with particular event is provided, that is to say, when snuffing gas begins, when snuffing gas stops, and when nose is exhaled begins, and when nose is exhaled stops.And, being in the patient under the situation of mouth breathing pattern, the nose pressure signal is enough weak to be arrived by these algorithm identified, and is that the PRU master controller produces prompting, indication mouth breathing pattern.

A these snuffing gas/expiration prompting synchronously and mouthful air-breathing/prompting synchronously of exhaling are used to adjust the conveying on time of changeable flow oxygen by the respiratory function subsystem, and the selection of adjustment mouth or nose capnometer data, the carbon dioxide waveform that is used to show, EtCO2 calculating and demonstration and breathing rate are calculated and are shown.

The respiratory function subsystem comprises auxiliary oxygen subsystem, capnometer functional subsystem and nose pressure subsystem.These subsystems by system level algorithm and control sequence with coordination mode synchronous operation.

When the patient was in the mouth breathing pattern, the oxygen delivery subsystem related to Oxygen Flow is set at existing continuous flow velocity.When the patient was in the nasal respiration pattern, the Oxygen Flow that the oxygen delivery subsystem relates between the fastest and slug flow amount was set up gate, and this flow and patient be air-breathing/exhale regularly synchronously.This is undertaken by nose pressure subsystem function synchronously, begins to determine when nose is exhaled,, when snuffing gas stops, and when nose is exhaled begins, and when nose is exhaled stops.These are air-breathing/and exhaling begins/stops the prompting of the control that detection mode progressively changes as oxygen flow speed.Therefore, oxygen delivery is in the variable flow synchronous with patient's breath cycle.

The drug delivery capabilities subsystem is provided for the instrument from the controlled drug delivery that is installed in the medicine bottle 250 in the PRU control station.The drug efflux pump tool of starting building comprises the IV pump module that combines operation with the box of installing.The moving speed of drug efflux pump is sent to the instruction control of IV pump module by the PRU master controller.

The miscellaneous function of drug delivery capabilities subsystem comprises pump door locked/non-locking, the position probing in commercially available Rule, T position in the appointment part of box, the existence that is placed in the medicine bottle in the box detects, the inner air tube that is used for detecting the air of IV pipeline detects, the moving monitor that detects of the occlusion detection of IV pipeline and unwanted pump.

When commercially available Rule, T position was placed in the box, pump was activated.When commercially available Rule, T position was placed in the box, the pump door can be opened.

Umbilicus cable electric power control subsystem (high-speed switch and status circuit) comprises and the bonded umbilicus cable of PRU control station high-speed switch, PRU status circuit, BMU high-speed switch, BMU status circuit and PRU master controller.

The umbilicus cable delivers power to BMU from PRU.The electric power that is provided to BMU comprises the charging again of BMU battery for the power supply of BMU interlock circuit.The umbilicus cable utilizes the electrical management control subsystem, and it allows " heat exchange " of umbilicus cable to equip simultaneously and is supplied to energy.When the umbilicus cable connector from whole connections break away from slightly in conjunction with the time, umbilicus cable electrical management and electric power disconnect and being connected.This helps prevent any spark in the umbilicus cable unloading process.Also help prevent owing to inadequate adapter combination makes umbilicus cable connector contact be subjected to too much stress.These electric power stop alleviation and are performed, and do not consider which end of umbilicus cable is removed.These functions provide by the jumper that is positioned on each end of umbilicus cable, and its electric power that is overlapped on the shortest pin that is called as quick pin in the adapter and adapter is replied between the pin.The strap that is arranged on first end of umbilicus cable is detected by PRU control station high-speed switch.The strap that is arranged on second end of umbilicus cable is detected by the BMU high-speed switch.

When umbilicus disconnect to connect, pin was to disconnect first selling of contacting with separately socket fast.This has triggered high-speed switch separately and has interrupted through the electric current of umbilicus cable power pin moving.

The another kind of function of an example of umbilicus cable electric power control subsystem is to disconnect when connecting from PRU or BMU when the umbilicus cable, helps to be cut to the electric power of the umbilicus cable connector pin at the arbitrary end of umbilicus cable place.This function is passed through PRU control station high-speed switch, the PRU status circuit, and BMU high-speed switch, BMU status circuit and PRU master controller are finished.In this example, when umbilicus disconnects when being connected with BMU under normal condition, the BMU status circuit combines with the PRU status circuit and detects this disconnection and PRU status circuit disconnection PRU high-speed switch, and described high-speed switch cut-out electric power also is communicated with umbilicus.Cause not having electric power at the pin place of umbilicus cable.In this example, under the situation of the abnormal condition aspect some of status circuit, detected and be labeled as may disconnecting of umbilicus cable by the PRU master controller through the connection disappearance of umbilicus cable, this causes the cut-off signal to high-speed switch.Electric power and communication line signal that high-speed switch will be applied to the umbilicus cable all disconnect.

The following passage shows the description of a kind of certain typical use of the SDS 100 that does not limit the scope of the invention.Shown in Figure 77-80, the member of SDS 100 all is used in whole surgical procedures, comprises preceding debugging of art and postoperative rehabilitation.In step 1200, the patient enters the art cup, and nurse or technical staff are fixed to BMU 300 any of bedrail or IV post.BMU300 is equipped with IV post clamp or connects fast also easily this unit is fixed on bedrail or the IV post rapidly.In step 1202, in case BMU 300 is in the position, nurse or clinician can be connected to the patient with NIBP cuff 120 and pulse blood oxygen amount probe 110.These are connected between patient and the BMU300 and carry out.In step 1203 and 1204, BMU 300 will begin monitoring parameter automatically, for example such as diastole and systolic blood pressure, and mean arterial pressure, pulse rate, Oxygenation plethysmogram and blood oxygen quantitative values.The reading that is obtained by BMU300 will be nurse or technician's demonstration on BMU GUI 212.When patient parameter was monitored, nurse or technician freely carried out other task.In step 1206, as the custom of present practice, nurse or technician assess before may needing to finish art.Assessment can comprise the vital signs of record patient before the art, determines any known allergy, and the medical history before definite patient.In step 1206, in case nurse or technician assess before having finished art, in step 1207, nurse or technician can begin IV on every side by place conduit on patient's arm.The IV conduit for example is connected such as the bag of 500mL normal saline with basic I V dropping system.When finishing above-mentioned activity, in step 1208, nurse or technician begin ECG pad 130, ARM mobile phone 342, and ARM receiver 362 and mouth and nose intubate 351 are connected to the patient.

In case the patient is connected with above-mentioned article, nurse or technician can explain ARM system 340 to the patient.This explanation can relate to nurse or technician and instruct the patient to respond the tactual stimulation of the ARM mobile phone 342 that produces from the auditory stimulus of receiver 362 and/or by extruding ARM mobile phone 342.If the patient can not produce response to audition or tactual stimulation, stimulus intensity will increase up to the patient and produce enough responses.At this moment, in step 1209, the nurse can begin automatic ARM training.Automatically the ARM training is by the program of BMU 300 operations, and how the instruction patient detects ARM stimulates and how to respond this stimulation and to the response of stimulus settings baseline patient, is open in 10/674,160 the U.S. Patent application as the serial number of reference in front.Nurse or technician freely carry out other patient's inter-related tasks, and the patient participates in automatic ARM training simultaneously.BMU 300 will show automatic ARM training condition, make nurse or technician can determine rapidly whether the patient participates in automatic training.In step 1210, the patient must successfully finish the automatic ARM training of being carried out; If the patient can not finish training, at step 1210-A, nurse or other clinicians must get involved and whether definite patient can continue.If the clinician determines the user to carry out, then the patient carry out step 1211; If the clinician determines the patient not continue, then will be cancelled in step 1213 operation.Enter operating room if the patient is required to wait for, the automatic ARM training of user customizable is so that repeat automatically with specific interval (for example 10 minutes).This can help the new response that obtains of instilment.

Except completing successfully automatic ARM training, in step 1205, patient parameter must be in acceptable scope.The clinician can what be acceptable scope by by BMU GUI 212 this information being input to BMU 300 decisions.At step 1205-A, if arbitrary detected parameter falls into outside the given range, the patient will not be allowed to undergo surgery, and check that up to nurse or other clinicians the patient is to determine whether the patient can continue.If the clinician determines the patient to continue, the patient will continue step 1211, if the clinician determines the patient not continue, then will be cancelled in step 1213 operation.Only leave the art cup before the operating room, in step 1211, the nurse gives the analgesic of predetermined low dosage, for example such as the sweet smell of 1.5mcg/kg slave too.After the injection analgesic, in step 1212, the patient is ready to be moved to operating room.

In step 1220, patient and BMU 300 relocate to operating room, and are received by doctor's (not being the anaesthetist) and operating nurse.In step 1221, when the patient entered operating room, BMU 300 can be connected with PRU 200 through umbilicus cable 160.When connecting, from patient's NIBP, pulse and oximeter history will be loaded on the PRU 200 automatically, show that patient's history is used for the monitoring of final stage.Except NIBP and pulse blood oxygen amount history, the record that the confirmation patient has finished the ARM training also is loaded.When BMU 300 was connected with PRU 200, BMU GUI 212 changed over the Telnet screen that is used for PRU 200 from the monitoring screen.Demonstration information from BMU 300 is transferred to PRU 200 automatically.

At this moment, in step 1222, if do not finish these work in the art cup, operating nurse can be connected mouth and nose intubate 145 with the patient is facial.In step 1223, PRU 200 can begin to monitor patient parameter now, for example such as ARM, and ECG, and end-tidal carbon dioxide chart, all these are connected between patient and the PRU 200 (through BMU 300) and all finish.In step 1224, PRU 200 will continue the monitoring patient parameter, for example such as NIBP, and pulse and oximeter.Then, operating nurse can scan the bar code label on the packing of medicine box 251 and medicine box is placed among the PRU 200 and in step 1225 and standard vial is pinned on the medicine bottle nail pin 261.In case fluid bottle and medicine box 64 are correctly loaded, the nurse can rise automatically and annotate IV pipe fitting 259.In one implementation, 227, operating nurse can be pushed the button that is arranged on the PRU 200 and annotate to start to rise automatically, and perhaps when all safe conditions had reached, annotating for automatic can be the auto-programming that is started by PRU 200.Automatically playing notes is that air is from IV pipe fitting 259 automatic purges.PRU 200 continuous monitorings play the notes process automatically to determine playing notes success fully automatically.If PRU 200 is purge IV pipe fitting correctly, step 1227 will be carried out alert notice to the user, make operating nurse can repeat to rise automatically the notes program up to IV pipe fitting 259 successful purges.

When successfully finishing automatic notes program, in step 1229, operating nurse can be imported the weight in patients with the pound note, and doctor's (not being the anaesthetist) can import initial medicine retention agent dose rate and dosage method simultaneously; Normal or rapid perfusion.After weight in patients and close rate be transfused to, in step 1230, doctor or operating nurse can start drug perfusion.When medicine worked to the patient, the doctor can carry out the standard procedures correlated activation, for example such as detection range and use any local anesthesia.In case medicine plays a role to the patient, in step 1231, doctor and operating nurse can undergo surgery.After operation was finished, in step 1232, the clinician can disconnect drug delivery cassette from conduit, and disconnected BMU 300 in step 1233 from PRU 200.If the clinician needs, in step 1234, this moment, PRU 200 can print the record of physiological parameter by printer 454.Being included on the operation record that prints is the patient-monitoring data, for example such as NIBP, and pulse blood oxygen amount, end-tidal carbon dioxide figure, breathing rate and the rhythm of the heart.Other system event that is included among the result of printing is the ARM ability, perioperative ARM response, oxygen therapy is historical, drug dose, monitoring at interval, amount of pills and time, and total injection volume of carrying of operation process.Print result comprises that operating nurse can import the part of remarks, for example such as the anesthetis of other input, the part spraying of using, the calm scoring of Ramsey, operation begins and the concluding time, use burn unit and setting, burn the ground connection position, expansion device model and size, and scoring (Aldrete Score) is recovered in the anesthesia back.After printing patient's record, in step 1235, the patient just can be moved to recovery room.

After leaving operating room, the patient arrives recovery room 1240 and still is connected with BMU 300.At this moment, BMU 300 can move under battery or AC electric power.After entering the room, the doctor in charge can remove the ECG pad from patient 1241, ECG lead, ARM mobile phone and receiver.Depend on doctor's preference and patient's state, the patient can need auxiliary oxygen in recovery room 1242.If the patient requires supplemental oxygen, in step 1243, mouth and nose intubate 145 will be included in patient's face and oxygen and obtain from external source through adapter 152 and BMU adapter 151, for example such as end wall or jar.If do not require supplemental oxygen in recovery room, nurse or technician can take mouth and nose intubate 145 from patient 1244.

Nurse or technician can discern ECG lead 334 and ARM mobile phone 342 now and be placed near the BMU 300 to be used for next patient 1245.As an alternative, ARM mobile phone 342 can be used to the patient, is used for the response based on the time, so that inquire from ARM.Nurse or technician can write down other information on patient's record.Nurse or technician will write the note of describing status of patient between convalescence and the NIBP that writes down patient between convalescence, pulse rate and blood oxygen levels as far as possible.Can abandon ECG pad 332 and mouth and nose intubate 145 in the standard waste vessel that is arranged in the recovery room 1247 this moment.Be important to note that BMU 300 still gathers and NIBP the data that pulse rate is relevant with the pulse blood oxygen levels.Nurse or technician must determine whether the patient can be allowed to leave 1249.The standard that is used for allowing to leave changes at patient care device, but anesthesia back is recovered to mark to such an extent that be divided into 10 and generally be used to allow to leave.Allow other mensuration of the standard of leaving to comprise by response ARM, the colour of skin, patient evaluation, the sense of touch of IV position, NIBP to requiring.Pulse, breathing rate, and blood oxygen levels all must be near the measured value of carrying out before art.If the patient does not reach in these standards any one, recommendation be that the patient accepts extra monitoring 1248.In case the patient clearly can be allowed to leave, nurse or technician disconnect NIBP cuff 58 on one's body from the patient, the pulse oximeter probe, and if also do not carry out, disconnect mouth and nose intubate 145 and ARM mobile phone 342.In case all are above-mentioned all finishes, the patient just can allow to leave from care appliances 1251.

Referring now to Figure 81,, peripheral medical display 1252 receives the patient data of handling, the patient data of display process on peripheral LCD display 1253 then from medical actuator system 100 '.Displayable information comprises the rhythm of the heart, blood pressure, pulse blood oxygen value, end-tidal amount of carbon dioxide, electrocardiogram and other medical parameter of being handled by medical actuator system 100 '.Except patient data, periphery medical science display 1252 can show the surgical parameters relevant with the function of medical actuator system 100 '.Functional parameter can comprise: battery charge level, and the persistent period of current operation, patient's name and other descriptive patient datas, the information relevant with IV pump module 220 is employed pharmacodynamics medicine and other parameter with the patient.Medical science display 1252 also comprises the ability that allows the medical science practitioner to set the predefined parameter restriction on every side, if surpass the actuation of an alarm that this restriction will cause periphery medical science display 1252, can increase any alarm that is produced by medical actuator system 100 ' in addition.Actuation of an alarm can be from 1254 flashes of light of periphery light-emitting section, from the audible signal of peripheral speaker 1255 or the form of the ejection alarm on the peripheral LCD touch screen 1253.

Peripheral medical display 1252 also can show the output of another kind of medical apparatus, such as endoscope camera 1256.Peripheral medical science display 1252 has the output of demonstration endoscope camera 1256 and the ability of patient and surgical data on peripheral LCD touch screen 1253 simultaneously.This function allows the medical science practitioner to observe associated patient and surgical data, and the output of he or she attention from endoscope camera can not scatter.

Peripheral medical display 1252 also can comprise user interface, allows the medical science practitioner to change the display setting on peripheral medical science display 1252.User interface can be arranged on the PRU monitor touch screen 443 on the peripheral medical science display 1252 or the form of peripheral monitor LCD touch screen 1253.By user interface, medical science practitioner can change the various vision parameters that comprise; Even if overlappingly in the output of endoscope camera also can select this medical science and surgical parameters.In addition, the medical science practitioner can relative to each other revise the size and the position of parameter display.Can comprise by other selection that user interface obtains, select display format or medical parameter (bar diagram, specification, histogram, diagram, perhaps numeral) the color adjustment, Time Created, table was with automatic change vision parameter, under the situation of alarm action, set up and show priority, the amplification of endoscope camera output, and the selection of alternative image source and other observation option.Patient and surgical parameters can be from the output gap settings of endoscope camera 1256, perhaps can be overlapping in the output of endoscope camera 1256.This is by being arranged in the peripheral medical science display 1252 or the vision mixing arrangement of medical actuator system 100 ' is finished.Similar peripheral medical science display 1252 can utilize picture in picture to show, comprises the output from endoscope camera 1256 or other image source.

Though described aspect of the present invention, embodiment and example etc., the applicant is not intended to the spirit and scope qualification of appended claims or limits so in detail.Under the situation that does not deviate from scope of the present invention, many other changes, changes and substitute can be expected for a person skilled in the art.For example, consider the obvious modification of described system and member and the compatibility of described mechanical system, but medical actuator system of the present invention and member thereof are also in the auxiliary surgery of application machine.Should be appreciated that aforementioned description provides as just example, under the situation of the scope and spirit that do not deviate from appending claims, other modification can be expected for a person skilled in the art.

Claims (119)

1, a kind of medical actuator system comprises:

A) based on the bed side monitoring means of microprocessor, have the first group of junction point that is used for receiving patient's input from the patient-monitoring connector, have second group of junction point exporting patient's output according to the input that receives, and have the display screen that is used to show at least a portion patient output;

B) based on the operation room unit of microprocessor, has medical actuator, and has a master controller, described master controller has the memorizer that comprises patient-monitoring and medical actuator scheduler program, described program to small part is operably connected to the program input according at least a portion patient output, and/or controls described medical actuator according to program input control and/or suggestion user to small part; And

C) umbilicus cable, have with second group of junction point of described bed side monitoring means and be connected or attachable first end, and have with described operation room unit and be connected or attachable second end, wherein at least one of first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit, and wherein said operation room unit comprises network and/or the modem connector that operationally is connected with described master controller.

2, a kind of medical actuator system comprises:

A) based on the bed side monitoring means of microprocessor, have the first group of junction point that is used for receiving patient's input from the patient-monitoring connector, have second group of junction point exporting patient's output according to the input that receives, and have the display screen that is used to show the described patient's output of at least a portion;

B) based on the operation room unit of microprocessor, has medical actuator, and has a master controller, described master controller has the memorizer that comprises patient-monitoring and medical actuator scheduler program, described program to small part is operably connected to the program input according at least a portion patient output, controls medical actuator according to program input control and/or suggestion user to small part; And

C) umbilicus cable, have with second group of junction point of described bed side monitoring means and be connected or attachable first end, and have with described operation room unit and be connected or attachable second end, at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit, the master controller of wherein said operation room unit comprises health level seven application protocols, sends and/or receive in the electronics mode to arrive and/or from the communication of remote computer.

3, a kind of medical actuator system comprises:

A) based on the bed side monitoring means of microprocessor, have the first group of junction point that is used for receiving patient's input from the patient-monitoring connector, have second group of junction point exporting patient's output according to the input that receives, and have the display screen that is used to show the described patient's output of at least a portion;

B) based on the operation room unit of microprocessor, has medical actuator, and has a master controller, described master controller has the memorizer that comprises patient-monitoring and medical actuator scheduler program, described program to small part is operably connected to the program input according at least a portion patient output, controls described medical actuator according to program input control and/or suggestion user to small part; And

C) umbilicus cable, have with described second group of junction point of described bed side monitoring means and be connected or attachable first end, and have with described operation room unit and be connected or attachable second end, at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit, and wherein said operation room unit comprises the printer that is operably connected to described master controller.

4, a kind of calm induction system comprises:

A) based on the bed side monitoring means of microprocessor, have the bed side monitoring means master controller that contains first program, described first program is carried out the following step: the patient sends requirement to non-sedating, requires to make non-sedating patient response; Respond received signal according to described non-sedating patient; And the non-sedating response time that sends the time difference calculating patient between requirement and the received signal to the small part basis;

B) based on the operation room unit of microprocessor, have the operation room unit master controller that contains second program, described second program is carried out the following step: send requirement by described bed side monitoring means to calm patient, require to make calm patient's response; Respond by described bed side monitoring means received signal according to calm patient; Calculate calm patient's calm response time, and the response time that calculates between described non-sedating and the calm response time is poor; And

C) umbilicus cable, have with described bed side monitoring means and be connected or attachable first end, and have with described operation room unit and be connected or attachable second end, at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit.

5, calm induction system according to claim 4, wherein, described operation room unit has the drug conveying infusion pump assembly of being controlled according to described response time difference at least in part by described operation room unit master controller.

6, a kind of medical actuator induction system operation room unit comprises:

Comprise the operation room unit master controller that contains the oxygen therapy program, described program is carried out the following step: from standing abirritative patient received pulse blood oxygen signal and calculating oxygen flow speed according to the pulse blood oxygen signal that receives at least in part; Wherein said operating room master controller is according to the oxygen flow speed control system oxygen that calculates flowing to the patient.

7, a kind of medical actuator system comprises:

A) the described operation room unit of medical actuator system of claim 6;

B) bed side monitoring means; And

C) umbilicus cable, have with described bed side monitoring means and be connected or attachable first end, and have with described operation room unit and be connected or attachable second end, at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit, wherein when described umbilicus cable is connected with described operation room unit and described bed side monitoring means, pulse blood oxygen signal from the patient flow through described bed side monitoring means and through described umbilicus cable to described operation room unit, and flow through described umbilicus cable and described bed side monitoring means of Oxygen Flow arrives the patient.

8, a kind of medical actuator system comprises:

A) based on the bed side monitoring means of microprocessor, have the first group of junction point that is used for receiving patient's input from the patient-monitoring connector, have second group of junction point exporting patient's output according to the input that receives, and have the display screen that is used to show the described patient's output of at least a portion;

B) based on the operation room unit of microprocessor, has the energy delivery medical actuator, and has a master controller, described master controller has the memorizer that comprises patient-monitoring and medical actuator scheduler program, described program is operably connected to the program input according at least a portion patient output at least in part, controls described energy delivery medical actuator according to program input control and/or suggestion user to small part; And

C) umbilicus cable, have with second group of junction point of described bed side monitoring means and be connected or attachable first end, and have with described operation room unit and be connected or attachable second end, at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit.

9, medical actuator system according to claim 8, wherein, described energy delivery medical actuator comprises that at least one can be transported to the time variation magnetic field patient the patient is produced the magnetic flux generator of sedation.

10, a kind of medical actuator system comprises:

A) based on the bed side monitoring means of microprocessor, has a side monitoring means master controller, have the first group of junction point that is used for receiving patient's input from the patient-monitoring connector, and have second group of junction point exporting patient's output according to the input that receives, and has the display screen that is used to show the described patient's output of at least a portion;

B) based on the operation room unit of microprocessor, has medical actuator, and has an operation room unit master controller that has the memorizer that comprises patient-monitoring and medical actuator scheduler program, described program is operably connected to the program input according at least a portion patient output at least in part, and this program is controlled described medical actuator according to program input control and/or suggestion user at least in part; With

C) umbilicus cable, have with second group of junction point of described bed side monitoring means and be connected or attachable first end, and have with described operation room unit and be connected or attachable second end, at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit, wherein when described umbilicus cable was connected with bed side monitoring means with described operation room unit, described operation room unit master controller and described bed side monitoring means master controller can link together in operation.

11, medical actuator system according to claim 10, wherein, the mobile Control Component of described drug conveying comprises drug conveying infusion pump assembly.

12, medical actuator system according to claim 10, wherein, described operation room unit (PRU) has independent PRU identifier, described bed side monitoring means (BMU) has Independent B MU identifier, wherein the electronics history that the described operation room unit master controller of described operation room unit is write described bed side monitoring means according to Independent B MU identifier when being connected with described operation room unit.

13, medical actuator system according to claim 12 also comprises the drug delivery cassette component that single patient uses, and it has independently box identifier, and is operably connected to the mobile Control Component of described drug conveying of described operation room unit; Further comprise having intubate identifier independently and can be connected to the cannula assembly that the single patient of described bed side monitoring means uses, the electronics history that the described operation room unit master controller of wherein said operation room unit is write described drug delivery cassette component and described cannula assembly according to independently box and intubate identifier.

14, medical actuator system according to claim 10, wherein, when described bed side monitoring means was connected with described operation room unit, the bed side monitoring means master controller of anastomosing bed side monitoring means was connected the operation room unit that disconnects.

15, medical actuator system according to claim 14, wherein, when described bed side monitoring means was connected with described operation room unit, the operation room unit master controller of anastomosing operation room unit was connected the bed side monitoring means that disconnects.

16, medical actuator system according to claim 10, wherein, when described bed side monitoring means was connected with described operation room unit, the operation room unit master controller of anastomosing operation room unit was connected the bed side monitoring means that disconnects.

17, medical actuator system according to claim 10, wherein, described bed side monitoring means shows patient-monitoring when not being connected with described operation room unit, and when being connected with described operation room unit when described operation room unit master controller detects some mistakes in the described operation room unit demonstration patient-monitoring.

18, medical actuator system according to claim 10, wherein, when detecting some mistakes in described bed side monitoring means that is connecting and/or the described operation room unit, described operation room unit master controller disconnects described drug conveying infusion pump assembly.

19, medical actuator system according to claim 10, wherein, described umbilicus cable wrap is drawn together the electric power supply line, when described umbilicus cable and described bed side monitoring means disconnect when being connected and/or described umbilicus cable when being connected with described operation room unit disconnection, described operation room unit master controller disconnection supplies to the electric power supply line of described umbilicus cable.

20, medical actuator system according to claim 19, wherein, described bed side monitoring means comprises a side monitoring means battery, wherein the electric power from described operation room unit is described bed side monitoring means battery powered through the electric power supply line of described umbilicus cable.

21, a kind of bite-block, comprise the bite-block main body that is suitable for being inserted in the patient oral cavity, wherein said bite-block main body comprises through-out pathway and comprises the air sampling passage that is provided with at interval with described through-out pathway, wherein said through-out pathway is suitable for holding medical apparatus and instruments, wherein said air sampling passage has the import that is set to receive from the air of patient's exhalation when described bite-block main body is inserted in the patient oral cavity, and has the outlet that can be connected with the breathing gas sampling port of intubate.

22, bite-block according to claim 21, wherein, the outlet of described air sampling passage can be connected to the described breathing gas sampling port of described intubate indirectly by connector tube.

23, a kind of cannula assembly comprises:

A) place disposable intubate on patient's face, comprise the breathing gas sampling port;

B) has the bite-block of the bite-block main body that can be inserted in the patient oral cavity, wherein said bite-block main body comprises through-out pathway and comprises the air sampling passage that is provided with at interval with described through-out pathway, wherein said through-out pathway is suitable for holding therein medical apparatus and instruments, wherein said air sampling passage has the import that is set to receive from the air of patient's exhalation when described bite-block main body is inserted in the patient oral cavity, and has outlet; With

C) connector tube, it has and is connected with the described breathing gas sampling port of described intubate or can connected first end, and has and be connected with described bite-block main body in the exit of the described air sampling passage of described bite-block main body or can connected second end.

24, a kind of bite-block assembly comprises:

A) be suitable for being inserted into bite-block main body in the patient oral cavity, wherein said bite-block main body comprises the through-out pathway that is suitable for holding therein medical apparatus and instruments; And

B) the air sampling pipe that is connected with described bite-block main body has the import that is set to when described bite-block main body is inserted in the patient oral cavity to receive the air of breathing out from the patient, and has with the breathing gas sampling port of intubate and be connected or attachable outlet.

25, bite-block assembly according to claim 24, wherein, described air sampling pipe is at least partially disposed in the described through-out pathway.

26, bite-block assembly according to claim 25, wherein, described air sampling pipe extends fully through described through-out pathway.

27, bite-block assembly according to claim 24, wherein, the outlet of described air sampling pipe is suitable for being connected indirectly with the described breathing gas sampling port of described intubate by connector tube.

28, a kind of bite-block assembly comprises:

A) be suitable for being inserted into bite-block main body in the patient oral cavity, wherein said bite-block main body comprises and is suitable for medical apparatus and instruments is contained in through-out pathway wherein and comprises the air sampling passage; And

B) be at least partially disposed on air sampling pipe in the described air sampling passage, have the import that is set to when described bite-block main body is inserted in the patient oral cavity to receive the air of breathing out from the patient, and have with the breathing gas sampling port of intubate and be connected or attachable outlet.

29, bite-block assembly according to claim 28, wherein, the described outlet of described air sampling pipe is suitable for being connected indirectly with the described breathing gas sampling port of described intubate by connector tube.

30, a kind of medical actuator subsystem comprises:

A) drug delivery pipe, its pharmaceutical pack that is suitable for having a controlled variable flow velocity with which and it be disposable so that conduct drugs to the patient;

B) pressure transducer, it has output signal and is suitable for the internal pressure of the described drug delivery pipe of perception; With

C) comprise the memorizer of obstruction program, it is operably connected to the output signal of described pressure transducer when operation on processor, wherein said obstruction program has the variable pressure warning value of setting, and warning user drug conveying pipe choking when the output signal of described pressure transducer surpasses described variable pressure and reports to the police the value of setting, wherein said obstruction program can be at least in part, the controlled variable flow velocity according to medicine changes described variable pressure warning value of setting directly or indirectly.

31, medical actuator subsystem according to claim 30, wherein, when the controlled variable flow velocity is lower than predetermined value, described obstruction program is set at fixing low value of setting with described variable pressure warning value of setting, when the controlled variable flow velocity equaled or is higher than predetermined value, described obstruction program was set at fixedly high value of setting with described variable pressure warning value of setting.

32, no matter when medical actuator subsystem according to claim 30 wherein, changes in the described controlled variable flow velocity, and described obstruction program all changes the described variable pressure value of setting of reporting to the police.

33, medical actuator subsystem according to claim 30, wherein, described drug delivery pipe is the intravenous drug delivery pipe.

34, medical actuator subsystem according to claim 30, wherein, described pressure transducer comprises pressure-sensitive importation, wherein said drug delivery pipe has atresia lateral surface part, and the importation of wherein said pressure transducer is configured to partly contact with the atresia lateral surface of described drug delivery pipe.

35, medical actuator subsystem according to claim 30, wherein, described memorizer and processor are the members of the master controller of operation room unit, and wherein said memorizer also comprises the drug conveying algorithm, its decision controlled variable flow velocity when operation on described processor.

36, medical actuator subsystem according to claim 30, also comprise the infusion pump that is suitable for receiving the controlled variable flow velocity, and have peristaltic pump and refer to, described peristaltic pump refers to be configured to and described drug delivery pipe interacts, and can be controlled to be under described controlled variable flow velocity and pump into medicine.

37, a kind of medical actuator subsystem comprises:

A) drug delivery pipe, its pharmaceutical pack that is suitable for having a controlled variable flow velocity with which and it be disposable so that conduct drugs to the patient, and comprise atresia lateral surface part;

B) pressure transducer, it has output signal and comprises and be configured to the pressure-sensitive importation that partly contacts with the atresia lateral surface of described drug delivery pipe; With

C) comprise the memorizer of obstruction program, it is operably connected to the output signal of described pressure transducer when operation on processor, wherein said obstruction program has the variable pressure warning value of setting, and warning user drug conveying pipe choking when the output signal of described pressure transducer is reported to the police the value of setting above variable pressure, wherein said obstruction program at least in part, directly or indirectly the described controlled variable flow velocity according to medicine changes the variable pressure warning value of setting.

39, a kind of drug conveying infusion pump sub-component comprises:

A) drug delivery pipe, it is suitable for holding therein medicine, and is disposable, to give the patient with drug conveying;

B) peristaltic pump refers to, it is configured to interact with described drug delivery pipe and with the pumping of controlled flow speed control pharmacy thing;

C) pressure transducer, it has output signal and is suitable for the internal pressure that the described peristaltic pump of perception refers to the described drug delivery pipe in downstream; With

D) block alarm unit, it is operably connected with the described output signal of described pressure transducer, and has the variable pressure value of setting of reporting to the police, warning user drug conveying pipe choking when the output signal of described pressure transducer is reported to the police the value of setting above variable pressure, wherein said obstruction alarm unit fully directly changes described variable pressure warning value of setting according to the controlled variable flow velocity of medicine.

40, according to the described drug conveying infusion pump of claim 39 sub-component, the member that wherein, described drug delivery pipe, described peristaltic pump refer to, described pressure transducer and described obstruction alarm unit are the operation room units of medical actuator system.

41, a kind of drug delivery cassette component comprises:

A) Rule (luer);

B) pipe fitting, it has medicine receiving terminal that can be connected with the medicine bottle fluid that contains medicine and the drug conveying end that is communicated with Rule fluid; With

C) drug delivery cassette mainboard, it has position, Rule base portion, wherein Rule can be with respect to the base portion dismounting of position, described Rule, wherein but position, Rule base portion has position, deflection Rule pick off crossbeam, described crossbeam is configured to by Rule deflection when Rule is connected with position, Rule base portion, and described crossbeam when position, Rule base portion is pulled down is configured to not deflection when Rule.

42, according to the described drug delivery cassette component of claim 41, wherein, described box mainboard can be connected with the operation room unit with built-in Rule optical sensor or pull down from it, and described optical sensor is arranged to a kind of in position, Rule pick off crossbeam of position, Rule pick off crossbeam of perception deflection and not deflection.

43, according to the described drug delivery cassette component of claim 42, wherein, described operation room unit conducts drugs to the patient at least in part according to perception or do not perceive built-in Rule optical sensor control medicine the flowing in pipe fitting of position, Rule pick off crossbeam with the air cleaning pipe fitting and through pipe fitting.

44, a kind of drug delivery cassette component comprises:

A) Rule;

B) drug delivery cassette nail pin has medicine bottle sealing member puncture nail needle point;

C) pipe fitting, it has and can be connected with described nail pin fluid or medicine receiving terminal that fluid disconnects and the drug conveying end that is communicated with Rule fluid; With

D) drug delivery cassette mainboard, wherein said nail pin can be with respect to the dismounting of described box mainboard.

45, a kind of drug delivery cassette component comprises:

A) Rule;

B) pipe fitting, it has medicine receiving terminal that can be connected with the medicine bottle fluid that contains medicine and the drug conveying end that is communicated with Rule fluid; With

C) drug delivery cassette mainboard, it has position, Rule base portion, wherein said Rule can be with respect to the base portion dismounting of position, described Rule, and position, wherein said Rule base portion has and is set to the drip chamber of collecting the medicine in any discharge Rule when described Rule is connected with position, Rule base portion.

46,, also comprise the drug absorption pad that is arranged in the described drip chamber according to the described drug delivery cassette component of claim 45.

47, a kind of drug delivery cassette component comprises:

A) Rule;

B) pipe fitting, comprise coil pipe and flexible pipe that fluid links together, wherein said flexible pipe has the medicine receiving terminal that can be connected with the medicine bottle fluid that contains medicine, and wherein said coil pipe has the drug conveying end that is communicated with described Rule fluid, and wherein said coil pipe can be extended by the user.

48, according to the described drug delivery cassette component of claim 47, wherein, described coil pipe comprises a plurality of pipeloops, and wherein adjacent pipeloop bonds together releasedly.

49, according to the described drug delivery cassette component of claim 47, wherein, the internal diameter of described coil pipe is less than the internal diameter of described flexible pipe.

50, a kind of medical science oxygen therapy apparatus, the current limiter that comprises oxygen therapy collector, mouth of pipe fixed size current limiter and mouth of pipe size variable with oxygen therapy stream, wherein said oxygen therapy stream comprises that stream inlet and fluid that fluid is connected to the pressurised oxygen source of the gas are connected to the flowing path outlet that is positioned at the disposable intubate on patient's face, wherein said mouth of pipe fixed size current limiter is arranged on the stream downstream of described stream inlet, and described mouth of pipe size variable current limiter is arranged on the stream downstream of described mouth of pipe fixed size current limiter.

51, according to the described medical science oxygen therapy of claim 50 apparatus, also be included in and be arranged on the high side pressure pick off that the primary importance place between described stream inlet and the described mouth of pipe fixed size current limiter is communicated with described stream fluid, also comprise the place, entry position that is arranged between described primary importance and the described mouth of pipe fixed size current limiter and be arranged on the differential pressure pickup that the place, exit position between described mouth of pipe fixed size current limiter and the described mouth of pipe size variable current limiter is communicated with described stream fluid.

52, according to the described medical science oxygen therapy of claim 51 apparatus, wherein, described mouth of pipe size variable current limiter is a mouth of pipe size variable solenoid.

53, according to the described medical science oxygen therapy of claim 50 apparatus, wherein, described oxygen therapy collector is the sub-component of the operation room unit of medical actuator system.

54, a kind of operation room unit of medical actuator system, comprise the operation room unit master controller that contains the oxygen therapy program, described program is carried out the following step: when the patient is confirmed as through oral inhalation and aerofluxus, arrive the oxygen delivery of at least one breathing gas delivery port pin of the cannula assembly that is operably connected to the patient with successive predetermined first rate control; When the patient is confirmed as being confirmed as when air-breathing through respiratory and as the patient, arrive the oxygen delivery of at least one breathing gas conveying nose pin of cannula assembly with predetermined second rate controlled; And be confirmed as through respiratory and when the patient is confirmed as exhaling as the patient, arriving the oxygen delivery of described at least one breathing gas conveying nose pin with predetermined third speed control, wherein said second speed is greater than described third speed.

55, according to the described operation room unit of medical actuator system of claim 54, wherein, described oxygen therapy program is also carried out and is determined the step of patient through nose or oral cavity breathing, if through respiratory nasal, also at least in part according to carrying out the step of determining that the patient sucks or breathes out from the nasal pressure reading of the sampling breathing gas that obtains by a breathing gas sampling nose pin of cannula assembly at least.

56, a kind of medical science oxygen therapy apparatus, comprise oxygen therapy collector with oxygen therapy stream and the oxygen sampling stream that can be connected with described oxygen therapy stream fluid, wherein said oxygen therapy stream comprises and can be connected to the stream inlet of pressurised oxygen source of the gas and can be connected to the flowing path outlet that is positioned at the disposable intubate on patient's face by fluid by fluid that wherein said oxygen sampling stream comprises the oxygen sensor that detects oxygen-depleted gas.

57, according to the described medical science oxygen therapy of claim 56 apparatus, wherein, described oxygen therapy collector is the sub-component of the operation room unit of medical actuator system.

58, a kind of drug conveying infusion pump assembly comprises:

A) drug conveying infusion pump shell;

B) drug delivery cassette component, it can be connected and have medicine bottle nail pin with described infusion pump shell; With

C) the pump case door that is connected with described infusion pump shell, it has opening position and the position of closing the door, and have medicine bottle and aim at and to refer to, described medicine bottle aim at the medicine bottle that refers to when following situation, to make different-diameter fixed in and aim at: when described case assembly is connected with described infusion pump shell; When described pump case door is in when closing the door the position; And when medicine bottle be inserted into described medicine bottle aim at refer between when engaging with described nail pin.

59, according to the described drug conveying infusion pump of claim 58 assembly, wherein, when described pump case door was in opening position, described case assembly can be with respect to the dismounting of described infusion pump shell.

60, according to the described drug conveying infusion pump of claim 58 assembly, also comprise and be arranged in the described infusion pump shell and have the drug conveying peristaltic pump that pump refers to, wherein be connected with described infusion pump shell and described pump case door when being in opening position when described case assembly, described case assembly is operably connected to described pump and refers to.

61, a kind of operation room unit of medical actuator system comprises:

A) operation room unit master controller; With

B) capnometer, have capnometer gas input that receives directly or indirectly the breathing gas that obtains from the disposable intubate that is positioned at patient's face and the capnometer signal output that can be connected to described operation room unit master controller in operation, wherein said operation room unit master controller sends described capnometer fluid according to the described capnometer signal output of capnometer to the user at least in part and connects and/or do not have fluid to be connected to the warning of described intubate.

62, according to the described operation room unit of medical actuator system of claim 61, wherein, described capnometer input receives the breathing gas that derives from intubate indirectly through bed side monitoring means between two parties, described bed side monitoring means can be connected and connect or can be connected to first end of umbilicus cable with described intubate, described umbilicus cable has second end that connects or can be connected to operation room unit, and at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit.

63, a kind of operation room unit of medical actuator system, comprise operation room unit of medical actuator system control station and capnometer sub-component with control desk fan, wherein said control desk fan enters air movement, through described operation room unit control station and from wherein discharging, wherein said capnometer sub-component has gas feed of capnometer sub-component and capnometer sub-component gas outlet, and wherein said capnometer sub-component gas outlet is arranged to make gas can be entrained with air that described control desk fan removes and leaves described capnometer sub-component gas outlet.

64, according to the described operation room unit of medical actuator system of claim 63, wherein, described carbon dioxide monitoring device sub-component has capnometer and is operably connected to the capnometer pump of described capnometer.

65, a kind of medical actuator system comprises:

A) the described operation room unit of medical actuator system of claim 3;

B) bed side monitoring means; And

C) umbilicus cable, have with described bed side monitoring means and be connected or attachable first end, and have with described operation room unit and be connected or attachable second end, at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit.

66, a kind of operation room unit of medical actuator system comprises:

A) operation room unit master controller;

B) capnometer, it has directly or receives indirectly from can be in the capnometer gas feed of the breathing gas of the facial disposable intubate of patient, and has the capnometer gas outlet that is operably connected to described operating room master controller;

C) have the oxygen collector of oxygen therapy stream, described oxygen therapy stream comprises the placed in-line stream inlet that can fluid be connected to the pressurised oxygen source of the gas, current limiter and can fluid be connected to the flowing path outlet of described intubate; With

D) downside pressure sensor, it is communicated with described flowing path outlet fluid, be arranged on the downstream of any oxygen collector current limiter, and having the low side pressure signal output that is operably connected to described operation room unit master controller, wherein said operation room unit master controller is exported according to the described low side pressure signal of the capnometer signal output of capnometer and described downside pressure sensor at least in part and is sent the capnometer fluid to the user and be connected and/or do not have fluid to be connected to the warning of intubate.

67, according to the described operation room unit of medical actuator system of claim 66, wherein, described capnometer input receives the breathing gas that derives from described intubate indirectly through bed side monitoring means between two parties, described bed side monitoring means can be connected and connect or can be connected to first end of umbilicus cable with intubate, described umbilicus cable has second end that connects or can be connected to described operation room unit, the flowing path outlet of wherein said oxygen collector by described bed side monitoring means and umbilicus cable indirectly fluid be connected to described intubate, at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit.

68, a kind of operation room unit of medical actuator system comprises:

A) operation room unit master controller;

B) capnometer, it has directly or receives indirectly from can be in the capnometer gas feed of the breathing gas of the facial disposable intubate of patient, and has the capnometer gas outlet that is operably connected to described operating room master controller; And

C) be operably connected with capnometer and by the capnometer pump of described operation room unit main controller controls, described operation room unit master controller is determined described capnometer fluid connection and/or is not had fluid to be connected to described intubate according to the capnometer signal output of capnometer at least in part, wherein when described capnometer was not connected with described intubate fluid, described operation room unit master controller had time delay or the described capnometer pump that has no time lingeringly to cut off.

69, according to the described operation room unit of medical actuator system of claim 68, wherein, described capnometer input receives the breathing gas that derives from described intubate indirectly through bed side monitoring means between two parties, described bed side monitoring means can be connected and connect or can be connected to first end of umbilicus cable with described intubate, described umbilicus cable has second end that connects or can be connected to described operation room unit, and at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit.

70, a kind of operation room unit of medical actuator system comprises:

A) operation room unit master controller;

B) capnometer, it has directly or receives indirectly from can be in the capnometer gas feed of the breathing gas of the facial disposable intubate of patient, and has the capnometer gas outlet that is operably connected to described operating room master controller; And

C) atmosphere pressure sensor, it has the atmosphere pressure sensor signal output that is operably connected to described operation room unit master controller; Described operation room unit master controller uses the atmosphere pressure sensor signal output of described at least atmosphere pressure sensor to determine whether described operation room unit of medical actuator system has moved to the reposition with difference in height bigger than predetermined height difference, wherein when described operation room unit of medical actuator system had moved to the reposition with difference in height bigger than predetermined height difference, described operation room unit master controller sent capnometer calibration warning to the user.

71, according to the described operation room unit of medical actuator system of claim 70, wherein, described capnometer input receives the breathing gas that derives from intubate indirectly through bed side monitoring means between two parties, described bed side monitoring means can be connected and connect or can be connected to first end of umbilicus cable with intubate, described umbilicus cable has second end that connects or can be connected to operation room unit, and at least one of wherein said first and second ends can be pulled down from corresponding bed side monitoring means or operation room unit.

72, a kind of operation room unit of medical actuator system comprises:

A) operation room unit master controller;

B) be positioned at disposable intubate on patient's face, have the breathing gas sample output that is operably connected to described operation room unit master controller; With

C) oxygen collector, it has the flowing path outlet that can be connected with described intubate fluid, and has a mouth of pipe size variable current limiter that is operably connected to and is arranged on described flowing path outlet upstream, wherein said operation room unit master controller uses the time of the intubate breathing of setting at least for the first time according to the definite patient of breathing gas sample output of described intubate, and opens mouth of pipe size variable current limiter when the patient is determined the intubate breathing that the first time, use was provided with.

73, according to the described operation room unit of medical actuator system of claim 72, wherein, the breathing gas sample of described intubate output through pressure transducer and/be operably connected on the described operation room unit master controller through capnometer.

74, according to the described operation room unit of medical actuator system of claim 72, wherein, described mouth of pipe size variable current limiter is a mouth of pipe size variable solenoid.

75, a kind of cannula assembly adapter, comprise at least one cannula assembly connector members, and have nose capnometer port, mouthful capnometer port, nose pressure port and breathing gas delivery port, wherein each port all is connected with the bed side monitoring means fluid of described medical actuator.

76, according to the described cannula assembly adapter of claim 75, wherein, described at least one cannula assembly connector members comprises plate.

77, according to the described cannula assembly adapter of claim 75, wherein, the distance that each port all has between center and any two the port centers wherein all is the shortest for nose capnometer and nose pressure port.

78, according to the described cannula assembly adapter of claim 75, wherein, described at least one cannula assembly connector members also has audio port.

79, according to the described cannula assembly adapter of claim 75, wherein, described bed side monitoring means is connected with the operation room unit fluid of described medical actuator system, wherein said operation room unit comprises mouthful capnometer and nose capnometer, wherein, when the mouth of described capnometer with nose capnometer port is connected with described bed side monitoring means fluid and described side monitoring means when being connected with described operation room unit fluid, described mouthful of capnometer is communicated with described mouthful of monitor port fluid, and described nose capnometer is communicated with described nose monitor port fluid.

80, a kind of cannula assembly comprises:

A) be positioned at disposable intubate on patient's face, comprise the breathing gas probe tube;

B) adapter, wherein said breathing gas probe tube can be connected with described adapter fluid, and wherein said adapter can be connected with the bed side monitoring means of calm induction system; With

C) the disposable audio frequency receiver of close patient's ear setting, it is operably connected to described adapter, when described adapter is connected with described bed side monitoring means and described audio frequency receiver when being provided with near patient's ear, the direction along described side monitoring means provides sound for the patient at least.

81, a kind of operation room unit of medical actuator system, comprise the operation room unit master controller that contains the oxygen therapy program, described program is carried out the following step: when the patient is confirmed as through oral inhalation and aerofluxus, arrive the oxygen delivery of at least one breathing gas delivery port pin of the cannula assembly that is operably connected to the patient with variable first rate control; When the patient is confirmed as being confirmed as when air-breathing through respiratory and as the patient, arrive the oxygen delivery of at least one breathing gas conveying nose pin of cannula assembly with variable second rate controlled; And be confirmed as through respiratory and when the patient is confirmed as exhaling as the patient, arrive the oxygen delivery that described at least one breathing gas is carried the nose pin with variable third speed control, wherein the patient has variable blood oxygen saturation percentage ratio, and described first, second depends on blood oxygen saturation percentage ratio with third speed.

82,1 described operation room unit of medical actuator system according to Claim 8, wherein, for the blood oxygen saturation percentage ratio that is higher than predetermined high percentage ratio, second speed is fixed low rate, for the blood oxygen saturation percentage ratio that is lower than predetermined low percentage ratio, second speed is fixed low rate.

83,2 described operation room unit of medical actuator system according to Claim 8, wherein, along with blood oxygen saturation percentage ratio is reduced to predetermined low percentage ratio from predetermined high percentage ratio, second speed repeatedly arrives fixedly two-forty from fixing low rate increase.

84,3 described operation room unit of medical actuator system according to Claim 8, wherein, for identical blood oxygen saturation percentage ratio, the second speed ratio third speed height.

85,4 described operation room unit of medical actuator system according to Claim 8 wherein, are zero at predetermined high percentage ratio place third speed.

86,1 described operation room unit of medical actuator system according to Claim 8, wherein, the first rate corresponding with the oxygen-saturated particular percentile of blood is the arithmetic mean of instantaneous value with corresponding second and the third speed of the oxygen-saturated particular percentile of blood.

87,1 described operation room unit of medical actuator system according to Claim 8, wherein, when blood oxygen saturation percentage ratio is higher than and when being not less than described predetermined high percentage ratio, described oxygen therapy program is accepted user's input, so that second speed is higher than but from being not less than fixedly low rate.

88,7 described operation room unit of medical actuator system according to Claim 8, wherein, when blood oxygen saturation percentage ratio is higher than and when being not less than described predetermined high percentage ratio, described oxygen therapy program is accepted user's input, so that raise but never reduce third speed.

89, a kind of operation room unit of medical actuator system, comprise the operation room unit master controller that contains the oxygen therapy program, described program is carried out the following step: when the patient is confirmed as being confirmed as when air-breathing through respiratory and as the patient, arrive the oxygen delivery of at least one breathing gas conveying nose pin of the cannula assembly that is operably connected to the patient with variable snuffing gas oxygen therapy flow speed control; And be confirmed as through respiratory and when the patient is confirmed as exhaling as the patient, arrive the oxygen delivery that described at least one breathing gas is carried the nose pin with variable nose expiration oxygen therapy flow speed control, wherein said patient has variable blood oxygen saturation percentage ratio, wherein said snuffing gas oxygen therapy flow velocity is variable, and it depends on blood oxygen saturation percentage ratio.

90,9 described operation room unit of medical actuator system according to Claim 8, wherein, described snuffing gas oxygen therapy flow velocity is variable, and it depends on blood oxygen saturation percentage ratio, wherein for identical blood oxygen saturation percentage ratio, described snuffing gas oxygen therapy flow velocity is higher than described nose expiration oxygen therapy flow velocity.

91, a kind of operation room unit of medical actuator system comprises:

A) capnometer, it is suitable for directly or receives breathing gas from the intubate that can use at the facial disposable single patient of patient indirectly; With

B) barcode reading instrument assembly, it is suitable for reading the bar code of the packing that contains intubate.

92, according to the described operation room unit of medical actuator system of claim 91, also comprise drug conveying infusion pump shell, it is suitable for holding the drug delivery cassette component that single patient uses, and wherein said barcode reading instrument assembly is suitable for reading the bar code of the packing that contains drug delivery cassette component.

93, according to the described operation room unit of medical actuator system of claim 92, wherein, described case assembly is suitable for holding the medicine bottle that contains medicine, and wherein said barcode reading instrument assembly is suitable for reading the bar code of the medicine bottle that contains medicine and/or contains the bar code of the packing of the medicine bottle that holds medicine.

94, a kind of drug conveying assembly comprises:

A) pipe fitting, it has the medicine receiving terminal and the drug conveying end parts that can be connected with the medicine bottle fluid that contains medicine;

B) storing position, when the drug conveying end parts of described pipe fitting was not communicated with patient's drug conveying, it was suitable for storing releasedly the drug conveying end parts of described pipe fitting;

C) pump, when pipe fitting was operably connected to described pump, its control medicine flowing in pipe fitting was so that air cleaning pipe fitting and process pipe fitting conduct drugs to the patient; With

D) pick off, whether it has the drug conveying end parts of exporting and being set to the described pipe fitting of perception and exists at described storing position.

95, according to the described drug conveying assembly of claim 94, wherein, only when the drug conveying end parts of being determined described pipe fitting by the output of described pick off is stored in the described storing position, the described pipe fitting of described pump air cleaning.

96, according to the described drug conveying assembly of claim 94, wherein, only when the drug conveying end parts of being determined described pipe fitting by the output of described pick off was stored in the described storing position, described pipe fitting operationally disconnected with described pump and being connected.

97, a kind of drug delivery cassette component, comprise the drug delivery cassette mainboard, wherein, medicine bottle can be connected with described box mainboard, wherein said box mainboard has deflectable medicine bottle position pick off crossbeam, crossbeam can be configured to by described medicine bottle deflection when described medicine bottle is connected with described box mainboard, and crossbeam can be configured to not deflection when described medicine bottle is not connected with described box mainboard.

98, according to the described drug delivery cassette component of claim 97, wherein, described box mainboard can be with respect to the operation room unit dismounting of the built-in medicine bottle optical sensor that one of has in the medicine bottle position pick off crossbeam that is set to only perception deflection and the undeflected medicine bottle position pick off crossbeam.

99, according to the described drug delivery cassette component of claim 98, wherein, described operation room unit is at least in part according to perception or do not perceive the drug flow of the built-in medicine bottle optical sensor control of described medicine bottle position pick off crossbeam from described medicine bottle.

100, according to the described drug delivery cassette component of claim 97, wherein, described medicine bottle comprises the medicine bottle sealing member, wherein said drug delivery cassette component also comprises the nail pin with nail needle point and nail pin agnail, wherein, when described medicine bottle was connected with described box mainboard, described medicine bottle sealing member kept by described nail needle point perforation and by described nail pin agnail, and described medicine bottle position pick off crossbeam upwards promotes described medicine bottle against described nail pin agnail.

101, a kind of drug delivery cassette component, comprise drug delivery cassette nail pin, wherein medicine bottle can be connected with described nail pin, wherein said medicine bottle comprises the medicine bottle sealing member, described nail needle set has nail needle point and nail pin agnail, when described medicine bottle was connected with described nail pin, described medicine bottle sealing member kept by described nail needle point perforation and by described nail pin agnail.

102, a kind of drug delivery cassette component comprises the drug delivery cassette mainboard, and it removably is connected and comprises the peristaltic pump cut-out with the operation room unit of medical actuator.

103, a kind of drug delivery cassette component, comprise the drug delivery cassette mainboard, this drug delivery cassette mainboard has top left part, top right side part, bottom left-hand section and right side, bottom part, wherein said box mainboard removably is connected with the operation room unit of medical actuator system, wherein said mainboard comprises the peristaltic pump cut-out that is arranged between top left part and the top right side part, and described mainboard has the inner air tube pick off cut-out between the top right side of being arranged on part and right side, the bottom branch.

104, according to the described drug delivery cassette component of claim 103, also comprise the drug conveying flexible pipe, it has and partly is connected with top right side with the top left part of described mainboard and across the generally linear first of peristaltic pump cut-out, and have and be connected with right side, bottom part with the top right side of described mainboard part and across the generally linear second portion of inner air tube pick off cut-out, wherein when described mainboard is connected with described operation room unit, the pump that the first of described flexible pipe is operably connected to the drug conveying peristaltic pump of described operation room unit refers to that the second portion of described flexible pipe is operably connected to the inner air tube pick off of described operation room unit.

105, according to the described drug delivery cassette component of claim 103, wherein, the lower left side of described mainboard part is extended down lower right sidepiece branchs of described mainboard, limits the pump door lock cut-out of the right side that extends to described lower left side part and extension under lower right sidepiece branchs of described mainboard.

106, the combination of a kind of drug conveying infusion pump assembly and drug delivery cassette component comprises:

A) drug conveying infusion pump shell;

B) drug delivery cassette component, it can be connected with the infusion pump shell, has Rule, and has the drug delivery cassette mainboard that comprises position, Rule base portion, and wherein said Rule can be with respect to the base portion dismounting of position, described Rule;

C) pump case door, it is connected with described infusion pump shell, and has opening position and the position of closing the door; With

D) pump case door lock, when described case assembly is connected with described infusion pump shell, when described Rule is connected with position, described Rule base portion, the described pump case door of described pump case door-lock opening.

107, according to the described drug conveying infusion pump of claim 106 assembly, wherein, described lock comprises pump door lock and the door lock solenoid that is operably connected on the pump door lock.

108, a kind of cannula assembly comprises:

A) be arranged on disposable mouth and nose intubate on patient's face, comprise breathing gas sampling nose pin and respiratory gas sampling port pin; With

B) sliding tube is slidingly connected one of in itself and described breathing gas sampling nose pin or mouthful pin, with the nose that is provided at different patients and the different distance between the oral cavity.

109, according to the described cannula assembly of claim 108, wherein, described sliding tube and described respiratory gas sampling port pin are slidingly connected, wherein said sliding tube has approximate right angle sweep and far-end, wherein, when described intubate was arranged on patient's face, the far-end of described sliding tube entered the patient oral cavity towards the patient oral cavity to remote extension or to remote extension.

110, a kind of cannula assembly comprises:

A) be arranged on disposable intubate on patient's face, comprise breathing gas sampling or breathing gas delivery port pin with opening; With

B) detachable mouthful of pin extension of user, itself and described mouthful of pin removably connect, and can be connected to the opening of mouthful pin by the user.

111, a kind of cannula assembly, comprise the disposable intubate that is arranged on patient's face, described intubate comprises the respiratory gas sampling port mouth pin with far-end and has the breathing gas delivery port pin of far-end, wherein, when described intubate is arranged on patient's face, described respiratory gas sampling port pin further towards or to enter patient's oral cavity farther to the far-end that remote extension gets nasal respiration gas delivery mouth pin.

112, a kind of cannula assembly comprises the disposable intubate that is positioned on patient's face, and described intubate comprises a left side and right intubate braced wing, and described braced wing has the detachable tip station that adheres to the adhesive pad that is connected to the facial side of patient of band respectively.

113, a kind of cannula assembly, comprise the disposable intubate that is positioned on patient's face, described intubate comprises the intubate main body with breathing gas sampling nose pin, and the intubate that comprises the breathing gas conveying nose pin with band pipe accommodation hole is covered, wherein said intubate lid is connected with described intubate main body, and described breathing gas sampling nose pin passes and extends beyond described pipe accommodation hole, wherein when described intubate is arranged on patient's the face, described pipe accommodation hole is set to the breathing gas nose bending of nose pin towards the patient of taking a sample.

114, a kind of cannula assembly, comprise the disposable intubate that is positioned on patient's face, the breathing gas conveying nose pin that described intubate comprises the breathing gas sampling nose pin with far-end and has far-end, wherein, when described intubate is arranged on patient's the face, the far-end of breathing gas sampling nose pin further towards or enter patient's a nostril and carry the remote extension of nose pin to get farther than breathing gas.

115, according to the described cannula assembly of claim 114, wherein, described breathing gas sampling nose pin by described breathing gas carry nose pin circumferential hoop around.

116, a kind of cannula assembly comprises:

A) be positioned at disposable mouth and nose intubate on patient's face, comprise left nare breathing gas probe tube, right naris breathing gas probe tube and mouth breathing gas sample tube; With

B) adapter, it comprises outer housing and the backboard that is connected with described outer housing, wherein said outer housing comprise intranasal dehumidification air chamber and with described intranasal dehumidification air chamber isolated mouthful in the dehumidification air chamber, wherein said backboard comprises nose capnometer port and mouthful capnometer port, wherein a left side is connected with described outer housing with right respiratory gas sample tube and is communicated with described intranasal dehumidification air chamber fluid, wherein said mouth breathing gas sample tube is connected with described outer housing and is communicated with dehumidification air chamber fluid in described mouthful, wherein said nose capnometer port is communicated with described intranasal dehumidification air chamber fluid, and described mouthful of capnometer port is communicated with dehumidification air chamber fluid in described mouthful.

117, according to the described cannula assembly of claim 116, wherein, described adapter also comprise be arranged on the hydrophobic filter between described intranasal dehumidification air chamber and the described nose capnometer port and be arranged on described mouthful in hydrophobic filter between dehumidification air chamber and the described mouthful of capnometer port.

118, according to the described cannula assembly of claim 116, wherein, described adapter also comprise be arranged on described intranasal and mouthful between the dehumidification air chamber and nose pressure, interior stream liner between nose capnometer and mouthful capnometer port, the stream liner comprises annular pylon in wherein said, it extends in described nose capnometer port and mouthful capnometer port, and to small part provide between described intranasal dehumidification air chamber and the nose capnometer port and in described mouthful the fluid between dehumidification air chamber and the described mouthful of capnometer port be communicated with.

119, a kind of cannula assembly comprises:

A) be positioned at disposable intubate on patient's face, comprise the breathing gas probe tube; With

B) adapter comprises:

(1) outer housing;

(2) backboard, it is connected with described outer housing, wherein said outer housing comprises interior dehumidification air chamber, wherein, described backboard comprises the capnometer port, wherein said breathing gas probe tube is connected with described outer housing and is communicated with described interior dehumidification air chamber fluid, and described capnometer is communicated with described interior dehumidification air chamber fluid; With

(3) liner, it is arranged between described interior dehumidification air chamber and the described capnometer port, wherein said liner comprises annular pylon, it extends in the described capnometer port, and provide at least in part described in the dehumidification air chamber be communicated with fluid between the described capnometer port.

120, a kind of cannula dewatering sub-assembly comprises:

A) cannula dewatering shell, it comprises having dampness collection chamber and the sampling breathing gas passes the dehumidification air chamber of chamber, wherein said sampling breathing gas passes chamber and is provided with highlyer and be communicated with its fluid than described dampness collection chamber, the described dampness of the volume ratio collection chamber that described sampling breathing gas passes chamber is little, and described sampling breathing gas passes chamber and has gas sampled inlet and gas sampled outlet; With

B) hydrophobic filter, it is set to cover the outlet that described sampling breathing gas passes chamber, wherein all enter the sampling breathing gas that the sampling breathing gas passes chamber and must pass hydrophobic filter, pass chamber to discharge the sampling breathing gas, the dampness of wherein said sampling breathing gas is collected in the described dampness collection chamber.

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