EP2373213A2

EP2373213A2 - Apparatus for monitoring vital signs

Info

Publication number: EP2373213A2
Application number: EP10729440A
Authority: EP
Inventors: Steven J. Young; Richard V. Rifredi; Yuri Zhovnirovsky
Original assignee: BAM Labs Inc
Current assignee: SleepIQ Labs Inc
Priority date: 2009-01-06
Filing date: 2010-01-06
Publication date: 2011-10-12
Also published as: EP2373213A4; WO2010080794A3; KR20110108386A; JP2012514501A; WO2010080794A2

Abstract

Embodiments of an apparatus for monitoring vital signs are disclosed herein. One such monitoring system includes a fluid bladder. A pump is in fluid communication with the fluid bladder, and the pump is operable to increase a fluid pressure within the fluid bladder. A sensor is packaged with the pump, and the sensor is in fluid communication with the fluid bladder and is operative to determine a pressure within the fluid bladder. A controller is configured to determine the at least one vital sign based on the pressure within the fluid bladder.

Description

APPARATUS FOR MONITORING VITAL SIGNS

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to U.S. Patent Application No. 12/349,167, filed January 6, 2009, U.S. Patent Application No. 12/349,667, filed January 7, 2009 and U.S. Patent Application No. 12/349,853, filed January 7, 2009, all of which are hereby incoiporated by reference in their entirety.

FIELD OF THE INVENTION [0002] The present invention pertains to a vital sign monitoring apparatus.

BACKGROUND

[0003] Historically, monitoring vital signs of a person has required expensive equipment, such as an electrocardiogram (EKG) or a ballistocardiograph (BCG). In addition to being prohibitively expensive for many situations (e.g., home use, ownership by a police or fire department of more than a few devices, etc.), both EKGs and BCGs can be too cumbersome for use outside of medical facilities. EKGs, for example, typically necessitate attaching electrodes to the bodies of users, while BCGs rely on large, heavy, and unaesthetic force-measuring platforms that users lie on. [0004] In more recent times, devices including piezoelectric films or arrays of sensors have been developed to measure heart and respiration rates. A user can lie on the device, and the film or sensors can generate a signal indicate of the user's heart rate and/or respiration rate. However, these devices can also be expensive.

SUMMARY

[0005] Some known air mattresses each include a pump connected to the respective air mattress by a hose. The pump can produce a high pressure to force air into the air mattress. However, the air mattress can lose air over time, causing the pressure in the air mattress to drop beneath a preset level. In order to reduce the problems associated with air loss, the pump can include a pressure sensor, and the pump automatically turn on when the pressure drops below the preset level. As a result, a user does not have to periodically turn on the pump to increase the air pressure in the air mattress. [0006] A pressure sensor used to communicate with the pump can additionally be leveraged to detect vital signs, such as a heart rate and respiratory rate of a person lying on the air mattress. According to an example of a sleep monitoring system that can determine at least one vital sign of a person, the sleep monitoring system includes a fluid bladder. A pump is in fluid communication with the fluid bladder, and the pump is operable to increase a fluid pressure within the fluid bladder. A sensor is packaged with the pump. The sensor is in fluid communication with the fluid bladder, and the sensor is operative to determine a pressure within the fluid bladder. A controller is configured to determine the at least one vital sign based on the pressure within the fluid bladder. [0007] As a result, the cost of the sleep monitoring system can be reduced compared to many vital sign monitoring devices. Further, since the sleep monitoring system can be less cumbersome to use compared to many vital sign monitoring devices, the sleep monitoring systems can be used outside of a medical center environment. Additionally, since a pump of a conventional air mattress may include a pressure sensor, that pressure sensor can be leveraged to create the sleep monitoring system by merely providing a software upgrade. Also, by analyzing sleep information generated over time, the sleep monitoring system can provide a pressure setting customized for a specific user to improve the user's sleep.

[0008] Another example of sleep monitoring system is also provided. The sleep monitoring system includes a fluid bladder. A pump is spaced from the fluid bladder, and the pump has a housing containing pump components and defining a fluid inlet for receiving fluid and a fluid outlet for outputting fluid pressurized by the pump. An elongate conduit fluidly couples the fluid outlet of the pump and the fluid bladder. The conduit provides a passage for the fluid pressurized by the pump to increase a fluid pressure within the fluid bladder, A pressure sensor is physically coupled to an interior of the pump housing such that the sensor is part of an integral pump unit, and the pressure sensor is configured to detect a pressure of fluid at the fluid outlet of the pump. A controller is configured to determine the at least one vital sign based on the pressure within the fluid bladder, [0009] An example of sleeping pad is also provided. The pad includes a fluid bladder. A pressure sensor is in fluid communication with the fluid bladder and is operable to detect a fluid pressure within the fluid bladder. A controller is in communication with the pressure sensor and is operable to determine at least one vital sign of a user based on the pressure within the fluid bladder. A memory for storing historical data including the pressure within the fluid bladder and the at least one vital sign and a processor for determining a sleep quality correlation between the pressure within the fluid bladder and the at least one vital sign based on the historical data are also included. A pressurized fluid source is operable to increase a pressure within the fluid bladder when the sleep quality correlation indicates a sleep quality of the user would improve if the pressure within the fluid bladder were higher.

[0010] Embodiments of another sleep monitoring system are disclosed herein, In one example, placing a sensor beneath a padding layer can provide more comfort than having a sensor occupy a top position on a mattress. However, when the sensor is placed beneath the padding layer, the padding layer can dampen pressure input to the mattress, thereby preventing the sensor from properly detecting pressure. For example, if the sensor is near a foot of the mattress and beneath the padding layer, a pressure exerted on the mattress resulting from a heart beat will not likely create a wave in the padding layer of sufficient strength to propagate all the way through the padding layer to the sensor. Using a fluid bladder beneath the padding layer can aid in the transmission of waves resulting from pressure exerting on the padding layer to the sensor. [0011] Accordingly, one example of a sleep monitoring system includes a first padding layer. A fluid bladder is beneath the first padding layer. A sensor is in fluid communication with the fluid bladder, and the sensor is configured to output a vital sign signal.

[0012] In another example, a mattress for determining at least one vital sign of a person lying thereon is provided. The mattress includes a first foam layer and a second foam layer. A fluid bladder is between the first and second foam layers, and the fluid bladder defines at least one aperture extending between a top side of the fluid bladder that the first foam layer rests on and a bottom side that rests on the second foam layer. A sensor in fluid communication with the fluid bladder is configured to output a vital sign signal. [0013] Embodiments for a portable apparatus for monitoring on site near an emergency field at least one vital sign of a patient reclined thereon is provided are also disclosed herein, In one such example, the apparatus includes a fluid bladder transformable between a stowable arrangement and a deployed arrangement. The fluid bladder in the deployed arrangement has a comfortable top surface of sufficient size to fully support at least a torso of the patient in a reclined position, and the fluid bladder has a ruggedized puncture resistant bottom layer. A sensor is configured to detect a pressure within the fluid bladder. A controller is configured to determine the at least one vital sign based on the pressure within the fluid bladder. A triage condition indicator is configured to indicate a care urgency level based on the at least one vital sign. [0014] In another example, an apparatus for monitoring vital signs of multiple persons is provided. The apparatus includes multiple patient beds. Each patient bed includes a fluid bladder and a sensor configured to detect a pressure within the fluid bladder. A controller is configured to determine the vital signs based on the pressures within the fluid bladders. A triage condition indicator is configured to indicate a care urgency level for at least one of the multiple patient beds based on the at least one vital sign.

BRIEF DESCRIPTION OF THE DRAWINGS

[0015] The description herein makes reference to the accompanying drawings, wherein like reference numerals refer to like parts throughout the several views, and wherein:

[0016] FIG. 1 is an end view of a sleep monitoring system including an air mattress and a pump;

[0017] FIG. 2 is a schematic view of the sleep monitoring system of FIG. 1;

[0018] FIG. 3 is a cross-section view of the air mattress of FIG. 1 along line A-A in FIG. 1;

[0019] FIG. 4 is a flowchart showing a determination of a pressure setting;

[0020] FIG. 5 is an exploded perspective view of an example of a mattress including a sensing layer; [0021] FIG. 6 is an end view of the mattress of FIG 5; [0022] FIG 7 is a plan view the sensing layer of FIG. 5;

[0023] FIG. 8 is a plan view of another example of a sensing layer;

[0024] FIG. 9 is a side view of another example of a mattress including a sensing layer

[0025] FIG. 10 is an end view of the mattress of FIG. 5;

[0001 ] FIG. 11 is a perspective view of an example of an emergency victim monitoring system in a deployed arrangement for use by an individual patient;

[0002] FIG. 12 is a perspective view of another example of an emergency victim monitoring system in a deployed arrangement;

[0003] FIG. 13 is a schematic view of the emergency victim monitoring system of

FIG. 11 in a stowable arrangement; and

[0004] FIG. 14 is a schematic view of an example of another emergency victim monitoring system for use by a group of people.

DETAILED DESCRIPTION

[0026] A sleep monitoring system 10 can include a mattress 12, a pump 14, and a control unit 15 as shown in FIGS. 1 and 2. The mattress 12 can include a fluid bladder 16. The mattress 12 can be sized for use on a king-size, queen-size, full, twin, or other sized bed frame 11. The mattress 12 can additionally include a padding layer 13 on top of and/or beneath the fluid bladder 16 as shown in FIG. 1. The padding layers 13 cart include one or more of a foam pad, a box spring, an additional fluid bladder, a straw-filled pad, a feather-filled pad, a sawdust-filled pad, a spring-based pad, and/or another type of padding that offers flexibility and/or softness. Alternatively, the mattress 12 can be used sized for use in a chair, hospital bed, crib, or another structure for which padding can add comfort.

[0027] The bladder 16 can hold air or another fluid, such as water. In addition to holding air or another fluid, the bladder 16 can enclose foam or another material through which fluid waves of an expected magnitude can propagate a sufficient distance without being too dampened. The fluid bladder 16 can be sized to have a surface area nearly as large as a surface area of a top side of the mattress 12 to allow the detection of a user's vital signs regardless of the position of the user. Alternatively, the bladder 16 can have a smaller size, such as a size covering an area of the mattress 12 above which the user's heart and/or lungs are expected to be positioned (e.g., a one foot by one foot square for an adult user). Even if the user is positioned on the mattress 12 such that the user's heart and/or lungs are not directly above the bladder 16, pressure fluctuations caused by the user may still be received by the bladder 16. The pressure in the fluid bladder 16 can vary depending on the amount of fluid in the bladder 16, whether a user is lying on the bladder 16, the heart rate of a user lying on the bladder 16, the respiration rate of a user lying on the bladder 16, other movement of a user lying on the bladder 16 (e.g., rolling or limb movement), the temperature of the fluid in the bladder 16, and other considerations. [0028] The pump 14 can be a separate unit from the mattress 12 and can be fiuidly coupled to an air inlet 17 of the bladder 16 via a hose 18 as shown in FIGS. 1 and 2. However, the pump 14 can alternatively be integral with the mattress 12 such that the pump 14 can output high pressure fluid directly into the bladder 16 instead of through the hose 18. The pump 14 can be a rotary type pump or another type of pump. The pump 14 can include an electric line 20 for connection to an outlet 21 as shown in FIG. 2 or for connection to another power source, and the pump 14 can also include a data line 23 for communication with the control unit 15. Alternatively, the pump 14 can include a self- contained power source, such as one or more batteries.

[0029] As shown in FIG. 2, the pump 14 can be packaged with a sensor 22 and a controller 24 in communication with both the sensor 22 and the control unit 15. That is, the pump 14 and sensor 22 can be part of an integral unit. For example, a pump housing 19 that acts as a casing containing components of the pump 14 can also contain the sensor 22, The pump housing 19 can be made from a rigid material (e.g., ABS plastic, polypropylene, a metal, or another material), and the pump housing 19 in its assembled form containing components of the pump 14 and sensor 22 can have the appearance of a monolith or of a single, commercial component. Also, the pump housing 19 can define a fluid inlet 27 and a pressurized fluid outlet 28. Fluid at an ambient pressure can be received by the pump 14 through the inlet 27, and the pump 14 can increase the pressure of the fluid before outputting the fluid through the outlet 28.

[0030] The sensor 22 can include a semiconductor pressure sensor or another type of pressure sensor. Additionally, other types of sensors, such as a temperature sensor, can also be included. The sensor 22 can be positioned within the pump housing 19 to detect an amount of air pressure in the hose 18. For example, the sensor 22 can be positioned in a portion of the pump 14 in communication with the hose 18, such as in fluid communication with the pressurized fluid outlet 28 of the pump 14 as shown in FIG. 1. Since the hose 18 can be in fluid communication with the bladder 16 of the mattress 12, the air pressure detected by the sensor 22 can indicate the air pressure in the bladder 16. While operation of the pump 14 may affect the pressure detected by the sensor 22, the pump 14 can operate only as required to maintain an average pressure within the bladder 16 (e.g., to replace any fluid that seeps out of the bladder 16). Additionally, the sensor 22 can draw power from a power source that also powers the pump 14, such as the electric line 21. The sensor 22 can output a pressure signal α to the controller 24. The sensor 22 can be hard-wired to the controller 24, the sensor 22 can wirelessly communication with the controller 24 by way of a transmitter using, for example, a standard wireless protocol (e.g., IEEE 802.11, RF, Bluetooth, or 3G ), or the sensor 22 can otherwise be coupled to the controller 24 for communication therewith.

[0031 ] The controller 24, which can be a microprocessor or another device including a memory and a CPU for executing a program stored on the memory, can control a motor 26 in the pump 14 shown in FIG. 2 to produce pressurized air in the outlet 28 portion of the pump 14 shown in FIG. 1. The controller 24 can be hard-wired to the motor 26 or be in wireless communication with the motor 26 using, for example, a standard wireless protocol. As a result, the controller 24 can control the operation of the pump 14. For example, the controller 24 can control the pump 14 in response to the pressure signal α such as by instructing the pump 14 to inflate the bladder 16 when the controller 24 determines the air pressure in the bladder 16 is below a set amount . Thus, when the controller 24 actuates the motor 26, the motor 26 can produce pressurized air in the outlet 28 that passes from the pump 14 through the hose 18 and into the bladder 16 to increase the fluid pressure inside the bladder 16. The controller 24 can also be in communication with an air release valve or other structure for releasing air from the bladder 16 such that the controller 24 can provide an instruction to decrease the fluid pressure in the bladder 16. Also, while the controller 24 is shown as packaged with the pump 14, the controller 24 can alternatively be packaged with the control unit 15 or some other component besides the pump 14.

[0032] Additionally, the controller 24 can analyze the pressure signal α to determine a heart rate, respiration rate, and/or other vital signs of a user lying or sitting on the mattress 12. More specifically, when a user lies on the mattress 12, each of the user's heart beats, breaths, and other movements can create a force on the mattress 12 that is transmitted to the bladder 16. As a result of the force input to the bladder 16 from the user's movement, a wave can propagate through the bladder 16, into the hose 18, and arrive at the pump 14. The sensor 22 can detect the wave, and thus the pressure signal α output by the sensor 22 can indicate a heart rate, respiratory rate, or other information regarding user. If the pump 14 is of the type including a sensor 22 of the type originally designed for monitoring the fluid pressure within the bladder 16 to maintain the pressure at a substantially constant amount, a software upgrade can be used to increase the functionality of the pump 14 to determine the heart rate, respiratory rate, and other characteristics of the user without the need for a hardware modification. In this case, a hardware upgrade can provide the control unit 15, if desired.

[0033] To overcome a DC offset in the pressure signal α, the pressure signal α can pass through a circuit splitting the signal into a DC coupled path and an AC coupled path, and the AC coupled path can be amplified and filtered. The controller 24 can perform a pattern recognition algorithm or other calculation based on the amplified and filtered pressure signal α to determine the user's heart rate and respiratory rate. For example, the algorithm or calculation can be based on assumptions that a heart rate portion of the signal α has a frequency in the range of 0.5-4.0 Hz and that a respiration rate portion of the signal α has a frequency in the range of the range of less than 1 Hz. The controller 24 can also be configured to determine other characteristics of a user based on the pressure signal α, such as blood pressure, tossing and turning movements, rolling movements, limb movements, weight, the presence or lack or presence of a user, and/or the identity of the user. Further, the controller 24 can receive signals from other sensors (e.g., a temperature sensor). The controller 24 can output a status signal β indicating the characteristics of the user (e.g., heart rate and respiratory rate) to the control unit 15. Additionally, if multiple users are lying or sitting on the mattress 12, the pressure signal α detected by the sensor 22 can indicate each of the multiple users' vital signs, and the pattern recognition algorithm or other calculation performed by the controller 24 can detect each user's heart rate and respiration rate.

[0034] The control unit 15 can include a transmitter 30, a screen 32, and controls

34. The transmitter 30 can relay the status signal β to a database 36 or other source. The transmitter 30 can be a wireless transmitter operating using a standard wireless protocol (e.g., IEEE 802,11, RF, Bluetooth, or 3G ) for communication with the database 36 or other source, though the transmitter 30 can alternatively be hardwired to the database using a phone line, Ethernet line, or other connection. As a result, the database 36 can store sleep information produced as a result of the status signal β, and the user can be alerted to sleep issues based on long-term sleep trends or provided with other communications regarding the user's sleep (e.g., an alarm warning of apnea), fitness level, cardiovascular condition, or other health information. An example of storing sleep information with the database is discussed below in respect to FIG. 4. [0035] The screen 32 can display information relayed in the status signal β, such as a sleep score based on the user's heart rate, respiratory rate, amount of time spend in REM sleep, total time in bed, and other considerations,

[0036] The control unit 15 can also be hard-wired or in wireless communication with the controller 24 for controller operation of the pump 14. As a result, the controls 34 can be used to control the operation of the sleep monitoring system 10. For example, the controls 34 can be used to increase the air pressure in the bladder 16. As another example, the controls 34 can be used to instruct the sensor 22 and/or controller 24 to operate in a privacy mode in which data is not detected, retained, displayed, transmitted, and/or analyzed, or to communicate with the database 36 to obtain sleep information (e.g., sleep trends, sleep scores from previous nights, sleeping tips). The database 36 can be accessible via the control unit 15 or a computer, e.g., via the internet, [0037] As shown in FIG. 3, the bladder 16 can include multiple longitudinal supports 38 spaced across the bladder 16. The supports 38 can define channels 40 for fluid in the bladder 16 to pass from, for example, the head of the bladder 16 to the hose 18 via the inlet 17, That is, the supports 38 can be positioned not to impede waves propagating through the bladder 16 in a direction toward the sensor 22 (which in this case is through the inlet 17). The supports 38 can also provide support for a user lying on the mattress 12. A different arrangement of supports can be used, though the supports should not substantially hinder waves from propagating to the sensor 24. Also, the mattress 12 can include more than one bladder 16. For example, the mattress 12 can include two side-by-side bladders 16 for detecting the heart and respiratory rates of two users. In this case, the pump 14 can include more than one sensor 22. [0038] The sleep monitoring system 10 can have a different structure from illustrated. For example, the pump 14 can include the transmitter 30 instead of the control unit 15. Additionally, the system 10 can have additional functions from those described above. For example, the control unit 15 can function as an alarm clock, and the alarm can be sounded until the system 10 determines that the user has awoken or got off the mattress 12.

[0039] As shown in FIG. 4, the sleep information stored in the database 36 can be used to improve the sleep of a user. In more detail, as shown in steps Sl and S2 and discussed above in greater detail, the sensor 22 can detect the pressure in the fluid bladder 16 and the controller 24 can determine at least one vital sign based on the pressure in the fluid bladder 16.

[0040] As shown in step S3, the database 36 can store sleep information generated over time. The sleep information can include the pressure in the bladder 16, one or more vitals signs (e.g., heart rate, respiratory rate, etc.), a frequency or amount of tossing and turning by a user, a temperature, a light level, and other information. The sleep information need not necessarily include one of the vital signs, as one or more of the vital signs can be determined by a computer or other processing unit (i.e., a processor other than the controller 24). Also, the sleep information can be transferred to the database 36 by communicably linking the controller 24 and transmitter 30 and also communicably linking the transmitter 30 and database 36 as shown in FIG. 2, or in another way (e.g., directly communicably linking the sensor 22 and the database 36, or communicably linking the sensor 22 to the transmitter 30 and the transmitter 30 to the database 36). [0041] The database 36 can store a log of sleep information as shown in step S3 of FIG. 4. For example, the database 36 can create a sleep score based on one or more vital signs. The sleep score can, for example, indicate high quality sleep when heart rate is low, when respiratory rate is low, and when tossing when turning movements are infrequent, Over time, the database 36 can accumulate sleep scores for a variety of conditions (e.g., a lower pressure in the bladder 16, a high pressure in the bladder 16, a cool temperature, a warm temperature, and/or a low level of light). [0042] As shown in step S4, an association can then be made using the sleep information between the sleep score and environmental conditions, such as the pressure in the bladder 16, the light level, and the temperature. The association can be performed by the controller 24 or another processor in communication with the database 36. The association between the sleep score and environmental conditions can include, for example, determining a correlation between the sleep score and environmental conditions. Based on the association, a pressure setting can be determined for customizing the environmental conditions (e.g., pressure in the bladder 16, light level, and temperature) to achieve a high sleep score. Additionally, other settings (temperature and light level, for example) can be determined based on the association.

[0043] As shown in step S5, the controller 24 can control the pump 14 based on the pressure setting. For example, the controller 24 can actuate the motor 26 to inflate the bladder 16 if the pressure setting indicates a higher pressure would result in a higher sleep score. Further, other controls (e.g., a heater, air conditioner, and/or a night light) can be adjusted based on the association.

[0044] A bed as shown in FIGS. 5 and 6 can include a frame 112 and a mattress

114. The frame 112 can be a standard sized bed frame, such as a frame for holding a twin, full, queen, or king mattress. The frame 112 can hold the mattress 114 off the ground, such as at a level allowing a user to easily mount and dismount the mattress 114. While shown as a standard bed frame, the frame 112 can alternatively be a crib, hospital bed, or another support structure for the mattress 114. Also, the mattress 114 can be set directly on the ground or a floor, in which case no frame 112 is necessary. [0045] The mattress 114 can include a bottom padding layer 116, the sensing layer

118, and a top padding layer 120, with the sensing layer 118 sandwiched between the padding layers 116 and 120 as shown in FIGS. 5 and 6. The mattress 114 can be an integral, inseparable unit, or the mattress 114 can be formed by stacking separate layers 116, 118 and 120.

[0046] The bottom padding layer 116 can be a firm layer for providing support.

For example, the bottom layer 116 can include firm high density foam (e.g., visco-elastic polyurethane foam sometimes referred to as memory foam), another type of foam, a conventional mattress, a box spring, a fluid bladder, a straw-filled pad, a feather-filled pad, a sawdust-filled pad, a spring-based pad, and/or another material that offers flexibility and/or softness. A top side 122 of the bottom layer 116 can partially define a recess 124 sized to receive the sensing layer 118. The recess 124 can have a depth less than a height of the sensing layer 118 when inflated to a normal pressure as shown in FIG 6. The recess 124 can have one open end 126 at a foot of the mattress 114 as shown in FIG. 6. The open end 126 can allow a cord, hose, or other structure to easily access the sensing layer 118, and the open end 126 can be on a different side of the mattress 114 than shown in FIGS. 5 and 6.

[0047] The top padding layer 120 can be a comfort layer, which can be softer (i.e., less firm) than the bottom padding layer 116. The top layer 120 can include high density foam (e.g., memory foam), another type of foam, a conventional mattress, a fluid bladder, a straw-filled pad, a feather-filled pad, a sawdust-filled pad, a spring-based pad, and/or another material that is offers flexibility and/or softness. A bottom side 128 can partially define the recess 124. Alternatively, the recess 126 can be entirely defined by just one of the bottom layer 116 and the top layer 120. Also, depending on the thickness of the air bladder 118 and the firmness of the bottom and top layers 116 and 120, among other considerations, the bladder 118 can fit between layers 116 and 120 without the need for the recess 124 (also open end 126).

[0048] The sensing layer 118 as shown in FIG. 7 includes a fluid bladder 130, a pressure sensor 132 configured to sense a fluid pressure within the fluid bladder 130, and a controller 134. The sensing layer 118 is also shown coupled to a control unit 138 and a pump 139. However, instead of using the pump 139 to inflate the bladder 130, another inflation mechanism can be provided. For example, the bladder 130 can be self-inflating by including a foam or other material within the bladder 130. As another example, compressed gas (e.g., compressed air or CO₂) can be used to inflate the bladder 130. Also, as is explained below in greater detail, the pressure sensor 132 can detect pressure changes caused by, for example, a pulse and/or breath of a user on the mattress 114, and the controller 134 can determine the user's heart rate, respiration rate, and/or other vital signs based on the detected pressure changes.

[0049] The fluid bladder 130 can hold air or another fluid, such as water, gel, another gas, or a combination thereof. The fluid bladder 130 can be sized to extend over a large portion of the top side 122 of the bottom layer 116, such as substantially the entire top side 122 of the bottom layer 116 as shown in FIG. 5. Alternatively, the bladder 130 can cover a smaller area of the top side 122 than as shown, such as an area of the top side 122 above which the torso of a user is expected to be positioned. Thus, the size of the fluid bladder 130 can allow the fluid bladder 130 to sense pressure changes over a wide range of positions of the user on the mattress 114. That is, even if the pressure sensor 132 is far from a source of a pressure change (e.g., a beating heart or inhaling or exhaling lungs of the user), the pressure change can create a wave within the bladder 130 propagating the pressure change to the sensor 132.

[0050] Also, the bladder 130 can be shaped to achieve a balance between allowing air to pass across the bladder 130 and providing the bladder 130 with a large area such that pressure changes are not dampened too greatly before reaching the bladder 130. Allowing air to pass across the bladder 130 can be beneficial for multiple reasons. First, passing air can dissipate heat from the top layer 120, thereby reducing a feeling of warmth common among foam mattresses. Second, passing air can remove moisture, thereby reducing the likelihood of mold growth within the mattress 114. [0051] To achieve this balance, the bladder 130 as shown in FIG. 7 defines a plurality of apertures 136 arranged in a grid pattern. The apertures 136 can allow heat and moisture to pass across the bladder 130. Due to the arrangement of the apertures 136, the bladder 130 defines transverse and lengthwise paths shown, respectively, by lines 135a and 135b in FIG. 7. Waves caused by pressure changes input to the top layer 120 can propagate along the paths 135a and 135b to the sensor 132. Thus, the bladder 130 as shown in FIG. 7 can both allow moisture to pass between the layers 116 and 120 and can prevent pressure input to the top layer 120 from being dampened before reaching the sensor 132.

[0052] However, the bladder 130 can have a different shape from illustrated while still achieving similar functionality. For example, FIG. 8 shows a bladder 140 including longitudinal slots 142 for allowing moisture to pass the bladder 140. The bladder 140 also includes longitudinal connectors 144 for allowing waves to propagate to the sensor 132 in the bladder 140. The sizes of the slots 142 and connectors 144 can be a trade off between providing a large area for the passage of moisture and providing the bladder 140 with a large area to prevent pressure changes from being dampened before reaching the bladder 140. As another example in which the shape of the bladder 130 can different from as shown in FIG. 7, the fluid bladder 130 can include multiple discrete compartments, in which case each compartment can include one of the pressure sensors 132. For example, if the mattress 114 is large enough for two users, the mattress 114 can include two discrete compartments, each including its own sensor 132, for separately detecting the vital signs of the two users. However, the pressure detected by a single sensor 132 can indicate vital signs of multiple users, and the controller 134 can perform a pattern recognition algorithm or other calculation to determine the users' respective vital signs as explained in more detail below.

[0053] As shown in FIG. 10, the sensing layer 118 can be subject to a shearing force is a lateral force applied to the top padding layer 120. As a result, the sensing layer 118 can be deformed to the shape shown in phantom at 118'. The height 131 of the fluid bladder 130 can be great enough such that when the sensing layer 118 undergoes an expected amount of deformation, the top of the sensing layer 118 does not contact the bottom of the sensing layer 118. Contact between the top and bottom of the sensing layer 118 can allow force to be transmitted directly from the top padding layer 120 to the bottom padding layer 116, in which case the pressure sensor 132 may not accurately detect pressure changes in the fluid bladder 130. The height 131 can also be based on the expected weight of the top padding layer 120 and any users that rest thereon, as well as the expected pressure within the fluid bladder 130. Under normal conditions (e.g., a normal user weight and a normal top layer 120 weight), the fluid bladder 130 portion of the sensing layer 118 can have an approximately 1.0" height.

[0054] As mentioned above, the pressure sensor 132 can be configured to sense a fluid pressure within the fluid bladder 130, For example, the pressure sensor 132 can be inside the bladder 130. As another example, the pressure sensor can be in a portion of the pump 139 in fluid communication with the bladder 130, and thus in a portion of the pump 139 having a pressure corresponding to a pressure in the bladder 130. The sensor 132 can include a semiconductor pressure sensor or another type of pressure sensor. Additionally, other types of sensors, such as a temperature sensor, can also be included. The sensor 132 can output a pressure signal α to the controller 134.

[0055] Further, the pressure signal α can indicate the whether or not a person is lying on the bladder 130, the heart rate of a person lying on the bladder 130, the respiration rate of a person lying on the bladder 130, other movement (e.g., rolling or limb movement) of a person lying on the bladder 130, the temperature of the fluid in the bladder 130, and vital signs because all these can be factors of the pressure within the fluid bladder 130. [0056] The controller 134, which can include a memory and a CPU for executing a program stored on the memory, can control the pump 139 to produce pressurized air. For example, the controller 134 can control the pump 139 in response to the pressure signal α such as by instructing the pump 139 to inflate the bladder 130 when the controller 134 determines the pressure in the bladder 130 is below a set amount. While the controller 134 is shown as inside the bladder 130, the controller 134 can alternatively be part of the control unit 138 or otherwise located outside the bladder 130. The controller 134 can be hard-wired to the sensor 132 and/or pump 139, in wireless communication with the sensor 132 and/or pump 139 using , e.g., a standard wireless protocol (IEEE 802.11, Bluetooth, etc.), or the controller 134 can communicate with the sensor 132 and/or pump 139 in another way.

[0057] Additionally, the controller 134 can analyze the pressure signal α to determine a heart rate, respiration rate, and/or other vital signs of a user lying or sitting on the mattress 114. As explained above, when a user lies on the top layer 120, each of the user's heart beats and breaths can create a force on the top layer 120 that is transmitted to the bladder 130. As a result of the force input to the bladder 130 from a heart beat or breath, a wave can propagate through the bladder 130 to the sensor 132. The sensor 132 can detect the wave, and the pressure signal α output by the sensor 132 can thus indicate a heart rate or respiratory rate of a user. As a result, the bladder 130 can prevent waves from being dampened by foam prior to reaching the sensor 132.

[0058] To overcome a DC offset in the pressure signal α, the pressure signal α can pass through a circuit splitting the signal into a DC coupled path and an AC coupled path, and the AC coupled path can be amplified and filtered. The controller 134 can perform a pattern recognition algorithm or other calculation based on the amplified and filtered pressure signal α to determine the user's heart rate and respiratory rate. For example, the algorithm or calculation can be based on assumptions that a heart rate portion of the signal α has a frequency in the range of 0.5-4.0 Hz and that a respiration rate portion of the signal α has a frequency in the range of the range of less than I Hz. The controller 134 can also be configured to determine other characteristics of a user based on the pressure signal α, such as blood pressure, tossing and turning movements, rolling movements, limb movements, weight, or the identity of the user. Further, the controller 134 can receive signals from other sensors (e.g., a temperature sensor), The controller 134 can output a status signal β indicating the characteristics of the user (e.g., heart rate and respiratory rate) to the control unit 138.

[0059] The control unit 138 can include a transmitter, a display screen, and controls. The transmitter can relay the status signal β to a database or other source. The transmitter can be a wireless transmitter operating using a standard wireless protocol (e.g., IEEE 802.11, RP, Bluetooth, or 3G ), though the transmitter can alternatively be hardwired to the remote source using a phone line, Ethernet line, or other connection, As a result, the database can store sleep information produced as a result of the status signal β, and the user can be alerted to sleep issues based on long-term sleep trends or provided with other communications regarding the user's sleep (e.g., an alarm warning of apnea), fitness level, cardiovascular condition, or other health information. [0060] The display screen can display information relayed in the status signal β, such as a sleep score based on the user's heart rate, respiratory rate, amount of time spend in REM sleep, total time in bed, and other considerations.

[0061] The controls can be used to control the operation of the sensor 132 and/or controller 134. For example, the controls can be used to increase the pressure in the bladder 130, instruct the sensor 132 and/or controller 134 to operative in a privacy mode in which data is not detected, retained, displayed, transmitted, and/or analyzed, or to communicate with the database to obtain sleep information (e.g., sleep trends, sleep scores from previous nights, sleeping tips). The database can alternatively or additionally be accessible using a computer, e.g., via the internet.

[0062] The pump 139 can be a rotary type pump or another type of pump. The pump 139 can be fluidly coupled to the bladder 130 via a hose. However, the pump 139 can alternatively be integral with the mattress 114 such that a hose is not necessary. [0063] The mattress 114 can have a different configuration from as shown in

FIGS. 5 and 6. As such, while the bottom layer 116, sensing layer 118, and top layer 120 are shown as being discrete structures, alternative configurations are possible. For example, FIG. 9 illustrates a foam mattress 160 including a top portion 162 and a bottom portion 164 connected by a linking portion 166. The mattress 160 defines an envelop 168 for receiving the sensing layer 118. As additional examples, the sensing layer 118 can be sealed within the mattress 114 during the manufacture of the mattress 114, or the sensing layer 118 and top layer 120 can be integral. Also, in another example, the bladder 130 can be positioned between a foundation (e.g., the frame 112) and the bottom layer 116 of the mattress 114.

[0064] As shown in FIG. 11 , an apparatus 210 for monitoring at least one vital sign of a patient 213 lying thereon can include a fluid bladder 212, a sensor 214, a control unit 215, and a pump 220. The apparatus 210 can measure a heart rate, a respiratory rate, and/or other vital signs of the patient 213 lying on the fluid bladder 212 as is explained beloλv.

[0065] The fluid bladder 212 can contain air or another fluid (e.g., water). The bladder 212 can define a single fluid compartment. Alternatively, the bladder 212 can define multiple compartments, in which case each compartment from which a pressure measurement is desired can include a sensor 214. The bladder 212 can be in fluid communication with the pump 220, such that the pump 220 can inflate the bladder 212. [0066] The bladder 212 can be sized to comfortably accommodate a patient 213 of ordinary size (e.g., the bladder 212 can be seven feet long by four feet wide such that even large patients 213 can be accommodated). However, the bladder 212 can have a different structure from as shown in FIG. 11. For example, the bladder 212 can have a smaller size, such as a size sufficient to fully support only a torso area of a patient 213 (e.g., the bladder 212 can be two feet long by three feet wide to accommodate an ordinarily sized torso even if the patient 213 is not centered on the bladder 212), and the smaller-sized bladder 212 can be integral with another type of pad for supporting the remainder of the patient 213. As another example, a foam pad including an air bladder near an area where the patient's heart and/or lungs are expected to be positioned can be used instead of the illustrated bladder 212.

[0067] Additionally, the bladder 212 can include a comfortable (e.g., soft and/or flexible) top surface 212a. The top surface 212a can include a layer of foam or some other type of padding, such as a thin fluid or gel filled layer. Alternatively, the pressure of the fluid 212a within the fluid bladder 212 can be sufficient to make the top surface 212a comfortable. The top surface 212a can also include a hydrophobic material for easy cleaning. For example, the use of a hydrophobic material can allow fluid to be easily wiped off the top surface 212a. The hydrophobic material can be a coating such as Duralon UltraTec by Cotec-GmbH or another hydrophobic material. Additionally, the top surface 212a can be covered with a disposable protective covering, and a new covering can be provided for each patient 213 for health and safety reasons, [0068] The bladder 212 can include a ruggedized puncture resistant layer 212b on its bottom to reduce the likelihood of puncture if, for example, the bladder 212 is placed on the ground in an area with sharp debris such as glass or metal shards, a nail or screw, or a similar object, The ruggedized puncture resistant layer 212b can be a layer of material of sufficient thickness to prevent the bladder 212 from being punctured if the bladder 212 encounters sharp debris such as glass or metal shards, a nail or screw, or a similar object. For example, the layer 212b can be 0,01" thick to 0,25" thick, though the layer 212b can have an alternative thickness depending on its material. The layer 12b can be made from a high strength material such as Kevlar, though other materials (e.g., rubber) can additionally or alternatively be used. Puncture resistance can also be provided by including a sealant within the fluid bladder 212.

[0069] The pressure within the fluid bladder 212 should be sufficient to suspend the patient 213 without the patient 213 contacting the ground or other surface beneath the bladder 212, However, even when a constant amount of fluid is in the bladder 212, the pressure in the fluid bladder 212 can vary depending on the temperature of the fluid in the bladder 212, whether the patient 213 is lying on the bladder 212 and, when the patient 213 is lying on the bladder 212, the heart rate of the patient 213, the respiration rate of the patient 213, other movement of the patient 213 (e.g., rolling or limb movement), and other considerations.

[0070] The sensor 214 can include a semiconductor pressure sensor or another type of pressure sensor. The sensor 214 can be positioned to detect the pressure in the fluid bladder 212. For example, the sensor 214 can be inside the fluid bladder 212 as shown in FIG. 11. As a result, a pressure signal output by the sensor 214 can correspond to the heart rate of the patient 213 lying on the bladder 212, the respiration rate of the patient 213 lying on the bladder 212, movement of the patient 213 lying on the bladder 212, and other considerations. The sensor 214 can be in communication with the control unit 215 by hard-wiring the sensor 214 and control unit 215, by wireless communication (e.g., using a standard wireless protocol such as IEEE 802.11, 3G, or Bluetooth), or using another connection, enabling the sensor 214 to communicate the pressure signal corresponding to the pressure in the bladder 212 to the control unit 215. Also, the apparatus 210 can include additional sensors, such as more than one sensor 214, a dedicated temperature sensor, and other types of sensors.

[0071] The control unit 215 can include a controller 216, a display screen 217, and controls 218. The control unit 215 can be integral with the fluid bladder 212 as shown in FIG. 11. For example, a body of the control unit 215 including the controller 216 can be below the top surface 212a of the bladder 212, while the display screen 217 can be visible and the controls 218 can be accessible near the top surface 212a of the bladder 212. Alternatively, the control unit 215 can have a different configuration from as shown. For example, the control unit 215 can be a separate unit from the bladder 212 and in communication with the sensor 214.

[0072] The controller 216 can include a memory and a CPU for executing a program stored on the memoiy. The controller 216 can be in communication with the pump 220 (e.g., by hard-wiring the controller 216 to the pump 220 or by wireless communication therebetween) to control the operation of the pump 220. For example, the controller 216 can control the pump 220 to inflate the bladder 212 when the sensor 214 indicates the pressure in the bladder 212 is below a set amount (e.g., an amount entered via the controls 218).

[0073] Additionally, the controller 216 can analyze the pressure signal output by the sensor to determine a heart rate, respiration rate, and/or other vital signs of the patient 213 lying or sitting on the fluid bladder 212. Since the pressure signal can include a change in pressure for each heart beat, breath, or other movement of the patient 213 on the bladder 212, the controller 216 can use an algorithm or other calculation to determine the heart rate and respiratory rate of the patient 213. For example, the algorithm or calculation can be based on assumptions that a heart rate portion of the signal α has a frequency in the range of 0.5-4.0 Hz and that a respiration rate portion of the signal α has a frequency in the range of the range of less than 1 Hz. The pressure signal can be filtered and/or amplified prior to being analyzed by the controller 216. The controller 216 can also be configured to determine other vital indications of the patient 213 based on the pressure signal, such as whether the patient 213 is present, the blood pressure of the patient 213, tossing and turning movements, rolling movements, limb movements, weight, and the identity of the patient 213. Further, the controller 216 can receive signals from other sensors (e.g., a temperature sensor). The controller 216 can output a status signal indicating the characteristics of the patient 213 (e.g., heart rate and respiratory rate) to the display 217. Additionally, the apparatus 210 can include a transmitter for wirelessly or otherwise transmitting the patient's vital signs and/or other information to a remote location, such as a triage.

[0074] In addition, the controller 216 can calculate a care urgency level based on the heart rate, respiration rate, weight, blood pressure, presence, weight, amount of movement and/or other considerations determined based on the pressure detected by the sensor 214 or otherwise input to the apparatus 210. For example, the care urgency level can indicate the urgency with which care should be given to the patient 213, such as whether the patient 213 needs immediate attention, and the care urgency level can be used either alone or in conjunction with a care urgency value of another apparatus 210 to determine an order of care. The care urgency level can be a multi-level indication (e.g., low, medium, and high) or an urgency ranking (e.g., most urgent, second most urgent, etc.).

[0075] The display 217 can display vital signs, such as heart rate, respiratory rate, frequency and/or amount of movement, and other information. In addition, the display 217 can display the care urgency level. As a result, the display 217 in conjunction with the controller 216 can form a triage condition indicator for indicating the care urgency level. However, another device such as a speaker, a transmitter in communication wirelessly or otherwise with a notification device (e.g., a pager, a triage station or a cellphone), a flag or some other notification device can additionally or alternatively act as a triage condition indicator by indicating the care urgency level. The display 217 can produce an alarm based on vitals signs and/or the triage value, for example by flashing or changing colors when the triage value suggests a high care urgency level. [0076] The controls 218 can be used to control the operation of the sensor 214 and/or controller 216. For example, the controls 218 can be used to increase the air pressure in the bladder 212, to enter age or weight information regarding the patient 213, to enter the patient's health history (e.g., allergies or prescriptions currently being taken), and to perform other controls.

[0077] The pump 220 can be a rotary type pump or another type of pump. An inlet portion of pump 220 can be fluidly coupled to the ambient environment via a vent 222, and an outlet portion of the pump can be fluidly coupled to the bladder 212 for inflating the bladder 212. The pump 220 can be integral with the bladder 212, though the pump 220 can alternatively be a separate unit coupled to the bladder 212 via a hose. Additionally, a single pump 220 can be coupled to multiple bladders 222. The pump 220 can be in communication with the control unit 215, allowing the at least one of the controller 216 and the controls 218 to control operation of the pump 220. The control unit 215 and pump 220 can be package in a hard-shell portion of the apparatus 10 to provide protection.

[0078] Another example of an apparatus 240 for monitoring at least one vital sign of a patient lying thereon can include a self-inflating fluid bladder 242 fluidly coupled to the control unit 215. The fluid bladder 242 can contain foam 43 or another material that urges the bladder 242 to expand to a deployed position, which is the position of the bladder 242 as shown in FIG. 12, and that allows fluid waves to propagate through the bladder 242. The fluid bladder 242 can include a fluid inlet, such as the illustrated oneway valve 245, for allowing fluid into the fluid bladder 242. In operation, when deployed from a deflated state, the foam 243 can urge the fluid bladder 242 to expand, creating a vacuum that draws fluid through the valve 245. The use of the one-way valve 245 can prevent fluid from being forced out of the bladder 242 when a patient rests thereon. The fluid bladder 242 can additionally include a fluid outlet 244 for releasing fluid from the bladder 242 to return the bladder 242 to a stowed position. In this example, the control unit 215 includes the sensor 214, and a hose 246 is attached to the fluid outlet 244 of the fluid bladder 242 and to the control unit 215, thereby fluidly coupling the sensor 14 to the fluid bladder 42. As a result, pressure fluctuations in the fluid bladder 242 can be detected by the sensor 214, and the sensor 214 can relay the detected pressure to a controller (e.g., a microprocessor) or a similar device in the control unit 215 for determining a vital sign, such as a heart rate and/or respiration rate, of a patient on the bladder 242. The self-inflating fluid bladder 242 can have a different configuration from as shown, such as by including the bladder 242 and sensor 214 in a single package along with a transmitter to relay the pressure detected by the sensor 214 to a remote controller for determining vital signs.

[0079] While the apparatuses 210 and 240 are shown in FIGS. 1 and 2, respectfully, in deployed arrangements in which the patient 213 can recline thereon, the apparatuses 210 and 240 can also be arranged in a stowable arrangement. For example, the bladder 212 can be transformed into a stowable arrangement as shown in FIG. 13 by deflating the bladder 212 then wrapping up or otherwise rearranging the bladder 212. Alternatively, the bladder 212 can be arranged to be stowed by folding the bladder 212 or otherwise reducing the footprint of the bladder 212.

[0080] To transform the bladder 212 from the stowable arrangement to the deployed arrangement, any straps or other connectors holding the bladder 212 in the stowable arrangement can be undone and the bladder 212 can be inflated using the pump 220. Alternatively, the apparatus 210 can include a fluid source other than the pump 220. For example, the apparatus 210 can include a source of compressed fluid (e.g., a CO₂ cartridge) that can be actuated to rapidly fill the bladder 212. As another example, the self-inflating bladder 242 described above can automatically intake fluid. [0081] Since the bladder 212, sensor 214, control unit 215, and pump 220 can be part of an integrally packaged unit that is stowable, the apparatus 210 can be more easily transported and deployed than a monitor include separate parts or parts that are not stowable. Further, the apparatus 210 can provide the urgency care level to make it easier to determine a proper order of care. Also, the urgency care level can provide an alert when care is needed very urgently. Additionally, the construction of the apparatus 210 (e.g., having a comfortable top layer 212a and ruggedized puncture resistant bottom layer 212b) can make the apparatus 210 suitable for use in an emergency field where debris may be present.

[0082] Another example of an apparatus 230 for monitoring vital signs of multiple patients lying thereon including multiple air bladders 232, each including a sensor 234, is shown in FIG, 14. The bladders 232 and sensors 234 can be similar to the bladder 212 and sensor 214 described above with respect of FIG. 11, or to the bladder 242 and sensor 214 described above with respect to FIG. 12. For example, the sensors 234 can measure the pressures in the respective bladders 232. The sensors 234 can be in communication with a control unit 236. The control unit 236 can include controls, a display, and a controller for determining vital signs (e.g., heart rates and respiration rates) similar to the control unit 215 as described in respect to FIG. 11. However, a single control unit 236 can be used to determine the vital signs of multiple patients, as opposed to using dedicated control unit for each bladder 232. Further, the control unit 236 can include rank an urgency of care for the patients on the bladders 232. As a result, the control unit 236 can function as a triage station. Additionally, a single pump 238, similar to the pump 220 described with respect to FIG. 11 , can be in fluid communication with multiple bladders 232. The pump 238 can additionally be in communication with the sensors 234 and/or the control unit 236.

[0083] While the invention has been described in connection with what is presently considered to be the most practical example, it is to be understood that the invention is not to be limited to the disclosed example but, on the contrary, is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the appended claims, which scope is to be accorded the broadest interpretation so as to encompass all such modifications and equivalent structures as is permitted under the law.

Claims

CLAIMS What is claimed:

1. A mattress arrangement having the capability to monitor vital signs, comprising: a bladder containing a fluid; a pressure sensor in fluid communication with the fluid bladder and generating an output indicative of the pressure of the fluid; and a pump in fluid communication with the fluid bladder, the pump responsive to the sensor output to increase fluid pressure when the pressure falls below a preset level; a pump housing wherein the pump and pressure sensor us disposed within the interior of the pump housing such that the sensor and the pump comprise an integrated pump unit; and a controller coupled to the sensor and configured to determine at least one vital sign of a person resting on the mattress based on the output of the pressure sensor.

2. The mattress arrangement of claim 1, wherein the controller is operative to change the preset level in response to the at least one vital sign.

3. The mattress arrangement of claims 1 or 2 wherein the controller is operative to control the pump in response to the output of the pressure sensor.

4. The mattress arrangement of claims 1 or 2 wherein the at least one vital sign includes at least one of a heart rate or a respiration rate,

5. The mattress arrangement of claims 1 or 2, wherein the fluid bladder encloses pathways aligned with a fluid inlet.

6. The mattress arrangement of claim 5, wherein an end of the fluid bladder defines the fluid inlet, and wherein the pathways extend longitudinally toward the fluid inlet.

7. The mattress arrangement of claim 5, wherein the fluid bladder includes parallel supports extending between a top side of the fluid bladder and a bottom side of the fluid bladder, the supports at least partially defining the pathways.

8. The mattress arrangement of claims 1 or 2, further comprising a control unit in communication with the controller, wherein the control unit includes a display configured to display the at least one vital sign.

9. The mattress arrangement of claims 1 or 2, further comprising a memoiy, wherein the controller is configured to store in the memory the value of the preset level and measurements of vital signs over time to provide an association of sleep quality and the preset level.

10. The mattress arrangement of claim 1, wherein the sensor and the pump comprise an integrated pump unit that is a monolithic commercial product sold separately from the controller configured to detect vital signs.

11. A mattress having the capability to monitor vital signs, comprising: a first padding layer; a fluid bladder beneath the padding layer, wherein the fluid bladder defines at least one aperture extending between a top side of the fluid bladder upon which the first padding layer rests and a bottom side of the fluid bladder; and a sensor in fluid communication with the fluid bladder, the sensor configured to output a vital sign signal.

12. The mattress of claim 11 , further comprising a second padding layer beneath the first padding layer.

13. The mattress of claim 12, wherein a firmness of the second padding layer is greater than a firmness of the first padding layer.

14. The mattress of claim 11, wherein the at least one aperture includes a plurality of apertures in a grid formation,

15. The mattress of claim 11, wherein the at least one aperture includes multiple longitudinally extending slots spaced across a width of the fluid bladder.

16. The mattres s of claim 11 , wherein the fluid bladder encloses longitudinally extending fluid pathways.

17. The mattress of claim 16, wherein the sensor is in fluid communication with at least one of the fluid pathways.

18. The mattress of claims 16 or 17, wherein the fluid bladder encloses supports extending between a top side of the fluid bladder upon which the first padding layer rests and a bottom side of the fluid bladder, the supports at least partially defining the fluid pathways.

19. The mattress of claim 18, wherein the supports are perpendicular to one another.

20. The mattress of claim 11 or 16, wherein the height of the fluid bladder is sufficiently great to prevent contact between a top of the fluid bladder and a bottom of the fluid bladder when the fluid bladder is subject to expected shearing forces.

21. A portable apparatus for monitoring on site near an emergency field at least one vital sign of a patient reclined thereon, the apparatus comprising: a fluid bladder transformable between a stowable arrangement and a deployed arrangement, the fluid bladder in the deployed arrangement having a comfortable top surface of sufficient size to fully support at least a portion of the patient in a reclined position and having a ruggedized puncture resistant bottom layer; a sensor configured to detect a pressure within the fluid bladder; a controller configured to determine the at least one vital sign based on the pressure within the fluid bladder; and a triage condition indicator configured to indicate a care urgency level based on the at least one vital sign.

22. The apparatus of claim 21, wherein the care urgency level is at least partially based on a second vital sign of a second patient for ranking the urgency care level of the patient relative to the second patient.

23. The apparatus of claim 21, further comprising a display configured to show at least one of the vital sign or the triage value.

24. The apparatus of claim 21, wherein the display and fluid bladder are integrally packaged.

25. The apparatus of claim 21 , wherein the vital sign includes at least one of patient presence, patient heart rate, patient respiration rate, or patient movement.

26. The apparatus of claim 21, wherein the controller is configured to produce an alarm instruction.

27. The apparatus of claim 21 , wherein the top surface of the fluid bladder is hydrophobic,

28. The apparatus of claim 21, wherein the top surface of the fluid bladder is a comfort surface.

29. The apparatus of claim 21, further comprising a pump in fluid communication with the fluid bladder.

30. The apparatus of claim 25, wherein the pump and fluid bladder are integrally packaged.