GB2546774A

GB2546774A - Vital signs monitor

Info

Publication number: GB2546774A
Application number: GB1601591.9A
Authority: GB
Inventors: Enrique Guerrero Ontiveros Julio
Original assignee: Metix Ltd
Current assignee: Metix Ltd
Priority date: 2016-01-28
Filing date: 2016-01-28
Publication date: 2017-08-02
Also published as: GB201601591D0

Abstract

A vital signs monitor comprising a housing (12, figure 1); a power supply 37; a plurality of measurement modules within the housing, each module being operable to measure and monitor at least one respective vital sign; one or more inputs for connection to sensors applied to a patient and arranged to supply sensor signals to respective measurement modules; and a user display 14a. In embodiments the vital signs monitor may be hand-held, or alternatively it may be a hand or wrist strap based monitor. The vital signs monitor may measure pulse, blood pressure, temperature, tympanic temperature, electrocardiogram (ECG), respiration, pulse oximetry and capnography.

Description

VITAL SIGNS MONITOR

Field of the invention

This invention relates to a vital signs monitor, preferably a portable, handheld, device for monitoring vital signs of a patient, such as pulse, blood pressure and respiration, and a vital signs monitoring system.

Background to the invention

In medical use, vital signs refers to basic physiological indicators, commonly comprising pulse rate, respiration (breathing rate), temperature and blood pressure. Other signs are sometimes included, such as pulse rate oximetry.

Instruments for monitoring individual vital signs, and certain combinations of vital signs, are well known. However, the majority of these are designed for use in hospitals and other fixed locations. There is a need for a readily-portable, self-contained, handheld device which can monitor multiple vital signs not only in sophisticated hospitals but also in the field, for example in ambulances and in remote unsophisticated medical facilities.

The present inventor has appreciated the shortcomings with known vital signs monitors.

It would also be useful to facilitate vital signs which have been monitored to be aggregated for the purpose of epidemiological studies or quality monitoring purposes.

According to a first aspect of the present invention there is provided a vital signs monitor comprising: a housing; a power supply; a plurality of measurement modules within the housing, each module being operable to measure and monitor at least one respective vital sign; one or more inputs for connection to sensors applied to a patient and arranged to supply sensor signals to respective measurement modules; and a user display.

The vital signs monitor may also comprise a user input device, the user input device being operable to allow a user to input data, patient details, control parameter, operating parameters, or the like, to the monitor.

The vital signs monitor may be a portable vital signs monitor. The vital signs monitor may be a hand-held monitor. The vital signs monitor may be ergonomically shaped with respect to a user’s hand. The vital signs monitor may include one or more apparatus or user attachment devices, the user attachment devices being configured such that the monitor may attachable to an apparatus or a user. The user attachment device may be a strap. The strap may be a hand strap. The strap may be configured such that it may be wrapped around the hand of a user when the user is holding the monitor. The strap may be a wrist strap or a torso strap.

The housing may be of a size suitable to be carried by a user. The housing may be of a size suitable to be carried in one hand by a user.

The housing may have dimensions of less than 200mm x 100mm x 100mm. The housing may have dimensions of less than 170mm x 90mm x 65mm.

The housing may be weatherproof. The housing may be sand proof. The housing may be shock proof. The housing may be submergible. The housing may be sand proof. The housing may have a micro-bacterial coating. The monitor may be weatherproof. The monitor may be sand proof. The monitor may be shock proof. The monitor may be submergible. The monitor may be sand proof. The monitor may have a micro-bacterial coating.

The housing may be made from a plastics material. The housing may be made from injection moulded plastic. The housing may be made from a thermoplastics material. The housing may be made from a metal material. The housing may be made from an alloy material. The housing may be made form a thermoplastic polyester alloy material.

The housing may be flame retardant. The housing may be made from a flame retardant material.

The monitor may be shielded to electromagnetic interference (EMI). The monitor may be EMI-shielded. The monitor may be resistant to ultraviolet (UV) radiation.

The monitor may be capable of operating between temperatures of -30°C to 50 °C. The monitor may be capable of operating at a relative humidity of 15 to 95% (non-condensing).

The power supply may be contained within the housing. The power supply may be a self-contained power supply. The power supply may be a rechargeable battery. The power supply may be a rechargeable lithium-ion battery. The power supply may be a mains power supply. The mains power supply may be a medical grade power supply.

The measurement modules may be located within the housing.

The measurement modules are electronic modules.

The measurement modules may be operable to measure at least one additional parameter in addition to the respective vital sign. The measurement modules may be operable to measure two or more vital signs.

The measurement modules are operable to measure and/or monitor vital signs selected from: pulse, blood pressure, temperature, tympanic temperature, electrocardiogram (ECG), respiration, pulse oximetry and capnography. Each measurement module may be operable to measure and/or monitor vital signs selected from: pulse, blood pressure, temperature, electrocardiogram (ECG), respiration, pulse oximetry and capnography.

The measurement modules are sensor modules. The monitor may comprise a blood pressure measurement module, an ECG measurement module or a pulse oximetry module, or one or more combinations of these. The monitor may comprise a blood pressure measurement module, an ECG measurement module, a pulse oximetry module or a capnography module, or one or more combinations of these.

The measurement modules may be operable with external sensors. The external sensors may be a blood pressure sensor, a temperature sensor, an ECG sensor, a respiration sensor, a pulse oximetry sensor or a capnography sensor. The monitor may include one or more external sensors. The external sensors may be a blood pressure sensor, a temperature sensor, an ECG sensor, a respiration sensor, a pulse oximetry sensor or a capnography sensor.

The blood pressure sensor may be a non-invasive blood pressure (NIBP) sensor. The blood pressure sensor may be located within an arm cuff, or the like. The blood pressure module may be operable to measure blood pressure at intervals of 10, 15, 30 or 60 minutes. The measurement may have a manual or automatic start/stop function. The blood pressure module may have a measurement time of 30 to 45 seconds (on deflation) and 15 to 30 seconds (on inflation). The blood pressure module may have a measurement range of 20 to 260 mmHg (systolic) and 10 to 220 mmHg (diastolic).

The EGC sensor may include sensors that are attachable to a patient.

The sensors may be chest electrodes, paddles, or the like. The EGC module may be operable with 3, 5 or 12 lead cables. The ECG sensor may be operable to measure heart rate in the range 30 to 300 bpm. The EGC module may be operable to measure cardiac pacing. The ECG module may be operable to measure rectilinear, constant width current pulses of 40 ms ± 2 ms at a pacer rate of 30 to 180 bpm. Such measurements may be external transcutaneous.

The ECG module may be operable to provide impedance pneumography. The ECG module may be operable to measure breath rate. The ECG module may be operable to measure breath rate between 2 to 150 breaths per minute. The ECG module may be operable to display the numeric breath rate. The module may be operable to display the impedance waveform. The ECG module may be operable to measure and/or monitor an averaged breath rate. The ECG module may be operable to activate an alarm for low, high and no breath rates.

The pulse oximetry sensor may be a non-invasive sensor. The pulse oximetry sensor may be a non-invasive light transmission sensor. The pulse oximetry sensor may be operable to measure Sp02, pulse rate and perfusion index. The pulse oximetry sensor may be operable to additionally measure total haemoglobin, oxygen content, carboxyhaemoglobin, methaemoglobin, and pleth variability index.

The capnography sensor may be a non-invasive sensor. The capnography sensor may be a non-invasive light transmission sensor or an electromechanical sensor, or an electrochemical sensor. The capnography sensor may be operable to measure end-tidal C02 (etC02). The capnography sensor may be operable to provide early indication of evolving respiratory compromise.

Each measurement module may be operable to provide instantaneous data measurements and/or historical data measurements. The data measurements may be presented numerically and/or visually. Each measurement module may be operable to predict trends and/or deterioration and provide warning alarms.

The monitor may include one or more alarm devices. The one or more alarm devices being operable to signal an alarm upon measurement of a vital sign having one or more predetermined signals or predetermined values or conditions.

The monitor may include a tracking module. The tracking module may be operable to detect when a measurement module/sensor module moves out of range with respect to the monitor. The monitor may be operable to signal an alarm when a measurement module/sensor module moves out of range with respect to the monitor. The monitor may be operable to provide a user with information relating to a last known location of the measurement module/sensor module. This information may be presented visually.

The one or more inputs include ports for connection cables. The ports may include cover members. The cover members may be resilient plugs that are at least partially beatable within the ports. The cover members may be configured to mitigate water ingress to the ports.

The monitor may be configured such that the one or more sensors communicate wirelessly with each measurement module. The sensor associated with each measurement module may be configured to communicate wirelessly therewith. The communication protocol may be Bluetooth, Bluetooth 4.0, Bluetooth 4.1, or the like.

The monitor may also comprise a network module, the network module being operable to control the communication between the measurement module sensors and the measurement modules. The network module may be operable to wirelessly control the communication between the measurement module sensors and the measurement modules.

The network module may also be operable to control the communication between the monitor and/or the measurement modules thereof, with one or more external devices or networks. The network module may be operable to wirelessly control the communication between the monitor and/or the measurement modules thereof, with one or more external devices or networks. The communication may be by cellular (mobile) telephony, or by Wi-Fi over a local area network (LAN), or the like.

The monitor may be configured to be operable with a remote application server. The remote application server may be operable to communicate with other devices, web applications or mobile clients. The remote application server may be operable to communicate with other vital sign monitors. The remote application server may be operable to communicate with one or more other vital sign monitors according to the first aspect of the invention.

The server may be cloud-based.

The remote application server may be able to use data to create a reporting framework. The reporting framework may be configured to store data that corresponds to vital sign monitoring sessions. The data may be presented using standard export formats. The formats may be: comma separated value (csv), MS Excel (xlsx), and PDF. Comma separated value (csv) formats allow for the manipulation of data through commercial off the shelf software. PDF formats enables the data to be presented using proprietary formats that may match the look and feel of a healthcare institution.

The reporting framework may be configured to run in its own web application. The reporting framework may be an independent module to achieve reusability.

The remote application may fully integrate the reporting framework with other patient file systems. This may decrease the navigation steps to get to patient information.

The monitor may also be operable to produce video reporting and data snapshots generation. The monitor may be operable to perform a feasibility study on how useful it would be to make the monitoring data anonymous so that it can be accessed openly throughout the world, most specifically by research centres and universities.

The monitor may have artificial intelligence (Al) algorithms that learn when data is normally requested. This provides the ability to automatically generate data reports based on the patient’s condition or the context the patient is in.

The monitor may further comprise an ECG module capable of supplying cardiac pulses. The monitor may further comprise an ECG module capable of supplying cardiac pacing pulses.

The monitor may further comprise an internal memory. The internal memory may be removable from the monitor. The monitor may further comprise two memories, one being selectively removable from the monitor.

The monitor may further comprise an output device for communication with a remote server. The output device may be the network module.

The user display may be located on a side surface of the housing. The user display may be located on one face of the housing.

The user input device may be operable to allow a user to input data to the monitor. The user input device may be operable to allow a user to operate the monitor. The user input device may include a touch screen display.

The vital signs monitor may also comprise a loudspeaker device and/or a microphone.

According to a second aspect of the present invention there is provided a vital signs monitoring system comprising: two or more vital signs monitors, each vital signs monitor comprising: a housing; a power supply; a plurality of measurement modules within the housing, each module being operable to measure and monitor at least one respective vital sign; one or more inputs for connection to sensors applied to a patient and arranged to supply sensor signals to respective measurement modules; and a user display; and a server, wherein each vital signs monitor is independently operable to provide a local display, and data is transferred between each vital signs monitor and the server.

The data may be transferred between each vital signs monitor and the server asynchronously.

The data may be stored in both the respective vital signs monitor and the server.

The server may be a central server.

The server may be operable to aggregate data from a population of individual data sets.

Each measurement module may have a unique identifier and/or location.

Embodiments of the second aspect of the present invention may include one or more features of the first aspect of the present invention or their embodiments.

According to a third aspect of the present invention there is provided a portable vital signs monitor, comprising a housing of a size suitable to be carried by a user; a self-contained power supply within the housing; a plurality of electronic modules within the housing, each being operable to monitor a respective vital sign; inputs for connection to sensors applied to a patient and arranged to supply sensor signals to respective electronic modules; a user display visible on one face of the housing; and user input means.

In particularly preferred forms of the invention, the housing is of a size suitable to be held in one hand for carrying and in use, and may for example have dimensions of less than 200mm x 100mm x 100mm, preferably about 170mm x 90mm x 65mm.

Embodiments of the third aspect of the present invention may include one or more features of the first or second aspects of the present invention or their embodiments.

According to a fourth aspect of the present invention there is provided a vital signs monitoring system comprising a plurality of monitors as defined above, and a central server; in which each monitor operates independently to provide a local display, and in which data is transferred between the monitors and the central server asynchronously.

Embodiments of the fourth aspect of the present invention may include one or more features of the first, second or third aspects of the present invention or their embodiments.

Preferred features found in embodiments of the invention will be apparent from the following description and the claims.

Brief description of the drawings

Embodiments of the invention will now be described, by way of example, with reference to the drawings, in which:

Figs. 1 a to 1 h are views of a vital signs monitor forming one embodiment of the present invention;

Fig. 2 is a schematic block diagram of the monitor of Fig. 1;

Fig. 3 shows an example of a screen display; and Fig. 4 illustrates a networked system.

Description of preferred embodiments

Referring to Figs. 1a to 1 h, in which Fig. 1a is a front view of a vital signs monitor 10, Fig. 1b is a perspective front view, Fig. 1c is a perspective rear view, Fig. 1d is a right side view, Fig. 1e is a bottom view, Fig. 1f is a left side view, Fig. 1g is a top view and Fig. 1 h is further rear perspective view, a vital signs monitor 10 has a housing 12 including a touch screen 14 and a number of connection ports 16, 16a, 16b, 16c, 16d (an example of one or more inputs). Note that in Figs. 1b to 1h the touch screen 14 and many of the internal components have been omitted for clarity. The connection ports 16, 16a, 16b, 16c, 16d may include cover members (not illustrated). The cover members may be resilient plugs that are at least partially beatable within the ports. The cover members may be configured to mitigate water ingress to the ports. Although the monitor 10 has been illustrated as including two navigation button (UP arrow and DOWN arrow), it should be appreciated that the monitor 10 may include four navigation buttons (UP, DOWN, LEFT and RIGHT arrows). These buttons may be in the membrane.

The housing 12 is designed to be hand held, and typically has dimensions of approximately 170mm x 90mm x65mm. As best illustrated in Figs. 1c, 1 d, 1f and 1 h, the monitor 10 is ergonomically shaped with respect to a user’s hand, as illustrated generally at 10c. The monitor 10 is also provided with a strap (an example of a user attachment device). The strap, which has been omitted for clarity may be attached to the rear of the monitor via strap attachment points 10a and 10b, as illustrated in Figs. 1c and 1h. The vital signs monitor is therefore portable. The monitor 10 is ruggedised and proof against ingress of water, shock and sand, suitably to IP67 standard; means of achieving such standards are well known. The monitor may also have a micro-bacterial coating.

The housing 12 should be of a size suitable to be carried in one hand, and held in one hand during use. In general terms, this means a size of 200mm x 100mm x 100mm or less.

The housing 12 may suitably be injection moulded in two parts from thermoplastic resin such as polyester. It is flame retardant and EMI shielded, resistant to hospital cleaners and disinfectants and UV. The monitor 10 is also shockproof, typically to IEC 60068-2-27, EN 1789, and/or IEC60601 -1. The monitor 10 may also be shielded to electromagnetic interference (EMI) and ultraviolet (UV) radiation.

The monitor 10 is capable of operating at temperatures of -30 to 50°C and relative humidity of 15 to 95% (non-condensing). Monitor weight with battery is approximately 800 grams, and the charger, accessories and cables an additional 400 grams.

The screen 14 (an example of a user display and a user input device) is 5" diagonal, 800 x 400 pixels, and is touch operable with latex gloves. A loudspeaker 15, typically of 2W power, is included. A microphone 15a is also provided. The monitor 10 may be operable to use the microphone 15a to communicate with the remote web application 46 (voice through IP communication).

Fig. 2 shows in schematic block form the electronics within the monitor 10, and associated external parts. The monitor 10 is based on a motherboard 18 which may for example be an i.MX6Q Freescale microprocessor. The touch screen 14 comprises a display 14a and a touch sensitive layer 14b. The monitor 10 is powered by an internal battery 20 (an example of a power supply) via a power distribution module 22. The internal batter is located within the housing 12. A front membrane 24 (an example of a user display) provides one or more membrane switches to control power on/off and optionally other functions.

The battery 20 is most suitably a medical grade lithium ion battery, and is charged via mini-USB from an external power supply 37 when required; any suitable power supply 37 may be used, such as AC-DC regulated switch mode for use in a wall socket, or a medical grade power supply. Battery capacity should be sufficient for at least 48 hours in stand-by mode and 6 hours of continuous monitoring of ECG, Sp02, C02 and two channels of temperature, with NIBP monitoring every 15 minutes.

The monitor 10 includes a number of sensor modules (an example of a measurement module) which cooperate with external sensors. The measurement modules are located in the housing 12. In this embodiment, these comprise a blood pressure module 26, an ECG sensing module 28, a pulse oximetry module 30 and a capnography module 33.

The blood pressure module 26 operates with a non-invasive blood pressure sensor 32 in an arm cuff. Suitable NIBP sensors are well known. The monitor 10 can be programmed to measure blood pressure at intervals of 10, 15, 30 or 60 minutes, with a manual start/stop function. Typical measurement time is 30 to 45 seconds (on deflation) and 15 to 30 seconds (on inflation), and typical measurement range systolic 20 to 260 mmHg, diastolic 10 to 220 mmHg. In a preferred embodiment, the blood pressure module 26 is a Sun Tech Medical blood pressure module. The blood pressure sensor 32 may be connected to connection port 16a.

The ECG sensing module 28 is connected in use to chest electrodes or paddles 34 of conventional type. In preferred embodiments, the monitor 10 is also usable for cardiac pacing. The chest electrodes or paddles 34 may be connected to connection port 16b.

The ECG is able to produce 3-, 5- and 12-lead ECG that will be input from 3,5,10 cables and sensing sources. The heart rate range is 30-300 bpm.

Pacing is external transcutaneous with rectilinear, constant current pulses with a pulse width of 40ms ±2ms and a pacer rate of 30 to 180bpm.

Output current is typically 0 to 140mA.

The ECG electrodes 34 and module 28 can also be used to provide impedance pneumography. The displayed data may be both numeric breath rate and impedance waveform. The displayed breath rate is most suitably the average of the last ten breath-to-breath rates. Alarms may be set for high and low rates and no breath.

The pulse oximetry module 30 is connected in use to a pulse oximetry sensor 36 which will typically be a non-invasive light transmission sensor using LEDs and applied to a body part such as a finger-tip or ear lobe. In a preferred embodiment, the pulse oximetry module 30 is a Masimo MX5 module, which may optionally be used with Masimo multiple wavelength LED sensors, as the pulse oximetry sensor 36, to provide additional measurements, including Total Haemoglobin, Oxygen Content, Carboxyhaemoglobin, Methaemoglobin, and Pleth Variability Index in addition to pulse oximetry measurements of Sp02, pulse rate and perfusion index. The pulse oximetry sensor 36 may be connected to connection port 16c.

The capnography module 33 is connected to a capnography sensor 35 which will typically be a non-invasive and be located in a patient’s airway.

In a preferred embodiment, the capnography module 33 is a Covidien Microstream C02 nano-mediC02 module, which may optionally be used with a Covidien etC02 sensor 35. The capnography module 33 may be operable to additionally measure other respiratory values, such as respiration rate, Integrated Pulmonary Index, SARA and Smart BDA, Apnoea Sat Alert and Oxygen desaturation index. The capnography module 33 may provide early indication of evolving respiratory compromise. The capnography sensor 35 may be connected to connection port 16d.

Each measurement module may be operable to provide instantaneous data measurements and/or historical data measurements. The data measurements may be presented numerically and/or visually. Each measurement module may be operable to predict trends and/or deterioration and provide waring alarms.

The monitor 10 may also include a tracking module. The monitor 10 alerts through a sound when the measurement modules are too far away/moved. When the measurement modules are out of Bluetooth range (up to 50 metres/160 feet in free open space only, in closed rooms this may be shorter) it will alert on the mono monitor or monitoring unit 10. The movement alert is triggered as soon as the measurement module is moved. (This feature pops up only when the monitoring unit 10 and Temp sensor range alert is enabled first, i.e. before you the measurement module goes out of range from the monitoring unit.). The monitor 10 may be operable to provide a user with information relating to a last known location of the measurement module/sensor module. This information may be presented visually. The tracking module is operable to track the measurement modules in real time and present their location on a map, or the like.

The monitor 10 also includes a network module 38 controlling wireless communication with external devices. In this embodiment, temperature information is supplied from a temperature sensor (not shown) via a Bluetooth module 40. The temperature sensor will typically be a non-contact infrared thermometer, many examples of which are well known.

The network module 38 also controls communication via a wireless and cellular module 42 with external devices or networks; this may be by cellular (mobile) telephony, or by Wi-Fi over a local area network, for example. In Fig. 2, the monitor 10 communicates via the wireless and cellular module 42 with a remote application server 44 which also communicates with other web and mobile clients 46. The other web and mobile clients 46 may include other similar vital signs monitors. Note that in the embodiment illustrated and described here the network module 38 is separate from the motherboard 18. Flowever, it should be appreciated that the network module 38 may be within, or part, of the motherboard 38.

The monitor 10 has sufficient memory to retain data collected for a number of patients (typically up to 40). Patient ID can be entered via the touch screen. A typical memory capacity gives over 48 hours of trends at one minute intervals, 2000 time stamped events, and 64 monitor snapshots (max 20 seconds duration). The memory may be provided by an integrated micro SD card, or other such device.

Finally, the monitor 10 of Fig. 2 is provided with one or more outputs 48 such as USB, HDMI and DisplayPort. A preferred output arrangement is 2 x USB 3.0, HDMI, Ethernet, Wi-Fi and 4G.

Fig. 3 shows an example of a screen display during monitoring. As will be seen, selected vital signs can be displayed as current readings, graphically, or both. The monitor and web application allow access of detailed views of each monitored parameter, which allows access to all calculations, measurement history and trends. The screen on the monitor and web application can be configured to select which parameter(s) is/are displayed.

The monitor as described can be used as a standalone unit in a healthcare setting such as a hospital or clinic, but is also suitable for use in the field, for example by ambulance or emergency medical technicians, or by medical staff in remote locations without sophisticated facilities. In addition, the monitor may also be used as part of a networked system.

The monitor 10 may also be provided with an ECG module capable of supplying cardiac pacing pulses.

Fig. 4 shows a networked system, typically in a hospital. A number of monitors 10, which may for example be in different wards or departments, communicate with a central server 50. Communication can be by any of the means discussed above, but will typically be by Ethernet or Wi-Fi. The central server can be used to integrate the monitored data with a patient record system, or to permit the patient readings to be shared in real time.

It should be noted that the individual monitors 10 and the central server 50 are not functionally interdependent, and thus data can be sent from the monitor 10 asynchronously.

It is also possible to use a monitor 10 in the field and stream the data to a remote server, for example to enable a patient in an ambulance to be monitored by a hospital doctor.

The central server may also be used to aggregate data received from a number of monitors for example to conduct epidemiological studies. The availability of readily usable handheld monitors makes it possible to acquire large amounts of data for this purpose.

The monitor according to the present invention may include the external sensors 32, 34, 35, 36.

The present invention thus provides a vital signs monitor which is readily portable, self-contained, and easy to use.

Modifications and improvements may be made to the above without departing from the scope of the present invention.

Claims

1. A vital signs monitor comprising: a housing; a power supply; a plurality of measurement modules within the housing, each module being operable to measure and monitor at least one respective vital sign; one or more inputs for connection to sensors applied to a patient and arranged to supply sensor signals to respective measurement modules; and a user display.

2. A vital signs monitor according to claim 1, further comprising a user input device, the user input device being operable to allow a user to input data, patient details, control parameter, operating parameters, or the like, to the monitor.

3. A vital signs monitor according to claim 1 or claim 2, wherein the vital signs monitor is a hand-held device.

4. A vital signs monitor according to any preceding claim, wherein the vital signs monitor includes one or more apparatus or user attachment devices, the user attachment devices being configured such that the monitor is attachable to an apparatus or a user.

5. A vital signs monitor according to claim 4, wherein the user attachment is a strap, the strap being configured such that it may be wrapped around the hand of a user when the user is holding the monitor.

6. A vital signs monitor according to any preceding claim, wherein the monitor is waterproof, shock proof, sand proof, or flame proof.

7. A vital signs monitor according to any preceding claim, wherein the monitor is shielded from electromagnetic interference (EMI) and/or ultraviolet (UV) radiation.

8. A vital signs monitor according to any preceding claim, wherein the power supply is located within the housing.

9. A vital signs monitor according to any preceding claim, wherein measurement modules are located within the housing.

10. A vital signs monitor according to any preceding claim, wherein the measurement modules are operable to measure and/or monitor vital signs selected from: pulse, blood pressure, temperature, tympanic temperature, electrocardiogram (ECG), respiration, pulse oximetry and capnography.

11. A vital signs monitor according to claim 10, wherein the measurement modules are operable with external sensors.

12. A vital signs monitor according to claim 11, wherein the external sensors are a blood pressure sensor, a temperature sensor, an ECG sensor, a respiration sensor or a pulse oximetry sensor.

13. A vital signs monitor according to any preceding claim, wherein each measurement module is operable to provide instantaneous data measurements and/or historical data measurements.

14. A vital signs monitor according to claim 13, wherein each measurement module is operable to predict trends and/or deterioration and provide waring alarms to a user.

15. A vital signs monitor according to any preceding claim, wherein the monitor includes one or more alarm devices and/or tracking devices, the one or more alarm devices being operable to signal an alarm upon measurement of a vital sign having one or more predetermined signals or predetermined values or conditions, the one or more tracking devices being operable to signal an alarm when a measurement module/sensor moves out of a predetermined range with respect to the monitor.

16. A vital signs monitor according to any of claims 11 to 15, wherein the monitor is configured such that the one or more sensors communicate wirelessly with each measurement module.

17. A vital signs monitor according to any preceding claim, wherein the monitor also comprises a network module, the network module being operable to control the communication between the measurement module sensors and the measurement modules.

18. A vital signs monitor according to claim 17, wherein the network module is operable to wirelessly control the communication between the measurement module sensors and the measurement modules.

19. A vital signs monitor according to claim 17 or claim 18, wherein the network module is also operable to control the communication between the monitor and/or the measurement modules thereof, with one or more external devices or networks.

20. A vital signs monitor according to claim 19, wherein the network module is operable to wirelessly control the communication between the monitor and/or the measurement modules thereof, with one or more external devices or networks.

21. A vital signs monitor according to any preceding claim, wherein the monitor is configured to be operable with a remote application server, the remote application server being operable to communicate with other devices, web applications, mobile clients, or other vital sign monitors.

22. A vital signs monitor according to any preceding claim, wherein the monitor further comprise an ECG module capable of supplying cardiac pulses.

23. A vital signs monitor according to any preceding claim, wherein the monitor further comprises an internal memory.

24. A vital signs monitor according to any preceding claim, wherein the monitor further comprises an output device for communication with a remote server.

25. A vital signs monitoring system comprising: two or more vital signs monitors, each vital signs monitors comprising: a housing; a power supply; a plurality of measurement modules within the housing, each module being operable to measure and monitor at least one respective vital sign; one or more inputs for connection to sensors applied to a patient and arranged to supply sensor signals to respective measurement modules; and a user display; and a server, wherein each vital signs monitor is independently operable to provide a local display, and data is transferred between each vital signs monitor and the server.

26. A vital signs monitoring system according to claim 25, wherein the data is transferred between each vital signs monitor and the server asynchronously.

27. A vital signs monitoring system according to claim 25 or claim 26, wherein the data is stored in both the respective vital signs monitor and the server.

28. A vital signs monitoring system according to any of claims 25 to 27, wherein the server is operable to aggregate data from a population of individual data sets.

29. A portable vital signs monitor, comprising: a housing of a size suitable to be carried by a user; a self-contained power supply within the housing; a plurality of electronic modules within the housing, each being operable to monitor a respective vital sign; inputs for connection to sensors applied to a patient and arranged to supply sensor signals to respective electronic modules; a user display visible on one face of the housing; and user input means.

30. A vital signs monitoring system comprising a plurality of monitors as defined above, and a central server; in which each monitor operates independently to provide a local display, and in which data is transferred between the monitors and the central server asynchronously.