JP2019076489A - Condition change determination apparatus - Google Patents

Abstract

To provide a condition change determination apparatus capable of improving accuracy in determination of change in a subject's condition.SOLUTION: A condition change discrimination apparatus comprises: a first acquisition unit 3 for acquiring a subject's first biological information; a first determination unit 6 for determining whether or not the first biological information acquired by the first acquisition unit 3 is changing so as to stepwisely access a predetermined threshold, a criterion for an acceptable range; and a second determination unit 7 for determining whether or not first biological information acquired after it is determined by the first determination unit 6 that the first biological information is changing so as to stepwisely access a predetermined threshold is out of the acceptable range.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a case change discrimination device.

  Conventionally, when the condition of a patient in a hospital changes, for example, when the heart rate falls below a certain value, a medical worker is notified by activating an alarm sensor.

  However, in the method of notifying the medical staff of the change in the condition of the patient by the alarm sensor, since the medical staff is notified when the disease has already developed, the disease can not be prevented. For this reason, it is desirable to be able to detect a disease at a precursor stage from the viewpoint of preventing a disease. For example, EWS (Early Warning Score) is known as a method for easily detecting a precursor of a disease (see Patent Document 1).

JP-A-2015-522822

  Biometric information often fluctuates widely due to various factors, and often shows an outlier. However, conventionally, it has been determined that the condition of the subject has changed due to the detection of a measured value which is equal to or greater than a predetermined reference value. For this reason, even when it is determined that the condition of the subject has changed, in fact, it is only the detection value that is above or below a certain reference value accidentally detected, and the change of the condition It is not uncommon to say that. As a result, such a method is unreliable as a method for easily detecting a precursor of an illness, and it has been difficult to appropriately determine the change in the condition of the subject.

  An object of the present invention is to provide a case change determination apparatus and a case determination method capable of improving the accuracy of determination of a case change of a subject.

The case change discrimination apparatus according to one aspect of the present invention is
A first acquisition unit that acquires first biometric information of a subject;
A first determination unit that determines whether the first biological information acquired by the first acquisition unit changes in a stepwise approach to a predetermined threshold that is a reference of an allowable range;
Whether the first biological information acquired after it is determined that the first biological information is approaching the predetermined threshold value stepwise by the first discrimination unit is outside the allowable range A second determining unit that determines
Equipped with

According to the above configuration, after the first determination unit determines the trend of whether or not the acquired first biometric information approaches the threshold in stages, is the first biometric information outside the allowable range acquired? The second determination unit determines whether the acquired first biometric information exceeds or falls below the threshold value. Therefore, in determining the condition change of the subject, two aspects of the transition state of the acquired first biological information and whether or not the first biological information is out of the allowable range are considered.
As described above, according to the above configuration, since the above two aspects can be considered with respect to the first biological information, it is possible to accurately grasp temporal changes in the first biological information, and change in the condition of the subject It is possible to provide a case change discrimination device capable of improving the accuracy of discrimination of

The method for determining a case change according to an aspect of the present invention
A first step of acquiring first biometric information of the subject;
A second step of determining whether or not the first biological information acquired in the first step changes stepwise toward a predetermined threshold which is a reference of an allowable range;
It is determined whether or not the first biological information acquired after it is determined that the first biological information is stepwise approaching the predetermined threshold value in the second step is outside the allowable range. The third step,
Have.

Further, according to the above configuration, after determining the trend whether or not the acquired first biological information approaches the threshold in a stepwise manner, whether or not the first biological information exceeds or falls below the predetermined threshold Is determined.
As described above, according to the above configuration, since the above two aspects can be considered with respect to the first biological information, it is possible to accurately grasp temporal changes in the first biological information, and change in the condition of the subject It is possible to provide a method that can improve the accuracy of the determination of

  According to the present invention, it is possible to provide a case change determination apparatus and a case determination method capable of improving the accuracy of determination of case change of a subject.

It is a functional block diagram of a case change discrimination device concerning one embodiment of the present invention. It is a flowchart in the case of determining the condition change of the subject which made the respiration rate and the blood pressure an example. (A) is a figure showing transition of the respiratory rate of a subject. (B) is a figure showing transition of the blood pressure of a subject. It is a figure regarding the screen which displays a condition state of a subject from respiratory rate and blood pressure. It is a figure which shows the state of the display part displayed when there exists a change in the test subject's body. It is a figure which shows the discrimination | determination flow of the body change of the subject based on 2nd embodiment. It is a functional block diagram of the case change discrimination | determination apparatus which concerns on 3rd embodiment.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

First Embodiment
FIG. 1 shows a functional block diagram of the case change discrimination device 1 according to the embodiment. As shown in FIG. 1, the case change discrimination device 1 is, for example, an electrocardiogram recording device, and the control unit 2, a first acquisition unit 3, a second acquisition unit 4, a first discrimination unit 6, and a second A determination unit 7, a third determination unit 8, a case determination unit 9, a display unit 10, an input operation unit 14, and a notification unit 15 are provided. These are communicably connected to each other via a bus 11.

  The control unit 2 includes a first determination unit 6, a second determination unit 7, a third determination unit 8, and a condition determination unit 9. The control unit 2 also includes a memory and a processor as a hardware configuration. The memory is configured of, for example, a ROM (Read Only Memory) storing various programs and the like, and a RAM (Random Access Memory) having a plurality of work areas storing various programs and the like executed by the processor. The processor is, for example, a CPU (Central Processing Unit), and is configured to expand programs specified from various programs incorporated in the ROM on the RAM and execute various processes in cooperation with the RAM. . For example, the control unit 2 controls to realize the processing of the first determination unit 6, the second determination unit 7, or the third determination unit 8 by executing the program in cooperation with the RAM. Further, in the control unit 2, biological information acquired via the first acquisition unit 3 or the second acquisition unit 4 is processed by the first determination unit 6, the second determination unit 7, or the third determination unit 8. Control to enable.

The first acquiring unit 3 acquires continuously measured first biological information (continuous measurement parameter) in a predetermined time range. The predetermined time range can be set as appropriate by the medical staff. Here, the case of acquiring the respiration rate per minute will be described as an example. The respiratory rate can be acquired by measurement with EtCO ₂ (End tidal CO ₂ ), measurement with respiratory sound, respiratory pressure or respiratory flow, measurement with chest impedance, and measurement with an impedance method using an electrocardiogram. Here, the continuous measurement parameter may be, for example, a parameter that measures data continuously (always) from a sensor attached to a subject.

  For example, in the case of measuring the respiration rate by an impedance method using an electrocardiogram, the first acquisition unit 3 is connected to the plurality of electrodes attached to the subject and the indifferent electrode. The electrode contacts the measurement site of the subject and functions as a sensor for deriving the potential change of the measurement site. The electrode is configured to derive a potential difference at the measurement site, and the indifferent electrode is configured to remove extraneous noise induced in phase to the electrode.

  In this example, the first acquisition unit 3 receives an electrical signal indicating a potential change (potential) output from the electrode and an electrical signal indicating a potential change (potential) output from the indifferent electrode. The first acquisition unit 3 differentially amplifies the potential derived from the electrode and the potential derived from the other electrode, removes extraneous noise by the potential derived from the indifferent electrode, and amplifies the amplified electrocardiogram signal. Generate Furthermore, the first acquisition unit 3 generates electrocardiogram waveform data by analog-digital conversion (AD conversion) of the amplified electrocardiogram signal. The generated electrocardiogram waveform data is supplied to the memory of the control unit 2 via the bus 11. Here, the electrocardiogram waveform data indicates a plurality of electrocardiogram waveforms (waveforms generated by one beat) continuously generated on the time axis.

  The second acquisition unit 4 acquires second biological information (non-continuous measurement parameter) measured in a spot manner at a predetermined time. The prescribed time can be determined by a healthcare professional as appropriate. Here, the case of acquiring the blood pressure in a specific one minute will be described as an example. Further, as a method of acquiring blood pressure, there is a non-invasive blood pressure measurement method using a cuff. Here, the non-continuous measurement parameter may be, for example, a parameter which is measured in a spot from a sensor attached to a subject, such as non-invasive blood pressure measurement or measurement of body temperature by circulation.

  For example, in the case of using a non-invasive blood pressure measurement method using a cuff, the second acquiring unit 4 wraps the cuff around the upper arm of the subject to increase the air pressure in the cuff so as to block the flow of blood; Measure blood pressure by pressing.

  The first determination unit 6 determines whether the respiration rate per minute acquired by the first acquisition unit 3 is equal to or higher than a preset value set by a medical worker in advance and less than the threshold. If the set value is equal to or less than the threshold value, a medical worker can arbitrarily set it. In the present embodiment, a respiration rate of 18 times / minute is set as the setting value. On the other hand, the threshold value is determined in accordance with the allowable range and reference value defined in the medical guidelines and the like. For example, as in the present embodiment, in the case of using the qSOFA used to determine sepsis to determine the change in the condition of the subject, the threshold value of 22 breaths / min, which is a reference value for diagnosis of sepsis, is the threshold. . In addition, the numerical value regarding the threshold value or reference value described in this specification is not limited to this, It is desirable to be able to change suitably according to a guideline, a use aspect, etc.

  Further, the first determination unit 6 can also determine whether or not the respiration rate which is equal to or more than the set value and less than the threshold or less than the set value is continuously acquired twice or more. In the present embodiment, the first determination unit 6 also determines whether or not the respiration rate below the set value or below the threshold or the respiration rate below the set value has been acquired twice in a row.

  After the first determination unit 6 makes the above determination, the second determination unit 7 determines whether the respiration rate acquired by the first acquisition unit 3 is equal to or greater than a threshold, that is, whether the respiration rate is out of the allowable range. Make a decision.

  The second determination unit 7 can also determine whether a respiration rate equal to or higher than the threshold or a respiration rate lower than the threshold is continuously acquired twice or more. In the present embodiment, the second determination unit 7 also determines whether or not the respiration rate above or below the threshold value has been obtained twice in a row.

  The third determination unit 8 determines whether the second biological information acquired by the second acquisition unit 4 is out of the allowable range, that is, whether or not it is equal to or more than a predetermined threshold. In the present embodiment, blood pressure is used as the second biological information, and the third discrimination unit 8 discriminates whether or not the acquired blood pressure is 100 mmHg / min or less which is a reference value for diagnosis of sepsis. There is. As described above, the numerical values related to the threshold value and the reference value described herein are not limited thereto, and it is desirable that they can be appropriately changed in accordance with the guidelines, the usage mode, and the like.

  The third determination unit 8 can also determine whether an out-of-tolerance blood pressure or an in-tolerance blood pressure has been acquired twice or more consecutively. In the present embodiment, the third discrimination unit 8 also discriminates whether or not the blood pressure equal to or lower than the threshold (100 mmHg / min) or the blood pressure exceeding the threshold is obtained twice in a row.

If the second discrimination unit 7 determines that the respiration rate equal to or more than the predetermined number of times is continuously acquired a predetermined number of times, the condition discrimination unit 9 determines that the condition of the subject has changed from the viewpoint of respiration rate. Do.
In addition, if the third discrimination unit 8 determines that the blood pressure outside the allowable range has been acquired a predetermined number of times consecutively, the condition determination unit 9 determines that the condition of the subject has changed from the viewpoint of blood pressure. Determine.
As in the present embodiment, when qSOFA is used to determine a change in the condition of a subject, respiratory rate, blood pressure, and consciousness level are used as parameters. Here, the level of consciousness refers to the degree of the subject's state of consciousness, such as being in a state of consciousness or being in a coma state, and more specifically, JCS (Japan Comba Scale) and GCS (Glasgow Comba)・ It is desirable to be determined based on indicators such as scale. The input of the awareness level is performed after the medical worker confirms the condition of the subject from the input operation unit 14 as a non-continuous measurement parameter. In qSOFA, when it is possible to confirm an abnormal value or abnormal state in two or more of these three items, it is determined that there is suspicion of sepsis.

  The display unit 10 is a display such as a liquid crystal display or an organic EL display, and when the condition judging unit 9 judges that the condition of the subject is changed, the condition of the subject is changed. The notification message is configured to be displayed. The display unit 10 may not be provided in the case change determination device 1.

  The input operation unit 14 is configured to receive an input operation of a medical worker who operates the condition change determination apparatus 1 and to generate an instruction signal corresponding to the input operation. The input operation unit 14 is, for example, a touch panel overlapped on the display unit 10, an operation button attached to a housing, an event switch, or the like. The input operation unit 14 receives an input operation for starting acquisition of biological information, an input operation for switching a display waveform, and the like, and generates an operation signal corresponding to the input operation. The generated instruction signal is transmitted to the control unit 2 via the bus 11, and the control unit 2 is configured to control the operation of the variation detection device 1 based on the instruction signal.

  The notification unit 15 is configured to notify the result of the determination by the condition determination unit 9. Notification is performed by at least one of optical notification (lighting of LED, display of message on display unit 10, etc.), acoustic notification (guidance message, melody, beep sound, etc.) and vibration notification.

  The case change determination device 1 has a power supply (not shown). The power source is, for example, a dry cell or a commercial power source. Furthermore, as shown in FIG. 1, the case change determination apparatus 1 may be configured of one case, or may be a system configured by connecting independent devices by a network.

Next, with reference to FIGS. 2 to 3, the flow of the operation performed by the body condition change discrimination device 1 will be described until the case where the body condition discrimination unit 9 discriminates that the patient has a change in the body condition. Do.
FIG. 2 is a flow chart in the case of determining a change in the condition of a subject taking respiratory rate and blood pressure as an example. Details of the flow in FIG. 2 will be described with reference to FIGS. 3 (a) and 3 (b) showing changes in the respiration rate and blood pressure of the subject.

  In step S1 (first process) of FIG. 2, the first acquisition unit 3 starts acquiring the respiration rate of the subject from time 0 minute in FIG. 3A.

Next, in step S2 (one of the second steps), the first determination unit 6 determines whether or not the acquired respiration rate is twice in a row and less than the set value and less than the threshold.
Here, referring to FIG. 3A, since the respiratory rates acquired during the period of 1 to 4 minutes are all less than the set value (in this example, the respiratory rate is 18 / minute), The first determination unit 6 determines No. For this reason, step S2 is repeated in time 1-4 minutes. In addition, the respiration rate shown here is a respiration rate converted into one minute, is continuously calculated, and can be measured.

  Next, the respiratory rate acquired at time 5 minutes is 20 and the respiratory rate acquired at time 6 minutes is 18. That is, since the respiratory rates acquired during the period of 5 to 6 minutes are all equal to or higher than the set value and lower than the threshold (in this example, 22 respiratorys / minute in this example), the first determination unit 6 determines as Yes. , Step S3 (one of the second steps).

  Next, in step S3 of FIG. 2, the first determination unit 6 determines again whether or not the acquired respiration rate is twice in a row and less than the threshold value. Since the respiratory rate acquired at 7 minutes is 17 times, it is less than the set value. If the respiration rate at time 8 is also less than the set value, the first determination unit 6 determines No and returns to step S2. However, since the respiratory rate at the time of 8 minutes is 18 times, that is, the set value or more, the first determination unit 6 does not determine No and stays in step S3.

  Next, the respiratory rate obtained at 8 and 9 minutes is 18 times. That is, since all respiratory rates acquired during the period of 8 to 9 minutes are equal to or greater than the set value and less than the threshold, the first determination unit 6 determines Yes and proceeds to step S4 (third step).

  Next, in step S4 of FIG. 2, the second determination unit 7 determines whether the acquired respiration rate is equal to or more than a threshold. Since the respiratory rate acquired at the time of 10 to 12 minutes is less than the threshold, the second determination unit 7 determines No and repeats step S4.

  Next, since the respiratory rate acquired at the time of 13 minutes is 22 times, that is, the threshold value or more, the second determination unit 7 determines Yes in step S4, and step S5 (one of the fifth steps Go to). Here, the respiration rate score is incremented by one.

  Next, in step S5 of FIG. 2, based on the fact that the respiratory rate score has become 1, the condition discrimination unit 9 determines that the condition of the subject has changed in terms of respiratory rate. Then, it progresses to step S6 (one of the 4th processes).

In step S6 of FIG. 2, the third discrimination unit 8 determines whether the blood pressure of the subject from the time of 13 minutes, that is, the time of transition to step S6, is equal to or less than the threshold (blood pressure 100 mmHg / min). Determine. In the present embodiment, the second acquisition unit 4 acquires the blood pressure of the subject every five minutes. Since the blood pressure acquired by the second acquiring unit 4 at time 10 minutes in FIG. 3B is 100 mmHg and the blood pressure acquired at 15 minutes is 90 mmHg, the blood pressure is continuous at 15 minutes. The blood pressure below the threshold is obtained twice. Therefore, the third determination unit 8 determines Yes and proceeds to step S7 (one of the fourth steps).
When the third determination unit 8 determines No in step S6, the process proceeds to step S9.

Next, step S7 of FIG. 2 will be described. The second acquiring unit 4 further acquires blood pressure after step S6. In step S7, the third determination unit 8 determines whether or not the newly acquired blood pressure is equal to or less than the threshold twice in a row. At time 20 minutes in FIG. 3B, the blood pressure acquired by the second acquiring unit 4 is 85 mmHg, that is, less than the threshold, and thus blood pressure less than the threshold twice in a row at 20 minutes. Was acquired. Therefore, the third determination unit 8 determines Yes and proceeds to step S8 (one of the fifth steps). Here, the blood pressure score is incremented by one.
When the third determination unit 8 determines No in step S7, the process proceeds to step S9.

  In step S8, based on the blood pressure score becoming 1, the condition determination unit 9 determines that the condition of the subject has changed from the viewpoint of blood pressure.

  In step S9, it is determined whether or not the respiratory rate score is 1. If the respiration rate at the time of transition to step S9 is still equal to or higher than the threshold (22 respirations / minute) and the respiration rate score is 1, the process proceeds to step S6. If not, the process proceeds to step S1.

  Next, referring to FIG. 4, a screen for displaying the result of discrimination of the subject's condition from the subject's respiration rate and blood pressure will be described.

  FIG. 4 is a diagram relating to a screen for displaying the condition state of the subject from the respiratory rate and the blood pressure. It is desirable that the screen is displayed on the display of an apparatus (such as a personal computer or a mobile communication terminal) other than the case change determination apparatus 1. Further, the changes in the respiration rate in FIG. 3 (a) and the blood pressure in FIG. 3 (b) are synchronized with the respiration rate and the blood pressure of the photoelectric taro displayed at the upper left of FIG.

  In the present embodiment, the state of the subject is classified into four, and in FIG. 4, visual distinction is made by hatching for convenience. Specifically, a state where the respiratory rate is less than the set value (normal state) is a diagonal line that inclines from the upper left to the lower right, and a state where the respiratory rate more than the set value and less than the threshold is acquired twice consecutively (respiratory rate abnormality The state of reserve forces) is a horizontal line, the respiratory rate score is 1 but the blood pressure score is 0 (respiratory rate abnormal state) is diagonally inclined from upper right to lower left, and both the respiratory rate score and blood pressure score are 1 (abnormal state) Are respectively represented by vertical lines. In addition, the method of distinction of each classification is not restricted to hatching. For example, instead of hatching, any color may be attached.

  Here, FIG. 4 will be described along the time series of FIG. 3 (a) and FIG. 3 (b), taking the bar graph of the photo diode of the upper left of FIG. 4 as an example. Since the respiratory rate at the time of 1 to 4 minutes is less than the set value, it is in a normal state. Therefore, the bar graph at time 1 to 4 minutes is a diagonal line that inclines from the upper left to the lower right.

  At the time of 5 to 12 minutes, since the respiration rate of the set value or more and less than the threshold value is acquired twice in a row, it is in the state of the respiratory rate abnormality reserve army. Therefore, the bar graph at time 5 to 12 minutes is displayed as a horizontal line.

  At time 13 to 19 minutes, the respiratory rate exceeds the threshold at time 13, so although the respiratory rate score is 1, the blood pressure score is 0, so the respiratory rate is abnormal. Therefore, the bar graph at time 5 to 12 minutes is displayed by oblique lines inclined from the upper right to the lower left.

  At time 20 minutes, the blood pressure score is also 1, which is an abnormal state. Therefore, the bar graph at time 5 to 12 minutes is displayed as a vertical line.

  Next, FIG. 5 will be described. FIG. 5 is a diagram showing the state of the display unit 10 displayed when there is a change in the condition of the subject.

  If the condition determination unit 9 determines that there is a change in the condition of the subject from the viewpoint of respiratory rate and blood pressure, the notification unit 15 displays a message indicating that the condition of the subject has a change, for example, “ Display a message on the display unit 10 stating "Please check the condition of Mr. Photoelectric Taro" or "suspect of sepsis".

  The means for informing the change in the condition of the subject is not limited to the display unit 10 displaying a message informing the change in the condition of the subject. For example, the notification unit 15 outputs a guide sound notifying that the condition of the subject has changed, for example, a message such as "Please check the condition of Mr. Photon Taro. There is a suspicion of sepsis." May be configured.

By the way, conventionally, biological information that can be used to grasp the change in the condition of the subject is limited to one that is reliable (for example, the heart rate) in the determination of the change in the condition of the subject.
In addition, as a main means by which a medical worker grasps a change in the condition of a subject, a method of monitoring a change in heart rate has been used. Therefore, when the condition of the patient in the hospital changes, for example, when the heart rate falls below a certain value, conventionally, the alarm sensor has been notified and the medical worker is notified. However, since it is rare for the heart rate to show an abnormal value before the change in the condition of the subject, when the heart rate showed an abnormal value, it was often out of phase. That is, in the method of notifying the medical staff of the change in the condition of the patient by the alarm sensor, the medical staff may be notified when the disease has already developed, so that it may not be possible to prevent the disease.

According to the above configuration, the first discrimination unit 6 discriminates in step S2 and S3 the trend whether or not the acquired respiration rate approaches the threshold value (22 respirations / minute in this example) stepwise. After that, the second determination unit 7 determines in step S4 whether a respiratory rate outside the allowable range is acquired, that is, whether the acquired respiratory rate exceeds a threshold. Therefore, when determining the change in the condition of the subject, it is possible to consider two aspects of the acquired change in respiratory rate and whether the respiratory rate is out of the allowable range.
As described above, according to the above configuration, since the above two aspects can be taken into consideration for the respiratory rate, it is possible to accurately grasp temporal changes in the respiratory rate, and it is possible to accurately determine the condition change of the subject. It is possible to provide the case change determination device 1 capable of improving the property.

  Further, according to the above configuration, in the first determination unit 6, whether the respiration rate acquired by the first acquisition unit 3 is between the set value set by the medical worker and the threshold value in steps S2 and S3. Determine if it is not. For this reason, after the first determination unit 6 determines the trend of whether the respiratory rate is rising stepwise, the second determination unit 7 determines in step S4 whether the respiratory rate equal to or higher than the threshold is acquired. it can.

  Further, according to the above configuration, when the change in the condition of the subject is determined, the change in the condition of the subject can be determined in consideration of the respiratory rate.

  Further, according to the above configuration, after the first determination unit 6 determines the trend of whether the respiratory rate measured by the impedance method by the electrocardiogram is rising stepwise in steps S2 and S3, The second determination unit 7 determines in step S4 whether the respiratory rate has been acquired. Therefore, even if the respiration rate is acquired by the low-reliability electrocardiogram impedance method in the measurement of respiration rate, it is possible to accurately grasp the temporal change of the respiration rate with high accuracy, and it is possible to discriminate the change in the condition of the subject It is possible to provide the case change discrimination device 1 capable of improving the accuracy of the above.

  Further, according to the above configuration, the first determination unit 6 determines at least twice each of steps S2 and S3 whether or not the respiration rate acquired by the first acquisition unit 3 exceeds the set value. Therefore, the determination in the second determination unit 7 is not performed unless the respiration rate exceeding the set value is acquired twice or more. For this reason, since the temporal change of the respiratory rate can be accurately captured, it is possible to provide the condition change determination device 1 capable of improving the accuracy of the determination of the condition change of the subject.

  Further, according to the above configuration, not only the respiration rate acquired by the first acquisition unit 3 but also the blood pressure acquired by the second acquisition unit 4 is set for blood pressure in each of steps S6 and S7. It is determined whether it is outside the allowable range. Therefore, not only the respiration rate but also the blood pressure can be considered when determining the change in the condition of the subject, so that the accuracy of the determination of the change in the condition of the subject can be improved.

  Further, according to the above configuration, when the change in the condition of the subject is determined, the change in the condition of the subject can be determined in consideration of the blood pressure.

Further, according to the above configuration, the condition of the subject is determined by the condition determination unit 9 based on at least the determination result of the second determination unit 7 (step S5). When the condition determining unit 9 determines that there is a change in the condition of the subject, the notification unit 15 notifies of a change in the condition of the subject.
As described above, according to the above configuration, it is possible to appropriately determine the change in condition of the subject, and to promptly notify the change in condition of the subject when the change in condition is recognized.

Further, according to the above configuration, after determining the trend of whether or not the acquired respiratory rate approaches the threshold in steps in steps S2 and S3, in step S4, whether the respiratory rate exceeds the predetermined threshold It is determined whether or not.
As described above, according to the above configuration, since the above two aspects can be taken into consideration for the respiratory rate, it is possible to accurately grasp temporal changes in the respiratory rate, and it is possible to accurately determine the condition change of the subject. It is possible to provide a method that can improve the quality.

  Further, according to the above configuration, after it is determined in step S4 that the respiration rate is out of the allowable range, it is determined in step S6 whether the blood pressure is out of the allowable range set for blood pressure. . Then, the condition change of the subject is determined based on at least the determination result for the respiratory rate and the determination result for the blood pressure (steps S5 and S8). Such a process can improve the accuracy of the determination of the change in the condition of the subject.

  Further, as shown in FIG. 4, since the display screen shows the result of comprehensively analyzing the patient's condition from the two pieces of biological information of respiratory rate and blood pressure, the condition change of the patient's condition is You can know the sign more accurately. In particular, the body condition change discrimination device 1 according to the present embodiment does not judge the case body condition change of the subject based solely on a plurality of pieces of biological information, and in general, an abnormal value is easily obtained suddenly For biological information (for example, respiration rate), the transition of the biological information is also analyzed. For this reason, even if biological information, which was conventionally difficult to use for discrimination of change in condition, is set as a parameter, a medical worker can accurately determine the symptom of the change in condition of the subject.

  Furthermore, as shown in FIG. 4, since the condition of the subject and the transition of the change are displayed in a simple manner, the medical worker can easily notice the sign of the change in the condition of the patient.

Second Embodiment
FIG. 6 is a diagram showing a determination flow of a change in condition of a subject according to the second embodiment. The flow chart shown in FIG. 6 is different from the first embodiment in that only the respiration rate is used as a parameter for determining the change in the condition of the subject.

  The contents performed in each step (S1 to S5) are the same as in the first embodiment, and thus the description will be omitted.

  In the second embodiment, at the stage when the respiratory rate score becomes 1 (step S5), the notification unit 15 displays a message indicating that there is a change in the condition of the subject, for example, “the condition of Mr. A message such as “Please confirm.” Is displayed on the display unit 10.

  The means for informing the change in the condition of the subject is not limited to the display unit 10 displaying a message informing the change in the condition of the subject. For example, the notification unit 15 may be configured to output a guide sound for notifying that there is a change in the condition of the subject, for example, a message such as "Please check the condition of Mr. Photon Taro". .

According to the above configuration, in steps S2 and S3, the first discrimination unit 6 determines whether the acquired respiration rate approaches the threshold value (22 respirations / minute in this example) stepwise in steps S2 and S3. After the determination, the second determination unit 7 determines in step S4 whether a respiratory rate outside the allowable range is acquired, that is, whether the acquired respiratory rate exceeds a threshold. Therefore, when determining the change in the condition of the subject, it is possible to consider two aspects of the acquired change in respiratory rate and whether the respiratory rate is out of the allowable range.
As described above, according to the above configuration, since the above two aspects can be taken into consideration for the respiratory rate, it is possible to accurately grasp temporal changes in the respiratory rate, and it is possible to accurately determine the condition change of the subject. It is possible to provide the case change determination device 1 capable of improving the property.

Third Embodiment
FIG. 7 is a functional block diagram of the case change discrimination apparatus according to the third embodiment. The condition change determination apparatus 1A shown in FIG. 7 is different from the first embodiment in that the third acquisition unit 5 is provided.

Here, it demonstrates using the example which discriminate | determines a sepsis using EWS. EWS, like qSOFA, measures biological information such as respiration rate and blood pressure and quantifies it. Then, when the numerical value reaches a certain level or more, a warning is issued to detect a change in the condition of the subject. However, EWS generally determines changes in the condition of a subject based on scores calculated from more parameters than qSOFA. Parameters used in the EWS include, for example, respiratory rate, blood pressure, body temperature, pulse rate, SpO ₂ , and consciousness level.

  The third acquisition unit 5 acquires other biological information different from the first biological information and the second biological information. For example, when the condition change of the subject is determined using EWS, the respiratory rate (first biological information), blood pressure (second biological information) and body temperature (third biological information) are respectively acquired, and the subject is examined. To determine the change in The first biological information is a continuous measurement parameter, and the second biological information and the third biological information are non-continuous measurement parameters. As described above, since three or more pieces of biometric information can be set as parameters, the determination accuracy can be improved as compared to the first embodiment. The continuous measurement parameters and the non-continuous measurement parameters are as described above.

Although the above-mentioned embodiment demonstrated using the example which discriminate | determines the condition change of a subject using a respiration rate as 1st biometric information and a blood pressure as 2nd biometric information, it is not restricted to this example. The first biological information may be any biological information which is continuously measured, and may be an electrocardiogram, a pulse rate, SpO ₂ , or an electroencephalogram. The second biological information may be any biological information to be measured in the form of a spot at a certain time, and may be, for example, the body temperature or the awareness level.

According to the above configuration, when the change in the condition of the subject is determined, the change in the condition of the subject can be determined in consideration of the electrocardiogram, the pulse rate, the SpO ₂ , the respiration rate, or the electroencephalogram.

  Further, according to the above configuration, when the change in the condition of the subject is determined, the change in the condition of the subject can be determined in consideration of the blood pressure, the temperature or the awareness level.

  Further, according to the above configuration, when determining the change in condition of the subject, the change in condition of the subject can be determined in consideration of the continuous measurement parameter and the non-continuous measurement parameter.

Further, according to the above configuration, when the change in the condition of the subject is determined, the change in the condition of the subject is determined in consideration of the electrocardiogram, pulse, SpO ₂ , respiration, electroencephalogram and blood pressure, body temperature, or awareness level. can do.

  Although the above-mentioned embodiment demonstrated using the example which sets one to three biometric information as a parameter used for the body change discrimination | determination of a subject, it is not restricted to this example. Four or more pieces of biometric information may be set as parameters.

  Although the above embodiment has been described using an example in which the image shown in FIG. 4 is displayed on a personal computer display or a display on a mobile communication terminal other than the package change determination device 1, the present invention is not limited to this example. The image may be displayed on the display unit 10 of the case change determination device 1.

  The present invention is not limited to the above-described embodiment, and modifications, improvements, and the like can be made as appropriate. In addition, the materials, shapes, dimensions, numerical values, forms, numbers, arrangement places and the like of each component in the above-described embodiment are arbitrary and not limited as long as the present invention can be achieved.

1: Volume change discrimination device, 2: Control unit, 3: First acquisition unit, 4: Second acquisition unit, 5: Third acquisition unit, 6: First discrimination unit, 7: Second discrimination unit, 8: First 3 discrimination unit, 9: case discrimination unit, 10: display unit, 11: bus, 14: input operation unit, 15: notification unit

Claims (14)

A first acquisition unit that acquires first biometric information of a subject;
A first determination unit that determines whether the first biological information acquired by the first acquisition unit changes in a stepwise approach to a predetermined threshold that is a reference of an allowable range;
Whether the first biological information acquired after it is determined that the first biological information is approaching the predetermined threshold value stepwise by the first discrimination unit is outside the allowable range A second determining unit that determines
A case change discrimination device comprising:   The first determination unit determines whether or not the first biological information acquired by the first acquisition unit is between a set value within the allowable range and a threshold serving as a reference of the allowable range. The condition change determination device according to claim 1.   The condition change determination apparatus according to claim 2, wherein the first biological information is a respiratory rate.   The condition change determination apparatus according to claim 3, wherein the first acquisition unit acquires the respiration rate measured by an impedance method using an electrocardiogram.   The first determination unit determines whether the first biological information acquired by the first acquisition unit is between the set value within the allowable range and the threshold value at least twice or more. The case change discrimination | determination apparatus as described in any one of 2-4. further,
A second acquisition unit that acquires second biometric information different from the first biometric information;
A third determination unit that determines whether the second biological information is out of an allowable range set for the second biological information;
Equipped with
The case change discrimination | determination apparatus as described in any one of Claims 1-5.   The condition change determination apparatus according to claim 6, wherein the second biological information is blood pressure. A condition determining unit that determines a change in condition of the subject based on at least the determination result of the second determining unit;
The notification unit according to any one of claims 1 to 7, further comprising: a notification unit that notifies a change in condition of the subject when the condition determination unit determines that there is a change in the condition of the subject. Case change discrimination device. The condition change determination apparatus according to any one of claims 1 to 8, wherein the first biological information includes at least one of an electrocardiogram, a pulse rate, an SpO ₂ , a respiration rate, and an electroencephalogram.   The condition change determination device according to claim 6, wherein the second biological information includes at least one of blood pressure, body temperature, and a consciousness level. A first step of acquiring first biometric information of the subject;
A second step of determining whether or not the first biological information acquired in the first step changes stepwise toward a predetermined threshold which is a reference of an allowable range;
It is determined whether or not the first biological information acquired after it is determined that the first biological information is stepwise approaching the predetermined threshold value in the second step is outside the allowable range. The third step,
Have
A method for determining the change in condition of a subject. The first step includes the step of acquiring second biological information different from the first biological information,
further,
After the third step determines that the first biological information is out of the allowable range, whether or not the second biological information is out of the allowable range set for the second biological information The fourth step to determine
A fifth step of determining a change in the condition of the subject based on at least the determination result on the first biological information in the third step and the determination result on the second biological information in the fourth step;
Have
A method for determining the change in condition of a subject according to claim 11. The first biological information is a continuous measurement parameter,
The second biometric information is a non-continuous measurement parameter,
A method for determining the change in condition of a subject according to claim 12. The continuous measurement parameters include at least one of an electrocardiogram, a pulse, SpO ₂ , a respiration, and an electroencephalogram.
The non-continuous measurement parameters include at least one of blood pressure, body temperature and awareness level,
A method for determining the change in condition of a subject according to claim 13.

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