JP5242141B2 - Medical safety system - Google Patents

Description

  The present invention relates to a medical safety system for managing medical practice.

  In general, when a medical practice such as surgery is performed at a medical site, the details are recorded as a document by a doctor involved in the medical practice. This record may be accompanied by charts, photographs or videos showing data output from various devices during medical practice.

  However, in such a recording, various types of data are often described regardless of the time-series order. Therefore, it can be said that it is difficult for specialists such as doctors to confirm and verify the procedure of the medical practice after the fact based on such records.

  Under such circumstances, various techniques for providing information that enables easy confirmation and verification of medical procedures are proposed. For example, Patent Document 1 discloses the following technique. ing.

That is, the medical information system disclosed in Patent Document 1 is a medical information system that performs information processing for managing a medical practice including a plurality of stages achieved by a combination of a plurality of events, and the medical practice system Collecting means for collecting state information indicating a medical device and / or human state in time series, and determining the execution order of the plurality of stages based on the occurrence state of the event determined based on the state information A first determination unit that performs determination, a second determination unit that determines the start timing of each of the plurality of stages based on the state information, the execution order, and the start timing of each of the plurality of stages. Means for generating the procedure information. Thus, according to the medical information system disclosed in Patent Document 1, information that enables easy confirmation and verification of a medical practice procedure is provided.
JP 2006-164251 A

  By the way, in the determination of a medical stage (a unit of a process or a period in which a series of work from the start to the end of a medical action is divided according to the work purpose) by a system for managing medical actions conventionally, for example, suddenly There is a problem of deterioration in determination accuracy caused by an unexpected event related to a used instrument, such as replacement of a used instrument. The technique disclosed in Patent Document 1 does not solve this problem.

  The present invention has been made in view of the circumstances as described above, and has high medical stage determination accuracy that is not affected by unexpected events related to the device used, such as sudden replacement of the device used. The aim is to provide a realized medical safety system.

In order to achieve the above object, a medical safety system according to the present invention according to claim 1 is a medical safety system for managing a series of medical actions, and a heart rate of a medical staff involved in the series of medical actions. A heart rate information measuring unit that measures heart rate information, which is information indicating the number and the amount of change thereof, and the type of medical practice performed by the medical staff based on the heart rate information of the medical staff measured by the heart rate information measuring unit And the medical practice determination unit for determining the implementation time, and the medical practice type that is determined by the medical practice determination unit for the type and implementation time of the medical stage that represents the unit of the process or period in which the series of medical practices are classified according to the work purpose Determined based on the type and execution time of the medical stage and the type and execution time of the other medical stage, and determined by the medical action determination unit. And the information of the type and execution time of the medical practice, characterized by comprising a recording unit for recording with information of the type and execution time of the medical stage which is determined by the medical stage determination unit.

In order to achieve the above object, a medical safety system according to the present invention as set forth in claim 3 is a medical safety system for managing a series of medical actions, and at least the positions of medical staff involved in the medical actions and Position and motion amount measuring unit for measuring the amount of motion, heart rate information measuring unit for measuring heart rate information which is information indicating at least the heart rate of the medical staff involved in the series of medical actions and the amount of change thereof, and the position and motion Based on the position and movement amount of the medical staff measured by the quantity measuring unit and the heart rate information of the medical staff measured by the heart rate information measuring unit, the type and time of the medical practice performed by the medical staff are determined. Medical action determination unit for determining, type of medical stage representing a unit of a process or a period in which the series of medical actions are classified according to work purpose, and at the time of implementation Determined based on the type and execution time of the medical action determined by the medical action determination unit and the type and execution time of the other medical stage, and determined by the medical action determination unit And a recording unit that records information on the type and execution time of the medical action together with information on the type and execution time of the medical stage determined by the medical stage determination unit.

  ADVANTAGE OF THE INVENTION According to this invention, the medical safety system which implement | achieved the high medical stage determination precision which is not influenced by the unexpected event regarding a use tool, such as sudden replacement | exchange of a use tool, for example can be provided.

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

[First Embodiment]
FIG. 1 shows a configuration of a medical safety system according to the first embodiment of the present invention. As shown in the figure, the medical safety system 1 according to the first embodiment includes a video acquisition / medical staff identification system 2, a medical staff measurement numerical value collection unit 4, a medical staff measurement numerical value analysis unit 6, and a medical practice. A data recording unit 8, a medical practice plan information storage unit 10, a stage determination rule storage unit 12, a medical stage / work determination unit 14, a medical stage recording unit 16, an incident determination unit 18, a warning device 20, A medical practice record browsing device 22 and a medical practice record analysis device 24 are provided.

  The video acquisition / medical staff identification system 2 is a system that acquires video, identifies medical staff in the video, performs video analysis, and measures the amount of movement of each medical staff. Details of the video acquisition / medical staff identification system 2 will be described with reference to FIGS.

  The medical staff measurement numerical value collection unit 4 collects the heart rate of the medical staff.

  The medical staff measurement numerical analysis unit 6 analyzes the heart rate of the medical staff collected by the medical staff measurement numerical value collection unit 4 and calculates the amount of change.

  The medical practice data recording unit 8 includes a video recording unit 8A and a medical staff measurement numerical value recording unit 8B. The video recording unit 8A records the video acquired by the video acquisition / medical staff identification system 2. The medical staff measurement numerical value recording unit 8B includes the medical staff heart rate collected by the medical staff measurement numerical value collection unit 4, the change amount of the medical staff heart rate analyzed by the medical staff measurement numerical analysis unit 6, and the like. Record.

  The medical practice plan information storage unit 10 stores medical practice plan information that is information related to a medical practice plan planned by a predetermined medical practice planning system (not shown).

  The stage determination rule storage unit 12 is a determination rule (operation to be described later) corresponding to a specific operation or medical stage (for example, a process or a unit of a period in which a series of flows from preparation for surgery to completion of surgery is classified according to work purpose). Determination rules, medical stage determination rules, and the like) and warning rules that are rules for notifying the user of warnings are stored.

  The medical stage / work determination unit 14 includes a video determination unit 14A and a medical staff measurement numerical value determination unit 14B. Although details will be described later, the medical stage / work determination unit 14 determines the type and execution time of the medical stage according to the medical stage determination rule defined for each medical stage and stored in the stage determination rule storage unit 12. Determine.

  The medical stage recording unit 16 records information on the type and execution time of the medical stage determined by the medical stage / work determination unit 14.

  The incident determination unit 18 determines an incident based on the video determination result and the medical stage determination result by the medical stage / work determination unit 14.

  The warning device 20 notifies a warning based on the incident determination result by the incident determination unit 18.

  The medical practice record browsing device 22 is a device for browsing information recorded in the medical stage recording unit 16.

  The medical practice record analyzing apparatus 24 is an apparatus that analyzes the medical practice based on information recorded in the medical stage recording unit 16 and generates and outputs an analysis report based on the analysis result.

  FIG. 2 is a diagram illustrating a configuration example of the video acquisition / medical staff identification system 2. As shown in the figure, the video acquisition / medical staff identification system 2 includes a video storage unit 2A, a video analysis unit 2B, a subject identification device 31, a position measurement device 33, and a video acquisition device 35.

  The subject identification device 31 includes an RF tag (not shown) and a wireless transmission / reception unit (not shown). The position measuring device 33 includes an ultrasonic oscillator (not shown), an ultrasonic sensor (not shown), and a measurement system position calculator (not shown).

  The RF tag and the ultrasonic transmitter are built in a signal transmitter (not shown). And this signal transmission body is mounted | worn with the medical staff.

  The wireless transmission / reception unit, the ultrasonic sensor, and the measurement system position calculation unit are built in a transmitter measurement device (not shown). The transmitter measurement apparatus further includes a control signal transmitter and is installed in the medical field.

  The RF tag includes an IC chip and an antenna. The identification code of the medical staff wearing the signal transmitter is stored in advance in the IC chip. The medical staff identification code is an ID uniquely assigned to each medical staff, and is a kind of medical staff identification information.

  The RF tag receives radio waves emitted from the outside with an antenna. When an electric wave is received from the outside, an electromotive force supplied to the IC chip is generated by a resonance action, and the RF tag transmits an identification code of a staff stored in the IC chip via an antenna.

  Further, the RF tag receives a control signal including a medical staff identification code from the outside, and when the received medical staff identification code is stored in the IC chip, a trigger signal is sent to the ultrasonic transmitter. Output.

  The wireless transmission / reception unit includes an antenna. The wireless transmission / reception unit transmits a radio wave that generates an electromotive force in the RF tag, and receives a medical staff identification code transmitted from the RF tag.

  In the subject identification device 31, the medical staff represented by the identification code is specified by transmitting the identification code of the medical staff from the RF tag to the wireless transmission / reception unit. The control signal transmitter transmits a control signal to the signal transmitter. The control signal includes an identification code of the medical staff whose position is to be measured.

  When the wireless transmission / reception unit receives the staff identification code, the control signal transmission unit includes the received staff identification code in the control signal and transmits it. When the identification codes of a plurality of medical staff are received, they are sequentially included in the control signal and transmitted at a predetermined interval in order to avoid interference.

  The ultrasonic oscillator oscillates an ultrasonic signal to the outside when a trigger signal is input from the RF tag. The ultrasonic sensor receives an ultrasonic signal generated by an ultrasonic oscillator. A plurality of ultrasonic sensors are installed at a medical site at a predetermined distance. Each ultrasonic sensor receives ultrasonic waves having different phase differences depending on the distance relationship between the installed position and the signal transmitter.

  The measurement system position calculation unit calculates the measurement system position of the signal transmitter represented by measurement system coordinates (Xs, Ys, Zs) with the ultrasonic sensor as the origin from the phase difference of the ultrasonic waves received by each ultrasonic sensor. Calculate information.

  The position measuring device 33 transmits the identification code of the medical staff stored in the signal transmitter worn by the medical staff whose existence has been confirmed, so that only the signal transmitter is responded to By oscillating the sound wave and calculating the position of the signal transmitter from the received ultrasonic wave, the position of the medical staff wearing the position-calculated signal transmitter is acquired in the measurement system coordinates.

  The transmitter measuring device uses the identification code for identifying the medical staff acquired by the subject identifying device 31 and the measurement system position information of the medical staff acquired by the measurement system position calculation unit as the subject identification position information, Output to the video recording unit 2A.

  The video storage unit 2A includes an identification information / position storage unit 2A1 and a video signal storage unit 2A2.

  The identification information / position storage unit 2A1 stores the subject identification position information acquired by the subject identification device 31 and the position measurement device 33.

  The video signal storage unit 2A2 stores a video signal acquired by a video acquisition device 35 such as a video camera.

  The video analysis unit 2B includes a video position calculation unit 2B1, a condition specifying unit 2B2, a ROI setting unit 2B3, a video analysis unit 2B4, and an analysis result storage unit 2B5.

  The video position calculation unit 2B1 indicates on which pixel on the video the signal transmitter, that is, the medical staff wearing the signal transmitter, is reflected from the measurement system position information output from the transmitter measurement device. Calculate video system position information.

  The condition designating unit 2B2 sets various conditions such as a region of interest in the video.

  The ROI setting unit 2B3 mainly includes a CPU, and stores a region of interest when a region of interest is designated on a screen displayed on a display device (not shown).

  The video analysis unit 2B4 mainly includes a CPU, and based on the video signal stored in the video signal storage unit 2A2 and the video system position information calculated by the video position calculation unit 2B1, The amount of movement of each medical staff shown in the video is calculated individually from the change in shape of the medical staff image. Further, when the ROI setting unit 2B3 has set the region of interest, it is determined whether or not there is a medical staff in the region of interest on the video, and only moves when there is a medical staff in the region of interest. Calculate the amount.

  The analysis result storage unit 2B5 stores the video analysis result by the video analysis unit 2B4, that is, the movement amount of each medical staff and the video system position information calculated by the video position calculation unit 2B1 in time series.

  The configuration of the video acquisition / medical staff identification system 2 is not limited to the configuration shown in FIG. 2 described above. For example, the video recording unit 2A is not provided as shown in FIG. 2A1 and the video signal storage unit 2A2 may be provided in the video analysis unit 2B, and the identification information / position storage unit 2A1 and the video signal storage unit 2A2 may be used for temporary storage, for example, as a buffer memory. Further, it is of course possible to perform the processing in real time without performing such temporary storage.

  Hereinafter, the flow of processing by the medical stage / work determination unit 14 will be described in detail with reference to FIG.

  First, medical practice plan information is input from the medical practice plan information storage unit 10 to the video determination unit 14A (step S1). Subsequently, the operation determination rule is input from the stage determination rule storage unit 12 to the video determination unit 14A (step S2). Further, basic medical stage information (medical stage determination rule, warning rule) is supplied from the stage determination rule storage unit 12 to the video determination unit 14A (step S3).

  Then, the image determination unit 14A selects an operation determination rule corresponding to the operation scheduled to be executed in the medical practice plan from the operation determination rule supplied from the stage determination rule storage unit 12 (step S4).

  Furthermore, the video determination unit 14A selects a medical stage determination rule and a warning rule corresponding to the medical stage included in the medical action plan from the medical stage determination rule and the warning rule supplied from the stage determination rule storage unit 12 ( Step S5).

  After the start of the medical practice, as described above, the video acquisition / medical staff identification system 2 acquires the video as described above and identifies the medical staff reflected in the video, and the amount of movement of the medical staff by video analysis. Is calculated. The subject identification position information acquired by the video acquisition / medical staff identification system 2 in this way is recorded in the medical practice data recording unit 8 (step S6).

  After the start of the medical practice, the medical staff measurement numerical value collection unit 4 measures the heart rate of the medical staff together with time information, and after the analysis by the medical staff measurement numerical analysis unit 6, the medical staff measurement numerical value recording unit 8B (Step S7).

  14 A of said image | video determination parts are based on the operation | movement determination rule selected in step S4 from the above various measured (recorded) data as medical action determination (motion determination), for example, suction operation | movement, incision operation | movement, etc. The presence / absence / time / implementation period of various operations is determined (step S8).

  Further, the video determination unit 14A performs the medical stage determination in the past and in the future, the operation of the medical staff, the amount of movement, the determination result of the position and the medical stage (type, time, period), and the various measurements described above. The type, start time, and end time (implementation period) of the executed medical stage are determined from the recorded data and the time information based on the medical stage determination rule selected in step S5 (step S9) ).

  Then, the video determination unit 14A records the determination result of the medical action determination (motion determination) performed in Step S8 and the determination result of the medical stage determination performed in Step S9 in the stage recording unit 16 ( Step S10).

  One of the main features of the medical safety system according to the first embodiment is that the medical staff's operation, movement amount, position, and time information included in the determination result of the medical stage are further converted into another medical action determination (operation determination). ) And used again as a determination material in medical stage determination. For example, regarding which medical stage information is used for which medical stage is determined, it is not always necessary to follow the time-series order in which those events occur.

  Hereinafter, the medical stage determination based on the movement amount and position of the medical staff by the video determination unit 14A will be described in detail.

  The processing relating to the calculation of the movement amount and position of the medical staff is performed by the video acquisition / medical staff identification system 2 as described above. The movement amount and time information of each medical staff calculated by the video acquisition / medical staff identification system 2 are associated with each other as shown in FIG. Here, the motion amount is calculated in real time.

  According to the video acquisition / medical staff identification system 2, it is possible to know the amount of movement in a designated region (ROI 001 to ROI 003 shown in FIG. 6A) on the video acquired by the video acquisition / medical staff identification system 2. it can. 6A is a diagram showing the ROI set on the video, and the linear graph in FIG. 6B is a graph showing the movement amount of the medical staff (ID 001 to ID 006) in the ROI 001. FIG. Here, the time zone indicated by the thick line in FIG. 6B is the time zone in which the person with the ID number exists in the ROI 001, and the time zone indicated by the thin line in FIG. 6B is the person in the ID number in the ROI 001. It indicates that the time is absent. In addition, a time zone with a parallelogram in the graph is a time zone in which the amount of motion related to the surgical technique is detected during ROI 001, and the amount of motion is “ROI ID: 001 operative field” in the graph. It is shown in the line graph.

  Of course, such a graph may be displayed on the display device (not shown), and when the user clicks a predetermined time, an image at the time will display the display device (not shown). Good.

  That is, for example, the user designates on the video the region where the surgical procedure in the operating room is performed and the region where the anesthesia / patient vital monitor related devices are arranged, and calculates the amount of movement in the region, It is possible to know the amount of movement related to surgical procedures and the amount of movement of medical staff related to anesthesia and patient maintenance.

  Specifically, as shown in FIGS. 6A and 6B, for example, which medical staff (ID 001 to ID 006 shown in the figure) is in which region (ROI 001 to ROI 003 shown in the figure) I can know. These pieces of information are also calculated in real time.

  Here, the relationship between the amount of movement of the medical staff and the medical stage will be described.

  Of course, the amount of movement of each medical staff varies depending on each medical stage. FIG. 7 is a graph showing changes in the amount of movement of the medical staff in the malignant brain tumor resection. Note that the shooting range for acquiring the video is approximately a shooting range 60 shown in FIG. That is, the surgical technique by the surgeon 61 and the assistant 63 and the delivery of the surgical instrument by the instrument table nurse 65 are photographed within the photographing range 60 shown in FIG.

  In the graph shown in FIG. 7, the vertical axis represents the amount of movement (here, to simplify the processing, the video file is divided every minute and compressed and saved at a variable video rate, and the size of the file is changed. The elapsed time from the video recording start time is shown on the horizontal axis in minutes.

  The work related to the surgical technique in the surgery represented by the graph shown in FIG. 7 is roughly divided into, for example, a chain of medical stages ordered as follows. In addition, in the following description, the process enclosed with [] represents a medical stage.

  That is, [preparation of craniotomy] → [craniotomy] → [approach to tumor] → [imaging diagnosis (1)] → [tumor extraction (1)] → [imaging diagnosis (2)] → [tumor extraction (2)] → [Image diagnosis (3)] → [Closed].

  Note that the graph shown in FIG. 7 includes the [Introduction of anesthesia] medical stage by the anesthesiologist 67 and the nurse 69 at the beginning of the malignant brain tumor resection. Moreover, the process which is not contained in any medical stage among the graphs shown in the same figure is a process which performs the preparation work of the next medical stage.

  [Preparation for craniotomy] The medical stage is an operation of mounting a fixed frame on the patient's head.

  The [craniotomy] medical stage is an operation of marking, disinfecting, cutting and cutting bones, and lifting the dura to secure an operative field. This is also usually performed by the surgeon 61 and the assistant 63. However, in the example of the graph shown in FIG. 7, since the craniotomy inspection was performed in advance, the osteotomy work was not performed.

  The [approach to the tumor] medical stage is an operation until the tumor part is exposed to the surgical field while excluding and excising the brain tissue, and is performed under a surgical microscope.

  The operations in the [preparation for craniotomy] medical stage or the [approach to tumor] medical stage described above are usually operations performed by a surgeon and an assistant under direct viewing. Here, in the work in the [preparation for craniotomy] medical stage and the [craniotomy] medical stage, movement of the medical staff during the work is large. On the other hand, the work at the [Approach to Tumor] medical stage is a work performed by the surgeon 61 and the assistant 63 by two people as in the [Preparation for craniotomy] medical stage and the [Craniotomy] medical stage. Since it is a precise work, the movement of the worker is small.

  In other words, when comparing the amount of movement, the amount of movement of the surgeon 61 and the assistant 63 is smaller in the [approach to tumor] medical stage than in the [preparation of craniotomy] medical stage and in the [craniotomy] medical stage.

  [Image diagnosis (1)] In the image diagnosis at the medical stage, the surgical microscope 71 and the instrument table 73 are temporarily retracted, and then a plurality of medical staff such as the anesthesiologist 67 and the nurse 65 put the patient 69 on the surgical bed. Since 75 is moved to the image diagnostic apparatus 77, the amount of movement temporarily increases.

  On the other hand, during the diagnostic imaging work, since the minimum necessary medical staff remains in the operating room and only waits, there is almost no movement unless the patient 69 changes suddenly. When the image diagnosis work is completed, the operation bed 75, the operation microscope 71, the instrument table 73, and the like are returned to their original positions, so that the amount of movement again increases.

  [Tumor extraction (1)] The medical stage is tumor extraction performed under the operating microscope 71, and when this tumor extraction operation starts, the amount of movement becomes small.

  After that, [image diagnosis (2)] image diagnosis at the medical stage, [tumor extraction (2)] tumor extraction at the medical stage, and image diagnosis in [image diagnosis (3)] were performed, and the tumor was extracted as intended. Is confirmed, the closing operation is performed at the [closing] medical stage.

  Since this [closed] medical stage is performed under direct vision, the amount of movement increases. In addition, in the malignant brain tumor enucleation which collected data for creating the graph shown in FIG. 7, in addition to the surgeon 61 and the assistant 63, 2 to 3 trainees (not shown) participated. The amount of movement in the [closed] medical stage is greater than the amount of movement in the [preparation for craniotomy] medical stage and the [craniotomy] medical stage, which are operations under direct vision.

  As described above, the number of medical staff who perform work and the magnitude (movement amount) of the body movement of the medical staff accompanying the work vary depending on each medical stage. Therefore, the medical stage can be determined by using the correlation between the amount of movement and the like and the medical stage.

  In the case of the same surgical procedure, when performed at the same facility or by the same person in charge of surgery, the time required for each medical stage and the number of times of image diagnosis differ depending on the individual case. However, the amount of movement of the medical staff during the operation is approximately the same.

  Therefore, for example, by using information such as the order of medical stages, the medical staff participating in the work, the scheduled work time, etc. stored in the medical action planning system (not shown), which medical care is currently being performed in the current operation. It can be estimated whether the stage is progressing.

  Although not described directly because it is not directly related to the determination of the medical stage described above, reference numeral 91 in FIG. 8 denotes an anesthesia machine / respirator, and reference numeral 92 is given. Is a vital monitor, the reference numeral 93 is a BIS monitor, the reference numeral 94 is a BOX of the medication device, and the reference numeral 95 is an external nurse. The reference numeral 96 denotes a nurse cart.

  FIG. 9 is a diagram illustrating an example of information stored in advance in the medical practice plan information storage unit 10 as the medical practice plan information. Here, the determination of the medical stage based on the amount of movement will be described using malignant brain tumor removal as an example. In the operating room where the malignant brain tumor is removed, a video camera for acquiring an image around the surgical field where the surgeon performs a procedure is installed in advance.

  In the example shown in FIG. 9, as the medical action plan information, the medical stage scheduled to be performed, the medical staff in charge, the order of the medical stage, the estimated required time, and the medical device used are associated with each other, It is stored in the medical practice plan information storage unit 10. In this example, even if the work is not a medical action, such as setting up a medical device, the work that requires a certain amount of time during the operation is regarded as a medical stage.

  FIG. 10 is a diagram illustrating an example of the medical stage determination rule. That is, the conditions corresponding to the medical staff existing within the imaging range and the movement amount of the medical staff within the imaging range are set as medical stage determination rules as shown in FIG. 10, for example. Information such as the amount of medical staff within the imaging range and the amount of movement of the medical staff within the imaging range is information that is known from the processing result of the video acquisition / medical staff identification system 2 described above.

  According to the medical stage determination rule shown in FIG. 10, when the medical safety system according to the first embodiment is operated immediately before starting the operation, the determination is performed as follows. In order to avoid redundant description, only the determination of the [head fixed] medical stage and the [draping, surgical instrument preparation] medical stage will be described in detail, and the description of these medical stage determinations and shown in FIG. Description of other medical stage determinations that are obvious from the medical stage determination rules will be omitted.

  First, if the movement amount is in the range of 580 to 620 and the medical staff ID 001, the medical staff ID 002, and the device ID 100 exist within the imaging range, the medical stage is compared with the medical action plan information and is the [head fixed] medical stage. Is determined.

  Subsequently, when the time of about 40 minutes elapses and the amount of movement decreases to about 400 to 500, it is determined that the medical stage has been switched to [draping, surgical instrument preparation] medical stage. As described above, when the medical stage is determined based on the condition relating to the motion amount, a change amount such as increase / decrease within a certain time may be designated.

  In the determination based on the medical stage determination rule, the medical stage determination may be performed when all the predetermined conditions are satisfied, or when some of the predetermined conditions are satisfied Alternatively, the medical stage determination may be performed.

  For example, as an example of performing the medical stage determination when all the defined conditions are satisfied, the following example can be given. In other words, the approach to the tumor and the removal of the tumor cannot be performed without using a surgical microscope, so even if the conditions regarding the amount of movement and surgical medical staff in the imaging area are satisfied Unless a surgical microscope is used as a device, it is assumed that the medical stage has not been entered. By performing such processing, it becomes possible to perform medical stage determination that is more realistic.

  Further, for example, the user may be notified as a warning that some conditions are not satisfied. For example, if a certain medical stage does not move to the next medical stage even when twice the scheduled time has elapsed, or the amount of movement exceeding 1.5 times the amount of movement determined as a condition is When measured, the user may be notified that some of the conditions are not satisfied. Thus, the medical stage determination rule can be used as a warning rule.

  Hereinafter, the medical stage determination based on the heart rate data (heart rate and change amount thereof) of the medical staff by the medical safety system according to the first embodiment will be described in detail.

  The medical stage determination based on the heart rate data of the medical staff is the medical staff collected by the medical staff measurement numerical value collection unit 4, analyzed by the medical staff measurement numerical value analysis unit 6, and recorded by the medical practice data recording unit 8 This is a medical stage determination performed by the medical staff measurement numerical value determination unit 14B of the stage / work determination unit 14 based on the heart rate and the amount of change thereof, and is a determination using the principle described below.

  When the heart rate of the medical staff during the operation is measured, the way of changing the heart rate changes depending on the work content. That is, there is a correlation between the heart rate change and the medical stage, which is as follows.

  First, the relationship between respiration and the RR interval will be described. The RR interval is a numerical value indicating the interval between the R wave and the R wave. For example, when the RR interval is 1.0, the heart rate is 60 and the RR interval is 0.6. The heart rate is 100.

  As a factor that greatly affects the fluctuation range of the RR interval, the way of breathing can be mentioned. For example, it is known that when breathing is stopped or when breathing is restricted, the fluctuation range of the RR interval is smaller than when breathing naturally.

  FIG. 11 is a diagram showing a graph of the time variation of the RR interval (vertical axis; RR interval, horizontal axis; time) measured when the subject sits on the chair and breathes naturally. FIG. 12 is a diagram showing a graph of time variation of the RR interval when the subject sits on the chair and stops breathing (vertical axis; RR interval, horizontal axis; time).

  As can be seen from the graphs shown in FIG. 11 and FIG. 12, the fluctuation of the RR interval of the subject is extremely less than when the breath is held (see FIG. 12) and when not (see FIG. 11). As described above, even when there is no large body movement / motion (such as breathing becomes rough), the way of changing the RR interval greatly varies depending on the way of breathing.

  FIG. 13 is a graph showing an RR interval graph (vertical axis; RR interval, horizontal axis; time) of the surgeon performing the skin cutting operation. FIG. 14 is a graph showing an RR interval graph (vertical axis; RR interval, horizontal axis; time) when the same surgeon is performing a tumor extraction operation.

  As is clear from comparison between the graphs shown in FIGS. 13 and 14, the fluctuation range of the RR interval is clearly different between the cutting operation and the tumor extraction operation even for the same surgeon. The difference in the fluctuation range of the RR interval is caused by the difference in the precision required for each work, and the manner of breathing of the surgeon performing each work is different.

  Specifically, the skin cutting operation is a comparatively rough operation performed under direct view as shown in the graph of FIG. 13, and the tumor extraction operation is performed under the surgical microscope as shown in the graph of FIG. Work.

  And when performing precise work such as tumor removal work, the surgeon performing the work reduces breathing in order to reduce the movement of his body and performs "breathing" at almost regular intervals. Yes. For this reason, the fluctuation range of the RR interval when performing precise work (see FIG. 14) tends to be smaller than the fluctuation range of the RR interval when not working (see FIG. 13). .

  As described above, since the fluctuation range of the RR interval varies depending on each work content, the surgeon currently collects the heart rate data of the surgeon and analyzes the fluctuation range of the RR interval. It is possible to determine whether the work being performed is a precise work or a relatively rough work.

  Hereinafter, medical stage determination based on such heart rate data will be described in detail.

  For example, the following rule may be set as a rule regarding fluctuation of the RR interval. That is, as shown in FIG. 15, the rise start point and the fall start point of the value of the RR interval are specified, and the magnitude of the fluctuation range of the RR interval is determined based on the rise start point and the fall start point. A threshold value is calculated and set, and a precise work and a work that is not so are discriminated based on the threshold value.

  Note that a restriction may be provided depending on the number of consecutive times that exceeded (or fell below) the previous threshold. Alternatively, the determination may be made using an average value of data belonging to a certain range, such as an average of the past five times (or an average of the past 30 seconds).

  Specifically, in a relatively rough work such as a skin cutting work, a craniotomy work, and a closing work, the heart rate change usually does not fall below a threshold value. For this reason, what is necessary is just to determine that the variation | change_quantity is more than a threshold value as determination conditions.

  Further, in a medical stage where precise work such as tumor removal is performed, for example, it may be set as a determination condition that the heart rate change is equal to or less than a threshold value and that the state continues for a certain period (number of times). Such rules are stored in advance in the stage determination rule storage unit 12. Further, the medical staff measurement numerical analysis unit 6 analyzes whether or not the collected data value exceeds the threshold and how long the state has continued.

  The determination of the medical stage based on the above-described information on the change in the heart rate of the medical staff is, of course, the amount of movement of the medical staff in the series of medical stage determination processes described with reference to the processing flowchart shown in FIG. And instead of determination based on position.

  That is, similar to a series of medical stage determination processing based on the movement amount and position of the medical staff, the information included in the determination result of the medical stage is applied again in another medical action determination (motion determination) and medical stage determination. Of course.

  As described above, according to the first embodiment, for example, medical safety that achieves high medical stage determination accuracy that is not affected by unexpected events related to the device used, such as sudden replacement of the device used. A system can be provided.

  Specifically, according to the medical safety system according to the first embodiment, it is possible to easily specify a time zone in which a particularly precise work is performed in the medical stage. Thereby, the analysis of an efficient medical practice is attained.

  For example, in brain tumor removal surgery, the tumor removal medical stage may take a very long time (several hours or more), but in reality, the tumor removal operation does not continue without interruption. There are many times when consultations and instructions to nurses are conducted.

  According to the medical safety system according to the first embodiment, for example, when analyzing whether or not an appropriate procedure has been performed due to a safety problem or the like with reference to a record at a later date, a precision work was actually performed. Since the time zone (the time zone during which the tumor is removed) can be easily identified, the time required for the work related to the analysis can be greatly reduced.

  Temporary interruption of work compared to the conventional technology that uses a method of judging from the usage status of the equipment in order to recognize and identify the medical staff performing the work and its location, and to judge the medical stage from the amount of movement Etc., and the determination accuracy is improved.

  Furthermore, since only a video camera is required as an apparatus provided at the medical site, there is no fear that the medical safety system according to the first embodiment interferes with the medical practice, and complicated processing or the like is unnecessary.

  In addition, the medical stage determination based on the movement amount and position of the medical staff and the medical stage determination based on the change information of the heart rate of the medical staff are appropriately combined to perform a more precise medical stage determination. Of course.

[Second Embodiment]
Hereinafter, a medical safety system according to a second embodiment of the present invention will be described. For convenience of explanation, only differences from the medical safety system according to the first embodiment will be described.

  FIG. 16 is a diagram illustrating a configuration example of the medical safety system according to the second embodiment. As shown in the figure, the medical safety system 50 according to the second embodiment includes a video acquisition / medical staff identification system 2, a medical staff measurement numerical value collection unit 4, a medical staff measurement numerical analysis unit 6, and a medical practice. A data recording unit 8, a medical practice plan information storage unit 10, a stage determination rule storage unit 12, a medical stage / work determination unit 14, a medical stage recording unit 16, an incident determination unit 18, a warning device 20, Medical practice record browsing device 22, medical practice record analysis device 24, medical instrument information collection unit 51, various measurement numerical value collection unit 53, terminal input device 55, terminal processing device 57, terminal display device 59, It comprises.

  In addition to the above-described video recording unit 8A and medical staff measurement numerical value recording unit 8B, the medical practice data recording unit 8 includes various measurement numerical value recording units 8C unique to the medical safety system according to the second embodiment, and a medical instrument. And an information recording unit 8D.

  The medical stage / work determination unit 14 includes, in addition to the above-described video determination unit 14A and medical staff measurement numerical value determination unit 14B, various measurement numerical value determination units 14C specific to the medical safety system according to the second embodiment, And an appliance information determination unit 14D.

  The medical instrument information collection unit 51 collects the position of each type of medical instrument used in the operation, the user of the medical instrument, the use time of the medical instrument, the operating status of the medical instrument, the position of the medical staff, and the like.

  The medical instrument information recording unit 8D records the information collected by the medical instrument information collecting unit 51.

  The medical instrument information determination unit 14D includes the position of the medical instrument collected by the medical instrument information collection unit 51 and recorded in the medical instrument information recording unit 8D, the user of the medical instrument, the use time of the medical instrument, and the medical device The type of medical practice performed is determined based on the operation status, the position of the medical staff, the medical practice plan, and the like.

  The various measurement numerical value collection unit 53 collects measurement values related to biological information such as heartbeat, respiration, blood pressure and the like together with measurement time from a sensor (not shown).

  The various measurement numerical value recording units 8 </ b> C record the information collected by the various measurement numerical value collection units 53.

  The various measurement numerical value determination units 14C are implemented based on measurement values and measurement times related to biological information such as heartbeat, respiration, and blood pressure collected by the various measurement numerical value collection units 53 and recorded in the various measurement numerical value recording units 8C. Determine the type of medical practice performed.

  By the way, the terminal input device 55, the terminal processing device 57, and the terminal display device 59 are members constituting a terminal as a man-machine interface of the medical safety system 50.

  With the configuration described above, in the medical safety system according to the second embodiment, not only the medical stage determination by the same process as the medical safety system according to the first embodiment, but also the medical stage based on the information related to the medical device. It is also possible to make a determination.

  That is, the medical stage can be determined by using at least one of the information on the movement amount and position of the medical staff, the change information of the heart rate of the medical staff, and the information related to the medical device. Of course, more accurate medical stage determination may be performed by appropriately combining the movement amount and position of the medical staff, the change information of the heart rate of the medical staff, and the information related to the medical device.

  As described above, according to the second embodiment, it is possible to provide a medical safety system that realizes higher determination accuracy than the medical safety system according to the first embodiment.

  Specifically, according to the medical safety system according to the second embodiment, the usage status of a small instrument (such as a scalpel) that is difficult to detect by video processing is added as a condition for determining the medical stage (for example, “and” Or “or”, etc., can be combined as appropriate), thereby further improving the determination accuracy. For example, when a drill is not used, even if other conditions are satisfied, a process that does not consider the transition to the [craniotomy] medical stage may be considered.

  Further, for example, the [craniotomy] medical stage is a medical stage composed of a skin cutting operation for incising the scalp and an osteotomy operation for opening the skull, and any of the operations is performed by the medical staff or the medical staff in charge of the operation. The amount of movement is almost the same. Therefore, it is difficult to clearly distinguish them, but since the instruments used are different, it is possible to clearly distinguish them by applying the second embodiment.

  It should be noted that the above-described embodiments include inventions at various stages, and various inventions can be extracted by appropriately combining a plurality of disclosed constituent elements. For example, even if some constituent requirements are deleted from all the constituent requirements shown in the embodiment, the problem described in the column of the problem to be solved by the invention can be solved, and the effect described in the column of the effect of the invention Can be extracted as an invention.

The figure which shows the structure of the medical safety system which concerns on 1st Embodiment of this invention. The figure which shows the example of 1 structure of an image | video acquisition / medical staff identification system. The figure which shows the example of 1 structure of an image | video acquisition / medical staff identification system. The figure which shows the flow of a process by a medical stage / work determination part. The figure which shows an example which links | relates and preserve | saves the amount of movement of each medical staff, and time information. The figure which shows an example which calculates the movement amount regarding the anesthesia technique and patient maintenance by calculating the movement amount of the medical staff in the designated area, respectively. The figure which shows an example which calculated the amount of movement regarding the surgical technique and the amount of movement related to anesthesia / patient maintenance by calculating the amount of movement of the medical staff in the specified area, and graphing them. The figure which shows the graph of the change of the amount of movement in malignant brain tumor extraction. The figure which shows an example of an imaging | photography range. The figure which shows an example of medical practice plan information. The figure which shows an example of a medical stage determination rule. The figure which shows the graph of the time fluctuation of the RR interval measured when the test subject was sitting on the chair and breathing naturally. The figure which shows the graph of the time fluctuation | variation of the RR interval when a test subject sits on a chair and stops breathing. The figure which shows the graph of the RR space | interval of the surgeon who performs a skin cutting operation | work. The figure which shows the graph of the RR space | interval when a surgeon is performing tumor extraction work. The rising start point and the falling start point of the value of the RR interval are specified, the magnitude of the fluctuation range of the RR interval is calculated based on these, and a threshold is set. The figure which shows the example of calculation of the said fluctuation | variation range at the time of discriminating the operation | work which is not so. The figure which shows the example of 1 structure of the medical safety system which concerns on 2nd Embodiment of this invention.

Explanation of symbols

    DESCRIPTION OF SYMBOLS 1 ... Medical safety system, 2 ... Medical staff identification system, 2A ... Video storage part, 2B ... Video analysis part, 2A1 ... Identification information and position storage part, 2A2 ... Video signal storage part, 2B1 ... Video position calculation part, 2B2 ... Condition specifying unit, 2B3 ... ROI setting unit, 2B4 ... Video analysis unit, 2B5 ... Analysis result storage unit, 4 ... Medical staff measurement numerical value collection unit, 6 ... Medical staff measurement numerical value analysis unit, 8 ... Medical practice data recording unit, 8A ... Video recording part, 8B ... Medical staff measurement numerical value recording part, 8C ... Species measurement numerical value recording part, 8D ... Medical instrument information recording part, 10 ... Medical action plan information storage part, 12 ... Stage determination rule storage part, 14 ... Medical care Stage / work determination unit, 14A ... image determination unit, 14B ... medical staff measurement numerical value determination unit, 14C ... seed measurement numerical value determination unit, 14D ... medical device Information determination unit, 16 ... medical stage recording unit, 18 ... incident determination unit, 20 ... warning device, 22 ... medical activity record browsing device, 24 ... medical activity record analysis device, 30 ... display device, 31 ... subject identification device, 33 ... Position measurement device, 35 ... Video acquisition device, 50 ... Medical safety system, 51 ... Medical instrument information collection unit, 53 ... Species measurement numerical value collection unit, 55 ... Terminal input device, 57 ... Terminal processing device, 59 ... Terminal display device .

Claims (6)

A medical safety system for managing a series of medical actions,
A heart rate information measuring unit for measuring heart rate information, which is information indicating the heart rate of the medical staff involved in the series of medical practices and the amount of change thereof,
Based on the heart rate information of the medical staff measured by the heart rate information measurement unit , a medical practice determination unit that determines the type and implementation time of the medical practice performed by the medical staff;
The type and execution time of the medical stage that represents the unit of the process or period in which the series of medical actions are classified according to the work purpose, the type and execution time of the medical action determined by the medical action determination unit, and the other medical stage A medical stage determination unit for determining based on the type and execution time;
A recording unit for recording information on the type and execution time of the medical action determined by the medical action determination unit together with information on the type and execution time of the medical stage determined by the medical stage determination unit;
A medical safety system comprising: It further comprises a device information acquisition unit for acquiring medical device information that is information related to the medical device,
The medical practice judging unit includes a medical device information acquired by the appliance information acquiring unit, the heartbeat information based on the heartbeat information of the medical staff measured by the measuring unit, the medical practice has been carried out by the medical staff The medical safety system according to claim 1, wherein the type and the execution time are determined. A medical safety system for managing a series of medical actions,
A position and movement amount measurement unit for measuring at least the position and movement amount of the medical staff involved in the medical practice;
A heart rate information measuring unit that measures heart rate information that is information indicating at least the heart rate of the medical staff involved in the series of medical actions and the amount of change thereof;
A position and movement amount of medical staff measured by the position and movement amount measuring unit, the heartbeat information based on the heartbeat information of the medical staff measured by the measuring unit, the type of medical care actions which are carried out by the medical staff And a medical practice judgment unit for judging the implementation time,
The type and execution time of the medical stage that represents the unit of the process or period in which the series of medical actions are classified according to the work purpose, the type and execution time of the medical action determined by the medical action determination unit, and the other medical stage A medical stage determination unit for determining based on the type and execution time;
A recording unit for recording information on the type and execution time of the medical action determined by the medical action determination unit together with information on the type and execution time of the medical stage determined by the medical stage determination unit;
A medical safety system comprising: It further comprises a device information acquisition unit for acquiring medical device information that is information related to the medical device,
The medical practice determination unit is measured by the medical device information acquired by the device information acquisition unit, the position and motion amount of the medical staff measured by the position and motion amount measurement unit , and the heart rate information measurement unit. The medical safety system according to claim 3, wherein the type and time of medical practice performed by the medical staff are determined based on heartbeat information of the medical staff. The medical stage determination unit has planned the type and execution time of the medical stage, the type and execution time of the medical operation determined by the medical operation determination unit, and the type and execution time of the other medical stage. The medical safety system according to any one of claims 1 to 4, wherein the determination is based on a medical stage procedure . The medical stage determination unit further comprises a determination rule storage unit that stores a determination rule for determining the type and execution time of the medical stage. The medical safety system described .

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