KR102275936B1 - Method for measuring respiratory sounds in telemedicine system, and telemedicine system implementing the same - Google Patents

Abstract

The present invention relates to a method for measuring respiratory sound in a telemedicine system, which is to measure respiratory sound of a tracheostomy tube patient. The method of the present invention comprises the steps of: monitoring whether a respiration is abnormal in a non-contact manner using laser with respect to a tracheostomy tube patient; outputting an alarm when a respiratory abnormality is detected in the step of monitoring whether the respiration is abnormal in a non-contact manner; displaying a contact type respiratory abnormality monitoring guide screen, which is a screen describing a procedure for monitoring whether the respiratory is abnormal by using a stethoscope module for collecting auscultation sounds by being in contact with the tracheostomy tube patient; and displaying a suction operation guide screen when rhonchus is detected during contact type respiratory abnormality monitoring. According to the present invention, the respiratory sound of the tracheostomy tube patient can be easily measured in a noncontact and non-face-to-face manner by measuring the respiratory sound of the tracheostomy tube patient by interworking a telemedicine device.

Description

{Method for measuring respiratory sounds in telemedicine system, and telemedicine system implementing the same}

The present invention relates to a telemedicine system, and more particularly, to a telemedicine system for measuring the respiratory sound of a patient with a tracheostomy tube.

Telemedicine refers to telemedicine. Telemedicine is generally defined as 'any activity that delivers medical information and medical services over a long distance using interactive information and communication technology'.

Telemedicine is a system that provides medical information and professional advice remotely when patients and information cannot be reached due to various problems such as a long distance or a large time difference. It is used as a comprehensive concept that includes medical education, consultation and referral. In other words, it is a generic term for technology that uses computer and data communication technology to exchange various data such as medical images, videos, and patient records and to deliver medical services.

Looking at the scope of application of telemedicine, the most common and actively developed at-home treatment, teleconference, other telemedicine image archiving and communications system (PACS), remote imaging diagnosis, virtual hospital, etc. have.

Recently, a mobile telemedicine device that treats a patient remotely has been used, and it has a characteristic that enables 1:1 real-time treatment and consultation between a doctor and a patient. To this end, the doctor shares the results of the questionnaire written by the patient in real time through the touch screen or smartphone provided in the telemedicine device, observes the patient's condition through the camera, and uses a stethoscope for respiratory hearing, including the lungs. It is possible to listen to a sound, measure a patient's body temperature in real time using a non-contact thermometer, and measure a patient's blood pressure using a blood pressure monitor.

By using the telemedicine device, doctors measure and utilize the patient's biometric information required for treatment in real time, and treat patients suspected of having COVID-19 in mountainous remote areas, islands, and ships where access to medical services is limited, and the patient's condition It is possible to provide professional and safe emergency medical services such as emergency transportation and emergency treatment for patients by identifying

In addition, by using a telemedicine device, elderly patients such as nursing hospitals with limited mobility can receive treatment from a respiratory specialist related to COVID-19 in the patient's room without unnecessary movement, and after disinfecting the telemedicine device used for treatment Since it can be transferred and applied to other patients immediately, it has the advantage of solving the cost burden caused by cross-infection between patients or disinfection of the treatment space.

In the case of a tracheostomy tube patient, the nurse checks the breathing at regular intervals and removes phlegm when there is a blockage. At this time, in order to confirm that the trachea is blocked, a respiration and a stethoscope are mainly used, but there is a problem that it has to be checked every time, and in the case of an inexperienced medical staff, the confirmation procedure may be overlooked.

Japanese Patent No. 6582261

The present invention has been devised to solve the above problems, and by interworking with a telemedicine device, measures the respiration of a tracheostomy patient using a digital stethoscope and non-contact respiration measurement, and measures airway blockage accordingly to prevent risk It aims to provide a telemedicine system that can

Objects of the present invention are not limited to the objects mentioned above, and other objects not mentioned will be clearly understood by those skilled in the art from the following description.

The present invention for achieving the above object relates to a method for measuring respiratory sound in a remote medical treatment system for measuring the respiratory sound of a tracheostomy patient, and monitoring non-contact respiratory abnormality using a laser for a tracheostomy patient. step, outputting an alarm when a respiratory abnormality is detected in the step of monitoring the non-contact breathing abnormality, a procedure of monitoring whether breathing abnormality using a stethoscope module that contacts the tracheostomy tube patient and collects auscultation sound Displaying a contact-type respiratory abnormality monitoring guide screen, which is a screen explaining the, and displaying a suction operation guide screen when dry water pops are detected during contact-type respiratory abnormality monitoring.

If a respiratory abnormality is not detected in the step of monitoring the non-contact breathing abnormality, the facial expression of the tracheostomy patient is monitored using a vision module, and facial grimaces are detected by monitoring the facial expression of the tracheostomy patient. or when the first predetermined time has elapsed, the method may further include outputting an alarm.

In addition, if no dry squeak is detected during the contact-type respiratory abnormality monitoring, performing a countdown for a predetermined second time period, and when the countdown is completed, displaying the contact-type respiratory abnormality monitoring guide screen again may include

At this time, if the step of performing the countdown is repeated a predetermined number of times consecutively, the contact-type respiratory abnormality monitoring process may be terminated.

In the telemedicine system for measuring the respiratory sound of a patient with a tracheostomy tube of the present invention, a terminal used by a medical person, having a touch screen, communicating through a wired/wireless communication network, and communicating with the medical personnel terminal through a wired/wireless communication network A stethoscope module for collecting auscultation sounds by contacting the patient's body, a vision module for imaging a patient with a tracheostomy tube and performing a vision examination, a laser module for irradiating a laser on the patient's body with a tracheostomy tube, and a screen A display unit for displaying, a speaker unit for converting electrical signals into sound waves and outputting them, a communication unit for communicating with the medical personnel terminal, a suction module performing a function of sucking foreign substances from the tracheostomy tube patient's organ, and overall of the device It includes a telemedicine device comprising a control unit for performing control.

The control unit monitors the non-contact breathing abnormality using the laser module for the tracheostomy patient, and when a breathing abnormality is detected in the process of monitoring the non-contact breathing abnormality, outputs an alarm through the speaker unit, the organ A contact-type respiratory abnormality monitoring guide screen, which is a screen explaining the procedure for monitoring respiratory abnormalities using a stethoscope module that contacts a patient with an incision tube and collects auscultation sounds, is displayed on the display unit, and dryness during contact-type breathing abnormality monitoring is displayed. When a crackling sound is detected, a suction operation guide screen may be displayed, and the operation of the suction module may be activated.

The control unit monitors the facial expression of the tracheostomy patient using the vision module if a respiratory abnormality is not detected in the process of monitoring the non-contact breathing abnormality, and monitors the facial expression of the tracheostomy patient to make a face When a distortion is detected or a predetermined first time has elapsed, an alarm may be output through the speaker unit.

The control unit, if dry water aspiration is not detected during the contact-type respiratory abnormality monitoring, the countdown is performed for a predetermined second time period, and when the countdown is completed, the contact-type respiratory abnormality monitoring guide screen is displayed again on the display unit can do.

When the countdown is continuously repeated a predetermined number of times, the controller may end the contact-type respiratory abnormality monitoring process.

According to the present invention, by measuring the respiratory sound of a tracheostomy patient in conjunction with a telemedicine device, there is an effect that can easily measure the breathing sound of a tracheostomy patient in a non-contact and non-face-to-face manner. Therefore, according to the present invention, it is possible to quickly identify the condition of the tracheostomy tube patient and take appropriate countermeasures.

In addition, according to the present invention, it is possible to secure stability in a closed space such as a negative pressure ward by linking the telemedicine system and digital health care, and to reduce the diagnosis error of medical staff.

1 is a conceptual diagram showing the configuration of a telemedicine system according to an embodiment of the present invention.
2 is a block diagram illustrating an internal structure of a telemedicine device according to an embodiment of the present invention.
3 is a flowchart illustrating a method for measuring a respiratory sound in a telemedicine system according to an embodiment of the present invention.
4 is a view showing the auscultation sequence of the anterior chest according to an embodiment of the present invention.
5 is a view showing the position of the percussion sound generated in the front of the chest according to an embodiment of the present invention.
6 is a waveform graph showing a general aspect of respiratory disease.
7 is a graph showing the waveform of dry water vapour.
8 is a diagram showing a position where a breathing sound can be heard in the upper body of the patient.

Advantages and features of the embodiments disclosed herein, and methods for achieving them will become apparent with reference to the embodiments described below in conjunction with the accompanying drawings. However, the embodiments to be proposed in the present disclosure are not limited to the embodiments disclosed below, but may be implemented in various different forms, and only the present embodiments are provided to those of ordinary skill in the art. It is only provided to fully indicate the category.

Terms used in this specification will be briefly described, and the disclosed embodiments will be described in detail.

The terms used in this specification have been selected as currently widely used general terms as possible while considering the functions of the disclosed embodiments, but may vary depending on the intention or precedent of a person skilled in the relevant field, the emergence of new technology, and the like. In addition, in a specific case, there is a term arbitrarily selected by the applicant, and in this case, the meaning will be described in detail in the detailed description part of the corresponding specification. Therefore, the terms used in the present disclosure should be defined based on the meaning of the term and the content throughout the present specification, rather than the simple name of the term.

References in the singular herein include plural expressions unless the context clearly dictates that the singular is singular.

When a part "includes" a certain element throughout the specification, this means that other elements may be further included, rather than excluding other elements, unless otherwise stated. Also, as used herein, the term “unit” refers to a hardware component such as software, FPGA, or ASIC, and “unit” performs certain roles. However, "part" is not meant to be limited to software or hardware. A “unit” may be configured to reside on an addressable storage medium and may be configured to refresh one or more processors. Thus, by way of example, “part” includes components such as software components, object-oriented software components, class components, and task components, processes, functions, properties, procedures, subroutines, segments of program code, drivers, firmware, microcode, circuitry, data, databases, data structures, tables, arrays and variables. The functionality provided within components and “parts” may be combined into a smaller number of components and “parts” or further divided into additional components and “parts”.

In addition, in the description with reference to the accompanying drawings, the same components are assigned the same reference numerals regardless of the reference numerals, and the overlapping description thereof will be omitted. In describing the present invention, if it is determined that a detailed description of a related known technology may unnecessarily obscure the gist of the present invention, the detailed description thereof will be omitted.

1 is a conceptual diagram showing the configuration of a telemedicine system according to an embodiment of the present invention.

Referring to FIG. 1 , the telemedicine system of the present invention includes a telemedicine device 100 and a medical care provider terminal 200 .

The telemedicine device 100 is a device that faces a patient and acquires and transmits biometric information. For example, the patient may face the telemedicine device 100 in a sitting posture at a designated place.

The medical personnel terminal 200 is a terminal used by medical personnel, and may include a touch screen. For example, the medical personnel terminal 200 may be implemented as a desktop PC, a laptop PC, a smart phone, a tablet PC, or the like.

The telemedicine device 100 and the medical personnel terminal 200 communicate with each other through a wired/wireless communication network.

2 is a block diagram illustrating an internal structure of a telemedicine device according to an embodiment of the present invention.

1 and 2 , the telemedicine system of the present invention includes a telemedicine device 100 and a medical care provider terminal 200 .

The medical personnel terminal 200 is a terminal used by medical personnel including doctors, has a touch screen, and is a terminal capable of communication through a wired/wireless communication network.

The telemedicine device 100 communicates with the medical personnel terminal 200 through a wired/wireless communication network.

The telemedicine device 100 includes a stethoscope module 110, a vision module 120, a laser module 130, a control unit 140, a display unit 150, a communication unit 160, a speaker unit 170, a suction module ( 180) is included.

The stethoscope module 110 is in contact with the body of the tracheostomy tube patient and serves to collect the stethoscope sound.

The vision module 120 performs a vision inspection by photographing a tracheostomy patient, and in particular, performs a vision inspection function of monitoring the facial expression of the tracheostomy patient.

In the present invention, the vision module 120 can be configured to include a remote camera that is bent naturally and can be moved by driving, can take high-pixel images, and has a zoom/out function. In addition, an infrared camera is further installed in the present invention to directly measure the temperature of the patient or the affected part in real time, and it is possible to check more precisely through the zoom/out function.

The laser module 130 serves to irradiate a laser to the body of the tracheostomy patient.

The display unit 150 serves to display a screen. For example, the display unit 150 may be implemented as an LCD panel, an LED panel, a touch screen panel, or the like.

The communication unit 160 serves to communicate with the medical personnel terminal 200 through a wired/wireless communication network.

The speaker unit 170 serves to convert an electrical signal into a sound wave and output it.

The suction module 180 performs a function of sucking foreign substances from the tracheostomy tube patient's trachea.

The controller 140 performs overall control of the telemedicine device 100 .

In the present invention, the patient's body photographed through the telemedicine device 100 and the vision module 120 is transmitted to the medical personnel terminal 200 .

And, when an event of selecting a specific point on the patient's body displayed on the medical care provider terminal 200 occurs, this event command signal is transmitted to the telemedicine device 100 .

In addition, the controller 140 of the telemedicine device 100 controls the laser module 130 to irradiate the laser to the body part corresponding to the selected point according to the event command signal received from the medical care provider terminal 200 .

In the present invention, when the stethoscope module comes into contact with a body part other than the point where the laser is irradiated through the laser module 130 , the controller 140 may output a warning message including a warning sound through the speaker unit 170 . .

The control unit 140 monitors the non-contact breathing abnormality by using the laser module 130 for the tracheostomy tube patient. And, when a respiratory abnormality is detected in the process of monitoring non-contact breathing abnormality, an alarm is output through the speaker unit 170 .

In addition, the control unit 140 displays a contact-type respiratory abnormality monitoring guide screen, which is a screen explaining the procedure for monitoring whether breathing is abnormal using the stethoscope module 110 that contacts the tracheostomy patient and collects auscultation sounds ( 150). And, when dry water pop (Rhonchi) is detected during contact-type respiratory abnormality monitoring, the suction operation guide screen is displayed on the display unit 150 and the operation of the suction module 180 is activated.

The controller 140 monitors the facial expression of the tracheostomy patient by using the vision module 120 if no respiratory abnormality is detected in the process of monitoring the non-contact breathing abnormality. In addition, when facial grimacing is detected by monitoring the facial expression of the tracheostomy patient or a first predetermined time has elapsed, an alarm may be output through the speaker unit 170 . For example, the first time may be set to 1 hour.

The control unit 140 performs a countdown for a predetermined second time period if no dry water agitation is detected during the contact respiration abnormality monitoring, and when the countdown ends, the contact type respiration abnormality monitoring guide screen is displayed again on the display unit 150 to express in For example, the second time period may be 30 seconds.

When the countdown is continuously repeated a predetermined number of times, the controller 140 ends the contact-type respiratory abnormality monitoring process. For example, the predetermined number of times may be set to three times.

4 is a view showing the auscultation sequence of the anterior chest according to an embodiment of the present invention.

In Fig. 4, the numbers indicate the positions of the stethoscopes. That is, using the stethoscope module 110, auscultate in the order of No. 2 (both sides) -> No. 3 (both sides) -> No. 4 (both sides).

5 is a view showing the position of the percussion sound generated in the front of the chest according to an embodiment of the present invention.

Referring to FIG. 5 , while auscultating the tracheostomy tube patient using the stethoscope module 110, percussion sounds such as resonance sounds, long blunt sounds, gastric sulcus sounds, heart blunt sounds, and flat sounds on muscles and bones may occur. can

6 is a waveform graph showing a general aspect of respiratory disease.

In FIG. 6 (a), normal breathing (eupnea) is characterized by smooth and regular rhythm and longer exhalation than inspiration.

(b) is rapid breathing (tachypnea), which is rapid and shallow breathing, with a regular or irregular rhythm.

(c) is a slow breathing (bradypnea), indicating a slow breathing rate, and a deeper breathing depth and regular rhythm than usual.

(d) is apnea, a state in which breathing is stopped.

(e) is hyperventilation, hyperpnea, the depth of respiration is increased, and the respiration rate is normal or increased, showing a regular rhythm.

(f) is a Cheyne-Stokes respiration, which is a cycle-variable respiration that leads to apnea as a cycle in which the depth and frequency of respiration gradually increase and then decrease regularly appears.

(g) is ataxic breathing, in which shallow breathing of the same depth is irregularly repeated in apnea.

(h) is Kussmaul's respiration, which is a deep, regular sighing breath with an increased respiration rate.

(i) Persistent inspiratory apneusis, a breath followed by a long, breathy inhalation followed by a short, insufficient exhalation.

(j) is obstructed breathing, which is a long, inefficient exhalation, shallow and increased breathing.

The types of abnormal breathing sounds include crackle, wheeze, rhonchi, and pleural friction rub.

The characteristics of the crackle sound are intermittent and short water drop sounds and mainly appear during inspiration. The cause is that the closed cell airways open during inspiration and an explosive sound is generated. Related diseases include chronic obstructive pulmonary disease and heart failure.

Wheezing is characterized by a continuous high sound during exhalation and inspiration, and is caused by air flowing through the narrowed airways, and related diseases include asthma, bronchitis, and pulmonary edema.

Dry blisters are characterized by a low, growling sound, which improves after coughing, and is caused by air flowing through a partially blocked airway, and related diseases include chronic bronchitis and secretion accumulation.

Pleural fricatives are characterized by a squeaky sound, and are caused by friction due to inflammation of the pleura, and related diseases include pleurisy.

In the present invention, the respiratory sound is measured by detecting the characteristics of dry water vapour, and a suction operation is performed. 7 is a graph showing the waveform of dry water vapour.

8 is a diagram showing a position where a breathing sound can be heard in the upper body of the patient.

In Figure 8 (a) is the front of the upper body of the patient, (b) is the back of the upper body of the patient.

Referring to FIG. 8 , the alveolar breathing sound can be heard at the v position, the bronchial breathing sound can be heard at the b position, the bronchial alveolar breathing sound can be heard at the bv position, and the tracheal breathing sound can be heard at the t position. can

3 is a flowchart illustrating a method for measuring a respiratory sound in a telemedicine system according to an embodiment of the present invention.

Referring to FIG. 3 , non-contact breathing abnormality is monitored using a laser for a tracheostomy patient (S301).

If breathing abnormality is detected in step S301, an alarm is output (S303, S309).

Then, the contact-type respiratory abnormality monitoring guide screen, which is a screen for explaining the procedure for monitoring whether breathing is abnormal, is displayed using the stethoscope module 110 that contacts the tracheostomy patient and collects auscultation sounds (S311).

And, when dry water pops are detected during contact-type respiratory abnormality monitoring (S313), a suction operation guide screen is displayed (S315).

Then, the suction operation using the suction module 180 is performed until no dry water splash is detected (S317, S319).

If a respiratory abnormality is not detected in steps S301 and S303, the facial expression of the tracheostomy patient is monitored using the vision module 120 (S305).

By monitoring the facial expression of the tracheostomy patient, when a facial grimacing is detected or a first predetermined time has elapsed, an alarm is output (S307, S309).

In step S313, if no dry water sounds are detected during contact respiration abnormality monitoring, the countdown is performed for a second predetermined time period, and when the countdown is completed, the contact type respiratory abnormality monitoring guide screen is displayed again (S321, S313, S321, S313, S311).

If the step of performing the countdown in the present invention is continuously repeated a predetermined number of times, the contact-type respiratory abnormality monitoring process is terminated (S321, S323).

The present invention has been described above using several preferred embodiments, but these embodiments are illustrative and not restrictive. Those of ordinary skill in the art to which the present invention pertains will understand that various changes and modifications can be made without departing from the spirit of the present invention and the scope of the appended claims.

100 Telemedicine device 200 Medical personnel terminal
110 Stethoscope Module 120 Vision Module
130 laser module 140 controller
150 display unit 160 communication unit
170 speaker unit 180 suction module

Claims (8)

delete delete delete delete In a telemedicine system for measuring the respiratory sound of a tracheostomy patient,
A terminal used by medical personnel, comprising: a medical personnel terminal having a touch screen and capable of communicating through a wired/wireless communication network; and
A stethoscope module for communicating with the medical personnel terminal through a wired/wireless communication network and collecting auscultation sounds by contacting the patient's body, a vision module for photographing a patient with a tracheostomy tube and performing a vision examination, and a laser on the body of a patient with a tracheostomy tube A laser module for irradiating a screen, a display unit for displaying a screen, a speaker unit for converting electrical signals into sound waves and outputting them, a communication unit for communicating with the medical personnel terminal, a function of sucking foreign substances from the tracheostomy tube patient's organ It includes a telemedicine device comprising a suction module for performing the above and a control unit for performing overall control of the device,
The control unit monitors non-contact breathing abnormality using the laser module for a tracheostomy patient, and outputs an alarm through the speaker unit when a respiratory abnormality is detected in the process of monitoring whether the non-contact breathing abnormality is present, and the organ A contact-type respiratory abnormality monitoring guide screen, which is a screen explaining the procedure for monitoring respiratory abnormalities using a stethoscope module that contacts a patient with an incision tube and collects auscultation sounds, is displayed on the display unit, and dryness during contact-type breathing abnormality monitoring is displayed on the display unit. When a crackling sound is detected, a suction operation guide screen is displayed, and the operation of the suction module is activated.
6. The method of claim 5,
The control unit monitors the facial expression of the tracheostomy patient using the vision module if a respiratory abnormality is not detected in the process of monitoring the non-contact breathing abnormality, and monitors the facial expression of the tracheostomy patient to make a face When a distortion is detected or a first predetermined time has elapsed, an alarm is output through the speaker unit.
6. The method of claim 5,
The control unit, if dry water aeration is not detected during the contact-type respiratory abnormality monitoring, the countdown is performed for a predetermined second time period, and when the countdown is completed, the contact-type respiratory abnormality monitoring guide screen is again displayed on the display unit A telemedicine system, characterized in that
8. The method of claim 7,
When the countdown is continuously repeated a predetermined number of times, the controller terminates the contact-type respiratory abnormality monitoring process.

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