KR20170124334A - Patient monitoring system built in the algorithm for the management of the proper sedation monitoring and patient monitoring method using the same - Google Patents

Abstract

Provided is a patient monitoring system with a built-in algorithm for the management of proper sedation and a monitoring method using the same. A patient monitoring method using a patient monitoring system with a built-in algorithm for managing the proper sedation of a patient and with a respiration measurement part attached to the body of the patient. The patient monitoring system includes a step of obtaining and analyzing a respiration sound through the respiration measurement part and checking the sedation of the patient from the respiration information; a step of notifying only the breath volume when the sedation of the patient is in a stable state and additionally performing an alarm operation for audibly notifying the sedation of the patient if not.

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a patient monitoring system having an algorithm for maintaining and managing an appropriate calm state of a patient, and a monitoring method using the same. 2. Description of the Related Art [0002]

The present invention relates to a patient monitoring system having an algorithm for maintaining and managing an appropriate calm state of a patient and a monitoring method using the same.

Background of the Invention [0002] With the recent development of medical technology, medical techniques are being widely used for simple procedures such as dental treatment, endoscopic examination, and plastic surgery, in which a patient undergoes a procedure under simple calm rather than inducing deep anesthesia.

However, the procedure performed under the true state of such a patient is relatively inexpensive and corresponds to a simple medical practice, so that a minimum number of medical personnel participate in the procedure. Accordingly, the medical practitioner performs medical treatment for the patient and at the same time, comprehensively analyzes the patient condition information displayed from the various patient monitoring devices, and it is burdened to determine the patient's calm condition.

In order to solve such a problem, Korean Patent Registration No. 10-0537168 has proposed a technique of monitoring a calm state and guiding the medical staff. However, this is only a level of monitoring the sedation based on the degree of the patient's response to audiovisual stimulation, so that the accuracy of the patient's sedation monitoring is relatively low and the patient is subjected to continuous visual stimulation, There is a disadvantage of giving inconvenience.

In order to solve the problems as described above, it is an object of the present invention to acquire and analyze various kinds of bio-signals in a comprehensive manner, thereby to more accurately monitor the patient's state of calm, And a monitoring method using the same.

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

An algorithm for maintaining and managing an appropriate calm state of a patient, including a respiratory measurement unit attached to a patient's body, such as a patient's chest or neck, according to an embodiment of the present invention, Acquiring and analyzing respiration sound through the respiration measuring unit to calculate respiratory amount, and then determining a patient calm state based on the calculated respiration sound and respiration amount. The method of analysis of respiration sound and respiration does not limit the analysis method such as respiratory sound and respiratory volume, respiratory rate, intensity and shape analysis.

The step of determining the patient calm state may include measuring an oxygen saturation of the patient through an oxygen saturation measuring unit, analyzing the occurrence of a decrease in oxygen saturation, the frequency of occurrence of a waveform, and a set value designated by a medical staff, And the like.

The step of grasping the patient calm state may be performed by measuring and analyzing the electroencephalogram and the electroencephalogram of the patient to calculate the calm depth, and further considering the calm depth to grasp the patient calm state. The method of analyzing the true depth can be combined through various types of analysis methods such as the frequency analysis method series of the electroencephalogram and EMG, the machine learning method, and the time series analysis method, and the method is not limited.

The step of grasping the patient calm state may be performed by measuring the blood pressure of the patient through the blood pressure measuring unit and further considering the patient's calm state by further considering the blood pressure. Additional considerations of blood pressure, like the oxygen saturation analysis method, include the measurement of blood pressure, the occurrence of deterioration, and the analysis of the value.

If the patient's sedation state is in a stable state, guide only the amount of respiration and respiration, oxygen saturation, sedation depth, and blood pressure as presented above. Otherwise, the patient's sedation state A step of providing a high degree of urgency to an alarm operation and an algorithm regarding each measurement amount for audiovisual notification.

Wherein the step of maintaining and managing the appropriate calm state of the patient includes: if the one of the respiratory and sound volume, the oxygen saturation, the calm depth, and the blood pressure of the patient is abnormal, And an " emergency state ". Especially, when respiratory and respiration volume and oxygen saturation are abnormal, it is characterized as unconditional "emergency and emergency state".

The present invention acquires and analyzes various bio-signals such as the patient's volume, oxygen saturation, sedation depth, and blood pressure, thereby enabling to more accurately grasp, maintain and manage the patient's calm state.

In addition, when the patient's calm state is abnormal, it is possible to provide a function of providing appropriate alarm to the medical staff, so that the medical staff can perform optimized calm guiding operation in various forms, . ≪ / RTI >

1 is a diagram illustrating a patient monitoring system in accordance with an embodiment of the present invention.
2 is a view for explaining a breath analysis process according to an embodiment of the present invention.
FIG. 3 is a schematic illustration of an algorithm for maintaining and managing an appropriate calm state of a patient according to an embodiment of the present invention.
FIG. 4 is a diagram for explaining a careful state notification of a patient monitoring system according to an embodiment of the present invention and a method of providing an emergency according to an algorithm to a medical staff.
5 is a diagram for explaining a method of providing information through a patient monitoring system according to an embodiment of the present invention in more detail.

Hereinafter, embodiments and examples of the present invention will be described in detail with reference to the accompanying drawings, which will be readily apparent to those skilled in the art to which the present invention pertains.

It should be understood, however, that the present invention may be embodied in many different forms and is not limited to the embodiments and examples described herein. In order to clearly illustrate the present invention, parts not related to the description are omitted, and similar parts are denoted by like reference characters throughout the specification.

Throughout this specification, when an element is referred to as "including " an element, it is understood that the element may include other elements as well, without departing from the other elements unless specifically stated otherwise.

As used herein, the terms "about," " substantially, "and the like are used herein to refer to or approximate the numerical value of manufacturing and material tolerances inherent in the stated sense, Accurate or absolute numbers are used to prevent unauthorized exploitation by unauthorized intruders of the mentioned disclosure. Also, throughout the present specification, the phrase " step "or" step "does not mean" step for.

Throughout this specification, the term "combination thereof" included in the expression of the machine form means one or more combinations or combinations selected from the group consisting of the constituents described in the expression of the machine form, And the like.

Throughout this specification, the description of "A and / or B" means "A or B, or A and B".

1 is a diagram illustrating a patient monitoring system in accordance with an embodiment of the present invention.

1, the patient monitoring system of the present invention includes a respiratory measurement unit 11, an oxygen saturation measurement unit 12, a calmness depth analysis unit 13, a blood pressure measurement unit 14, a control unit 20, A data input / output unit 30, a communication unit 40, and the like.

The breath measuring unit 11 notifies the control unit 20 of a breathing sound obtained through a breathing apparatus and a breathing apparatus attached to the vicinity of the patient's body such as around the nostrils, neck or chest.

The respiration measuring unit 11 acquires an audio signal as shown in FIG. 2 (a) through a sound processor, and after processing an envelope signal as shown in FIG. 2 (b), the envelope signal generating cycle, Peak value analysis can be used to determine not only the patient's respiration, but also the volume, respiration, and respiration quality. For example, from the envelope generation cycle, the respiration rate is calculated according to the respiration rate, respiration rate, and respiration rate from the number and frequency of envelope generation.

The oxygen saturation measuring unit 12 is provided with a pulse oximeter or the like attached to the patient's body so that the oxygen saturation of the patient can be measured and reported in real time.

The calorie depth analyzer 13 has an electroencephalogram measurement sensor and an electromyography sensor attached to the patient's face (particularly, the forehead), and analyzes the electroencephalogram and electromyogram obtained through these sensors according to the calorie depth calculation algorithm, And report it. Table 1 below shows an example of the true depth according to the present invention, and it can be seen that the true depth of the patient can be divided into 6 levels in total.

Patient response Calm depth Responded when calling a name with a normal tone voice 5 Response slowed when called with a normal tone voice 4 Respond only if you call your name repeatedly or with a loud voice 3 Responds when tapping lightly or slightly shaking 2 Respond only to painful stimuli such as pinching One Does not respond to pain stimuli 0

The blood pressure measuring unit 14 is attached to the forearm of the patient or the wrist, and measures and notifies the patient's blood pressure.

The control unit 20 receives the biological signals (that is, the respiration sound and the respiration amount, the oxygen amount, and the oxygen amount) obtained through the breath measurement unit 11, the oxygen saturation measurement unit 12, the calmness depth analysis unit 13, Saturation degree, sedentary depth, and blood pressure) of the patient to determine whether the patient's state of calm is one of stability, attention, seriousness, urgency, and emergency, and then performs audible and visual alarms and information providing operations necessary for the medical staff. In other words, sedation monitoring, alarming, etc. are performed to prevent the risk of patient death due to apnea during patient sedation.

That is, if all of the breathing sound and respiration, oxygen saturation, sedation depth, and blood pressure are in a normal state, it is confirmed that the patient state is in a stable state, and then no separate operation is performed.

However, in the case where one or more abnormal signals such as respiration and respiration, oxygen saturation, sedation depth, and blood pressure are generated, it is preferable to first check whether a malfunction due to skin adhesion of a measuring unit that generates an abnormal signal is detected. If one or more signals are continuously detected even though the device is not in a malfunction state, a warning for abnormality signal and an alarm notification operation of a state of 'attention' or 'serious' (in case of volume or oxygen saturation) Lt; / RTI >

On the other hand, if there are two abnormality signals, it is first checked whether the malfunction due to the skin adhesion of the measuring unit which generates the abnormal signal is preferentially checked. If it is not the device malfunctioning state, (2 cases of abnormality of respiration volume and oxygen saturation) alert to the medical staff appropriately.

If the abnormality signal is three or more, the emergency body notification operation is performed immediately after the patient body judges that the operation is impossible, so that the medical staff can take appropriate follow-up actions.

However, if there is one abnormality in the respiratory and respiratory volume or oxygen saturation, if the abnormality signal is confirmed even after the malfunction is confirmed, it is judged as 'serious' as the two abnormality signals occur. The abnormality signal alarm and the 'serious' If an abnormal signal is detected even after the malfunction is confirmed, it is judged as "Emergency and Emergency state" and the abnormal signal alarm And an 'emergency' status notification operation are performed immediately.

The data input / output unit 30 is provided with a data output device such as a monitor 31, a warning light 32, a speaker 33 and the like, through which a respiration measuring unit 11, an oxygen saturation measuring unit 12, (13) and the blood pressure measuring unit (14). Under the control of the control unit 20, information for guiding each of the 'stable state', the 'attention state', the 'serious state', 'the emergency state and the emergency state' is visually and audibly output, To be able to recognize specific details more quickly and accurately, and to take immediate follow-up action, if necessary, corresponding to the patient's condition.

In addition, by providing a data input device such as a keyboard, a button device, a mouse, and the like, the medical staff can determine whether the system is operated or not, and if necessary, additional information such as patient name, medical staff name,

Accordingly, the control unit 20 of the present invention can store all the information acquired in accordance with the operation of the system according to the present invention in chronological order, and can store the information such as patient name, sex, patient registration number, By categorizing and storing information according to the information, the medical staff can easily search and browse the necessary information through one of the patient name, the patient registration number, the name of the medical staff, and the operation place.

In addition, the patient monitoring system may further include a communication unit 40 for supporting interoperation with a hospital server, a medical care terminal, and the like.

If the control unit 20 needs the help of an external medical staff to solve an emergency situation, the external medical staff can be immediately notified of the occurrence of an emergency through a hospital server and a medical staff terminal. In addition, by sharing the information obtained through the control unit 20 through the hospital server, utilization of the information can be further increased.

FIG. 3 is a schematic illustration of an algorithm for maintaining and managing an appropriate calm state of a patient according to an embodiment of the present invention.

Referring to FIG. 3, the method of the present invention collectively measures and analyzes respiratory volume, oxygen saturation, sedation depth, and pulse, and checks the sensor attachment state when the measured value is abnormal. If there is no abnormality of the sensor, it is judged that the measured value is higher than the measured value and the calm state is monitored by the step described below.

If at least one of the patient's respiratory and respiratory volume, oxygen saturation, sedation depth, and blood pressure information is abnormal, the user is informed of the 'caution or serious condition'. However, if at least two of the patient's respiratory sounds and respiratory volume, oxygen saturation, sedation depth, and blood pressure information are abnormal, the user is notified of a 'serious or emergency condition', and the respiratory volume and respiratory volume, oxygen saturation, If at least three of the information are abnormal, it is judged as 'emergency and emergency state' and notified.

Of these, when the respiratory sound and the respiratory volume of the patient are in an abnormal state, the abnormality signal is judged to be 'emergency and emergency state' in spite of the two.

For example, Table 2 shows the detection criteria of anomalous signals according to the signal. If the respiratory state is maintained for 5 seconds or more, the respiration rate is less than 250 mL or 80% or less, the oxygen saturation is 94% When the depth of blood pressure is more than two steps, when the blood pressure is decreased by more than 20% in the blood pressure measured before sedation or when the average blood pressure is less than 60, it is understood that each bio-signal is in the abnormal signal state. This can change the criterion according to the user's opinion.

 It is possible to change the criterion according to the type of biological signal, abnormal condition, and user's opinion Types of biological signals Abnormal condition Breath If the apnea status is maintained for more than 5 seconds If the volume is reduced below 250 ml or below 80% Oxygen saturation 94% or less Calm depth If more than 2 levels Blood pressure If the blood pressure is decreased by more than 20% or if the mean blood pressure is less than 60

FIG. 4 is a diagram for explaining a state notification of a patient monitoring system according to an exemplary embodiment of the present invention and a method for providing relevant information to a medical staff.

First, when a respiratory abnormality is detected (S41), the control unit 20 notifies the medical care staff of a serious alarm to guide the patient to the respiratory condition and induce self-breathing of the patient (S42 ) do.

If an abnormality in oxygen saturation is detected (S43), a 'serious' alarm is provided to the medical staff so that the monitor can be confirmed and respiration can be encouraged while guiding the abnormality in the oxygen saturation (S44).

In addition, even if the calmness depth abnormality is detected (S45), the careful alarm is provided to the medical staff while guiding that the calm depth is abnormal (S46).

On the other hand, if a blood pressure abnormality is detected (S47), a 'caution' alert is provided to the medical staff so that the blood pressure can be restored to the normal range by performing blood pressure re-measurement while guiding the abnormality of blood pressure. At this time, the patient's age, sex, weight, blood pressure abnormality, etc. can be determined in consideration.

5 is a diagram for explaining in more detail the step of providing a severity status notification of a patient monitoring system according to an embodiment of the present invention.

First, when an abnormality of respiration and oxygen saturation is detected (S51), taking into account abnormal signals while guiding that there is abnormality in respiration and oxygen saturation simultaneously with confirming the malfunction, a. Medication dose adjustment operation, b. Oxygen dose adjustment operation, c. Respiratory retaining device activation d. Positive pressure respiration activation action, e. The 'emergency' alarm is performed so that the operation of supplying the liquid can be performed immediately (S52). At this time, the degree of stimulation for inducing the patient's awakening and the dose of the drug may be determined in consideration of the patient's age, sex, weight, blood pressure abnormality, and the like.

On the other hand, if an abnormality of respiration and calmness depth is detected (S53), while guiding that there is abnormality in respiration and calmness depth simultaneously with confirming the malfunction, a. Medication dose adjustment operation, b. Oxygen dose adjustment operation, c. Respiratory retaining device activation d. Positive pressure respiration activation action, e. (S55). When the abnormality of the breathing and the blood pressure is detected (S55), the user is notified of the abnormality of the breathing and the blood pressure simultaneously with the confirmation of the malfunction, Including fluid supply and drug reduction a. Medication dose adjustment operation, b. Oxygen dose adjustment operation, c. Respiratory retaining device activation d. Positive pressure respiration activation action, e. A 'serious' alarm is provided so that the operation of supplying liquid can be performed (S56).

On the other hand, when an abnormality of oxygen saturation and sediment depth is detected (S57), it is confirmed that there is abnormality in oxygen saturation and sediment depth simultaneously with confirmation of malfunction, and a. Medication dose adjustment operation, b. Oxygen dose adjustment operation, c. Respiratory retaining device activation d. Positive pressure respiration activation action, e. (S58). If the oxygen saturation and the abnormality of the blood pressure are detected (S59), it is determined that the oxygen saturation and the blood pressure are abnormal , Including fluid supply and drug reduction, including: a. Medication dose adjustment operation, b. Oxygen dose adjustment operation, c. Respiratory retaining device activation d. Positive pressure respiration activation action, e. A 'serious' alarm is provided so that the operation of supplying liquid may be performed (S510).

Finally, when an abnormality of the calmness depth and the blood pressure is detected (S511), it is advised that there is an abnormality in the calorie depth and blood pressure abnormality after confirming the malfunction, and a. Medication dose adjustment operation, b. Oxygen dose adjustment operation, c. Respiratory retaining device activation d. Positive pressure respiration activation action, e. A 'serious' alarm is provided so that the operation of supplying liquid may be performed (S512).

If three or more abnormal signals are detected, an emergency state notification operation is performed to notify that the current physical condition of the patient is critical. a. Medication dose adjustment operation, b. Oxygen dose adjustment operation, c. Respiratory retaining device activation d. Positive pressure respiration activation action, e. An emergency alert is provided so that the treatment including the fluid supply operation and the like can be performed and the urgent state notification operation is performed through the hospital server or the medical staff terminal if necessary, Recognize the situation and make it possible to carry out collaborations for emergency situations. Also, if the two alarms of respiration and respiration and oxygen saturation occur even though they are not malfunctioning, perform them according to three abnormal signals.

It will be understood by those skilled in the art that the foregoing description of the embodiments is for illustrative purposes and that those skilled in the art can easily modify the invention without departing from the spirit or essential characteristics thereof. It is therefore to be understood that the above-described embodiments are illustrative in all aspects and not restrictive. For example, each component described as a single entity may be distributed and implemented, and components described as being distributed may also be implemented in a combined form.

The scope of the present invention is defined by the appended claims rather than the detailed description, and all changes or modifications derived from the meaning and scope of the claims and their equivalents should be interpreted as being included in the scope of the present invention .

Claims (13)

A monitoring method using a patient monitoring system having an algorithm for maintaining and managing a proper calming state of a patient having a respiration measuring unit attached to a patient's body,
Acquiring and analyzing respiration sound through the respiration measurement unit, and determining a calm state of the patient from respiration information obtained from the respiration measurement unit;
Further comprising: performing an alarm operation for notifying only the breath volume when the calm state of the patient is in a stable state, and audibly notifying the patient calm state when the calm state of the patient is in a stable state; A monitoring method using a patient monitoring system with an embedded algorithm. 2. The method according to claim 1,
Wherein the system acquires the oxygen saturation information of the patient through the oxygen saturation measuring unit included in the system and grasps the patient saturation state by further considering the oxygen saturation information, A monitoring method using the inherent patient monitoring system. 3. The method according to claim 2, wherein the step of grasping the patient calm state comprises:
Wherein the controller is configured to acquire the true depth information from the electroencephalogram information and the electroencephalogram information of the patient through the electroencephalogram measurement sensor and the electroencephalogram measurement sensor, A monitoring method using a patient monitoring system having an algorithm that maintains and manages state. 4. The method according to claim 3, wherein the step of grasping the patient calm state comprises:
Wherein the blood pressure of the patient is measured through the blood pressure measuring unit, and the blood pressure information obtained from the measured blood pressure is further taken into account to determine the patient's calming state. 5. The method according to claim 4,
If at least one of the respiratory and respiratory volume, oxygen saturation, sedation depth, and blood pressure information of the patient is abnormal,
If at least two of the patient's respiratory and respiratory volume, oxygen saturation, sedation depth, and blood pressure information are abnormal,
An emergency and an emergency state "if at least three of the respiration and respiration amounts, oxygen saturation, sedation depth, and blood pressure information of the patient are abnormal. 6. The method of claim 5,
And if the respiratory volume and the respiratory volume of the patient are abnormal, it is determined that the patient is in an emergency and an emergency condition. [7] The method of claim 6,
Further comprising the step of re-installing and rebooting after checking whether the device for outputting the abnormality signal is malfunctioning only when it is determined that the device is in a state of emergency or caution. A respiration measuring unit for measuring and notifying the patient breath based on the respiration sound of the patient; And
The method according to any one of claims 1 to 3, wherein the patient calm state is determined based on the respiration sound and the breath volume measured by the breath measuring unit, and if the patient calm state is a stable state, And a controller for performing an alarm operation to inform the patient that the patient is in an alert state. 9. The method of claim 8,
Further comprising an oxygen saturation measuring unit for measuring and notifying the oxygen saturation of the patient. ≪ Desc / Clms Page number 24 > 10. The method of claim 9,
And a calorie depth analyzer for calculating and reporting the calorie depth based on the electroencephalogram of the patient and the electroencephalogram of the patient. 11. The method of claim 10,
Further comprising a blood pressure measuring unit for measuring and reporting the blood pressure of the patient. 12. The apparatus of claim 11, wherein the control unit
At least two of the patient's respiratory and sound volume, oxygen saturation, sedation depth, and blood pressure information if at least one of the patient's respiration and respiratory volume, oxygen saturation, sedation depth, and blood pressure information is abnormal, Emergency state and emergency state "if at least three of the" serious or emergency state ", the respiratory sound and respiration amount of the patient, the oxygen saturation, the pacing depth, and the blood pressure information are abnormal, Patient monitoring system with built-in algorithm to maintain and manage state. 6. The method of claim 5,
And if the respiratory volume and the respiratory volume of the patient are abnormal, it is determined that the patient is in a 'serious condition'.

Images