TW202015615A - 早期預警評分系統適用的多重生理參數偵測裝置 - Google Patents

早期預警評分系統適用的多重生理參數偵測裝置 Download PDF

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TW202015615A
TW202015615A TW108136474A TW108136474A TW202015615A TW 202015615 A TW202015615 A TW 202015615A TW 108136474 A TW108136474 A TW 108136474A TW 108136474 A TW108136474 A TW 108136474A TW 202015615 A TW202015615 A TW 202015615A
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blood pressure
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周福強
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Abstract

一種可穿戴式生理參數監測裝置,特別指可以穿戴在病患上臂的單件式(one-piece)裝置,用以監測多種生理參數,且該裝置不需透過額外線材將感測器連接到身體其他部位,所有生理信號皆透過位於上臂的多個感測器量測而得。

Description

早期預警評分系統適用的多重生理參數偵測裝置
本發明有關於一種穿戴式生理參數監測裝置,特別指可以穿戴在病患上臂的單件式(one-piece)裝置,用以監測多種生理參數,且該裝置不需透過額外線材將感測器連接到身體其他部位,所有生理信號皆透過位於上臂的多個感測器量測而得。
傳統的生理信號監測裝置普遍用於醫院的各個單位,特別是在加護病房或手術室等高危險區域。但是在普通病房,有的醫院會使用早期預警評分(Early Warning Score)系統來判斷病程,同時在必要時介入重症監護。早期預警評分系統是透過計算個別生理參數的評分再加總而成,這些生理參數包括了血壓、呼吸頻率、血氧濃度(SpO2)、心率、體溫以及清醒程度等。傳統監測這些參數的一種作法是採用手提式或壁掛式的床邊生理訊號監測裝置,但是這一類的生理訊號監測裝置常過於笨重且病患在受監測時無法移動,並不適合一般還可以下床的住院病患使用。為了解決這個問題,有些公司開始發展穿戴式生理信號監測裝置,用於自動蒐集多個參數。然而,受限於傳統的生理信號監測原理及方法,需要使用多件式的裝置在不同的身體部位監測特定的生理信號,例如US8475370B2的圖3A與圖3B所示,血氧濃度(SpO2)在手指偵測,血壓在上臂偵測,心電圖(ECG)監測則要將貼片貼在胸部等。對護士而言,將這些裝置完整安裝在病人身上並不容易,而在身體不同部位的裝置固定方式也造成病人較大的不舒服與不適應。
此外,傳統量測體溫的穿戴式裝置常在量測其他生理信號的位置直接量測體溫,譬如手腕或胸口。然而問題在於,在這些位置所量測的體表溫度(skin temperature)不能反應真實體內溫度。一般比較好能用於連續監測體溫的部位是腋下(可量測腋溫),其他醫院常用於量測體溫的部位,例如口溫、耳溫、肛溫則比較不適合用於連續監測。
其他像意識清醒程度(Conscious Level)之類無法直接由生理信號量測的參數,被使用於某些早期預警評分系統,譬如 NEWS ( National Early Warning Score),這是由英國皇家照護學院提出的早期預警評分系統。意識清醒程度的判別需要由護士與病人互動以測定病人的實際反應,並無法直接由生理信號的監測產生,因此,使用傳統生理信號監測裝置對於某些早期預警評分系統的自動計算有其困難。
綜上所述,有必要發展出一種單件式,適用於多數早期預警評分系統的多重生理信號監測裝置,並且對體溫監測與透過裝置與病患互動等功能提出有實用性與進步性的解決方案,以利一般病患照護的順利運作。
本發明之目的係揭露一種單件式的整合裝置,可同時監測血壓、呼吸頻率、血氧濃度、心率、體溫這5種生理信號,並且採用互動式程序,以自動的方式判別病人意識清醒程度。
該裝置的主體係為一血壓偵測器,使用傳統振盪法(Oscillometric Method)以量測病人上臂血壓,其中包含微處理器(MCU)的電子系統與壓脈帶整合在一起,因此不需外接一般帶有空氣管的壓脈帶。為了在同一位置量測血氧濃度(SpO2),所以將反射式脈搏血氧濃度感測器(Pulse Oximetry Sensor)與壓脈帶整合,以量測上臂的血氧濃度,另外心率與呼吸頻率則能由脈搏血氧濃度感測器的光體積變化描記圖(Photoplethysmography ,PPG)信號推導出來。至於體溫則可由整合於壓脈帶且位於手臂內側的溫度感測器(Thermal Sensor)監測。整合上述電子線路與機械構造可以量測以下5項生理信號,包含血壓、血氧濃度、心率、呼吸頻率以及體溫。
整合裝置同時安裝互動式程序,透過與病人互動來判定病人的意識清醒程度,該互動式程序與量測血壓的程序結合,以直覺且不突兀的方式與使用者互動。當系統程序判斷當前需要量測血壓時(譬如每4小時一次的間隔),互動式程序會提示病人(透過語音、震動或閃光的方式)去按壓裝置主體的血壓按鈕,使血壓量測裝置開始動作,如果病人正確互動,則反應病人意識是清醒的,否則視為意識不正常,藉以作為判斷病人意識清醒程度之方法。
圖1所示為本發明穿戴單件式裝置之外觀實施例,如圖所示,一溫度感測器1整合於血壓監測器的壓脈帶2,該壓脈帶2會穿著於病患上臂,該溫度感測器1以附著於壓脈帶2的方式固定於腋下,以偵測體溫。由此設計,溫度感測器1可以量測腋下溫度,且對應一種測量體溫的標準位置(腋溫)。電源開關3係用以開啟/關閉穿戴式裝置,按鈕開關4係用於啟動或停止血壓量測。該裝置會定期提示使用者按壓按鈕開關4以啟動血壓量測,使用者必須按壓按鈕開關4來啟動該血壓量測。換言之,該裝置使用該互動式程序以確定使用者的意識清醒程度。
圖2所示為本發明穿戴單件式裝置之另一視角外觀,揭示反射式脈搏血氧濃度感測器5整合於壓脈帶2,於圖2中揭示一透過孔洞安裝反射式脈搏血氧濃度感測器5的方法,經由該孔洞發出兩種不同波長的光線射入皮膚並反射進入光探測器(Photodetector)以測量血氧濃度(SpO2),於圖1及圖2可得知內置的電子線路具機構連結,溫度感測器1與反射式脈搏血氧濃度感測器5位於壓脈帶2內側相對的位置,但這兩個感測器的位置的選定並非唯一的選擇。
圖3所示為本發明一可穿戴單件式裝置的系統圖,如圖所示,微處理器(MCU)6控制整個系統;無線模組7建立穿戴式裝置與其他設備的連線,藉以傳送生理信號資料到其他設備,以供進一步應用;輸入/輸出模組8具有按鈕開關4,喇叭、震動裝置、LED等其他元件,可以根據使用情境,以聲音、震動或閃光等方式與使用者互動;電池與電源模組9是設計用來提供電源給系統且與微處理器6相連;血壓模組10透過控制壓脈帶的氣壓與對應的演算法,用來偵測血壓並且傳遞資料到微處理器6;反射式脈搏血氧濃度模組11包含了反射式脈搏血氧濃度感測器5與其他元件,透過偵測光體積變化描記圖(PPG)信號並將資料傳到微處理器6,以對應的演算法計算血氧濃度、心率及呼吸頻率;體溫感測模組12包含溫度感測器1與其他元件,用來監測體溫,並將數據傳到微處理器6。
本發明實施例之敘述如下所述,一種可穿戴單件式生理信號監測裝置包含一血壓監測器,具有整合式壓脈帶2;於該壓脈帶2的一孔洞中設置一反射式脈搏血氧濃度感測器5可測量上臂位置的血氧濃度;一溫度感測器1,與該壓脈帶2結合以偵測腋下體溫。上述裝置進一步包括一按鈕開關4位於該裝置主體,用於啟動或停止血壓量測程序。當系統需要定期量測血壓數據時,裝置會以聲音、震動或閃光等方式,提示使用者去按壓按鈕開關4,以啟動血壓量測,並根據使用者的反應來決定使用者的意識清醒程度。上述裝置進一步包括一無線模組7(主要包含藍芽以及WIFI傳輸功能),用來連結該生理訊號監測裝置與其他設備,藉以傳送生理信號資料到其他設備以供進一步應用,然而在某些場景,也可以採用其他無線連結方式,例如NFC或無線行動網路等來傳輸資料;一輸入/輸出模組8,提供使用者按鈕操作,與聲音、震動或閃光等反饋,用以應對各種使用情境。此輸入/輸出模組8,可以外接額外的傳感器(譬如:加速度傳感器、GPS、NFC等模組),提供跌倒偵測、用戶定位、用戶身分確認等其他應用。
在其他實施態樣中,上述生理訊號監測裝置可以提供跌倒偵測與連接定位系統,用戶身分識別等功能,確保使用者安全。
本發明之實踐係整合各種不同生理信號監測的方法,以創新的方式,在同一位置量測多種生理信號,解決傳統生理信號監測器不方便穿戴以及穿戴不舒適的問題。透過量測腋下溫度得到真正的體溫,而非一般裝置在其他位置所量到的體表溫度。並透過互動方式,檢測傳統生理信號監測裝置無法處理的意識清醒程度的問題,具有新穎性及進步性。本發明之多重生理參數偵測裝置適用於醫院的早期預警評分系統,該輸入/輸出模組8供使用者操作,將訊息以該無線模組7傳送至醫院的信息系統,並整合至整體醫療照護流程,供照護者提供病患更安全有效的照護。
1:溫度感測器 2:壓脈帶 3:電源開關 4:血壓按鈕開關 5:反射式脈搏血氧濃度感測器 6:微處理器(MCU) 7:無線模組 8:輸入/輸出模組 9:電池與電源模組 10:血壓模組 11:反射式脈搏血氧濃度模組 12:體溫感測模組
圖1,為本發明外觀實施例,為壓脈帶與溫度感測器結合的示意圖;
圖2,為本發明另角度外觀實施例,以顯示反射式脈搏血氧濃度感測器與壓脈帶的結合方式;
圖3,為本發明穿戴單件式裝置的系統圖,包含必要電子組件。
6:微處理器(MCU)
7:無線模組
8:輸入/輸出模組
9:電池與電源模組
10:血壓模組
11:反射式脈搏血氧濃度模組
12:體溫感測模組

Claims (8)

  1. 一種單件式生理信號監測裝置,安裝於一使用者的上臂,其包含: 一血壓監測器,具有一壓脈帶; 一反射式脈搏血氧濃度感測器,設置於該壓脈帶內側,具有外露的一光學元件,以量測血氧信號; 該生理信號監測裝置至少可以量測血壓、血氧、心率等三種生理信號。
  2. 如申請專利範圍第1項所示的生理訊號監測裝置,還具有一微處理器透過該脈搏血氧濃度感測器的光體積變化描記圖(Photoplethysmography ,PPG)信號推導出使用者的呼吸頻率。
  3. 如申請專利範圍第1項所示的生理訊號監測裝置,設置有一溫度感測器與該壓脈帶結合,用於量測該使用者腋下的體溫。
  4. 如申請專利範圍第1項所示的生理訊號監測裝置,其中該血壓監測器的量測可於預定時間啟動,並透過聲音、震動或閃光等方式通知使用者,在得到使用者回應後啟動血壓量測,並藉以判定使用者的意識清醒程度。
  5. 如申請專利範圍第2項所示的生理訊號監測裝置,並設置一溫度感測器與該壓脈帶結合,用於量測該使用者腋下的體溫。
  6. 如申請專利範圍第2項所示的生理訊號監測裝置,其中該血壓監測器的量測可在預定時間啟動,並透過聲音、震動或閃光等方式通知使用者,在得到使用者回應後啟動血壓量測,並藉以判定使用者的意識清醒程度。
  7. 如申請專利範圍第3項所示的生理訊號監測裝置,其中該血壓監測器的量測可在預定時間啟動,並透過聲音、震動或光線等方式通知使用者,在得到使用者回應後啟動血壓量測,並藉以判定使用者的意識清醒程度。
  8. 如申請專利範圍第5項所示的生理訊號監測裝置,其中該血壓監測器的量測可在預定時間啟動,並透過聲音、震動或閃光等方式通知使用者,在得到使用者回應後啟動血壓量測,並藉以判定使用者的意識清醒程度。
TW108136474A 2018-10-17 2019-10-08 早期預警評分系統適用的多重生理參數偵測裝置 TW202015615A (zh)

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