A configuration register is incorporated into an electrically powered tourniquet apparatus for enabling an operator to change the values of parameters initially employed at the time of the next use of the apparatus, such as the initial pressure settings and elapsed time limits. These changed initial values of parameters are stored in memory and remain there despite inadvertent or intentional interruption of electrical power to the apparatus. An event register provides capability for recording the occurrence of events (cuff inflation, cuff deflation, etc.) and for relating the occurrence of the events to hazards and undesirable outcomes such as nerve damage associated with tourniquet usage. A safety circuit is included to detect and respond safely to certain failures which are possible within the tourniquet apparatus.

Physiologic tourniquet with safety circuit

The invention provides a body-worn vital sign monitor that measures a patient's vital signs (e.g. blood pressure, SpO2, heart rate, respiratory rate, and temperature) while simultaneously characterizing their activity state (e.g. resting, walking, convulsing, falling) and posture (upright, supine). The monitor processes this information to minimize corruption of the vital signs and associated alarms/alerts by motion-related artifacts. It also features a graphical user interface (GUI) rendered on a touchpanel display that facilitates a number of features to simplify and improve patient monitoring and safety in both the hospital and home.

Body-worn vital sign monitor

The invention provides a system for measuring respiratory rate (RR) from a patient. The system includes an impedance pneumography (IP) sensor, connected to at least two electrodes, and a processing system that receives and processes signals from the electrodes to measure an IP signal. A motion sensor (e.g. an accelerometer) measures at least one motion signal (e.g. an ACC waveform) describing movement of a portion of the patient's body to which it is attached. The processing system receives the IP and motion signals, and processes them to determine, respectfully, frequency-domain IP and motion spectra. Both spectra are then collectively processed to remove motion components from the IP spectrum and determine RR. For example, during the processing, an algorithm determines motion frequency components from the frequency-domain motion spectrum, and then using a digital filter removes these, or parameters calculated therefrom, from the IP spectrum.

Body-worn monitor for measuring respiration rate

The invention provides a body-worn system that continuously measures pulse oximetry and blood pressure, along with motion, posture, and activity level, from an ambulatory patient. The system features an oximetry probe that comfortably clips to the base of the patient's thumb, thereby freeing up their fingers for conventional activities in a hospital, such as reading and eating. The probe secures to the thumb and measures time-dependent signals corresponding to LEDs operating near 660 and 905 nm. Analog versions of these signals pass through a low-profile cable to a wrist-worn transceiver that encloses a processing unit. Also within the wrist-worn transceiver is an accelerometer, a wireless system that sends information through a network to a remote receiver, e.g. a computer located in a central nursing station.

Body-worn pulse oximeter

The invention provides a body-worn monitor that measures a patient's vital signs (e.g. blood pressure, SpO2, heart rate, respiratory rate, and temperature) while simultaneously characterizing their activity state (e.g. resting, walking, convulsing, falling). The body-worn monitor processes this information to minimize corruption of the vital signs by motion-related artifacts. A software framework generates alarms/alerts based on threshold values that are either preset or determined in real time. The framework additionally includes a series of ‘heuristic’ rules that take the patient's activity state and motion into account, and process the vital signs accordingly. These rules, for example, indicate that a walking patient is likely breathing and has a regular heart rate, even if their motion-corrupted vital signs suggest otherwise.

Alarm system that processes both motion and vital signs using specific heuristic rules and thresholds

A pressure cuff on the patient is inflated to a predetermined pressure above systolic, and then is deflated incrementally. At each decrement, oscillatory complexes are detected, and respective peaks are compared and evaluated as "true" complexes if they are within certain size matching criteria. After such "true" complexes are identified at a predetermined number of levels (e.g. 2 or 3), only a single complex is investigated at subsequent levels, provided specified size and timing criteria are met.

Method of automated blood pressure detection

An adaptive monitor and method for rapidly determining blood pressure, selects an initial cuff pressure to be applied to an artery of the test subject and then measures the amplitude of pressure pulses caused by the pumping of blood by the subject's heart. The cuff pressure is incrementally increased while the pulse amplitudes are monitored in order to obtain blood pressure readings by the oscillometric method. If the pulse amplitudes decrease for increases in pressure above the initial value, it is taken as an indication that mean arterial pressure is below the initial cuff pressure. Thus the cuff pressure is substantially decreased to a new initial value and the process is restarted. If it should be found upon a determination of the mean arterial pressure and the systolic pressure, that the initial or new cuff pressure was not low enough to determined diastolic pressure, the cuff pressure is automatically decreased in one large step to a level below the initial pressure and is then decreased in steps until diastolic pressure is located.

Adaptive incremental blood pressure monitor

A blood pressure cuff is applied about a subject's artery, and inflated above the systolic level thus fully occluding the artery for a full heart cycle. The cuff pressure is thereafter reduced to permit an increasing flow through the progressively less occluded artery, and a measure of the peak amplitudes of the successively encountered blood flow (oscillatory complex) pulses stored in memory. Also retained is the cuff pressure obtaining for each stored complex peak. In accordance with varying aspects of the present invention, the stored complex peak-representing data ensemble is corrected for aberrations; and improved data processing operates on the stored (and advantageously corrected) pulse peak data and the corresponding cuff pressure information to determine the subject's diastolic arterial blood pressure.

Automated diastolic blood pressure monitor with data enhancement

A blood pressure cuff is applied about a subject's artery, and inflated above the systolic level thus fully occluding the artery for a full heart cycle. The cuff pressure is thereafter reduced to permit an increasing flow through the progressively less occluded artery, and a measure of the peak amplitudes of the successively encountered blood flow (oscillatory complex) pulses stored in memory. Also retained is the cuff pressure obtaining for each stored complex peak. In accordance with varying aspects of the present invention, the stored complex peak-representing data ensemble is corrected for aberrations; and improved data processing operates on the stored (and advantageously corrected) pulse peak data and the corresponding cuff pressure information to determine the subject's mean arterial blood pressure.

Automated mean arterial blood pressure monitor with data enhancement

The deflation of the inflatable and deflatable cuff worn by a subject during automatic sphygmomanometric measurement is accomplished in unequal size decrements and principally in larger steps than 7 Torr. Each step after detection of the initial oscillations is determined in the first instance by reference to a look-up table or an equation as a function of prevailing cuff pressure. This Base Step dimension is augmented by a factor proportional to the last oscillation amplitude, the factor being increased after detection of the maximum oscillation amplitude. A valve mechanism with at least two different effective orifice sizes is used for deflation, the smaller size effective orifice being used first, to maintain control over the decrement step rate while holding the time for decrement within a predetermined limit of 8 mSec. per Torr, i.e., maintaining the rate above 125 Torr per second. The valve mechanism can consist of two valves with unequal orifice size, or it can consist of two equal orifice size valves to be used singly for providing the effective smaller orifice, or in parallel to provide the effective larger origice. Alternatively a single variable orifice valve can be used.

Rush W. Hood

Papers

Method of automated blood pressure detection

Adaptive incremental blood pressure monitor

Automated diastolic blood pressure monitor with data enhancement

Automated mean arterial blood pressure monitor with data enhancement

Oscillometric blood pressure monitor employing non-uniform pressure decrementing steps