# Patent

## Title
Medical sensor

## Abstract

The present disclosure generally relates to a medical sensor configured to attach to a patient's finger. According to embodiments, a sensor body is attached to a ring such that the sensor body is limited to contact with the patient's finger. The ring may have a fixed diameter or be adjustable. The ring may also include an indicator that facilitates the determination of whether the ring applies appropriate tension to the patient's finger. The sensor body may comprise a strip attached to the ring at two points or a hood that covers the distal end of the patient's finger. The sensor body may be coupled to the patient's finger with adhesives or securing flaps.

## Background
BACKGROUND
The present disclosure relates generally to medical sensors and, more particularly, to finger-type pulse oximeter sensors.
This section is intended to introduce the reader to various aspects of art that may be related to various aspects of the present disclosure, which are described and/or claimed below. This discussion is believed to be helpful in providing the reader with background information to facilitate a better understanding of the various aspects of the present disclosure. Accordingly, it should be understood that these statements are to be read in this light, and not as admissions of prior art.
Many types of medical sensors, such as optical sensors, are used to measure physiological characteristics of a patient. Typically, an optical sensor emits light into tissue, which then scatters through a portion of the tissue and is detected. Various characteristics of a patient can be determined from analyzing such detected light, such as oxygen saturation, pulse rate, tissue bilirubin, etc.
Pulse oximetry is typically used to measure various blood flow characteristics including, but not limited to, the blood-oxygen saturation of hemoglobin in arterial blood, the volume of individual blood pulsations supplying the tissue, and the rate of blood pulsations corresponding to each heartbeat of a patient. Measurement of these characteristics has been accomplished by use of a non-invasive sensor that scatters light through a portion of the patient's tissue where blood perfuses the tissue and that photoelectrically senses the absorption of light in such tissue. The amount of light absorbed and/or scattered is then used to calculate the amount of blood constituent being measured.
The light transmitted through the tissue is selected to be of one or more wavelengths that are absorbed by the blood in an amount representative of the amount of the blood constituent present in the blood. The amount of transmitted light scattered through and/or absorbed by the tissue will vary in accordance with the changing amount of blood constituent in the tissue. For measuring blood oxygen level, such sensors have typically been provided with a light source that is adapted to generate light of at least two different wavelengths, in accordance with known techniques for measuring blood oxygen saturation.
Known non-invasive sensors include devices that are secured to a portion of the body, such as a finger, an ear, or the scalp. In animals and humans, the tissue of these body portions is perfused with blood and the tissue surface is readily accessible to the sensor. However, sensors are generally designed for the body part to which they attach. For example, a sensor configured to attach to a finger could produce inaccurate measurements if it was attached to the scalp.



BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is an example of a medical finger sensor, in accordance with an embodiment of the present disclosure.
FIG. 2 is a bottom view of a rigid adjustable ring utilizing a leaf spring mechanism that may be used with the medical finger sensor of FIG. 1.
FIG. 3 is a bottom view of a rigid adjustable ring utilizing a ratcheting mechanism that may be used with the medical finger sensor of FIG. 1.
FIG. 4 is a drawing of an adjustable ring with a tension indicator that may be used with the medical finger sensor of FIG. 1.
FIG. 5 is a bottom view of an adjustable ring with an expansion limiter that may be used with the adjustable ring of FIG. 4.
FIG. 6 is a drawing of a strip-type sensor body with two securing flaps that may be used with the medical finger sensor of FIG. 1.
FIG. 7 is a perspective view of a strip-type sensor body with four securing flaps that may be used with the medical finger sensor of FIG. 1.
FIG. 8 is a drawing of a hood-type sensor body with one securing flap that may be used with the medical finger sensor of FIG. 1.
FIG. 9 is a drawing of the medical finger sensor of FIG. 1 showing the path of internal sensor conductors.
FIG. 10 is a patient monitoring system coupled to a multi-parameter patient monitor and the medical finger sensor of FIG. 1.



DETAILED DESCRIPTION
One or more embodiments of the present disclosure will be described below. In an effort to provide a concise description of these embodiments, not all features of an actual implementation are described in the specification. It should be appreciated that in the development of any such actual implementation, as in any engineering or design project, numerous implementation-specific decisions must be made to achieve the developers' specific goals, such as compliance with system-related and business-related constraints, which may vary from one implementation to another. Moreover, it should be appreciated that such a development effort might be complex and time consuming, but would nevertheless be a routine undertaking of design, fabrication, and manufacture for those of ordinary skill having the benefit of this disclosure.
Some embodiments are directed toward configuring a medical finger sensor such that it may not be attached to a patient's body at any location other than the finger. For example, a sensor body containing an emitter and a detector may be attached to a ring. When a patient or clinician places the ring on the patient's finger, the emitter and detector are communicatively coupled to the patient's finger. However, because the sensor body is attached to the ring, the sensor body may not be placed flat on the patient's forehead, for example, thus ensuring that the finger sensor is properly placed on the patient's finger.
Typical medical finger sensors comprise a flat strip configured to wrap around the distal end of the patient's finger. However, as discussed above, this flat strip may be placed on portions of the patient's body other than the finger. To prevent such misuse, a ring may be attached to this flat strip, limiting application of the medical finger sensor to the patient's finger. FIG. 1 is a drawing of a medical finger sensor 10 according to an embodiment. As illustrated, a ring 12 is attached to a sensor body 14, containing an emitter 16 and a detector 18. In this embodiment, placing the ring 12 on a patient's finger 20 causes the emitter 16 and the detector 18 to contact the finger 20. The emitter 16 and the detector 18 may be components of a transmission-type pulse oximetry sensor. Furthermore, as discussed below, the pulse oximetry sensor may be connected to a patient monitor via the external sensor cable 22 and the sensor connector 24.
According to an embodiment, transmission-type sensors may include an emitter 16 and a detector 18 that are typically placed on opposite sides of the sensor site. If the sensor site is a fingertip, for example, a medical finger sensor 10 may be positioned over the patient's fingertip such that the emitter 16 and detector 18 lie on opposite sides of the patient's nail bed. In other words, the medical finger sensor 10 may be positioned so the emitter 16 is located on the patient's fingernail and the detector 18 is located opposite the emitter 16 on the patient's finger pad. During operation, the emitter 16 shines one or more wavelengths of light through the patient's fingertip, and the light received by the detector 18 is processed to determine various physiological characteristics of the patient. In each of the embodiments discussed herein, it should be understood that the locations of the emitter 16 and detector 18 may be interchanged. For example, the detector 18 may be located at the top of the finger and emitter 16 may be located underneath the finger. In either arrangement, the medical finger sensor 10 will perform in substantially the same manner.
The emitter 16 and the detector 18 may be of any suitable type. For example, the emitter 16 may be one or more light emitting diodes adapted to transmit one or more wavelengths of light in the red to infrared range, and the detector 18 may be one or more photodetectors selected to receive light in the range or ranges emitted from the emitter 16. Alternatively, the emitter 16 may also be a laser diode or a vertical cavity surface-emitting laser (VCSEL). Emitter 16 and detector 18 may also include optical fiber elements. An emitter 16 may include a broadband or “white light” source, in which case the detector 18 could include any variety of elements for selecting specific wavelengths, such as reflective or refractive elements or interferometers. These kinds of emitters and detectors would typically be coupled to the rigid or rigidified sensor via fiber optics. Alternatively, the medical finger sensor 10 may sense light detected from the tissue at a different wavelength from the light emitted into the tissue. Such sensors may be adapted to sense fluorescence, phosphorescence, Raman scattering, Rayleigh scattering and multi-photon events or photoacoustic events. Similarly, in other applications, a tissue water fraction (or other tissue constituent related metric) or a concentration of one or more biochemical components in an aqueous environment may be measured using two or more wavelengths of light. In certain embodiments, these wavelengths may be infrared wavelengths between about 1,000 nm to about 2,500 nm.
It should be understood that, as used herein, the term “light” may refer to one or more of ultrasound, radio, microwave, millimeter wave, infrared, visible, ultraviolet gamma ray or X-ray, and/or electromagnetic radiation, and may also include any wavelength within the radio, microwave, infrared, visible, ultraviolet, or X-ray spectra, and that any suitable wavelength of light may be appropriate for use with the present techniques.
Returning to FIG. 1, the illustrated embodiment shows a ring 12 with a fixed diameter. The ring 12 in this embodiment forms a continuous loop around the patient's finger 20 and may not be adjusted. The diameter of the ring 12 may be sufficient to accommodate fingers of varying girth. The ring 12 may be composed of a rigid material, such as metal or hard plastic, or a flexible material, such as cloth, paper or soft plastic.
Tightly securing the ring 12 to the patient's finger 20 may facilitate improved contact between the finger 20 and the sensor components (emitter 16 and detector 18). Therefore, the ring 12 may be composed of an elastic material which may expand to fit the patient's finger 20. The unexpanded diameter of the ring 12 may be small enough to securely attach to a thin finger, while allowing for expansion sufficient to accommodate a thick finger.
According to an embodiment, other ring configurations may also serve to tightly secure the ring 12 to the patient's finger 20. For example, FIGS. 2 and 3 present various embodiments in which the ring 12 is constructed of a rigid material and its diameter is adjustable. FIG. 2 illustrates a leaf spring mechanism that may automatically adjust the diameter of the ring 12 based on the thickness of the patient's finger. In this embodiment, a semicircular spring 26 may be attached to an inner surface of the rigid ring 12 at one point 28. As the patient's finger enters the ring, the semicircular spring 26 may compress, providing tension around the patient's finger. However, excessive tension may reduce blood flow to the finger, leading to inaccurate sensor readings. Therefore, the spring force may be adjusted to provide tension around the patient's finger without reducing circulation.
Similarly, FIG. 3 demonstrates another embodiment of a rigid adjustable ring. In this embodiment, a ratcheting mechanism may be employed to facilitate manual adjustment of the ring diameter. Applying pressure to a ratchet release mechanism 30 permits a sizing section 32 to be incrementally inserted into or removed from a ring opening 34. As the size of the ring changes, each ring segment 12A and 12B rotates about a hinge 36 located opposite the ratchet release mechanism along the circumference of the ring 12. In this manner, the ring 12 may be adjusted by small increments to properly fit a patient's finger. Furthermore, the hinge 36 may be configured to limit the angle of expansion such that the sizing section 32 may not be completely removed from the ring opening 34. This hinge configuration may ensure that the ring 12 maintains a continuous loop.
According to an embodiment, a ring constructed of a flexible material may be adjustable as well. For example, the ring 12 depicted in FIG. 4 may include a low-stretch, i.e., generally inelastic, segment 38 sized to fit around a patient's finger, and a generally elastic band 40 that may be coupled to the low-stretch segment 38. The generally elastic band 40 may be elastic along substantially its entire length, or it may include an elastic portion and an inelastic portion. In this embodiment, the elastic band 40 has a loose end 42 and an attached end 44, where the elastic band 40 is attached at its attached end 44 with the low-stretch segment 38. The elastic band 40 is threaded through a guide band 46 of the low-stretch segment 38, which functions to prevent slippage of the elastic band 40. In this configuration, the diameter of the flexible ring 12 may be adjusted to fit the patient's finger 20.
According to an embodiment, when securing an adjustable ring 12 to the patient's finger 20, selecting a proper tension is important to producing accurate medical measurements. For example, if the tension is too low, the emitter 16 and the detector 18 may not adequately contact the patient's finger 20. If the tension is too high, blood flow to the finger may be reduced, leading to inaccurate sensor readings. To facilitate proper ring adjustment, the ring 12 may indicate when it has been secured with the appropriate tension. Specifically, the elastic band 40 may include tension arrows 48 that align with a tension indicator zone 50 on the low-stretch segment 38 when the elastic band 40 is in a stretched state. In this embodiment, the opposite face of the loose end 42 of the elastic band 40 has hook and loop fasteners 52 which may couple to the low-stretch segment 38 to affix to the ring 12 around the patient's finger 20 and maintain the ring 12 at the desired tension. Hence, when the low-stretch segment 38 has been placed about the patient's finger 20 and secured in the proper range with the tension arrows 48 aligned in the tension indicator zone 50, the ring 12 should be adequately secured to the patient's finger 20 in a manner that will facilitate proper sensor readings from the sensor described above.
As previously discussed, the finger sensor should not be reconfigured such that it may be applied to another part of a patient's body. To prevent such a reconfiguration, the ring 12 may be adapted such that its diameter is adjustable, but the ring 12 maintains a continuous loop even when not secured to the patient's finger 20. FIGS. 4 and 5 illustrate how this functionality may be accomplished in an embodiment. A retention band 54 may be attached to the guide band 46 along an outer surface of the ring 12. The low-stretch segment 38 may then pass through the retention band 54. In addition, an expansion limiter 56 may be attached to an end of the low-stretch segment 38 opposite the guide band 46. The expansion limiter 56 may be configured such that it is incapable of passing through the retention band 54. Therefore, in this embodiment the ring 12 may maintain a continuous loop even when the hook and loop fasteners 52 are uncoupled from the low-stretch segment 38. The expansion limiter 56 may take any suitable form so long as it prevents the ring 12 from being separated and opened. For example, the expansion limiter 56 may comprise a solid attachment to the end of the low-stretch segment 38, or it may comprises a section of the low-stretch segment 38 of greater thickness.
According to embodiments, various sensor body configurations may be employed to couple the emitter 16 and the detector 18 to the patient's finger 20. One such configuration may include the strip-type sensor body 14 depicted in FIG. 6. As illustrated, the sensor body 14 is connected to the ring 12 at two attachment points 60A and 60B. The attachment points 60 may be positioned opposite each other along the circumference of the ring 12. In the present embodiment, the securing mechanism comprises two flaps 58A and 58B. The flaps 58 may be coated on one side with a layer of pressure sensitive adhesive 62. In this embodiment, an adhesive layer 62A is affixed to a front side of flap 58A, while an adhesive layer 62B is affixed to a back side of flap 58B. In this configuration, when the flaps 58 are wrapped around the patient's finger 20 in a counter-clockwise direction, the flaps 58 are adhesively coupled to the sensor body 14 and the patient's finger 20, serving to secure the sensor body 14 to the finger 20. The resulting contact between the finger 20 and the sensor body 14 may ensure a proper coupling of the finger 20 to the emitter 16 and the detector 18.
To further secure the sensor body 14 to the patient's finger 20, an adhesive layer may be affixed to an inner surface of the sensor body 14. In this embodiment, the sensor body 14 may adhere to the finger 20 upon contact. Similar to the previous embodiment, this adhesion may provide effective coupling between the finger 20 and the sensor components (emitter 16 and detector 18). The adhesive layer affixed to the sensor body 14 may be the sole securing mechanism, or it may be combined with the flaps 58 described above.
Another embodiment of the securing mechanism may employ four flaps 58 to secure the sensor body 14 to the patient's finger 20. In this embodiment, as shown in FIG. 7, adhesive layers 62A and 62B may be affixed to a bottom surface of flaps 58A and 58B, respectively. Similarly, adhesive layers 62C and 62D may be affixed to a top surface of flaps 58C and 58D, respectively. When flaps 58A and 58C are placed in contact with each other, they may adhere to one another, forming a bond between the two flaps (58A and 58C). Correspondingly, flaps 58B and 58D may form a similar bond upon contact. The combination of adhering flap 58A to flap 58C and flap 58B to flap 58D may serve to secure the sensor body 14 to the patient's finger 20. In addition, a layer of adhesive may be affixed to an inner surface of the sensor body 14, further securing the sensor body 14 to the patient's finger 20.
In certain situations ambient light may interfere with the effectiveness of the detector 18. For example, if a patient has sensitive skin or is allergic to the adhesive described above, a medical finger sensor 10 without adhesives, either on the sensor body 14 or the flaps 58, may be employed. However, without adhesives to secure the sensor body 14 to the patient's finger 20, a gap may form between the detector 18 and the finger 20. This gap may allow ambient light to enter the detector 18, interfering with its ability to measure light from the emitter 16. To combat ambient light, a substantially opaque hood-type sensor body 14 may be placed around the finger 20. For example, FIG. 8 presents an embodiment in which the sensor body 14 forms a hood around the distal end of the patient's finger 20. The hood-type sensor body 14 may be attached to the ring 12 along the ring's circumference, extending 180 degrees or more around the ring 12. The sensor body 14 may be configured to enclose all or a portion of the distal end of the finger 20. In this embodiment, a single flap 58 may be coupled to the sensor body 14 such that when secured, the flap 58 and the hood 14 form a complete loop around the finger 20. The flap 58 may also have a layer of adhesive 62 affixed to a front surface. In this configuration, when the flap 58 is wrapped around the finger 20 in a counter-clockwise direction, the flap 58 may secure the sensor body 14 to the finger 20, ensuring contract between the finger 20 and the sensor components (emitter 16 and detector 18). Furthermore, an adhesive may be affixed to an inner surface of the hood-type sensor body 14, further securing the finger 20 to the sensor body 14.
As discussed above, the medical finger sensor 10 should not be reconfigured such that the sensor body 14 may be placed on a portion of a patient's body other than the finger 20. For example, if the sensor body 14 was physically removed from the ring 12, the sensor body 14 may be attached to a patient's scalp. Such a misuse of the sensor body 14 could yield inaccurate measurements of medical parameters. One embodiment which may prevent the sensor body 14 from being removed from the ring 12 is illustrated in FIG. 9. In this embodiment, internal conductors 64 and 66 connect the emitter 16 and the detector 18 to the sensor cable junction 68. The emitter conductor 64 may originate at the emitter 16 and extend down the sensor body 14 through the connection point 60A to the ring 12. The emitter conductor 64 may then traverse the circumference of the ring 12 to the sensor cable junction 68. In the sensor cable junction 68, the emitter conductor 64 may be coupled to the detector conductor 66 and the external sensor cable 22. Similarly, the path of the detector conductor 66 may begin at the detector 18 and pass down the sensor body 14. The detector conductor 66 may then pass through the connection point 60B and around the circumference of the ring 12 to the sensor cable junction 68. At the sensor cable junction 68, the detector conductor 66 may form an electrical connection with both the emitter conductor 64 and the external sensor cable 22. In this embodiment, separation of the sensor body 14 from the ring 12 at either connection point 60A or 60B will sever the emitter conductor 64 and/or the detector conductor 66. Without a proper connection to both the emitter 16 and the detector 18, the medical finger sensor 10 will not function.
According to an embodiment, separating the sensor body 14 from the ring 12 will only sever the internal conductors 64 and 66 if the conductors are physically coupled to the medical finger sensor 10. In other embodiments, for example, if the ring 12 or sensor body 14 is composed of multiple layers of soft plastic, the internal conductors 64 and 66 may pass between two of the layers. Similarly, if the ring 12 or sensor body 14 is composed of fabric, the internal conductors 64 and 66 may be sewn into the fabric. If the ring 12 is composed of a rigid material such as hard plastic or metal, the internal conductors 64 and 66 may pass through holes in the ring 12 located at each connection point 60. In these configurations, the sensor body 14 could not be removed from the ring 12 without severing at least one of the internal conductors 64 or 66.
According to an embodiment, it should be appreciated that the medical finger sensor 10 is designed for use with a patient monitoring system. For example, referring now to FIG. 10, the medical finger sensor 10 as depicted in FIG. 1 may be used in conjunction with a patient monitor 70. In an embodiment an external sensor cable 22 connects the medical finger sensor 10 to the patient monitor 70 via a sensor connector 24. The medical finger sensor 10 and/or external sensor cable 22 may include or incorporate one or more integrated circuit or electrical devices, such as a memory processor chip, that may facilitate or enhance communication between the medical finger sensor 10 and the patient monitor 70. Similarly, the external sensor cable 22 may be an adaptor cable, with or without an integrated circuit or electrical device, for facilitating communication between the medical finger sensor 10 and various types of monitors, including different versions of the patient monitor 70 or other physiological monitors. In other embodiments, the medical finger sensor 10 and the patient monitor 70 may communicate via wireless means, such as using radio frequency, infrared or optical signals. In such embodiments, a transmission device may be connected to the medical finger sensor 10 to facilitate wireless transmission between the medical finger sensor 10 and patient monitor 70. The external sensor cable 22 (or a corresponding wireless connection) may typically be used to transmit control or timing signals from the patient monitor 70 to the medical finger sensor 10 and/or to transmit acquired data from the medical finger sensor 10 to the patient monitor 70. In other embodiments, the external sensor cable 22 may be an optical fiber that enables optical signals to be transmitted between the patient monitor 70 and the medical finger sensor 10.
In one embodiment, the patient monitor 70 may be a suitable pulse oximeter, such as those available from Nellcor Puritan Bennett L.L.C. In other embodiments, the patient monitor 70 may be a monitor suitable for measuring tissue water fractions, or other body fluid related metrics, using spectrophotometric or other techniques. Furthermore, the patient monitor 70 may be a multipurpose monitor suitable for performing pulse oximetry and measurement of tissue water fraction, or other combinations of physiological and/or biochemical monitoring processes, using data acquired via the medical finger sensor 10 and/or other sensors. Moreover, to upgrade conventional monitoring functions provided by the system, the patient monitor 70 may be coupled to a multi-parameter patient monitor 72 via a monitor cable 74 connected to a sensor input port and/or a cable connected to a digital communication port.
While the disclosure may be susceptible to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and have been described in detail herein. However, it should be understood that the disclosure is not intended to be limited to the particular forms provided. Rather, the disclosure is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the disclosure as defined by the following appended claims. Indeed, the present disclosed methods may not only be applied to transmission type sensors for use in pulse oximetry, but also to other sensor designs.

## Claims

1. A sensor comprising:
a ring configured to be placed on a patient's finger and to maintain a continuous loop when removed from the patient's finger and configured to maintain the continuous loop when adjusting the size of the ring, wherein the ring comprises an inelastic segment configured to be placed around the patient's finger, and an elastic segment coupled to the inelastic segment, the elastic segment having a fastener to secure the ring to the patient's finger;
a sensor body being integrally coupled to the ring and having a substantially closed end and a substantially open end, the substantially open end being coupled to the ring, and the substantially closed end configured to at least partially enclose a distal end of the patient's finger when the ring is placed on the patient's finger;
a securing mechanism coupled to the sensor body, the securing mechanism configured to secure the sensor body to the finger; and
a sensor disposed on the sensor body, the sensor configured to communicatively couple to the patient's finger.

2. The sensor of claim 1, wherein the inelastic segment comprises at least one indicator and the elastic segment comprises at least one tension indicator zone configured to align with the indicator to indicate whether the ring has been secured to a patient's finger at an appropriate tension.

3. The sensor of claim 1, wherein the sensor comprises a pulse oximetry sensor.

4. The sensor of claim 3, wherein the sensor comprises a transmission-type pulse oximetry sensor.

5. The sensor of claim 3, wherein the sensor comprises a reflectance-type pulse oximetry sensor.

6. The sensor of claim 1, wherein the sensor is configured to be disabled if the sensor body is at least partially separated from the ring.

7. A pulse oximetry system comprising:
a pulse oximetry monitor; and
a pulse oximetry sensor operatively coupled to the pulse oximetry monitor, the pulse oximetry sensor comprising:
a ring configured to be placed on a patient's finger and to maintain a continuous loop when removed from the patient's finger and configured to maintain the continuous loop when adjusting the size of the ring, wherein the ring comprises an inelastic segment configured to be placed around the patient's finger, and an elastic segment coupled to the inelastic segment, the elastic segment having a fastener to secure the ring to the patient's finger;
a sensor body being integrally coupled to the ring and having a substantially closed end and a substantially open end, the substantially open end being coupled to the ring, and the substantially closed end being configured to at least partially enclose a distal end of the patient's finger when the ring is placed on the patient's finger;
a securing mechanism coupled to the sensor body, the securing mechanism being configured to secure the sensor body to the finger; and
a sensor disposed on the sensor body, the sensor being configured to communicatively couple to the patient's finger.

8. The system of claim 7, wherein the inelastic segment comprises at least one indicator and the elastic segment comprises at least one tension indicator zone configured to align with the indicator to indicate whether the ring has been secured to a patient's finger at an appropriate tension.

9. The system of claim 7, wherein the sensor comprises a transmission-type pulse oximetry sensor.

10. The system of claim 7, wherein the sensor is configured to be disabled if the sensor body is at least partially separated from the ring.

11. The system of claim 7, wherein the sensor comprises a reflectance-type pulse oximetry sensor.