Abstract:
A physiological status monitor has a monitor and an interconnected sensor that generates a sensor signal. The monitor computes physiological parameters responsive to the sensor signal and displays physiological parameters accordingly. In an embodiment, the monitor displays physiological parameter information across multiple patients in a cumulative pie chart format so that a caregiver can quickly discern and readily identify patients in need of immediate medical attention.

Description:
PRIORITY CLAIM TO RELATED PROVISIONAL APPLICATION 
       [0001]    The present application claims priority benefit under 35 U.S.C. §119(e) to U.S. Provisional Patent Application Ser. No. 61/775,568 filed Mar. 9, 2013, titled Physiological Status Monitor. The above-cited provisional patent application is hereby incorporated in its entirety by reference herein. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    Pulse oximetry is a widely accepted noninvasive procedure for measuring the oxygen saturation level of arterial blood, an indicator of a person&#39;s oxygen supply. A typical pulse oximetry system utilizes an optical sensor attached to a fingertip to measure the relative volume of oxygenated hemoglobin in pulsatile arterial blood flowing within the fingertip. Oxygen saturation (SpO 2 ), pulse rate and a plethysmograph waveform, which is a visualization of pulsatile blood flow over time, are displayed on a monitor accordingly. 
         [0003]    Conventional pulse oximetry assumes that arterial blood is the only pulsatile blood flow in the measurement site. During patient motion, venous blood also moves, which causes errors in conventional pulse oximetry. Advanced pulse oximetry processes the venous blood signal so as to report true arterial oxygen saturation and pulse rate under conditions of patient movement. Advanced pulse oximetry also functions under conditions of low perfusion (small signal amplitude), intense ambient light (artificial or sunlight) and electrosurgical instrument interference, which are scenarios where conventional pulse oximetry tends to fail. 
         [0004]    Advanced pulse oximetry is described in at least U.S. Pat. Nos. 6,770,028; 6,658,276; 6,157,850; 6,002,952; 5,769,785 and 5,758,644, which are assigned to Masimo Corporation (“Masimo”) of Irvine, California and are incorporated in their entirety by reference herein. Corresponding low noise optical sensors are disclosed in at least U.S. Pat. Nos. 6,985,764; 6,813,511; 6,792,300; 6,256,523; 6,088,607; 5,782,757 and 5,638,818, which are also assigned to Masimo and are also incorporated in their entirety by reference herein. Advanced pulse oximetry systems including Masimo SET® low noise optical sensors and read through motion pulse oximetry monitors for measuring SpO 2 , pulse rate (PR) and perfusion index (PI) are available from Masimo. Optical sensors include any of Masimo LNOP®, LNCS®, SofTouch™ and Blue™ adhesive or reusable sensors. Pulse oximetry monitors include any of Masimo Rad-8®, Rad-5®, Rad®-5v or SatShare® monitors. 
         [0005]    Advanced blood parameter measurement systems are described in at least U.S. Pat. 7,647,083, filed Mar. 1, 2006, titled Multiple Wavelength Sensor Equalization; U.S. Pat. No. 7,729,733, filed Mar. 1, 2006, titled Configurable Physiological Measurement System; U.S. Pat. Pub. No. 2006/0211925, filed Mar. 1, 2006, titled Physiological Parameter Confidence Measure and U.S. Pat. Pub. No. 2006/0238358, filed Mar. 1, 2006, titled Noninvasive Multi-Parameter Patient Monitor, all assigned to Cercacor Laboratories, Inc., Irvine, Calif. (Cercacor) and all incorporated in their entirety by reference herein. Advanced blood parameter measurement systems include Masimo Rainbow® SET, which provides measurements in addition to SpO 2 , such as total hemoglobin (SpHb™), oxygen content (SpOC™), methemoglobin (SpMet®), carboxyhemoglobin (SpCO®) and PVI®. Advanced blood parameter sensors include Masimo Rainbow® adhesive, ReSposable™ and reusable sensors. Advanced blood parameter monitors include Masimo Radical-7™, Rad-87™ and Rad-57™, Pronto-7® and Pronto® monitors, all available from Masimo. Such advanced pulse oximeters, low noise sensors and advanced blood parameter systems have gained rapid acceptance in a wide variety of medical applications, including surgical wards, intensive care and neonatal units, general wards, home care, physical training, and virtually all types of monitoring scenarios. 
       SUMMARY OF THE INVENTION 
       [0006]    Advantageously, a physiological status monitor provides information that allows a medical practitioner to visually discern patient condition at a glance. In an embodiment, a colored historical pie chart for a critical parameter, such as oxygen saturation, can be displayed for multiple patients. In another embodiment, multiple historical pie charts are displayed, depicting various parameters for a single patient so as to allow assessment of real time data and duration of time spent in various ranges. In particular, colored historical pie charts reflect visual representations of parameter histograms. Furthermore, colored pie charts may also represent alarm histories or medical personnel shifts. 
         [0007]    One aspect of a physiological status monitor displays historical physical information of patients side by side, visually compares the information and identifies patients in need of immediate medical attention. In various embodiments, the display divides the information into medical conditions including a normal condition and a serious condition and distinguishes the conditions with indicators. Comparing may comprise viewing the indicators and discerning a serious condition with an indicator representing a particular serious condition. Identifying may comprise determining a patient having a high percentage of a serious condition indicator as the one in need of immediate medical attention. A particular condition may be oxygen saturation status. Distinguishing may comprise assigning colors to the conditions or assigning objects to the conditions. 
         [0008]    Another aspect of a physiological status monitor is a monitor having an interconnected sensor. The sensor transmits optical radiation into a tissue site and generates a sensor signal responsive to the optical radiation after attenuation by pulsatile blood flow within the tissue site. The monitor computes a physiological parameter responsive to the sensor signal and utilizes a display to show the physiological parameter on screen. In an embodiment, the physiological status monitor comprises a monitor that determines a physiological parameter in response to an optical sensor signal derived from patients, a display incorporated with the monitor so as to present the physiological parameter, objects representing historical information regarding the physiological parameter over patients and a preferred screen presenting the objects side by side on the display for viewing by a caregiver so that the caregiver can visually discern and readily identify patients in need of immediate medical attention. 
         [0009]    In various embodiments, the objects are colored pie charts. Each of the pie charts have zones representing different medical conditions, wherein the zones are assigned colors to make a visual distinction. The physiological parameter is oxygen saturation. The colors comprise a green color indicating a normal condition, an orange color indicating an abnormal condition and a red color indicating a serious condition, wherein a patient corresponding to one of the pie charts having the most percentage of the red color is in need of a immediate medical attention. The objects are different shapes, wherein the shapes are filled in lines, dots, circle and square patterns to make a distinction for a color blind user. 
         [0010]    As used herein the term “display” is used to denote how a monitor screen appears on a physical monitor device. The term “monitor” is used as shorthand for a monitor screen and its associated appearance to someone viewing a physical monitor. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0011]      FIG. 1  is an illustration of a multiple-patient and a selected-patient physiological status monitor displaying a critical parameter, such as oxygen saturation, over time; 
           [0012]      FIG. 2  is an illustration of a single-patient physiological status monitor displaying multiple parameters, such as oxygen saturation, pulse rate, blood pressure, perfusion index, respiration rate and temperature over time; 
           [0013]      FIG. 3  is an illustration of a single-patient, single-parameter physiological status monitor displaying a parameter over time, where the pie chart colors correspond to assigned ranges for the parameter; 
           [0014]      FIG. 4  is an illustration of a single-patient, single-parameter physiological status monitor displaying time intervals that correspond to pie chart segments; 
           [0015]      FIG. 5  is an illustration of a single-patient, multiple-parameter physiological monitor displaying parameter alarm limits; 
           [0016]      FIG. 6  is an illustration of a single-patient, single-parameter physiological status monitor displaying parameter trends having integrated pie-chart summaries at specific time intervals; 
           [0017]      FIG. 7  is an illustration of a single-patient, single-parameter physiological status monitor displaying a pie-chart having a height that represents the total monitored time interval and pie slices that each represent the percentage of time a parameter is within the specified value range; and 
           [0018]      FIG. 8  is an illustration of single-patient, single-parameter physiological status monitor displaying iconic patterns utilized in lieu of colors, such as for a color blind user, a monochromatic display or high contrast display applications. 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       [0019]      FIG. 1  illustrates a physiological status monitor  100  having a multiple-patient display  110  and a selected-patient display  120  of a critical parameter, such as oxygen saturation, over time. Historical information of a critical parameter over a duration of time is advantageously displayed for multiple patients simultaneously so as to allow a caregiver to visually discern and readily identify one or more patients in need of immediate medical attention. Advantageously, multiple colored historical pie charts  110  are advantageously utilized to represent the historical information. In an embodiment, each pie chart  110  has zones  112 ,  114 ,  116  representing the percentage of time a parameter has been measured in a particular range of values. Each zone  112 ,  114 ,  116  is assigned a different color indicating a different medical condition so that a relative comparison is made by simply viewing the size of a particular slice. For example, a pie chart  110  having a large red slice may indicate the corresponding patient has been experiencing difficulties and is in need of immediate medical attention. 
         [0020]    As shown in  FIG. 1 , the exemplar parameter depicted in the pie charts  110  is oxygen saturation (SpO 2 ). In other embodiments, the display  100  may depict any of various alternative parameters, such as those described above and with respect to  FIG. 2 , below. In an embodiment, each pie chart  110  has a first zone  112  assigned to a safe green color indicating a normal oxygen saturation condition, a second zone  114  assigned to an orange color indicating an abnormal oxygen saturation condition and a third zone  116  assigned to a warning red color indicating a serious oxygen saturation condition. A normal patient condition is advantageously identified when the first zone  112  (green) is the largest slice of a pie chart, with the second zone  114  (orange) and the third zone  116  (red) being significantly smaller slices, such as shown with respect to pie charts  101  and  103 . That is, patients represented by the pie charts  101 ,  103  are in a normal condition over most of a specified time period, such as 12 hours. 
         [0021]    Also shown in  FIG. 1 , an abnormal, but not serious, patient condition is advantageously identified when the third zone  116  (red) occupies a significant portion, but less than half, of a pie chart and the other zones  112 ,  114  combined occupy more than half of the pie chart. An example is pie chart  105 , which a caregiver can readily identify at a glance as a patient needing an immediate medical assessment and further care. 
         [0022]    Further shown in  FIG. 1 , a serious patient condition is advantageously identified when the third zone  116  (red) occupies most of the pie chart, and the other two zones  112 ,  114  combined occupy less of the pie chart than the third zone  116 . As example is pie chart  107 , which a caregiver can readily identify at a glance as a patient in distress and in need of emergency medical attention. 
         [0023]    Additionally shown in  FIG. 1 , a selected-patient display  120  has a pie chart  130  mini screen and a graph  150  mini screen that provide more details regarding a selected patient than are available from the multiple patient display  110 . In particular, the pie chart  130  mini screen shows details of a particular pie chart  131  including the critical parameter  132 , a duration of time  134 , a histogram  136  and range categories  138 . The range categories  138  have predetermined value ranges and corresponding percentages of time that the selected parameter  132  spent in each range. Each range  138  is assigned to a color corresponding to that in the pie chart  130 . The percentages of time spent in each range  138  over the specified time duration  134  is automatically tracked and displayed. In this manner, the details of one pie chart  131  can be viewed with respect to parameter ranges  138  that each color represents. For example, a green color in the pie chart  131  represents an SpO 2  range of 93-85, and the patient spent 86% of time spent in this range. An orange color represents an SpO 2  range of 96-94 and 84-80 and the patient spent 10% and 0% of the time in those ranges, respectively. A red color represents an SpO 2  range of 100-97 and 79-0 and the patient spent 4% and 0% of the time in those ranges, respectively. 
         [0024]    Also shown in  FIG. 1 , the selected-patient display  120  has a graph mini-screen  150  showing further details of the pie chart  131 . The graph mini-screen  150  has a graph  152  showing parameter values versus time over a period, an upper alarm limit  153  and a lower alarm limit  155 . Thus, the specific times in an alarm state are illustrated. 
         [0025]      FIG. 2  illustrates a single-patient physiological status monitor  200  displaying multiple parameters, such as oxygen saturation, pulse rate, blood pressure, perfusion index, respiration rate and temperature over time. Advantageously, the display  200  allows a caregiver to view multiple parameter histories side-by side in a visually-rich format. In this manner, a caregiver can readily identify a patient having a serious medical condition or one incapable of adapting to a constantly changing medical environment. In particular, multiple-colored historical pie charts  210  are advantageously utilized to represent multiple parameters over time. Each colored pie chart  210  corresponds to a parameter and is a visual representation of the percentage of time spent in predetermined parameter ranges. Each range is assigned to a different color so that a serious medical condition can be rapidly discerned by simply comparing the multiplicity of the colors across the pie charts  210 . Specifically, pie charts  210  that have a rainbow of colors indicate physiological variability, which is a normal condition depending on the parameter. Pie charts  210  having only a single color, or just a few colors, indicate a patient that may not be adapting to their environment, which may indicate an abnormal condition depending on the parameter. 
         [0026]    As shown in  FIG. 2 , the display  200  has multiple-colored pie charts  210  representing parameters over time. In this embodiment, a SpO 2  pie chart  201 , a pulse rate (PR) pie chart  202 , a blood pressure (BP) pie chart  203 , a perfusion index (PI) pie chart  204 , a respiration rate (RR) pie chart  205  and a temperature (T) pie chart  206  are shown. The PR pie chart  202  has a rainbow of colors showing that the patient&#39;s pulse rate is constantly varying over time and indicating the patient is adapting to a varying environment in this respect. The T pie chart  206  has only a single color showing the patient&#39;s temperature is constant. The pie charts SpO 2    201 , BP  203 , PI  204  and RR  205  each has moderate color changes in between a rainbow style and a single color showing the measured parameters SpO 2 , BP, PI and RR are varying somewhat, but are not constantly varying over the monitored time duration. By viewing the color variety in pie charts  201 - 206 , the patient&#39;s condition may be determined as moderately good. Advantageously, the display of multiple parameters over time as colored pie charts may allow a ready determination of a patient&#39;s condition based upon color variability. If all or most of the pie charts  210  have a single color, the patient may have a serious condition in need of immediate medical attention. 
         [0027]      FIGS. 3-4  illustrate a single-patient, single-parameter physiological status monitor  300 ,  301  displaying a parameter over time, where the pie chart colors correspond to assigned ranges for the parameter. The displays  300 ,  301  track a single parameter  320  for a single patient over a period of time and includes a pie chart  310 , a parameter indicator  320  and time duration  330 . The pie chart  310  has different zones  312 ,  314 ,  316  representing ranges of parameter values  340 . Each zone  312 ,  314 ,  316  is assigned a different color so as to be easily viewed by a user. The parameter indicator  320  indicates the particular parameter depicted in the charts, such as SpO 2 , HbCO, HbMet, Hbt, Hct, PI or PVI, to name a few. 
         [0028]    As shown in  FIG. 3 , the single-patient, single parameter monitor  300 ,  301  has parameter value ranges  340  ( FIG. 3 ) and the associated percentage of time  350  ( FIG. 3 ) the parameter  320  spends in each range  340 . Each of the ranges  340  is assigned a corresponding color in the pie chart  310 . In this manner, the details of each zone (color) can be viewed. For example, a green zone  312  indicates a normal condition, i.e. SpO 2  in the range of 85-100%, an orange zone  314  indicates an abnormal condition, i.e. SpO 2  in the range of 84-80%, and a red zone  316  indicates a serious condition, i.e. SpO 2  below 79%. 
         [0029]    As shown in  FIG. 4 , an alternative display  301  shows sequential time intervals  360  in the two unsafe zones  314 ,  316  of the pie chart  310 . These unsafe intervals  360  are shown sequentially. When scrolled down, the display  360  shows all of the intervals in the two unsafe zones  314 ,  316  until reaching the total duration of time. The intervals  360  have colors corresponding to the colors in the two unsafe zones  314 ,  316  so as to provide the details of specific times spent in the unsafe zones. In another embodiment, the display  301  shows the longest intervals in the dangerous zone  316  of the pie chart  310 . By repeatedly clicking on the intervals, smaller intervals in the dangerous zone  316  are shown. In yet another embodiment, the display  301  shows intervals sequentially in all zones  312 ,  314 ,  316  of the pie chart  301 . The totality of intervals are shown by scrolling down the display  360  until the time duration  370  is displayed. 
         [0030]      FIG. 5  illustrates a single-patient, multiple-parameter physiological monitor  500  displaying parameter alarm limits. The display  500  has a pie chart  510 , an indicator of duration of time  520 , a parameter value  540  and alarm limits  550 . The pie chart  510  has a zone  512  assigned in a distinct color, red, for example, representing a percentage of time in alarm during the duration of time. The alarm limits  550  are displayed next to the actual parameter value  540  having a lower limit  552  and an upper limit  554 . An alarm is activated when the limits  552 ,  554  are exceeded. 
         [0031]    Also shown in  FIG. 5 , the display  500  has a graph  570  showing the parameter values versus time during the duration of time and thus the specific times in alarm are shown. By repeatedly clicking the graph  570 , the rest of the times can be shown until the end of the recorded time duration is reached. For example,  FIG. 5  shows the lower limit  552  is  83  and no upper limit  554 . Because the graph  570  does not exceed the lower limit  83  between 8:00 to 9:00, no alarm is activated during this period of time. By clicking the graph  570 , other values and times in alarm will be shown until reaching the duration of 12 hours. 
         [0032]      FIG. 6  illustrates a single-patient, single-parameter physiological status monitor  600  displaying parameter trends having integrated pie-chart summaries at specific time intervals. The display  600  has a trend line  610  with integrated pie-chart summaries  612  at specific time intervals. The display  600  also has a parameter indicator  620 , a duration of time  630  and a shift timeline  640 . The parameter indicator  620  corresponds to the trend line  610  and pie chart summaries  612 . The duration of time  630  is the duration of the trend line  610 . The trend line  610  has a plurality of pie charts  612  indicating a patient&#39;s parameter levels for each of the shifts over the shift duration. This trend line  610  advantageously provides an overview of each staff shift with respect to difficulty or success in patient management. In particular, the trend line  610  indicates acceptable levels of patient condition during each staff shift. This provides hospital or a medical institution feedback of medical care efficacy. For example, the monitor  600  advantageously provides information regarding which shift is maintaining the better patient management and which staff members are maintaining better patient management. 
         [0033]    As shown in  FIG. 6  as an example, six shifts and associated pie charts are displayed  600 . Shift 3 had difficulty with this patient. However, the patient improved over his three day stay across the different shifts. 
         [0034]      FIG. 7  illustrates a single-patient, single-parameter physiological status monitor  700  has a pie chart  710 , a parameter indicator  720  and a duration of time indicator  730 . The pie-chart  710  has a height  705  that represents the total monitored time interval and pie slices  712 ,  714 ,  716  that each represent the percentage of time  750  a parameter is within the specified value range  740 . The pie chart  710  is a histogram over a duration of time  730 , such as 24 hours. The pie chart  710  has different zones  712 ,  714 ,  716  indicating percentage of time  750  spent in each of the different value ranges  740 . Each zone  712 ,  714 ,  716  is assigned to a different color so as to be easily viewed by a user to determine, at a glance, an overview of a patient&#39;s condition over a time interval. 
         [0035]    For example, in the pie chart  710 , a safe green color  712  indicates a normal condition occurring 75% of the time. An orange color  714  indicates an abnormal condition occurring 17% of the time. A red color  716  indicates a dangerous condition occurring 8% of the time. Accordingly, the details of the pie chart  710  are viewed in the range chart  740 ,  750  showing 9% of time spent in a SpO 2  range of 100-97, 66% of time spent in a range of 96-94, 9% in a range of 93-95, 8% in a range 84-80 and 8% in a range of 79-0. 
         [0036]      FIG. 8  illustrates a single-patient, single-parameter physiological status monitor  800  displaying iconic patterns utilized in lieu of colors, such as for a color blind user, a monochromatic display or a high contrast display. The display  800  has different shapes  810  representing percentages of time in each condition instead of a pie chart. Further, each shape  810  has lines, dots, circle patterns to distinguish each other rather than different colors assigned in a pie chart. Accordingly, value ranges  820  and percentages of time  830  have corresponding lines, dots, circle and square patterns, instead of different colors, assigned to each range. 
         [0037]    A physiological status monitor has been disclosed in detail in connection with various embodiments. These embodiments are disclosed by way of examples only and are not to limit the scope of the claims that follow. One of ordinary skill in art will appreciate many variations and modifications.