Patent Publication Number: US-2012032808-A1

Title: Connector for patient monitoring device

Description:
FIELD OF INVENTION 
     This invention relates generally to a patient monitoring device and in particular to a patient monitoring device which produces an alarm to alert a caregiver when the patient moves into an undesirable position. 
     BACKGROUND OF INVENTION 
     In a variety of settings, such as in hospitals, hospices, nursing homes, home care, and other types of health care institutions, patients are monitored, often continuously, by doctors, nurses, and other support staff. In many circumstances, it may be impractical for one caregiver to monitor only one patient. It is more common, for example, in a nursing home, for a nurse to be assigned to care for and monitor 10 to 20 patients. 
     Various types of patient monitoring devices are known to assist a caregiver when the caregiver is monitoring more than one patient at a time. These types of monitoring devices may alert the caregiver when a particular patient may require the caregiver&#39;s immediate attention. For example, a patient monitoring device may include a pressure sensor and will alert a caregiver with a warning sound if a patient falls and/or moves away from the pressure sensor. 
     Another type of patient monitoring device, known as a pull cord alarm, mechanically couples a patient (or the patient&#39;s clothing) to an alarm that will alert a caregiver if the patient is decoupled from the alarm. For example, one type of pull cord alarm monitoring device  10  is illustrated in  FIGS. 1-2 . The monitoring device  10  includes a clip  30  coupled to a warning system  20  through a cord  32 . As shown in  FIG. 2 , the cord  32  includes a male end/plug  34  which is inserted into a female end/receptacle  36  in the warning system  20  to couple the cord  32  directly to the warning system  20 . The clip  30  is configured to be coupled to a patient, for example, by directly attaching to the patient&#39;s clothing. When the patient moves away from the warning system  20 , the male end  34  of the cord  32  pulls out of the warning system  20 , thus decoupling the patient from the warning system  20  and activating an alarm. 
     Another type of pull cord alarm monitoring device is illustrated in  FIG. 3 . This monitoring device  40  similarly includes a clip  30  coupled to a warning system  20  through a cord  32 . Instead of a male/female attachment of the cord  32  directly to the warning system  20 , the cord  32  is magnetically coupled to the warning system. For example, the end of the cord  32  may include a magnet  38  which is attracted to a magnet (not shown) associated with the warning system  20 . When a patient moves away from the warning system, the cord  32  and magnet  38  pull away from the warning system  20 , thus decoupling the patient from the warning system and activating an alarm. 
     SUMMARY OF INVENTION 
     In one aspect, a patient monitoring device for use with a patient and a caregiver is disclosed. The monitoring device includes a warning system configured to provide an alarm to indicate, to a caregiver, a change in the position of a patient, a tether extending outwardly from the warning system, and a clip configured to be removably coupled to the tether and removably coupled to the patient, where the warning system is configured to activate the alarm when the clip is decoupled from the tether. 
     In another aspect, a patient monitoring device for use with a patient and a caregiver is disclosed. The monitoring device includes a warning system configured to provide an alarm to indicate, to a caregiver, a change in the position of a patient, a clip configured to be non-magnetically removably coupled to the warning system and removably coupled to the patient, where the warning system is configured to activate the alarm when the clip is decoupled from the warning system. The clip is flexibly connected to the warning system such that the clip may be decoupled from the warning system at a pull angle range of at least approximately 180 degrees. 
     In yet another aspect, a method of monitoring a patient by a caregiver is disclosed. The method includes attaching a clip of a patient monitoring device to a patient, where the patient monitoring device includes a warning system configured to provide an alarm, a tether extending outwardly from the warning system, and a clip configured to be removably coupled to the tether, and activating the alarm when the clip is decoupled from the tether. 
     In yet another further aspect, a patient monitoring device for use with a patient and a caregiver is disclosed. The monitoring device includes a warning system configured to provide an alarm to indicate, to a caregiver, a change in the position of a patient, and a first tether extending outwardly from the warning system at one end and being configured to be attached to a patient at another end, the first tether having associated therewith a first receptacle into which a first plug is inserted, the first plug being pulled from the first receptacle when a certain force is applied thereto resulting from patient movement, to activate the warning system with a first alarm. The monitoring device further includes a second tether extending outwardly from the warning system at one end and being configured to be attached to the patient at another end. Associated with the second tether is a second receptacle into which a second plug is inserted. The second plug is pulled from the second receptacle only after the first plug is pulled from the first receptacle upon continued movement of the patient to activate the warning system with a second alarm. In one embodiment, a first clip is provided which is configured to be removably coupled to the patient and to one of the first receptacle and the first plug. A second clip may also be provided and is configured to be removably coupled to the patient and one of the second plug and second receptacle. In another embodiment, one of the second plug and second receptacle is configured to be coupled to the first clip. In yet another embodiment, the second tether is longer than the first tether. In another further embodiment, the second plug requires a force to be pulled from the second receptacle that is greater than the force required to pull the first plug from the first receptacle. In yet another embodiment, when the first plug is pulled from the first receptacle, a light is activated for illuminating an area around the patient. 
     Various embodiments provide certain advantages. Not all embodiments share the same advantages and those that do may not share them under all circumstances. 
     Further features and advantages, as well as the structure of various embodiments that incorporate aspects are described in detail below with reference to the accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
       The accompanying drawings are not intended to be drawn to scale. In the drawings, each identical or nearly identical component that is illustrated in various figures is represented by a like descriptor. For purposes of clarity, not every component may be labeled in every drawing. 
       Various embodiments will now be described, by way of example, with reference to the accompanying drawings, in which: 
         FIG. 1  is a perspective view of a prior art patient monitoring device; 
         FIG. 2  is a side view of a portion of the prior art patient monitoring device shown in  FIG. 1 ; 
         FIG. 3  is a perspective view of another prior art patient monitoring device; 
         FIG. 4  is a perspective view of a patient monitoring device according to one embodiment; 
         FIG. 5  is a side view of a patient monitoring device according to one embodiment; 
         FIG. 6  is a perspective view of another embodiment of a patient monitoring device; 
         FIG. 7  is a perspective view of yet another embodiment of a patient monitoring device; 
         FIG. 8  is a perspective view of a patient monitoring device according to yet another embodiment; and 
         FIG. 9  is a perspective view of a patient monitoring device according to yet another further embodiment. 
     
    
    
     DETAILED DESCRIPTION 
     Applicant recognized that there are some drawbacks associated with some of the above-mentioned pull cord patient monitoring devices. For example, with the monitoring device  10  shown in  FIGS. 1-2 , the angle of the pull cord  32  relative to the warning system  20  may affect whether the cord  32  pulls out from the warning system  20  and activates an alarm. In particular, Applicant recognized that when the cord  32  is pulled at an angle that is approximately parallel to the male plug  34  (i.e. when the cord is substantially perpendicular to the top plane of the warning system  20  shown in  FIG. 2 ), the male plug  34  may more easily pull out of the female receptacle  36  decoupling the patient from the warning system and activating an alarm. However, as the angle of the cord  32  is varied, the amount of force needed to pull the cord  32  out of the warning system  20  may increase. Applicant recognized that the cord  32  cannot be pulled out of the warning system when the cord is substantially parallel to the top plane of the warning system. Applicant determined that for a pull cord patient monitoring device having a male plug  34  attachment to the warning system  20 , the cord  32  has an effective pull angle range A (see  FIG. 2 ), which, with one particular type of monitoring device, is approximately 90°. When the cord  32  is oriented outside of the effective pull angle range, for example, due to the position of the patient, it may be more difficult to decouple the cord from the warning system. This may lead to undesirable results such as pulling or tension on the patient as the patient moves away from the warning system, decoupling of the clip from the patient which may not cause the alarm activate, and/or pulling and even dragging of the warning system in the direction of the patient. 
     Applicant recognized that there are also drawbacks associated with a magnetic pull cord patient monitoring devices, such as that disclosed above and shown in  FIG. 3 . For example, there are various circumstances where magnets are undesirable and/or cannot be used, such as, but not limited to in a cardiac intensive care unit because the magnets may affect devices, such as pacemakers. 
     Thus, aspects of the present invention are directed to pull cord patient monitoring devices that do not suffer from some of the above-mentioned drawbacks. In particular, as discussed in greater detail below, a pull cord patient monitoring device is provided that has a wider effective pull angle range. For example, in one embodiment, a patient monitoring device is provided that has an effective pull range angle of at least 180°. In this respect, the monitoring device is configured such that the clip/cord may be decoupled from the warning system when the clip/cord is substantially parallel to the surface of the enclosure for the warning system to which the cord is coupled, or even if the clip/cord drops below the surface of the enclosure for the warning system to which it is coupled to form an angle of greater than 180 degrees with respect to that surface. Typically, the cord is made of a flexible material, although it need not be. Furthermore, as discussed below, a non-magnetic patient monitoring device is provided. 
     As set forth below, the present invention is directed to a patient monitoring device that has a warning system which is configured to provide an alarm if a patient moves outside of a defined area. The monitoring device includes at least one clip which is configured to be removably coupled to the patient and the warning system is configured to activate the alarm when the clip is decoupled from the warning system. In this respect, the monitoring device activates an alarm to alert a caregiver if the position or location of the patient deviates undesirably. 
     In one aspect, the present invention is directed to a patient monitoring device for less critical types of patient monitoring. In one embodiment, the patient monitoring device detects when a patient is slouching in his/her seat. The patient monitoring device may also be employed to detect sacral sitting or forward sliding, which are common problems with a patient sitting in a wheelchair. In another embodiment, the monitoring device detects when a patient may be about to slide or fall out of his/her chair or bed. In yet other embodiments, the monitoring device detects when a patient has wandered away from his/her bed or chair. The patient monitoring device may be used to detect a variety of different types of changes in the patient&#39;s position and/or location depending upon the particular desired application. 
     It should be appreciated that the term “patient” refers to anyone who may be monitored, and may include for example people in either outpatient and inpatient care, as well as people being treated at nursing homes, hospitals, doctor&#39;s offices, etc. It should be recognized that a “patient” may also be used to describe a person in a home care setting. Furthermore, the term “caregiver” may refer to anyone who is monitoring a patient. A representative but not limiting list of types of caregivers includes doctors, nurses, hospital or nursing home support staff, and home caregivers. 
       FIG. 4  illustrates one embodiment of a pull cord patient monitoring device  50  according to the present invention. In this embodiment, monitoring device  50  has a clip  30  or a similar device that is configured to be coupled to a patient, for example, by directly attaching to the patient&#39;s clothing, and a warning system  20  that is configured to provide an alarm to indicate a change in the position of the patient. The monitoring device  50  further includes a tether  52  coupled to and extending outwardly from a surface or wall of the warning system  50 . Warning system  50  may include a top wall  24  and side walls  26 . In the embodiment of  FIG. 4 , tether  52  extends from top wall  24 . The clip is configured to be removably coupled to the tether  52  and the warning system is configured to activate the alarm when clip  30  is decoupled from tether  52 .  FIG. 4  illustrates one embodiment where clip  30  is decoupled from tether  52 . 
     Clip  30  may be removably coupled to tether  52  in a variety of ways as the invention is not limited in this respect. In one illustrative embodiment, a cord  54  extends out from clip  30  and clip  30  is removably coupled to tether  52  through the cord  54 . In one particular embodiment, the end of cord  54  includes a male end/plug  56  and the end of tether  52  includes a female end/receptacle  58  which is configured to receive plug  56  to removably couple clip  30  to tether  52 . It should be appreciated that in another embodiment, the male end of the removable connection may be located on the tether and the mating female end may be located on the clip or cord as the invention is not so limited. Furthermore, the invention also contemplates other types of mechanical couplings such as, but not limited to various hook and loop fasteners, such as VELCRO®, snaps, buckles and the like. As shown, when the patient moves away from warning system  20 , end  56  of cord  54  pulls out of receptacle  58  in tether  52 , thus decoupling the patient from warning system  20  and activating an alarm. 
     As illustrated in  FIG. 5 , in one embodiment, tether  52  is configured such that clip  30  may be decoupled from the warning system  20  at a pull angle range B of at least approximately 180 degrees, and in some embodiments at a pull angle B of greater than 180 degrees. Pull angle B is the angle tether  52  forms with respect to the surface of system  20  to which tether  52  is coupled when a pull force is applied to tether  52 . As mentioned above and as illustrated in  FIG. 2 , one of the drawbacks associated with some of the prior art pull cord patient monitoring devices is that because male plug  34  is inserted directly into a surface of warning system  20 , cord  32  has an effective pull angle range A with respect to that surface (see  FIG. 2 ), in one particular type of monitoring device, of only approximately 90°. When cord  32  is oriented with respect to that surface outside of the effective pull angle range, it may be more difficult to decouple the cord from the warning system. 
     Applicant recognized that by incorporating tether  52  into the warning system  20 , a patient monitoring device is provided which has a wider effective pull angle range B. 
     In this respect, the position of the patient, and thus the orientation of clip  30 , cord  54 , and/or tether  52  may not undesirably affect the amount of force needed to decouple the clip from the warning system. As shown in  FIG. 5 , in one embodiment, a patient monitoring device is provided where the clip is flexibly connected to the warning system such that the clip may be decoupled from the warning system with a pull range angle B of at least approximately 180°. As shown in  FIG. 5 , this angle B may extend out at one end in a first direction substantially parallel to the surface of the warning system to which the tether is attached, and at the other end of the pull range angle B in a second direction that is opposite of the first direction. In this respect, the monitoring device is configured such that the clip/cord may be decoupled from the warning system when the clip/cord is substantially parallel to the surface of the warning system to which the tether is attached in multiple directions. It is also contemplated that the patient monitoring device may be configured such that the clip/cord may be decoupled from the warning system when the clip/cord is positioned below or behind an imaginary surface extending from and substantially parallel to the surface of the warning system to which the tether is attached, such as a plane extending from and substantially parallel to surface  24 . In one embodiment, a patient monitoring device is provided where the clip is flexibly connected to the warning system such that the clip may be decoupled from the warning system with a pull range angle B of at least approximately 360°. In such an embodiment, the clip/cord may be moved into a wide variety of orientations relative to the surface of the warning system to which the tether is attached while still being capable of decoupling from the warning system to activate the alarm. 
     The configuration of tether  52  may vary as the invention is not limited in this respect. In one embodiment, tether  52  is made from a flexible material. For example, tether  52  may be sufficiently flexible to allow it to flex or bend to be parallel to surface  24  or even to allow it to bend around the edges of surface  24  so that clip  30  is disposed below a plane extending from and substantially parallel to surface  24 . In another embodiment, tether  52  may be made from materials such as, but not limited to, a wire coated with an insulating material, such as a plastic material. In another embodiment, tether  52  is made from a substantially rigid material, such as, but not limited to a metal or plastic tube. When tether  52  is made from a substantially rigid material, it is contemplated that there may be one or more swivel joints either as part of tether  52  and/or at one of the ends of tether  52  to enable tether  52  to flexible connect the clip to the warning system. 
     It is contemplated that the stiffness of tether  52  may be substantially uniform throughout the length of tether  52 . It is also contemplated that the stiffness of tether  52  may vary across the length of tether  52 , for example, by varying the cross-sectional thickness and/or varying the material. As shown in  FIG. 6 , it is also contemplated that a sleeve  60  may be placed over all or portions of tether  52  to vary the stiffness of tether  52 . 
     The length of tether  52  may also vary according to various embodiments of the present invention. For example, in one embodiment, tether  52  may be approximately 2-6 inches in length, whereas in another embodiment, tether  52  may be at least approximately 1 foot in length, at least approximately 2 feet in length, at least approximately 3 feet in length, and at least approximately 4 feet in length. In one embodiment, the length of the tether is adjustable so that the caregiver may adjust the length of tether  52  based upon the patient and/or the particular patient setting. For example, if the patient is sitting on a chair, the length of tether  52  may be adjusted to enable to patient to be able to lean forward and/or back and shift his/her weight around in the chair without activating the alarm. In another embodiment, the length of tether  52  may be adjusted to allow the patient to stand up and/or walk around the warning system without activating the alarm. 
     In one embodiment, tether  52  includes a channel therethrough. As shown in  FIG. 4 , in one embodiment, the channel may form receptacle  58  which is configured to receive plug  56 . The channel through tether  52  may also include one or more components which enable warning system  20  to detect when plug  56  (and thus clip  30 ) is decoupled from receptacle  58 . For example, there may be a mechanical or electrical switch which is configured to activate the alarm in warning system  20  when plug  56  is decoupled from receptacle  58 . Thus, it is contemplated that one or more electrical wires may extend within the channel. One of skill in the art of pull cord patient monitoring devices will recognize that there are a variety of ways in which the alarm may be activated, and the invention is not limited in this respect. 
     As shown in  FIGS. 4-6 , in one embodiment, tether  52  may be coupled to a top surface  24  of the warning system  20 . However, the invention is not so limited. As shown in  FIG. 7 , in another embodiment, tether  52  is coupled to a side surface  26  of warning system  20 . It should be appreciated that the tether may be coupled to any surface of the warning system. 
     Furthermore, tether  52  may be either permanently or removably coupled to warning system  20  as the invention is not so limited. For example, in one embodiment, tether  52  may be permanently coupled to warning system  20  (i.e. tether  52  is not readily removable from the warning system), such as with adhesive, interlocking components, or integrally formed components. In another embodiment, tether  52  may be removably coupled to the warning system, such as by way of one of the above-mentioned plug  56  and receptacle  58 . However, it should be appreciated that in an embodiment where tether  52  is removably coupled to warning system  20 , the force required to disconnect or decouple the connection between the tether  52  and the warning system  20  should be greater than the force required to decouple plug  56  from receptacle  58 . In this respect, when the patient moves into a position that is outside of the boundaries designated by the monitoring device, the device should be configured such that plug  56  decouples from receptacle  58  to activate the alarm, rather than have the tether  52  decouple from the warning system  20  which may not activate the alarm. 
     Clip  30  may be any type of attachment device, as the invention is not limited in this respect. In one illustrative embodiment, clip  30  is similar to an alligator clip and it is configured to attach to the patient&#39;s clothing. It is contemplated that clip  30  may include one or more locking features to prevent the clip from detaching from the patient before plug  56  decouples from receptacle  58  (for example, either by the patient removing the clip and/or due to the clip sliding off of the patient&#39;s clothing). Other types of clips that may be used include any type of mechanical fastener, such as, but not limited to, a clothespin, a safety pin, a button, a snap, a hook and loop fastener, a strap or the like. 
     In other embodiments, as shown in  FIGS. 8 and 9 , a second tether may be provided. Referring now to  FIG. 8 , a second tether  62  may extend independently of tether  52  from warning system  20 . A clip  68  may be attached to a cord  67  which may include a male plug  64 . A female end/receptacle  66  is configured to receive plug  64  to removably couple the clip  68  to tether  62 . In one embodiment, the combination of tether  62  and cord  67  may be longer than the combination of cord  54  and tether  52 , so that when the patient first begins to move, plug  56  decouples from receptacle  58  before plug  64  decouples from receptacle  66 . Only when the patient moves a greater distance does plug  64  decouple from receptacle  66 . This could allow a staged alarm system. When plug  56  decouples from receptacle  58 , a first alarm could be sounded. This alarm could be a gentle alarm, such as a flashing light, or a low decibel audio signal. When plug  64  decouples from receptacle  66 , a louder signal, or a brighter light, or even a strobe light could be utilized to provide a signal providing a higher level of alert to the caregiver, or even to the patient who may be unaware of any danger that might befall him/her. In another embodiment, the combination of tether  62  and cord  67  may be about the same length as the combination of tether  52  and cord  54 , but the force required to pull plug  64  from receptacle  66  is greater than the force required to pull plug  56  from receptacle  58 . This result could be achieved by providing a tighter fit between plug  64  and receptacle  66  than the fit between plug  56  and receptacle  58 . A tighter fit could be produced by making the outer diameter of plug  64  with respect to the inner diameter of receptacle  58  somewhat larger than the diameter of plug  56  with respect to receptacle  58 . This result can also be achieved by providing a friction between plug  64  and receptacle  66  that is greater than the friction between plug  56  and receptacle  58 , in a manner well known to those of skill in the art. More force would be required to separate plug  64  from receptacle  66  than would be required to separate plug  56  from receptacle  58 . 
     In the embodiment of  FIG. 9 , tether  70  may extend from tether  52  at a location  76  spaced from warning system  20 . In this embodiment, cord  77  could rejoin cord  54  at a location between plug  56  and clip  30 . The electrical wiring in tether  70  and cord  77  would be independent of the electrical wiring in tether  52  and cord  54 , but tether  70  could be bundled with tether  52  at location  76  as long as the wiring in each tether was insulated from the wiring in the other tether. Like the embodiment of  FIG. 8 , tether  70  and cord  77  together could have a length somewhat greater than that of tether  52  and cord  54  together to allow plug  56  to disengage from receptacle  58  prior to disengagement of plug  74  from receptacle  72 . In an alternative embodiment, the fit between plug  74  and receptacle  72  could be tighter, or have a greater level of friction than that between plug  56  and receptacle  58  so that plug  74  is pulled from receptacle  72  at a time after plug  56  is pulled from receptacle  58  and only in response to greater movement by the patient. In yet another embodiment (not shown), tether  70  could join with tether  52  at point  76 , but could be provided with its own clip at the end of cord  77  to be attached to the patient. It is also contemplated that more than two tethers, such as three or four tethers, could be provided having different lengths, or requiring different amounts of force to separate the plug from the receptacle to provide varying levels of urgency in the alarm produced. 
     Warning system  20  may be in the same room as the patient and is configured to provide an alarm to alert a caregiver when plug  56  is decoupled from receptacle  58  or when plugs  64  and  74  are decoupled from receptacles  66  and  72 , respectively, to detect a change in the position and/or location of a patient. In another embodiment, the alarm may be produced at a remote site, such as a nurses station  44 , either in addition to warning system  20  or instead of warning system  20 . Warning system  20  may be configured to produce an auditory alarm and/or a visual alarm. In one embodiment, warning system  20  may include an auditory alarm which is produced by speaker  22 . An auditory alarm may produce a beeping sound, a siren sound, an intermittent sound, or a continuous sound. The auditory alarm may also include other sounds to alert a caregiver, such as an automated voice recording, a chime, or a tone. A visual alarm may include a light which may either be flashing or steady. A visual alarm could also include a strobe light. In other embodiments, the visual and/or auditory alarms may include other types of known alarms featured in various conventional alarm systems. If warning system  20  includes both an auditory and a visual alarm, warning system  20  may be configured so that a caregiver can select the type of alarm which will be activated. Furthermore, warning system  20  may include different settings to adjust the volume and/or brightness of the alarm. For example, in one embodiment, where the alarm is an auditory alarm, the caregiver may be able to adjust the volume of the alarm between, for example, 100 dB and 90 dB. Varying levels of urgency could be provided such as by varying the loudness in an audible alarm or by varying the levels of brightness in a visual alarm. Different colors could also be used or a pulsing or strobe light could be employed to provide a greater sense of urgency in a visual alarm. 
     In another aspect, as shown in  FIGS. 8 and 9 , a light  46  may be activated when movement of a patient is detected. Light  46  may be activated either in addition to an alarm, or in place of the alarm. Light  46  provides illumination adjacent the patient, or in the room in which the patient is located, so that the patient may avoid injuring himself or herself as the patient moves from one location to another. In one embodiment, light  46  is used in conjunction with the embodiments of  FIGS. 8 and 9 , and is activated when plug  56  is separated from receptacle  58  but before plug  64  is separated from receptacle  66 , or before plug  74  is separated from receptacle  72 . In this way, a light  46  may be illuminated to assist the patient without setting off an alarm. In another embodiment, light  46  may be used in conjunction with an alarm. If the patient continues to move, light  46  remains illuminated, but as plug  64  is pulled from receptacle  66  or as plug  74  is pulled from receptacle  72 , an alarm is set off indicating additional movement of the patient. 
     The patient monitoring device of the present invention may be either battery powered or powered by a standard AC current. The embodiments illustrated in  FIGS. 4 ,  8  and  9  may be battery powered and may require batteries in warning system  20 . 
     It should be appreciated that various embodiments may be formed with one or more of the above-described features. The above aspects and features may be employed in any suitable combination as the present invention is not limited in this respect. It should also be appreciated that the drawings illustrate various components and features which may be incorporated into various embodiments. For simplification, some of the drawings may illustrate more than one optional feature or component. However, the invention is not limited to the specific embodiments disclosed in the drawings. It should be recognized that the invention encompasses embodiments which may include only a portion of the components illustrated in any one drawing figure, and/or may also encompass embodiments combining components illustrated in multiple different drawing figures. 
     It should be understood that the foregoing description of various embodiments are intended merely to be illustrative thereof and that other embodiments, modifications, and equivalents of the invention are within the scope of the invention recited in the claims appended hereto.