Patent Publication Number: US-2013239038-A1

Title: Visual indication of alarms on a ventilator graphical user interface

Description:
RELATED APPLICATIONS 
     This application claims benefit under 35 U.S.C. §119(e) to U.S. Provisional Application No. 61/287,914 entitled “Graphical User Interface for Use on Medical Ventilator” filed on Dec. 18, 2009 the entire disclosure of all of which is hereby incorporated herein by reference. 
    
    
     INTRODUCTION 
     A ventilator is a device that mechanically helps patients breathe by replacing some or all of the muscular effort required to inflate and deflate the lungs. During ventilation, the ventilator may be configured to generate various alarms upon detecting a change in the patient&#39;s condition, a malfunction of the ventilatory equipment, or other indication that clinician intervention may be warranted. Thus, alarms generally function to alert a clinician of an abnormal or unsafe condition that may impact the patient. In this sense, alarms are a very important and necessary feature of any therapeutic instrument. However, alarms may not convey enough information regarding which alarms need to be alleviated first. In addition, multiple simultaneous alarms may compound this insufficiency of alarm information, costing the clinician valuable time while deciding which alarm to address first. 
     Visual Indication of Alarms on a Ventilator Graphical User Interface 
     The disclosure describes improved systems and methods for displaying alarms to a clinician in a ventilatory system. Specifically, embodiments described herein seek to optimize the informative presentation of alarms on a ventilator interface. Embodiments of the present disclosure may provide one or more selection elements, each selection element indicating a summarized alarm message. The summarized alarm message may include a parameter indication, an alarm event indication, and an alarm level indication. The one or more summarized alarm messages are associated with ranked alarm events. The most highly ranked alarm event is displayed in a selection element at the top of a hierarchical display, with the next most highly ranked alarm event displayed below it in descending order of rank. An alarm event&#39;s ranking is determined, first by the alarm level. In some embodiments, alarm events are associated with high, medium or low alarm levels. If an alarm event is the only alarm event associated with a high alarm level, it will be ranked highest and displayed in the selection element at the top of the hierarchical display. However, if two alarm events are both associated with a high alarm level, a ranking determination is made by comparing the parameter priority associated with each alarm event. Each ventilatory parameter is assigned a priority level. In the case of identical alarm levels, the alarm event associated with the parameter with the highest parameter priority will be ranked higher. 
     Alarm event rankings can change over time. For example, an alarm level for a given alarm event can elevate or de-elevate, depending on the condition of the patient. When an alarm event&#39;s ranking changes, the hierarchical display of alarm events is rearranged to reflect the new ranking. As will be appreciated, all alarm events, such as an alarm event with a low ranking, may not be provided in the graphical display. As a result, if an alarm event&#39;s ranking drops enough, it may disappear from the graphical display completely and a new alarm event may replace it. In some embodiments, the rearrangement is displayed by “floating” the alarm messages either up or down the hierarchical display based on whether the ranking has increased or decreased. 
     Other embodiments of the present disclosure provide for an expanded alarm message. Upon accessing a selection element in the hierarchical display, a clinician can ascertain more information about the alarm event including, but not limited to, suggested alarm alleviation measures, detailed alarm event description, and a hyperlink to an alarm settings window. In one embodiment, a clinician can access the hyperlink to access an alarm settings window providing more information about all the alarms. As discussed above, the graphical display may not display all currently emitting alarms. The alarm settings window provides the clinician with information about all currently emitting alarms with user adjustable parameters. The alarm settings window may also provide the clinician with an opportunity to adjust alarm settings for each ventilatory parameter. 
     Other embodiments of the present disclosure provide for an alarm log window. The alarm log window provides a clinician with a temporal log of all alarm events. In one embodiment, the alarm log window records all alarm events since manual reset of the ventilator. In another embodiment, the alarm log window records all alarm events since the ventilator began monitoring a new patient. 
     These and various other features as well as advantages which characterize the systems and methods described herein will be apparent from a reading of the following detailed description and a review of the associated drawings. Additional features are set forth in the description which follows, and in part will be apparent from the description, or may be learned by practice of the technology. The benefits and features of the technology will be realized and attained by the structure particularly pointed out in the written description and claims hereof as well as the appended drawings. 
     It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory and are intended to provide further explanation of the invention as claimed. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The following drawing figures, which from a part of this application, are illustrative of described technology and are not meant to limit the scope of the invention as claimed in any manner, which scope shall be based on the claims appended hereto. 
         FIG. 1  is a diagram illustrating an embodiment of an exemplary ventilator connected to a human patient. 
         FIG. 2  is a block-diagram illustrating an embodiment of a ventilatory system having a graphical user interface for displaying structured and informative alarms. 
         FIG. 3  is an illustration of an embodiment of a user interface for hierarchically indicating alarms on a graphical display. 
         FIG. 4  is an illustration of an embodiment of a user interface for displaying an expanded alarm tab. 
         FIG. 5  depicts an alarm setup window for display in user interface. 
         FIG. 6  depicts an alarm log window for display in user interface. 
     
    
    
     DETAILED DESCRIPTION 
     Although the techniques introduced above and discussed in detail below may be implemented for a variety of medical devices, the present disclosure will discuss the implementation of these techniques for use in a mechanical ventilator system. The reader will understand that the technology described in the context of a ventilator system could be adapted for use with other therapeutic equipment having user interfaces, including graphical user interfaces (GUIs), for prompt startup of a therapeutic treatment. 
     This disclosure describes systems and methods for displaying alarms to a clinician in a ventilatory system. Specifically, embodiments described herein seek to optimize the informative presentation of alarms on a ventilator interface. Embodiments of the present disclosure may provide one or more selection elements, each selection element indicating a ranked alarm event. The ranking of an alarm event may be determined by alarm level. If two alarm events are associated with the same alarm level, the ranking of the alarm events may be determined by parameter priority. Alarm event ranking is communicated by display in a hierarchical structure. When an alarm event ranking changes, the alarm event may shift up or down the hierarchical structure, depending on whether the ranking increased or decreased. 
     As such, the present disclosure provides an institution or clinician with optimal control over routine ventilatory settings. Specifically, routine layout configuration settings may be preconfigured according to a hospital-specific, clinic-specific, physician-specific, or any other appropriate protocol, Moreover, layout configuration settings may be changed and edited in response to a particular patient&#39;s changing needs and/or condition. 
       FIG. 1  illustrates an embodiment of a ventilator connected to a human patient  150 . The ventilator includes a pneumatic system  102  (also referred to as a pressure generating system  102 ) for circulating breathing gases to and from patient  150  via the ventilation tubing system  130 , which couples the patient to the pneumatic system via an invasive patient interface (e.g., endotracheal tube). 
     Ventilation tubing system  130  may be a two-limb (shown) or a one-limb circuit for carrying gas to and from the patient  150 . In a two-limb embodiment as shown, a fitting, typically referred to as a “wye-fitting”  170 , may be provided to couple the patient interface to an inspiratory limb  132  and an expiratory limb  134  of the ventilation tubing system  130 . 
     Pneumatic system  102  may be configured in a variety of ways. In the present example, system  102  includes an expiratory module  108  coupled with the expiratory limb  134  and an inspiratory module  104  coupled with the inspiratory limb  132 . Compressor  106  or other source(s) of pressurized gases (e.g., air, oxygen, and/or helium) is coupled with inspiratory module  104  to provide a gas source for ventilatory support via inspiratory limb  132 . 
     The pneumatic system may include a variety of other components, including sources for pressurized air and/or oxygen, mixing modules, valves, sensors, tubing, accumulators, filters, etc. Controller  110  is operatively coupled with pneumatic system  102 , signal measurement and acquisition systems, and an operator interface  120  that may enable an operator to interact with the ventilator (e.g., reset alarms, change ventilator settings, select operational modes, view monitored parameters, etc.). Controller  110  may include memory  112 , one or more processors  116 , storage  114 , and/or other components of the type commonly found in command and control computing devices. 
     The memory  112  is computer-readable storage media that stores software that is executed by the processor  116  and which controls the operation of the ventilator. In an embodiment, the memory  112  includes one or more solid-state storage devices such as flash memory chips. In an alternative embodiment, the memory  112  may be mass storage connected to the processor  116  through a mass storage controller (not shown) and a communications bus (not shown). Although the description of computer-readable media contained herein refers to a solid-state storage, it should be appreciated by those skilled in the art that computer-readable storage media can be any available media that can be accessed by the processor  116 . Computer-readable storage media includes volatile and non-volatile, removable and non-removable media implemented in any method or technology for storage of information such as compute-readable instructions, data structures, program modules or other data. Computer-readable storage media includes, but is not limited to, RAM, ROM, EPROM, EEPROM, flash memory or other solid state memory technology, CD-ROM, DVD, or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other medium which can be used to store the desired information and which can be accessed by the computer. 
     As described in more detail below, controller  110  may monitor pneumatic system  102  in order to evaluate the condition of the patient and to ensure proper functioning of the ventilator based on various parameter settings. The specific parameter settings may be based on preconfigured settings applied to the controller  110 , or based on input received via operator interface  120  and/or other components of the ventilator. In the depicted example, operator interface  120  includes a display  122  that is touch-sensitive, enabling the display to serve both as an input and output device. 
       FIG. 2  is a block-diagram illustrating an embodiment of a ventilatory system  200  having a graphical user interface for displaying structured and informative alarms. The ventilator  202  includes a display module  204 , memory  208 , one or more processors  206 , user interface  210 , and ventilation module  212 . Memory  208  is defined as described above for memory  112 . Similarly, the one or more processors  206  are defined as described above for the one or more processors  116 . Ventilation module  212  may oversee ventilation as delivered to a patient according to the ventilatory settings prescribed for the patient. For example, ventilation module  212  may deliver pressure and/or volume into a ventilatory circuit, and thereby into a patient&#39;s lungs, by any suitable method, either currently known or disclosed in the future. 
     The display module  204  presents various input screens and displays to a clinician, including but not limited to one or more structured alarm displays, as will be described further herein, for receiving clinician input and for displaying useful clinical data and alerts to the clinician. The display module  204  is further configured to communicate with user interface  210 . The display module  204  may provide various windows and elements to the clinician for input and interface command operations. Additionally, user interface  210  may accept commands and input through display module  204  and may provide useful alarm information to the clinician through display module  204 . Display module  204  may further be an interactive display, whereby the clinician may both receive and communicate information to the ventilator  202 , as by a touch-activated display screen. Alternatively, user interface  210  may provide other suitable means of communication with the ventilator  202 , for instance by a keyboard or other suitable interactive device. 
     Alarm display module  214  may be useful for providing comprehensive alarm information and access to alarm settings and data on a graphical user interface (GUI) of the ventilator, as may be provided by display module  204 . Specifically, a hierarchical alarm structure may be provided in which a summarized alarm message may be initially presented and, upon clinician selection, an additional detailed alarm message may be displayed. The summarized alarm message may further provide comprehensive information to the clinician in abbreviated form, for example the seriousness of an alarm message may be communicated via various icons and exclamation indicators and the priority of the alarm message vis-à-vis other alarm messages may be communicated via the relative graphical placement of the alarm message. 
     Additionally, a summary and/or detailed alarm message may provide immediate access to the display and/or settings window associated with an alarm event. For example, an associated alarm settings window may be accessed from an alarm message via a hyperlink such that the clinician may reconfigure alarm conditions as necessary. The alarm settings window allows a clinician to view patient information for various ventilatory parameters, even those parameters that are not currently associated with an alarm event. In this way, the clinician may access additional information regarding patient respiration. 
     In order to accomplish the various aspects of the hierarchical informative alarm display, the alarm display module  214  may communicate with various other components and/or modules. For instance, an alarm settings module  228  may be provided. Alarm settings module  228  may monitor the various settings and other input provided by a clinician to the ventilator via the user interface  210  or display module  204 . Alarm settings module  228  may compare and evaluate parameter settings entered by the clinician according to any suitable method or procedure. For example, alarm settings module  228  may detect when patient settings are missing or otherwise inappropriate for a particular input field. Inappropriate parameter settings may be indicated where settings entered for different parameters are inconsistent, e.g., one parameter setting indicates that the patient is a child, while another parameter setting indicates that the patient is an adult male, etc. In addition, alarm settings module  228  may evaluate parameter data received from monitor module  230  against the settings associated with the monitored parameters. When alarm settings module  228  determines that the parameter data falls outside applicable settings and ranges, alarm settings module  228  may communicate with alarm display module  214 , or other modules of the alarm display module  214 , in order to generate an informative alarm message. 
     Alarm display module  214  may also be configured with a hierarchical display module  216 . The hierarchical display module  216  may be in communication with the monitor module  230  and/or alarm settings module  228  to receive an indication that an alarm event has occurred. The hierarchical display module  216  may be responsible for generating a multi-level alarm message via any suitable means. For example, a first level summary alarm message may be provided as a tab, banner, dialog box, or other similar type of display. Further, a summary alarm messages may be provided along a border of the graphical user interface that is either blank or that displays minimally important information. The shape and size of the summary alarm message may also be optimized for easy viewing with minimal interference. The summary alarm message may be further configured with a combination of icons and text such that the clinician may readily identify the priority of the alarm message. Hierarchical display module  216  may be preconfigured with various summary messages or alarm descriptions corresponding to each general type of alarm event. General summary messages may also be preconfigured to provide abbreviated information to a clinician. For example, when a pressure reading indicates that the peak pressure setting has been breached, an abbreviated summary message may be displayed: “⇑ P peak .” This abbreviated summary message may provide both an indication that a high limit was breached, i.e. by the indicator, and an abbreviated indication of the particular breached parameter, L e. by the P peak  notation. The same general summary message may also include explanatory information regarding the particular breach, for instance: “⇑ P peak -High Inspiratory Pressure.” In general, a summary level alarm message may be provided in any suitable position on the screen, by any suitable means, such that a general description of an alarm event and/or its gravity may be efficiently communicated to a clinician. 
     The hierarchical display module  216  may also generate a selectively accessed second level alarm message. The second level alarm message may provide additional details and information regarding the alarm event and may be accessible from the first level summary alarm message. Second level alarm messages may be preconfigured with a detailed alarm message or description corresponding to various types of alarm events. For example, a detailed alarm message may provide possible reasons for an alarm breach, suggested checks or procedures for mitigating the alarm, or other helpful information. Additionally, other embodiments may provide for semi-custom detailed alarm messages. For instance, portions of a detailed alarm message may be preconfigured for similar types of alarm events, while other portions may provide variable fields that may be populated with more specific information regarding a particular breach, for instance the extent that a parameter was breached, the number of breaths over which the breach occurred, whether a maximum or minimum parameter setting was breached, etc. 
     Alarm display module  214  may also be configured with a translucent display module  218 . Translucent display module  218  may allow for display of the summary alarm message and/or the detailed alarm message such that displayed respiratory data may be visualized behind the alarm message. This feature may be particularly useful for displaying the detailed alarm message. As described previously, alarm messages may be displayed in areas of the display screen that are either blank or that cause minimal distraction from the respiratory data and other graphical representations provided by the GUI. However, upon selective expansion of a detailed alarm message, respiratory data and graphs may be at least partially obscured. As a result, translucent display module  218  may provide the detailed alarm message such that it is partially transparent. Thus, graphical and other data may be visible behind the detailed alarm message. 
     Alarm display module  214  may also be configured with a selective display module  220 . As discussed above, a detailed alarm message may be selectively displayed in order to offer additional information or details regarding an alarm event to a clinician. According to some embodiments, the second level detailed alarm message may be activated by clicking on the first level display message, touching a portion of the message, or otherwise. Additionally or alternatively, the first level summary alarm message may provide an arrow, or some other feature or icon for selection or activation of the detailed alarm message. Thus, a general summary alarm message may expand upon selection to provide a detailed alarm message. The detailed alarm message may be provided as a tab, banner, dialog box, or other similar type of display, which may extend from behind the general summary alarm message upon selection. In addition, according to some embodiments, the detailed alarm message may be condensed upon selection of an arrow, or some other feature or icon, via touching, clicking, or otherwise. Upon clearing or otherwise resetting an alarm following an alarm event, the summary alarm message and the detailed alarm message may also be cleared from the graphical user interface. 
     Alarm display module  214  may also be configured with an icon display module  222 . Icon display module  222  may provide various icons and other identifiers that may communicate additional abbreviated information to a clinician, for instance regarding the alarm level. An alarm level reflects the seriousness or priority of an alarm message. For instance, “!!!” may be represented in a corner, or other visible area, of the general summary message and may indicate that the alarm is a “High” alarm level and, therefore, is relatively serious. Alternatively, while “!!” or “!” may indicate that the alarm is a “Medium” or “Low” alarm level and is, therefore, less serious. In other embodiments, a number, letter, or other priority icon may be provided to communicate the priority of an alarm message vis-à-vis other displayed alarm messages. In still other embodiments, a status icon may be provided such that the status of an alarm message may be communicated, for instance, an active status or an inactive status, a high or low status, etc. Status may also refer to the number of times during a time period that the same alarm has occurred. In still other embodiments, an up-arrow, e.g., “⇑,” or a down-arrow, e.g., “⇓,” may be provided to communicate whether a high or low limit was breached, respectively. Indeed, any number or combination of icons or other indicators may be employed to communicate additional, abbreviated information to a clinician. 
     Alarm display module  214  may also be configured with a prioritized display module  224 . As noted above, multiple alarm events may occur at the same or similar time. In this case, it may be useful for the clinician to readily determine which alarm events are of higher priority and should be addressed more quickly. The present disclosure provides for presentation of one or more pending alarms events in a vertical array, for example, that may convey an alarm event ranking and/or status. According to some embodiments, higher ranked alarm events may be presented above other alarm events. Thus, based on a graphical placement of alarm events relative to other alarm events, additional information regarding the priority or status of alarm events relative to other alarm events may be communicated to a clinician. 
     As will be discussed in further detail below, prioritized display module  224  is configured to rank an alarm event. The ranking of an alarm event determines whether the alarm event will be displayed in an alarm tab and, if so, where the alarm tab displaying the alarm event will be placed in the hierarchical display structure. Alarm event ranking is based on first, an alarm level and second, a parameter priority. An alarm event with a “High” alarm level will be assigned a higher ranking than an alarm event with a “Medium” or “Low” alarm level. If two alarm events have the same alarm level, ranking will be based on a predetermined parameter priority. Each ventilator parameter is assigned a priority. The assignment of parameter occurring may be done by a clinician during ventilator setup. A parameter priority may also be assigned automatically according to a hospital protocol. 
     When two alarm events have the same alarm level, the alarm event with the higher parameter priority will be assigned the higher ranking. 
     Alarm display module  214  may also be configured with a hyperlink module  226 . Hyperlink module  226  may be configured to provide access from the various hierarchical alarm messages to various settings and display screens associated with an identified alarm event. For example, an icon or other link indicator may be provided in either the summary alarm message and/or the detailed alarm message that may be activated or otherwise selected. Upon selection, the icon may provide direct access, via a hyperlink or otherwise, to associated settings or display screens corresponding to a particular alarm event. When access to a settings screen is provided, the clinician may reset the alarm following clinician intervention or may reconfigure alarm settings as appropriate. When access to a display screen is provided, the clinician may view additional information and respiratory data regarding the alarm event. Hyperlink module  226  may further provide access to any useful display screen, settings screen, or other graphical user interface available on the ventilator that is associated with a particular alarm event. 
     Monitor module  230  may operate to monitor the physical condition of the patient in conjunction with the proper operation of the ventilator  202 . The monitor module  230  may communicate with display module  204 , user interface  210 , alarm display module  214 , or other suitable modules or processors of the ventilator  202 . Specifically, monitor module  230  may communicate with alarm display module  214  and/or display module  204  such that information regarding alarm events may be displayed to the clinician. Monitor module  230  may further utilize one or more sensors to detect changes in various physiological or mechanical parameters. Indeed, any sensory or derivative technique for monitoring the physical condition of the patient or the mechanical operation of the ventilator may be employed in accordance with embodiments described herein. 
       FIG. 3  is an illustration of an embodiment of a user interface  300  for hierarchically indicating alarms on a graphical display. 
     User interface may be accessed via any suitable means, for example via a main ventilatory user interface on display module. As illustrated, user interface may provide one or more windows for display and one or more elements for selection and/or input. Windows may include one or more elements and, additionally, may provide graphical displays, instructions, or other useful information to the clinician. Elements may be displayed as buttons, tabs, icons, toggles, or any other suitable visual access element, etc., including any suitable element for input selection or control. 
     User interface  300  may include various icons for controlling the ventilator. These icons are selectable elements wherein selection results in display of a new window. Some exemplary control icons include a setup icon  306 , a tools icon  308 , a log icon  310 , an alarm adjustment icon  312 , an oxygen concentration icon  314 , and a help icon  316 . While each of these icons controls ventilatory function, only the setup icon  306  and log icon  310  will be discussed in detail below in relation to indicating alarms on a ventilator display. 
     According to one embodiment, as illustrated in  FIG. 3 , a user interface  300  is provided that includes one or more hierarchically structured alarm tabs  302 A-D. The alarm tabs  302 A-D are selectable elements that provide a summarized alarm message. As depicted in user interface  300 , the alarm tabs  302 A-D are stacked one on top of another in a hierarchical structure on the right side of user interface  300 , As will be appreciated by one skilled in the art, the alarm tabs can be located on any side of user interface  300  and can be arranged in any hierarchical structure as contemplated within the scope of the present disclosure. Furthermore, user interface  300  displays four alarm tabs  302 A-D. As will also be appreciated by one skilled in the art, the user interface  300  may display any number of alarm tabs. 
     Each of the four alarm tabs  302 A-D provides an alarm message that summarizes an alarm event  304 A-D. An alarm event corresponds to a change in a ventilatory parameter that causes the controller  110  monitoring the parameter to issue an alarm. For example, alarm tab  302 A provides an alarm message that summarizes an alarm event  304 A related to the Peak Pressure parameter as indicated by the abbreviation “P Peak ” on the alarm tab  302 A. As also indicated on alarm tab  302 A, the alarm event  304 A that caused the alarm was an increase in Peak Pressure. This alarm event  304 A is indicated on alarm tab  302 A in two different manners. First, an upwards arrow next to the “P peak ” abbreviation signifies that Peak Pressure has increased. Second, the words “High Inspiratory Pressure” are also displayed on alarm tab  302 A to signify the alarm event  304 A. As will be appreciated by one skilled in the art, any number of methods of indicating an alarm event on an alarm tab is contemplated as within the scope of the present disclosure. 
     Each of the four alarm tabs  302 A-D summarizes an alarm message that corresponds to an alarm event  304 A-D that is different from the alarm event corresponding to another alarm tab  302 A-D. As discussed above, alarm tab  302 A corresponds to a “High Inspiratory Pressure” alarm event  304 A. Alarm tab  302 B, on the other hand, corresponds to “Low Exhaled Minute Volume”  304 B. 
     Each alarm tab  302 A-D also displays the alarm level associated with the alarm event  304 A-D in the summarized alarm message. In one embodiment, the alarm levels are indicated by one or more exclamation points on the alarm tab. For example, user interface  300  displays three different alarm levels each indicated by different numbers of exclamation points. A “High” alarm level is indicated by three exclamation points (“!!!”). A “Medium” alarm level is indicated by two exclamation points (“!!”). A “Low” alarm level is indicated by one exclamation point (“!”). Furthermore, multiple methods of indicating alarm level can be simultaneously employed by user interface  300 . For example, user interface might also color tabs differently based on alarm level. In one embodiment, an alarm tab with an alarm level of “High” is colored red, while alarm tabs with alarm levels of either “Medium” or “Low” are colored yellow. As can be appreciated by one skilled in the art, any symbol, color, or other method of alarm level indication can be used alone or in combination to indicate an alarm level. 
     Alarm tabs  302 A-D are stacked on top of one another in a hierarchical structure based on the ranking of the alarm event  304 A-D displayed by the alarm tab  302 A-D. The ranking is derived from alarm level and parameter priority level. For the purpose of this disclosure, the alarm tab at the top of the stack, as exemplified by alarm tab  302 A, is said to display the highest ranked alarm event. The alarm tab  302 B below the alarm tab  302 A displaying the highest ranked alarm event is said to display the second highest ranked alarm event. The alarm tab  302 C below the alarm tab  302 B displaying the second highest ranked alarm event is said to display the third highest ranked alarm event. The alarm tab  302 D below the alarm tab  302 C displaying the third highest ranked alarm event is said to display the fourth highest ranked alarm event. 
     The ranking is derived from, first, the alarm level and second, if two alarm events have the same alarm level, from parameter priority level. An alarm event indicating an alarm level of “High” will be ranked higher than an alarm event indicating an alarm level of 
     “Medium” which will be ranked higher than an alarm event indicating an alarm level of “Low.” As illustrated by user interface  300 , alarm event  304 A is associated with an alarm level of “High.” As a result, alarm event  304 A is ranked higher than alarm events  302 C and  302 D that indicate alarm events with alarm levels of “Medium” and “Low” respectively. As will be discussed in greater detail below, alarm levels are parameter specific. In other words, measurements that cross a certain threshold for a first parameter may trigger a “Low” alarm level while measurements that cross the same threshold for a second parameter may trigger a “Medium” or “High” alarm level. 
     If two alarm tabs indicate alarm events with the same alarm level, the ranking of each alarm event is then derived from parameter priority level. A ventilator monitors a multitude of ventiltatory parameters. Each parameter is assigned a priority. The parameter priority level may be assigned by a clinician or based on uniform protocol at ventilator setup. The priority level associated with a parameter is stored by the ventilator in storage  114  or RAM  112  of the controller  110 . In one embodiment, the parameter priority level can be changed by utilizing setup icon  306 . 
     As illustrated in user interface  300 , when two alarm events  302 A and  302 B have the same alarm level (“High”), one alarm event  302 A is still ranked higher than the other alarm event  302 B. In the case of exemplary user interface  300 , alarm event  304 A is ranked higher than alarm event  304 B because parameter “P peak ” is assigned a higher priority than parameter “V E TOT . ”  As such, alarm event  304 A is displayed in alarm tab  302 A and alarm event  304 B is displayed in alarm tab  304 B. 
     An alarm level associated with an alarm event can increase or decrease over time. For example, a patient&#39;s condition may improve, causing the alarm level to either decrease or disappear entirely. This is known as alarm level de-elevation. Alternatively, a patient&#39;s condition may worsen, causing the alarm level to increase. This is known as alarm level elevation. When the ventilatory system detects a de-elevation or elevation of an alarm event, a clinician or other ventilatory user is notified of the change by a warning symbol superimposed on setup icon  306  and/or log icon  310 . In one embodiment, the warning symbol is a yellow triangle, as exemplified in user interface  300 . As will be appreciated by one skilled in the art, any symbol, word, sound, or other notification method may be used to notify the clinician that an alarm event has changed. It should be noted that a change in an alarm event may or may not be displayed on alarm tabs  302 A-D depending on whether the alarm event is ranked high enough for display. The ventilator removes the warning symbol from an icon when clinician selects that icon. Selection of setup icon  306  causes user interface  300  to display alarm setup window  500 . Alarm setup window  500  will be discussed in detail with regard to  FIG. 5  below. Selection of log icon  310  causes user interface  300  to display alarm log window  600 . Alarm log window  600  will be discussed in detail with regard to  FIG. 6  below. 
     When an alarm level associated with an alarm event elevates to de-elevates, the change may trigger an increase or decrease in that alarm events ranking as well as the ranking of other alarm events. Changes to the ranking of alarm events necessitates that the alarm events be reordered in the user interface. As will be appreciated, reordering alarm events may cause the user interface  300  to display a previously undisplayed alarm event in an alarm tab or remove from display an alarm event previously displayed in an alarm tab. 
     As alarm events  304 A-D are reordered in the hierarchical structure, the alarm tabs displaying the alarm events slide up and down passed one another to reflect the reordered alarm events. For example, the ventilator may detect an elevation in alarm level for alarm event  304 D “High End Expiratory Pressure” from “Low” to “Medium.” The elevated alarm level results in two alarm events  304 C and  304 D with “Medium” alarm levels. To determine the ranking of each alarm event, the system compares the parameter priority of “% LEAK” to the parameter priority for “PEEP.” In one embodiment, “PEEP” has a higher parameter priority than “% LEAK.” As a result, the ranking of alarm event  304 D associated with “PEEP” changes from fourth highest ranked to the third highest ranked. In a similar vein, the ranking of the alarm event  304 C associated with “% LEAK” changes from third highest ranked to the fourth highest ranked. Reordering of the alarm events  304 C and  304 D is visualized in user interface  300  by sliding the reordered alarm tabs  302 D and  302 C up and down, respectively, to occupy the new ranking position. Alarm tab  302 D displaying alarm event  304 D slides up to occupy the location of alarm tab  302 C. Likewise, alarm tab  302 C displaying alarm event  304 C slides down to occupy the location of alarm tab  302 D. In one embodiment, alarm tab  302 D slides straight up while alarm tab  302 C may partially retract, or partially fade, while sliding by alarm tab  302 D. The alarm tabs  302 A-D on user interface  300  now properly reflect the rankings of alarm events  304 A-D. 
     As illustrated in user interface  300 , alarm tabs  302 A-D may be displayed by default in a minimized state. The minimized state of the alarm tab  302 A-D still conveys information such as alarm event  304 A-D, parameter, alarm level and ranking while not occupying too much space on the user interface. Alarm tabs may  302 A-D also include an arrow  318 A-D indicating that the minimized alarm tab can be expanded. Making a selection, such as by clicking, anywhere in alarm tab  312 A-D will cause the selected alarm tab to expand. Expanding an alarm tab will be discussed in detail with reference to  FIG. 4 . 
       FIG. 4  is an illustration of an embodiment of a user interface  400  for displaying an expanded alarm tab. 
     With reference to like numerals from  FIG. 3 ,  FIG. 4  illustrates a user interface  400  that includes an expanded alarm tab  402 . The expanded alarm tab  402  is accessed by making a selection anywhere in alarm tab  302 A. Upon making the selection, the maximization arrow  318 A is flipped in the opposite direction to indicate that maximization arrow is now a minimization arrow  410 . When a clinician wants to deflate the expanded alarm tab  402 , the clinician may make a selection anywhere in expanded alarm tab  402  and the expanded alarm tab  402  is minimized back to alarm tab  302 A. Upon minimization, the minimization arrow  410  is converted back into maximization arrow  318 A. User interface  400  illustrates single expanded alarm tab  402 . However, as will be appreciated by one skilled in the art, any number of alarm tabs  302 A-D may be expanded or minimized at any given time for display in user interface  400 . 
     In another embodiment, certain alarm tabs associated with very high priority alarm events may be automatically expanded upon detection of the alarm event. The very high priority alarm events may be indicated by a clinician or may be industry standards. Upon initial detection of the high priority alarm event, the alarm tab will expand immediately. The clinician can then choose to minimize the expanded alarm tabs by the any of the minimization methods as discussed above. This behavior of automatically expanding alarm tabs associated with very high priority alarm events has the added advantage of maximizing the visibility of the alarm. Because the expanded alarm tab may overlap other items on screen and thus interrupt on screen activity, the behavior, in one embodiment, may only be used on alarms that require immediate intervention. This may include alarm events associated with activity outside of the ventilatory parameters such as circuit disconnect, occlusion, etc. 
     As is illustrated in user interface  400 , expanded alarm tab  402  provides clinician with more detailed information about the alarm event. In one embodiment, expanded alarm tab  402  provides clinician with an explanation  404  as to why an alarm event is associated with a particular alarm level. For example, expanded alarm tab  402  may provide an explanation  404  for the “High” alarm level associated with alarm event  302 A, stating that “Last 4 Or More Breaths&gt;=Set Limit.” This explanation  404  provides the clinician with a reason why the alarm level for the alarm event  304 A is set to “High.”Expanded alarm tab  402  may also provide clinician with possible solutions  406  that may de-elevate the alarm level associated with an alarm event  304 A. For example, expanded alarm tab  402  may provide possible solutions  406  to increased Peak Pressure, suggesting “Check Patient, Circuit, and ET Tube.” These possible solutions  406  provide clinician with suggestions that may alleviate the problem and, as a result, de-elevate the alarm level associated with an alarm event. 
     Expanded alarm tab  402  may also provide the clinician with a hyperlink  408  to alarm setup window  500 . The hyperlink  408  allows a clinician to “jump” to the alarm setup window  500  for that alarm without having to navigate to it through the setup icon  306 . 
       FIG. 5  depicts an alarm setup window  500  for display in user interface  300 . As discussed above, alarm setup window  500  may be accessed by selecting the hyperlink  408  in the expanded alarm tab  402 . By selecting the hyperlink  408 , a clinician is able to “jump” to the meter for the parameter associated with the selected alarm event. The alarm setup window  500  can also be accessed by selecting the setup icon  306  and navigating to the alarm setup window  500 . As depicted by alarm setup window  500 , alarm tabs  302 A-D may still be visible when alarm setup window  500  is displayed. 
     Alarm setup window  500  displays a meter for each ventilatory parameter associated. 
     It will be appreciated that only those alarms with user-adjustable parameters, i.e. those alarms associated with ventilatory parameters, may be associated with a meter in alarm setup window  500 . Some alarms issued by the ventilator are not user-adjustable alarm such as an alarm indicating apnea, procedure error, or circuit disconnect. As discussed above, a ventilator monitors a multitude of ventilatory parameters. As such, alarm setup window  500  may display meters for parameters that are not visible on alarm tabs  302 A-D in user interfere  300 . Parameters may not be visible on alarm tabs  302 A-D because either the parameter is not associated with an alarm event or, if the parameter is associated with an alarm event, the alarm event is not ranked high enough to be displayed in alarm tabs  302 A-D. In either event, alarm setup window  500  allows a clinician to view a meter for each ventilatory parameter, whether that parameter is displayed in alarm tabs  302 A-D or not. 
     Alarm setup window  500  displays five meters  504 A-E, each meter associated with a different parameter. As discussed above, ventilator may monitor more or less than five parameters. Additional meters for parameters not currently displayed in alarm setup window  500  can be accessed using scroll bar  506 . Scroll bar  506  includes multiple symbols, each symbol representing one parameter. In one embodiment, the symbols on the scroll bar  506  are bells. However, any symbol can be used within the scope of the present disclosure. Parameters associated with alarm events are further depicted on scroll bar  506  by superimposing an alarm event symbol onto the parameter symbol. As illustrated by scroll bar  506 , the bells representing the parameter may be superimposed with a yellow triangle representing that the parameter is associated with an alarm event. Furthermore, the yellow triangle may include the number of exclamation points associated with the alarm level of the alarm event for that parameter. For example, a parameter with an alarm event of alarm level medium might be represented in scroll bar  506  as a bell with a yellow triangle superimposed onto in it, the yellow triangle including two exclamation points. Again, any method of representing alarm events, alarm levels, or parameters on a scroll bar  506 , is contemplated within the scope of the present disclosure including differing colors, symbols, and graphical effects. 
     Scroll bar  506  may also include scroll bar window  508 . Scroll bar window  508  encases the parameter symbols representing the parameters with meters currently displayed in alarm setup window  500 . In one embodiment, alarm setup window  500  displays five meters  504 A-E so scroll bar window encases five parameter symbols,  506 A-E, representing the five meters. For example, the P Peak  parameter meter  504 A is displayed in the left most position of alarm setup window  500 . The P Peak  parameter meter  504 A is, therefore, represented by symbol  506 A in the left most position of scroll bar  506 . The symbol  506 A in the left most position of scroll bar  506  indicates that it represents a parameter associated with “High” level alarm event. This description matches the P Peak  parameter which is associated with an “High” level alarm event, as indicated by alarm tab  302 A. 
     Scroll bar window  508  can be shifted to the left or right on scroll bar  506  to display meters associated with different parameters. For example, a clinician may access scroll arrows  516  to shift scroll bar window  508  one position to the right on scroll bar  506 . Such a shift would cause alarm setup window  500  to display parameters associated with symbols  506 B- 506 F, The scroll bar window  508  can be shifted in either direction until the end of the scroll bar  506  is reached. Clinician can also access a meter for a parameter by directly selecting its symbol from scroll bar  506 . For example, if clinician was interested in the “Medium” level alarm event associated with symbol  506 I, the clinician could directly click on symbol  506 I and alarm setup window  500  would display five meters, one being the parameter associated with symbol  506 I. In one embodiment, whenever the scroll bar  506  is accessed, whether by shifting the scroll bar window  508  using scroll bar arrows  516  or by clicking a symbol on scroll bar  506 , scroll bar  506  illuminates to inform a clinician of the shift. 
     Each meter  504 A-E displays ranges and measurements associated with a particular parameter. The big numbers  510 A-I indicate either an upper or lower limit of a safe range for a given parameter. The safe range is the range in which parameter measurements for a patient indicate that the patient is not in danger. For example, the P Peak  parameter has a safe range with an upper limit  510 A of 40 cmH2O and a lower limit  510 B of 14 cmH2O. The f TOT  parameter, on the other hand, has a safe range with an upper limit  510 C of 40 l/min but does not have any lower limit. As a result, only one limit is displayed in association with the f TOT  parameter meter  504 B. 
     The upper and lower limit for each meter  504 A-E can be adjusted. For example a clinician can select the upper limit MOD and drag it up or down. When upper limit MOD is released at a new value, the big numbers inside upper limit  510 D will change to reflect the new value. If an upper limit  510 A, C, D, F, or H is dragged to the top of the meter, the upper limit may disappear, or read “OFF”. Likewise, if a lower limit  510 B, E, G, or I is dragged to the bottom of the meter the lower limit may disappear, or read “OFF”. An upper limit  510 A, C, D, F, or H can only be dragged as low as the lower limit for that meter. Likewise, a lower limit  510 B, E, G, or I can only be dragged as high as the upper limit for that meter. In another embodiment, a meter may be associated with an alarm that has a factory preset limit and cannot be turned off. 
     The numbers  512 A-D represent the current measurement for a given parameter. For example, the current measurement for the P Peak  parameter is 40 cmH2O. The current measurement  512 A-D is displayed as a line through a white box  514 A-D in the meter  504 A-D for the parameter. The white box  514 A-D represents the measurements of the parameter for a given period. In one embodiment, the period is a period of time, such as two minutes, and the white box represents the measurements for the parameter for the last two minutes. In another embodiment, the period is a period of breaths, such as 200 breaths, and the white box represents the measurements for the parameter for the last 200 breaths. As will be appreciated by one skilled in the art any sort of period can be used to define the bounds of the white box. 
     As is illustrated in alarm setup window  500 , some meters may not display any measurements. In one embodiment, a meter may not display any measurement because the alarm for the parameter associated with the meter may only be required under certain breath modes or breath types. For example, in alarm setup window  500 , the meter for the parameter V TE SPONT  does not display any measurements. This is because the current breath mode does not require V TE SPONT  measurements. In one embodiment, the alarm setup window  500  will automatically switch and begin displaying measurements for the V TE SPONT  parameter when the current breath mode changes. 
     Alarm setup window  500  may also include one or more controls for alarm volume. As illustrated in alarm setup window  500 , alarm volume may be controlled by a volume adjust scrollbar  518 . By sliding volume adjust scrollbar  518  either left or right, clinician can control the volume of an emitted alarm. Volume adjust scrollbar  518  may also display the current alarm value as a numerical value. As displayed by alarm setup window  500 , the alarm volume may be based on a scale from one to ten. As will be appreciated by one skilled in the art, any scale or other manner of conveying alarm value may be used as contemplated within the scope of the present disclosure. 
     Alarm setup window  500  also includes a transparency button  522  and a pin-up button  524 . When the transparency button  522  is accessed, the alarm setup window  500  may be viewed simultaneously with other data displayed on user interface  300 , or other user interface. When the pin-up button  524  is accessed, the alarm setup window  500  may remain open unless and until a clinician desires to close the alarm setup window  500  by accessing the “Close” button  520 . Otherwise, the alarm setup window  500  may close automatically after some period of inactivity. In another embodiment, the alarm setup window  500  will close, and the changes to the alarm limits will be implemented, when an “Accept” button (not depicted) is accessed. When the alarm setup window  500  is pinned and the “Accept” button (not depicted) is accessed, the changes will be implemented, but the alarm setup window  500  will not be closed. 
       FIG. 6  depicts an alarm log window  600  for display in user interface  300 . As discussed above, selection of log icon  310  causes user interface  300  to display alarm log window  600 . This selection is indicated by the bold box surrounding log icon  602 . As will be appreciated, any manner of indicating selection may be used. 
     Alarm log window  600  provides a temporal log of alarm events. In one embodiment, the alarm log records all alarm events emitted since the last manual reset of the mechanical ventilator. In another embodiment, the alarm log records all alarm events emitted since the ventilator began monitoring a new patient. A variety of information categories related to alarm events may be provided by alarm log window  600 . For example, alarm log window  600  may provide information categories regarding the time  604 , event  606 , priority  608 , alarm  610 , and analysis  612 . These categories may be arranged as columns in a table. In other embodiments, some or different information categories associated with alarm events may be provided by alarm log window  600 . 
     Alarm log window  600  may provide a time  604  information category indicating the time at which an alarm event occurred. In one embodiment, the alarm events are arranged hierarchically from the most recent event to the least recent event. The time  604  information category may be accompanied by a flip arrow  614 . By accessing the flip arrow  614 , a clinician may flip the order the alarm log hierarchy such that the alarm events are displayed from the least recent event to the most recent event. 
     Alarm log window  600  may also provide an event  606  information category indicating a type of alarm event. In one embodiment, there are three types of alarm events: manual reset, augmented, and detected. However, it will be appreciated that there may be any number of alarm events. A manual reset alarm event may indicate that an alarm was manually reset by the operator pressing an alarm reset button on the ventilator. An augmented alarm event may indicate that an alarm has been escalated in priority. A detected alarm event may indicate that an alarm was first detected at that point in time. 
     Alarm log window  600  may also provide a priority  608  information category indicating an alarm level associated with an alarm event. As discussed above, an alarm event may be associated with an alarm level that reflects the severity of the alarm event. Exemplary alarm levels include high, medium, and low. 
     Alarm log window  600  may also provide an alarm  610  information category indicating a change in a parameter measurement associated with an alarm event. As discussed above, parameter names may be represented by parameter abbreviations. For example, Peak Pressure may be represented by the abbreviation “P Peak .” The parameter abbreviation may be accompanied by a symbol indicating the change in the parameter measurement. In one embodiment, the parameter abbreviation is accompanied by either an upward pointing arrow or a downward pointing arrow. For example, the “P Peak”  parameter may be accompanied by an upward pointing arrow indicating that the Peak Pressure has increased. 
     Alarm log window  600  may also provide an analysis  612  information category indicating more detailed information about the cause of the alarm event. The alarm  612  information category may provide the measurement that triggered the alarm event. For example, if the ventilator measures the last 4 or more breaths of the patient as greater than or equal to the set limit, the ventilator may trigger an increased Peak Pressure alarm event with a high alarm level. 
     Alarm log window  600  may also include a scroll bar  622 . By accessing the scroll bar  622 , a clinician can display different alarm events in the alarm log window  600 . In one embodiment, when the scroll bar  622  is accessed it is illuminated to indicate to the clinician that the alarm events displayed in the alarm log window  600  have changed. 
     Alarm log window  600  may also include a transparency button  616  and a pin-up button  618 . When the transparency button  616  is accessed, the alarm log window  600  may be viewed simultaneously with other data displayed on user interface  300 , or other user interface. When the pin-up button  618  is accessed, the alarm log window  600  may remain open unless and until a clinician desires to close the alarm log window  600  by accessing the “Close” button  620 . Otherwise, the alarm log window  600  may close automatically after some period of inactivity. When the alarm log window  600  is pinned, the changes will be implemented, but the alarm log window  600  will not be closed. 
     It will be clear that the systems and methods described herein are well adapted to attain the ends and advantages mentioned as well as those inherent therein. Those skilled in the art will recognize that the methods and systems within this specification may be implemented in many manners and as such is not to be limited by the foregoing exemplified embodiments and examples. In other words, functional elements being performed by a single or multiple components, in various combinations of hardware and software, and individual functions can be distributed among software applications at either the client or server level. In this regard, any number of the features of the different embodiments described herein may be combined into one single embodiment and alternative embodiments having fewer than or more than all of the features herein described are possible. 
     While various embodiments have been described for purposes of this disclosure, various changes and modifications may be made which are well within the scope of the present invention. Numerous other changes may be made which will readily suggest themselves to those skilled in the art and which are encompassed in the spirit of the disclosure and as defined in the appended claims.