Source: http://www.google.com/patents/US6655545?dq=patent:7076806
Timestamp: 2016-04-29 14:56:01
Document Index: 609353406

Matched Legal Cases: ['art 100', 'art 100', 'art 100', 'art 100', 'art 100', 'art 100']

Patent US6655545 - Medical code system - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inPatentsAn improved emergency code cart (100) is provided. The cart contains a number of drawers (130), each containing medications (305, 310) and instruments (315) required for a particular code algorithm. The contents of each drawer are organized according to ACLS (American Cardiac Life Support) or other guidelines....http://www.google.com/patents/US6655545?utm_source=gb-gplus-sharePatent US6655545 - Medical code systemAdvanced Patent SearchPublication numberUS6655545 B1Publication typeGrantApplication numberUS 10/132,503Publication dateDec 2, 2003Filing dateApr 25, 2002Priority dateApr 25, 2002Fee statusLapsedPublication number10132503, 132503, US 6655545 B1, US 6655545B1, US-B1-6655545, US6655545 B1, US6655545B1InventorsJennifer SonnebornOriginal AssigneeJennifer SonnebornExport CitationBiBTeX, EndNote, RefManPatent Citations (7), Referenced by (23), Classifications (11), Legal Events (5) External Links: USPTO, USPTO Assignment, EspacenetMedical code system
When respiratory and circulatory processes are interrupted, prompt treatment directly correlates with optimal outcome for successful revival and minimization of neurological damage to the patient. In the past in hospitals, clinics, and some paramedic units, the traditional “code cart” came into use. The cart carries equipment needed to monitor activity of the heart, emergency medications, electrical defibrillator, and supplies and apparatus necessary to maintain respiratory function. Drawers in the cart typically contain supplies such as intravenous equipment, syringes, supplies for airway management, an electrocardiograph (EKG), a defibrillator equipped with EKG capability for cardioversion, and the like. The placement of supplies and equipment in a code cart often vary from one medical facility to another.
The cart is normally wheeled to a patient who is in a life-threatening medical condition, usually referred to as a “code”. A group of hospital personnel remove various items from the cart as they are needed and administer them to the patient, usually under the direction of one person, i.e. a physician, who leads the code. This person calls out the recommended “interventions” that are needed at any point during the code. One member of the code team, the recorder, observes the code as it progresses and records all events related to the code. Other code team members identify and manage airway problems, give Cardio-Pulmonary Resuscitation (CPR) if required, maintain an intravenous (IV) site, and administer medications.
Accordingly, several objects and advantages of the invention are to provide an improved medical code cart system for dispensing medicines and medical equipment, with the addition of a check system of medications and equipment prior to use, to act as a safety mechanism for appropriateness for use. Other objects are to provide a computerized system which reduces human error, maintains a running inventory of the contents of the cart, provides information to a facility's restocking and billing departments, contains its own internal clock and calculator, optionally provides visible and audible alarms appropriate to various unsafe conditions, and provides diagnostic interplay with code team users to promote speed and accuracy in delivery of patient care. Further objects and advantages will become apparent from a consideration of the ensuing description and the accompanying drawings.
FIG. 1 is a front perspective view of a medical code cart system and interconnections to a patient, according to the present invention.
FIG. 1 is a front perspective view of a medical code housing or cart 100 according to the present invention. Cart 100 is made of a strong, sturdy material such as metal, reinforced plastic, or wood. Wheels 105 swivel in their mounts (not shown) permitting universal maneuverability. They can also be locked by locking mechanisms (not shown) to prevent movement of the cart. Handles 110 on both sides of cart 100 allow cart 100 to be pushed or pulled, as required. Alternatively, system may comprise a non-rolling housing such as a cabinet.
A “rhythm strip” 140 printed by computer 175 documents the EKG of patient 101 during the code. This is a printed strip that includes time marks indicating when each intervention takes place, and shows the response of patient 101 to these interventions. Normally, just the chronological sequences of these events need to be documented, but the entire code can be recalled from computer 175 if desired. Strip 140 can be very long, on the order of ten or more meters for a typical code, and contains a longer history of EKG events than can be displayed at one time on monitor screen 150.
In FIG. 4A, sensor 400 is a photo-emitter-photo-detector combination. A typical sensor of this type is the model OBP742, made by Optek Technology, Inc. of Carrollton, Tex. U.S.A. When compartment 300 is empty, as in FIG. 4A, light 405 is emitted by sensor 400 and escapes into the void above. In this case, the output of sensor 400 is sensed by computer 175 (FIG. 1) as a logical “0”, indicating the absence of contents in compartment 300. In FIG. 4B, when an object such as vial 305 rests on the bottom of compartment 300, light 405 is reflected as beam 410 back into sensor 400 and detected by the internal photo-detector. In this case, the output of sensor 400 is sensed by computer 175 as a logical “1”, indicating the presence of an object such as vial 305. Sensors 400 are designed such that objects which are detected must be located within a small distance, such as on the order of 1 cm. Objects which are at a greater distance are not detected. This prevents sensor 400 from erroneously detecting objects which lie outside the confines of compartment 300.
A simpler sensor is shown in FIG. 5A. Electrical contacts 500 and 505 are normally not in contact. Contact 500 is normally biased away from contact 505. In this case, an open circuit, or logical “0” is detected by circuitry (not shown) associated with computer 175 (FIG. 1), indicating the absence of contents in compartment 300. In FIG. 5B, when an object such as vial 305 rests on top of contact 500, its weight causes contact 500 to bend downward and come into contact with contact 505, closing the circuit between contacts 500 and 505. In this case, a logical “1” is detected by circuitry associated with computer 175, indicating the presence of an object such as vial 305 in compartment 300.
When there is no code in progress, cart 100 (FIG. 1) operates in “standby mode” and is parked at a convenient location and plugged into a main power source (not shown) via an electrical cable (not shown) which is connected to power connector 205 (FIG. 2). This source is normally a red electrical outlet, indicating that the medical facility's emergency generator will provide power to this outlet in the event of an external power failure. UPS 210 is connected to connector 205 and receives power whenever power is delivered to connector 205. Batteries (not shown) in UPS 210 are kept in a fully-charged condition when the cart is in standby mode.
2. Defibrillation: An “intelligent” defibrillator is contained in computer 175. Exemplar defibrillators are manufactured by Medtronic Physio-Control, of Redmond, Wash., U.S.A., and sold under the mark “LIFEPAK”. When the defibrillator is enabled, defibrillating shocks are applied to patient 101 via EKG leads 117 or paddles 145. Computer 175 analyzes the patient's EKG and determines the proper time in the patient's heart rhythm to apply a defibrillating shock. This action is called “synchronized cardioversion”. Prior to automatic application of the defibrillation voltage, computer 175 issues a verbal command to the code team via loudspeaker 116: “CLEAR!” or “STAND BACK”.
Next, monitor screen 150 shows the prompt (block 657, FIG. 9A) “Unstable, with serious signs or symptoms?” If the answer is “yes”, and if the ventricular rate, as shown by the EKG, is greater than 150 beats per minute, the algorithm offers two choices (block 657): (1) Prepare for immediate cardioversion, (2) May give brief trial of medications based on arrythmia (block 658). A prompt, indicating such as “CARDIOVERSION OR CONSIDER BRETYLIUM 50 mg” will appear on screen 150, as shown in FIG. 11A. The volume of medication proposed is based on the previously entered weight of patient 101. This prompt may also be given audibly via loudspeaker 116, if desired. If bretylium is withdrawn from cart 100, light 156 is illuminated by computer 175. When the dose is given, the recorder presses button 156 and computer 175 indicates this as shown in FIG. 12A. Meanwhile, the patient's pulse is as shown on screen 150 and rhythm strip 140. In this example, cardioversion was chosen. Under these conditions, cardioversion is proposed by the ACLS guidelines (block 658), so monitor screen 150 displays the warning message: “CARDIOVERSION: STAND BACK”, shown in FIG. 10A. At the same time, loudspeaker 116 (FIG. 1) loudly issues the same warning. The defibrillating shock is then applied through leads 117, and the code continues. At this point, as well as after each following step in the algorithm, the steps in FIG. 7 are interposed. These are shown explicitly only once in this example, in order to save space and avoid repetition.
Refer to FIG. 7. After an intervention (block 900), the patient's condition is assessed (block 905). This assessment includes the patient's pulse, blood pressure, EKG, color, and any other factors the emergency team deems important. If the patient has not improved, the code continues with the algorithm (block 910). If the answer for block 905 is “yes”, the patient's condition is monitored (block 915). If the conditions which initiated the code are still present (block 920), the code continues with the next intervention in the algorithm (block 910). The patient's condition during a code is usually ever-changing. For example, at one moment one type of heart rhythm may be present, and at another moment, a different heart rhythm may be present. The diagnostic capability of computer 175, with its various connections to the patient, helps guide progress of the code. If the code conditions are not still present, the code procedure is terminated (block 925). The recorder enters “End of Code” in the program in computer 175, and the various appliances, blood pressure monitor, EKG, etc., are removed from the patient as appropriate. The recorder then prints and annotates the records from the code.
At the end of the code, the recorder enters this fact into computer 175 by typing “End of Code” on keyboard 115. Computer 175 then prints on paper 135 all information gathered during the code as a function of time. This information includes the patient's blood pressure, blood oximeter readings, heart rate, and any other data gathered during the code. The EKG rhythm strip 140 is also appended to the record on paper 135. Finally, the recorder or another member of the emergency team annotates these records as appropriate. At this point, the code is ended and the record is filed.
The user or recorder may terminate the code at any time by entering an “end-of-code” command on keyboard 115 of computer 175, block 1260. If this is done, the operation of this computer program is halted, as indicated by “END” in block 1265.
Accordingly, an improved medical emergency code cart is provided. The new cart employs a computer, a computer program, and sensor mechanisms which operate in conjunction with predetermined emergency code algorithms. Patient care is improved and emergency team stress levels are reduced by guidance from the algorithms during the stressful period of a code. Prompts are provided on the cart's computer monitor screen and over its loudspeaker. Alarms are given when the computer detects deviations from a code algorithm, yet medical personnel are permitted to stray from the algorithm if they believe it is necessary for the patient's welfare. The progress of the code is documented accurately using a single time reference. A permanent record is printed. All medications and apparatus for a particular type of code are kept in a drawer which is labeled for that code. The organization of the contents of the drawer is standardized according to ACLS or other guidelines. This further reduces the possibility for error.
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