US20090275844A1 - Monitor configuration system - Google Patents
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- US20090275844A1 US20090275844A1 US12/430,742 US43074209A US2009275844A1 US 20090275844 A1 US20090275844 A1 US 20090275844A1 US 43074209 A US43074209 A US 43074209A US 2009275844 A1 US2009275844 A1 US 2009275844A1
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Definitions
- a pulse oximetry system generally includes an optical sensor applied to a patient, a monitor for processing sensor signals and displaying results and a patient cable electrically interconnecting the sensor and the monitor.
- a pulse oximetry sensor has light emitting diodes (LEDs), typically one emitting a red wavelength and one emitting an infrared (IR) wavelength, and a photodiode detector. The emitters and detector are attached to a patient tissue site, such as a finger.
- LEDs light emitting diodes
- IR infrared
- the patient cable transmits drive signals to these emitters from the monitor, and the emitters respond to the drive signals to transmit light into the tissue site.
- the detector generates a signal responsive to the emitted light after attenuation by pulsatile blood flow within the tissue site.
- the patient cable transmits the detector signal to the monitor, which processes the signal to provide a numerical readout of physiological parameters such as oxygen saturation (SpO 2 ) and pulse rate.
- Advanced physiological monitoring systems utilize multiple wavelength sensors and multiple parameter monitors to provide enhanced measurement capabilities including, for example, the measurement of carboxyhemoglobin (HbCO), methemoglobin (HbMet) and total hemoglobin (Hbt).
- Pulse oximeters capable of reading through motion induced noise are disclosed in at least U.S. Pat. Nos. 6,770,028, 6,658,276, 6,650,917, 6,157,850, 6,002,952, 5,769,785, and 5,758,644; low noise pulse oximetry sensors are disclosed in at least U.S. Pat. Nos. 6,088,607 and 5,782,757; all of which are assigned to Masimo Corporation, Irvine, Calif. (“Masimo”) and are incorporated by reference herein.
- Physiological monitors and corresponding multiple wavelength optical sensors are described in at least U.S. patent application Ser. No. 11/367,013, filed Mar. 1, 2006 and titled Multiple Wavelength Sensor Emitters and U.S. patent application Ser. No. 11/366,208, filed Mar. 1, 2006 and titled Noninvasive Multi-Parameter Patient Monitor, both assigned to Masimo Laboratories, Irvine, Calif. (“Masimo Labs”) and both incorporated by reference herein.
- physiological monitoring systems that include low noise optical sensors and pulse oximetry monitors, such as any of LNOP® adhesive or reusable sensors, SofTouchTM sensors, Hi-Fi TraumaTM or BlueTM sensors; and any of Radical®, SatShareTM, Rad-9TM, Rad-5TM, Rad-5vTM or PPO+TM Masimo SET® pulse oximeters, are all available from Masimo.
- Physiological monitoring systems including multiple wavelength sensors and corresponding noninvasive blood parameter monitors, such as RainbowTM adhesive and reusable sensors and Rad-57TM, Rad-87TM and Radical-7TM monitors for measuring SpO 2, pulse rate, perfusion index, signal quality, HbCO and HbMet among other parameters are also available from Masimo.
- Advanced noninvasive physiological parameter monitors provide medical practitioners with substantial operational flexibility, including the ability to set parameters displayed, display format, alarm thresholds, alarm types, sensitivity and averaging times, to name just a few.
- Optimal settings vary with the monitoring application. Monitoring in a hospital environment may differ from that of an ambulance or out-patient clinic. Also different hospital wards servicing different types of patients with different medical care needs are likely to require different monitor settings. For example, ER monitoring requirements will likely differ from those of a surgical ward. Monitoring of neonatal patients will likely differ from monitoring of geriatric patients.
- the operational flexibility of these monitors is a challenge to medical staff and administrators at various facilities, especially if a monitor is used for multiple purposes and patient types or if monitors are frequently moved between locations within a large facility.
- a monitor configuration system meets this challenge in various respects.
- a monitor configuration system advantageously provides a readily recognizable indication of the current default settings. This indication can be associated with a particular ward or patient group, as examples.
- a monitor can be programmed with any of multiple user-defined default settings, each associated with a unique configuration indication.
- the monitor control panel and display provide hidden menus that allow technical support staff to quickly change configuration profiles to best suit the current monitor usage without risk of accidental configuration changes by medical staff. Also, technical staff can utilize manual procedures or programming aids to conveniently enter or modify one or more default settings.
- an aspect of a monitor configuration system allows users to change to default settings using front-panel keys or an external configuration application.
- This user-defined “configuration profile” overrides the factory default settings and is retained after a power cycle.
- a user may also associate a color and/or a display message with the profile, as a “configuration indicator,” which allows a user to verify at a glance which configuration profile is the default.
- a front-panel colored light is a configuration indicator. If changes are made to the device settings after the configuration profile feature has been enabled, the front panel light will turn off, indicating a change from the saved profile settings.
- a colored plug-in memory, dongle or similar device programs the monitor settings and serves as a profile indicator.
- a monitor configuration system communicates with a physiological sensor and includes a processor, for example, a digital signal processor (DSP) and an instrument manager processor.
- the physiological sensor can have emitters that transmit optical radiation into a tissue site and at least one detector that receives the optical radiation after attenuation by pulsatile blood flow within the tissue site.
- the DSP can communicate with the sensor and calculate physiological parameters responsive to the sensor.
- An instrument manager receives the calculated physiological parameters from the DSP, transmits the physiological parameters to a display and controls alarms based upon the physiological parameters.
- the instrument manager is responsive to a configuration profile that specifies DSP calculations, physiological parameter displays and alarms.
- the configuration indicator identifies the configuration profile.
- the configuration indicator comprises a panel light.
- the instrument manager selects between a factory-default configuration profile and a user-specified configuration profile.
- the panel light displays a first color when the factory-default settings are selected and a second color when the user-specified settings are selected.
- the user-specified settings are manually defined.
- the panel light color for user-specified settings is manually defined.
- the configuration indicator comprises a top-mounted alphanumeric display.
- a monitor configuration system comprises a sensor having emitters that transmit optical radiation into a tissue site and at least one detector that receives the optical radiation after attenuation by pulsatile blood flow within the tissue site.
- a calculator communicates with the sensor and calculates physiological parameters responsive to the sensor.
- An instrument manager receives the calculated physiological parameters from the calculator, transmits the physiological parameters to a display and controls alarms based upon the physiological parameters.
- the instrument manager is responsive to a configuration profile with respect to calculator calculations, physiological parameter displays and alarms.
- the instrument manager reads the configuration profile via the I/O port.
- a memory device stores the configuration profile and is removably attached to the I/O port so as to communicate the configuration profile to the instrument manager.
- a color is affixed to at least a portion of the memory device.
- the color corresponds to the configuration profile.
- the memory device and its color are readily visible to a monitor user when the memory device is removably attached to the I/O port so as to designate the configuration profile to the user.
- a configuration profile routine executes on the instrument manager and writes the memory device with configuration profile settings.
- a further aspect of a monitor configuration system comprises a configuration profile of user-specified settings defined for a physiological monitor.
- the configuration profile is selected to override corresponding factory-specified settings.
- a color is associated with the configuration profile.
- the selected profile is indicated by displaying the associated color.
- the user-specified settings and the factory-specified settings each relate to at least one of calculating physiological parameters, displaying the physiological parameters and alarming based upon the physiological parameters.
- the configuration profile is defined by reading the configuration profile into the physiological monitor.
- the selected profile is indicated by illuminating a portion of the physiological monitor with the color.
- the reading comprises downloading the configuration profile from an input/output (I/O) port.
- the illuminating comprises activating a colored panel light on the monitor.
- the selecting comprises receiving from a wireless device a code corresponding to the configuration profile and activating the configuration profile according to the code.
- An additional aspect of a monitor configuration system comprises a profile definition means for setting parameter measurement, display and alarm characteristics of a physiological monitor, a profile selection means for activating a defined profile and a profile indication means for cuing a monitor user as to the selected profile.
- the profile definition means comprises a menu means for manually entering profile settings.
- the profile selection means comprises a save means for specifying a defined profile as the monitor default settings.
- the profile indication means comprises a color selection means for associating a color with a saved profile and an illumination means for displaying the color.
- the profile definition means comprises a downloading means for transferring profile settings to the monitor via at least one of an I/O port and a docking port.
- the profile selection means comprises a wireless means for specifying a defined profile as the monitor default settings.
- FIGS. 1-5E are perspective views of physiological monitors utilizing various monitor configuration system embodiments
- FIG. 1 is a standalone physiological monitor having a front-panel colored light and a top-mounted display as configuration indicators;
- FIG. 2 is a standalone physiological monitor having a color-coded plug-in configuration indicator
- FIG. 3 is a removable handheld monitor having a front-panel colored light and a corresponding docking station having a top-mounted display configuration indicator;
- FIG. 4 is a physiological monitoring system and a corresponding plug-in module having a colored panel light and a colored monitor display as configuration indicators;
- FIGS. 5A-E is a physiological monitoring system including a removable satellite module, a docking handheld monitor and plug-ins each having configuration indicators;
- FIG. 6 is a perspective view of a physiological monitoring system responsive to a wall-mounted or a tag-mounted short-range wireless device for selection of a configuration profile;
- FIG. 7 is a hierarchical block diagram of a monitor configuration system
- FIG. 8 is a detailed block diagram of a physiological measurement system that utilizes a monitor configuration system
- FIG. 9 is a perspective view of a I/O port download embodiment for defining configuration profiles
- FIG. 10 is a perspective view of a plug-in programming embodiment for defining configuration profiles
- FIG. 11 is a detailed block diagram of a physiological monitoring system responsive to a short-range wireless device for selection of a configuration profile
- FIGS. 12A-D are front, top and back views, respectively, of a horizontal monitor embodiment and a front view of a vertical monitor embodiment having configuration indicators;
- FIG. 13 is a general block diagram illustrating a tri-level configuration user interface, further illustrated in FIGS. 14-16 ;
- FIG. 14 is a level 1 exemplar flow diagram
- FIG. 15 is a level 2 exemplar flow diagram
- FIGS. 16A-B is a level 3 exemplar flow diagram.
- FIG. 1 illustrates a physiological measurement system 10 that utilizes a configuration indicator embodiment.
- the physiological measurement system 10 has monitor 10 and a multiple wavelength optical sensor 20 .
- the sensor 20 allows the measurement of various blood constituents and related parameters.
- the sensor 20 is configured to communicate with a monitor sensor port 110 via a patient cable 30 .
- the sensor 20 is typically attached to a tissue site, such as a finger.
- the patient cable 30 transmits a drive signal from the monitor 100 to the sensor 20 and a resulting detector signal from the sensor 20 to the monitor 100 .
- the monitor 100 processes the detector signal to provide a numerical readout of measured blood parameters including oxygen saturation (SpO 2 ), pulse rate (PR), carboxyhemoglobin (HbCO), methemoglobin (HbMet) and total hemoglobin (Hbt), to name a few.
- Displays 120 provide readouts, bar graphs or other visual presentations of the measured parameters.
- a speaker 130 or other audio transducer generates beeps, alarms or other audio presentations of the measured parameters.
- Monitor keys (buttons) 140 provide control over operating modes and alarms, to name a few.
- a system status light 160 indicates alarm status, data status and monitor mode.
- a user can determine the operational characteristics of the monitor 100 by changing various factory default settings.
- a particular group of custom settings described herein as a configuration profile, determines the physiological parameters that are measured, various options related to those measurements, how the physiological parameters are displayed, alarm thresholds for the physiological parameters and alarm types, to name a few.
- Many configuration profiles are possible for a monitor, and some profiles are more appropriate for a particular healthcare application or environment than others.
- a configuration indicator advantageously allows a user to quickly recognize that a particular configuration profile is the current default setting for that monitor.
- a panel light 150 displays a selected one of various colors, such as shown in TABLE 1.
- each color of the panel light 150 can be associated with a unique configuration profile. Accordingly, medical staff using the monitor can readily recognize and discern the monitor's settings by observing the illumination color. As an example, pink can be associated with standardized ER settings, teal with surgical ward settings and blue with general ward settings.
- the panel light 150 illuminates with a color associated with a user-defined profile at power on.
- the panel light 150 glows and slowly cycles from bright to dim if a temporary change has been made to the user-defined profile or if defaults have been activated via the control buttons 140 .
- the panel light 150 returns to a solid state when settings are returned to the user-defined profile.
- a factory default profile is associated with purple having RGB values of R 75, G 40 and B 55.
- optional profile colors for user defined profiles are represented by the RGB codes listed in TABLE 1, below.
- a top-mounted display 170 such as an LCD mini-screen, displays radio communication status, system status and, in an embodiment, a textual description of the current profile corresponding to the panel light 150 .
- This allows medical staff to verify the profile associated with a particular panel light color.
- the display 170 might indicate “ER,” “surgical,” or “general” corresponding to selected profiles for those wards.
- the monitor illustrated in FIG. 1 is described in further detail with respect to FIGS. 12A-D , below.
- FIG. 2 illustrates a physiological measurement system 200 that utilizes a plug-in configuration indicator.
- a color-coded memory device 250 is removably plugged into a configuration port 252 .
- the memory 250 is preloaded with a specific configuration profile, and the monitor 210 reads the memory 250 so as to transfer the corresponding settings into the monitor.
- Different color-coded memories may store different configuration profiles, i.e. user-selected monitor settings.
- a user can advantageously select a memory by color and plug the memory 250 into the configuration port 252 so as to quickly customize the monitor 210 for a particular medical application or healthcare environment. For example, red may represent a hospital emergency room (ER), yellow a surgical ward and green a general care ward.
- ER hospital emergency room
- red, yellow and green-coded memories are loaded with monitor settings appropriate to the ER, surgical ward and general ward, respectively.
- a healthcare provider using the monitor 210 can then quickly determine if the monitor is configured appropriately for their purpose.
- the memory 250 serves both as a configuration defining device and as a configuration indicator.
- color-coded dongles each having a memory, standard connectors and corresponding standard interface electronics can be plugged into a standardized monitor port, such as USB or RS-232.
- color coded buttons are provided instead of, or in addition to the memories or dongles discussed above. The color coded buttons allow a user to quickly select a desired configuration.
- a color coordinated or non-color coordinated light is provided on or next to each button, memory or dongle. The light corresponding to the selected profile is lit.
- FIG. 3 illustrates a physiological measurement system 300 having a removable handheld monitor 310 and a corresponding docking station 320 .
- the docking station 320 may range in complexity from a simple charging station to an independent physiological measurement system that enhances the capabilities of the handheld when docked.
- a docking station embodiment may upgrade the capabilities of other monitors, such as described in U.S. Pat. No. 6,584,336 titled Universal/Upgrading Pulse Oximeter, issued Jun. 24, 2003, assigned to Masimo and incorporated by reference herein.
- a panel light 350 on the handheld 310 displays a selected color associated with a handheld configuration profile, such as described with respect to FIG. 1 , above.
- a top-mounted display 360 on the docking station also provides a textual description of a current profile.
- the display 360 simply provides a textual description of the handheld configuration profile when docked.
- the display 360 indicates a pre-programmed docking station profile that is adopted by the handheld when docked, modifying the panel light 350 accordingly.
- the docking station profile is combined with the handheld profile when docked, modifying both the panel light 350 and the display 360 accordingly.
- the docking station profile is downloaded to the handheld 310 when docked, as verified by the handheld panel light 350 . In this manner, the docking station 320 functions as a profile defining device for the handheld 310 .
- FIG. 4 illustrates a physiological monitoring system 400 comprising a multi-parameter physiological monitoring system (MPMS) 410 and a corresponding plug-in module 440 .
- the MPMS 410 may be capable of measuring a wide range of physiological parameters according to various plug-in modules, such as pulse oximetry, blood pressure, ECG and capnography to name a few.
- a MPMS having plug-in modules is described in U.S. Pat. No. 6,770,028 titled Dual Mode Pulse Oximeter, issued Aug. 3, 2004, assigned to Masimo and incorporated by reference herein.
- a panel light 450 on the plug-in 440 displays a selected color associated with a plug-in profile, such as described with respect to FIG. 1 , above.
- a monitor display 420 also provides a color profile indicator 460 and a corresponding textual description of a current profile.
- the display profile indicator 460 simply reflects the configuration profile of the plug-in.
- the display profile indicator 460 indicates a pre-programmed MPMS profile that is adopted by the plug-in 440 when plugged into the MPMS, modifying the panel light 450 accordingly.
- the MPMS profile is combined with the plug-in profile when docked, modifying both the panel light 450 and the display indicator 460 accordingly.
- an MPMS configuration profile is downloaded to the plug-in, as verified by the plug-in profile indicator 450 . In this manner, the MPMS 410 functions as a profile defining device for the plug-in 440 .
- FIGS. 5A-E is a multi-module monitor 500 including a display and docking station 510 , a removable shuttle 520 , a handheld monitor 530 and plug-ins 540 , all having corresponding profile configuration indicators 522 , 532 , 542 .
- the docking station 510 has a shuttle port that allows the shuttle 520 to dock.
- the shuttle 520 has a handheld port that allows the handheld monitor 530 to dock.
- the modular patient monitor 500 has three-in-one functionality including a handheld 530 , a handheld 530 docked into a shuttle 520 as a handheld/shuttle and a handheld/shuttle docked into the docking station 510 .
- the three modules of handheld 530 , shuttle 520 and docking station 510 function as one unit.
- Plug-in modules 540 expand parameter functionality.
- the handheld monitor 530 incorporates blood parameter measurement technologies including HbCO, HbMet, SpO 2 and Hbt
- the shuttle station 520 incorporates non-blood parameters, such as intelligent cuff inflation (ICI), end-tidal CO 2 (EtCO 2 ), acoustic respiration rate (ARR), glucose, patient body temperature (Temp) and ECG, to name a few.
- ICI intelligent cuff inflation
- EtCO 2 end-tidal CO 2
- ARR acoustic respiration rate
- glucose patient body temperature
- Temp patient body temperature
- ECG ECG
- the monitor 500 is capable of measuring a wide range of physiological parameters according to a combination of plug-in modules 540 , a removable shuttle 520 , a removable handheld 530 and a docking station 510 .
- the docking station 510 can display a color profile indicator 560 and a corresponding textual description of a current profile.
- the shuttle 520 has a color profile indicator 522 .
- the handheld 530 has a color profile indicator 532 .
- the plug-in modules 540 each have individual color profile indicators 542 .
- the docking station 510 and shuttle 520 simply reflect the configuration profile of what is docked.
- a pre-programmed docking station profile is adopted, at least in part, by each layer of docked components, modifying individual profile indicators 522 , 532 , 542 accordingly.
- the docking station 510 profile is combined with one or more of the profiles of each of the docked components 520 , 530 , 540 when docked, modifying the docking station configuration profile indicator 560 accordingly.
- a docking station configuration profile is downloaded to one or more of the docked components 520 , 530 , 540 as verified by the docked component profile indicators 522 , 532 , 542 . In this manner, the docking station 510 functions as a configuration profile defining or programming device.
- FIG. 6 illustrates a physiological monitor 100 that is responsive to a wireless device for configuration profile selection.
- multiple configuration profiles are pre-defined for the monitor 100 , such as described in detail with respect to FIGS. 7-16 , below.
- a fixed wireless device 610 or a mobile wireless device 620 communicates with the monitor 100 so as to select a particular one of the pre-defined configuration profiles.
- the monitor 100 then activates that profile, i.e. utilizes the profile settings as the monitor default settings, and illuminates the panel light 150 to a color that designates the active profile, as described above.
- the active profile may also be indicated by a display 170 .
- the wireless device may use any of various short-range wireless technologies, such as RFID (Radio Frequency Identification) or Bluetooth® (Bluetooth SIG) or medium-range wireless technologies, such as Wi-Fi.
- one or more fixed wireless devices such as a wall-mounted transmitter or transceiver 610 define particular sections inside of a medical care facility according to the wireless device range and coverage.
- the wireless device(s) 610 within a particular section transmit a unique ID or code to any monitor located within that section.
- the monitor 100 responds to that code to activate a pre-defined configuration profile associated with that section.
- one or more wall-mounted wireless devices 610 may be located in each of an ER, ICU or surgical ward, to name a few.
- a monitor 100 moved to or otherwise located within a particular section, such as an ER will automatically activate the ER configuration profile and illuminate the panel light 150 with a color indicating the ER configuration, e.g. red.
- the same monitor 100 If the same monitor 100 is then moved to the ICU, it will receive an ICU code from a fixed wireless device located in the ICU and will automatically activate the ICU configuration profile and illuminate the panel light 150 with a color indicating the ICU configuration, e.g. yellow.
- a mobile wireless device such as incorporated within a personal ID badge or tag 620 transmits a unique ID or code associated with a particular medical care provider or group of providers or associated with technical support.
- a particular provider such as a head physician or medical specialist
- the monitor to temporarily activate a specific configuration profile suited to that person's needs as long as that person remains in proximity to the monitor.
- technical support could utilize the tag 620 to quickly change the configuration profile of a particular monitor.
- the ID badge or tag 620 may also have a button or switch that selectively activates the specific configuration profile when desired. Wireless activation of configuration profiles is described in further detail with respect to FIG. 11 , below.
- FIG. 7 illustrates a monitor configuration system 700 according to a functional hierarchy that includes device 701 , code 702 , configuration 703 and input/output (I/O) 704 levels.
- a sensor 710 At the device level 701 is a sensor 710 and a monitor 720 having the functional characteristics described with respect to FIG. 1 , above.
- a monitor At the code level 702 , a monitor has a parameter measurement function 730 and a configuration management function 740 implemented, for example, in code executing on one or more processors within the monitor 720 .
- Parameter measurement 730 involves receiving a sensor signal, processing the sensor signal so as to derive various physiological parameters of interest and displaying the result.
- Configuration management 740 involves defining one or more configuration profiles 750 , selecting one of the defined profiles 760 and indicating the selected profile 770 so that a monitor user can readily determine the default settings that determine the monitor characteristics. Configurable defaults for a patient monitor are described in U.S. Provisional Application Ser. No. 61/126,268 titled Monitor User Interface, which is cited above and incorporated by reference herein.
- a configuration profile is a collection of user-defined default settings for a monitor specifying parameter measurement, display and alarm characteristics, to name a few.
- a configuration profile overrides factory defaults at power up.
- a configuration indicator 770 is a readily visible cue confirming to medical staff that the monitor is operating according to a selected profile 760 or a factory default.
- a configuration indicator 770 can be a color or an alphanumeric or both.
- a color indicator 770 may be a colored light that illuminates with a user-defined color representing a specific profile 760 .
- a color indicator 770 may also be a colored device, such as a memory, dongle or button plugged into a monitor programming port 787 .
- an alphanumeric indicator 770 may be a display of words or numbers that are either descriptive or are recognizable code associated with a selected profile 760 .
- a monitor's profile definition 750 can be manually entered on front-panel keys (buttons) 782 ; transferred via short-range wireless technology, such as RFID or wireless personal area network (PAN) 784 ; defined on a PC and downloaded via communications port 785 ; programmed into a memory device and transferred to a monitor via a specialized programming port 787 ; transferred to a monitor via local area network (LAN) or wide area network (WAN) 784 , whether wired or wireless or downloaded from a docked device via a docking port 780 .
- a configuration application executing on a PC may interactively prompt a user to define a configuration profile, which is then downloaded to one or more monitors according to any of the methods described above, or with respect to FIGS. 9-10 , below.
- FIG. 8 illustrates a patient monitoring system 800 including a sensor 810 and a physiological monitor 815 with configuration management features.
- the sensor 810 is attached to a tissue site, such as a finger 10 .
- the sensor 810 includes a plurality of emitters 812 irradiating the tissue site 10 with multiple wavelengths of light, and one or more detectors 814 capable of detecting the light after attenuation by the tissue 10 .
- the sensor 810 transmits optical radiation at wavelengths other than or including the red and infrared wavelengths utilized in pulse oximeters.
- the monitor 815 inputs a corresponding sensor signal and is configured to determine the relative concentrations of blood constituents other than or in addition to HbO 2 and Hb, such as HbCO, HbMet, fractional oxygen saturation, Hbt and blood glucose to name a few.
- the monitor 815 has a processor board 820 and a host instrument 830 .
- the processor board 820 communicates with the sensor 810 to receive one or more intensity signal(s) indicative of one or more physiological parameters.
- the host instrument 830 communicates with the processor board 820 to receive physiological parameter data calculated by the processor board 820 and to display or otherwise output that data.
- the host instrument 830 also communicates predetermined settings, described herein as a configuration profile, to the processor board 820 .
- a configuration profile determines, in part, what parameters are displayed and how those parameters are calculated.
- the processor board 820 comprises drivers 821 , a front-end 822 , a sensor port 824 , a digital signal processor (“DSP”) 826 and parameter measurement firmware 828 .
- the drivers 821 convert digital control signals into analog drive signals capable of driving sensor emitters 812 .
- the front-end 822 converts composite analog intensity signal(s) from light sensitive detector(s) 814 into digital data 823 input to the DSP 826 .
- the drivers 821 and front-end 822 are adapted to communicate via the sensor port 824 , which is capable of connecting to the sensor 810 .
- the DSP 826 is adapted to communicate via the sensor port 824 with one or more information elements 816 located on the sensor 810 and one or more cables connecting the sensor 810 to the physiological monitor 815 .
- the processor board 820 may also include one or more microcontrollers in communications with the DSP 826 so as to monitor activity of the DSP 826 and communicate calculated parameters to the host instrument 830 .
- the processor board 820 comprises processing circuitry arranged on one or more printed circuit boards capable of installation into the monitor 815 , or capable of being distributed as some or all of one or more OEM components for a wide variety of host instruments monitoring a wide variety of patient information.
- the host instrument 830 includes an instrument manager 840 , a user interface 850 , I/O ports 860 and in some embodiments a docking port 870 .
- the host instrument 830 displays one or more of a pulse rate, plethysmograph data, perfusion index, signal quality, and values of blood constituents in body tissue, including for example, SpO 2 , carboxyhemoglobin (HbCO), methemoglobin (HbMet), total hemoglobin (Hbt), fractional oxygen saturation, blood glucose, bilirubin, or the like.
- the host instrument 830 may also be capable of storing or displaying historical or trending data related to one or more of the measured values or combinations of the measured values.
- the instrument manager 840 may be one or more microcontrollers that are in communications with the processor board 820 , the user interface 850 , the I/O ports 860 and the docking port 870 .
- the instrument manager 840 inputs calculated parameters and alarm conditions from the processor board 820 and outputs parameter values to the displays 851 and alarm triggers to the user interface 850 .
- the instrument manager 840 responds to user-actuated keys 853 and communicates with external devices via various I/O ports 860 .
- the instrument manager 840 also executes configuration management 842 firmware.
- Configuration management defines and manages one or more configuration profiles that provide operational settings to the DSP 826 and define user interface characteristics among other functions, as described above with respect to FIG. 7 .
- the instrument manager 840 communicates with one or more of a user interface 850 , I/O ports 860 or a docking port 870 to receive configuration profile data and, in some embodiments, to transmit indications of the default settings.
- I/O ports 860 may include one or more of a communication port 861 , a programming port 862 and a networking port 863 .
- the instrument manager 840 may communicate with an external device removable attached to a docking port 870 .
- a profile is defined via manually-actuated keys 853 and communicated to the instrument manager 840 .
- a profile is defined in an external device, such as a PC, and communicated to the instrument manager 840 via a communication port 861 , such as a USB or RS-232 interface.
- a profile is defined in a characterization element having monitor settings stored in memory. The characterization element communicates the defined profile to the instrument manager 840 via a programming I/O port 862 .
- the instrument manager 840 executes configuration management instructions 842 for downloading or otherwise determining one or more user-defined configuration profiles and for indicating the corresponding default settings.
- FIG. 9 illustrates a profile programming embodiment 900 having a monitor 910 in communications with a PC 920 , notebook, PDA or similar device running a configuration application program (AP).
- the configuration AP for example, prompts a user through a menu of monitor default setting options. Once a complete set of options is selected, the PC 920 encodes the data as a user-defined profile and downloads the profile as default settings to the monitor 910 . Alternatively, a set of predefined configuration profiles may be provided on a CD ROM 930 or similar storage media. A user then simply selects a desired profile via the PC 920 , which downloads that profile to the monitor 910 .
- a monitor 910 may be factory delivered with a variety of configuration profiles, which are selected via configuration codes, menus or similar cataloging functions using front-panel keys 940 .
- a selected profile is associated with a uniquely colored panel light 950 and/or an identifying alphanumeric on a mini-screen 960 so that medical staff can quickly determine that the appropriate monitor defaults are active upon monitor power-up.
- FIG. 10 illustrates another profile programming embodiment 1000 having a monitor 1010 in communications with a characterization element 1060 via a programming port 1050 .
- a user-defined configuration profile is stored in a colored characterization element 1060 , such as an EEPROM, EPROM, PROM or similar non-volatile memory device.
- the monitor 1010 has a specialized programming or configuration port 1050 that electrically and mechanically accepts and communicates with the memory device 1060 .
- the monitor 1010 reads the characterization element 1060 to determine its default settings upon power-up.
- the characterization element 1060 is specifically colored so as to provide a readily visible indication of the default profile stored within.
- the user-defined default profile is easily changed by removing one characterization element 1060 from the port 1050 and replacing it with a differently colored characterization element 1060 selected from a preloaded set of memory devices.
- a profile programming device 1070 has multiple programming slots 1072 for mass programming profiles into characterization elements 1060 .
- a profile is either defined directly in the monitor 1010 or communicated from an external device, such as a PC 1020 .
- a profile may be directly programmed in the PC 1020 or loaded from a CD ROM 1030 .
- the PC 1020 communicates with the programming device 1070 to mass-produce characterization elements all having the same profile or each having different profiles depending on the programming slot 1072 .
- a single characterization element 1060 may be programmed via the monitor 1010 while inserted into the port 1050 .
- the profile programmed may be downloaded to the monitor 1010 from the PC 1020 or entered directly into the monitor 1010 via front-panel keys 1040 .
- FIG. 11 illustrates a physiological monitor 100 that is responsive to a wireless device 50 for configuration profile selection, such as described with respect to FIG. 6 , above.
- the monitor 100 has an instrument manager 1110 that receives calculated physiological parameters 1112 from a digital signal processor (DSP) and provides default settings 1114 to the DSP, such as described with respect to FIG. 8 , above.
- DSP digital signal processor
- the monitor 1100 has a profile lookup table 1120 , a wireless transceiver 1130 or receiver, predefined profiles 1140 , and a profile indicator 1150 .
- a wireless device 50 is in communications with the wireless transceiver 1130 when the wireless device 50 is in the vicinity of the monitor 100 .
- the wireless device 50 may be a fixed device, such as a wall-mounted transceiver or transmitter that designates an area within a building or facility, such as described with respect to FIG. 6 , above.
- the wireless device may be a tag or card utilizing short range wireless transceiver or transmitter technology, such as RFID or Bluetooth®.
- the wireless device 50 transmits a code 1132 to the transceiver 1130 that corresponds to one of the predefined profiles 1140 .
- the transceiver 1130 communicates the profile code 1132 to the instrument manager 1110 .
- the instrument manager 1110 access the lookup table 1120 so as to determine a particular profile corresponding to the code 1124 .
- the instrument manager 1110 loads the selected profile as the monitor default settings and communicates at least some of those settings 1114 to the DSP.
- FIGS. 12A-D illustrate further details of a monitor 100 described above with respect to FIG. 1 .
- the monitor front panel 101 has a sensor port 110 , parameter displays 120 , a speaker 130 , control buttons 140 , a panel light 150 and a status light 160 .
- the sensor port 110 accepts a patient cable 30 ( FIG. 1 ) connector so as to communicate with a sensor 20 ( FIG. 1 ).
- the parameter displays 120 provide numerical readouts of measured blood parameters such as oxygen saturation (SpO 2 ), pulse rate (BPM) and total hemoglobin.
- the speaker 130 provides, for example, an audio indication of alarms.
- the control buttons 140 provide user control and selection of monitor features including power on/off 141 , sensitivity 142 , brightness 143 , display 145 , alarm silence 147 and alarm limits 148 and allow input of a configuration profile via up and down scrolling 149 and enter 144 buttons.
- An alarm status light 135 indicates high priority alarms.
- the monitor top panel 102 has an LCD display 170 .
- the monitor back panel 103 provides a power entry module 181 , a serial output connector 182 , a nurse call connector 183 and a ground connector 184 .
- FIG. 12D illustrates a vertical monitor 109 embodiment of the monitor 100 described with respect to FIG. 1 and FIGS. 12A-C , above.
- FIG. 13 illustrates a tri-level monitor user interface that utilizes front panel buttons (keys) to navigate through the menu selections.
- monitor settings that are typically adjusted most often for patient monitoring (level 1) are segregated from settings typically adjusted less often (level 2).
- Level 1 and level 2 settings are further segregated from advanced settings (level 3) that require a timed, combination button press to enter.
- this user interface allows a user to manually enter a configuration profile, such as described above, and to associate that profile with a color displayed by the panel light.
- setup level 1 1320 contains the parameter and measurement settings that are adjusted most often including alarm limits 1360 , display brightness 1370 , and sensitivity settings 1380 .
- Setup level 2 1330 contains parameter and measurement settings that are not changed as frequently as level 1, including alarm volume, alarm silence, alarm delay, clear trend and button volume parameters.
- Setup level 3 1340 contains advanced parameter and measurement settings.
- FIG. 14 illustrates a level 1 example for setting alarm limits.
- the alarm limits button is pressed to access the alarm limits menu.
- the alarm limits button is used to access the alarm limits options and to move between options of % SpO 2 LO 1410 , % SpO 2 HI 1420 , Pulse rate (BPM) LO 1430 , Pulse rate (BPM) HI 1440 , PVI LO 1450 and PVI HI 1460 .
- Up or down buttons are used to adjust the value to the desired setting.
- the alarm limits button is pressed to accept the setting and move to the next option. Once the last option is accessed, an additional press of the alarm limits button returns the device to an initial screen.
- the display button is pressed to exit at any time and return to the initial screen.
- FIG. 15 illustrates a level 2 example for setting button volume.
- the settings options include default level 2 1510 , level 1 1520 , off 1540 and level 3 1530 .
- Up or down button is used to move between settings and the enter button 1540 is used to accept the setting and move to the next menu screen.
- the display button is pressed to exit without saving the new setting and to return to the initial display screen.
- FIGS. 16A-B illustrate a level 3 example for altering the factory defaults.
- the enter button is held down and the down button is pressed for 5 seconds. After entering level 3, the enter button is used to save new settings and move to the next menu. The user may cycle through the menu options by continuing to press the enter button. Pressing the display button exits the menu and returns the display to an initial display screen.
- the settings options are no change (do not adjust factory default settings) 1610 , user default (set to user settings) 1625 and factory default (restore factory default settings) 1620 .
- Up or down button is used to move between settings and the enter button is pressed to accept the setting and move to the next menu.
- the display button is pressed to exit without saving the new setting and to return to the home display screen.
- the factory default is set to this setting when configuring a device profile and selecting a color for the device profile LED.
- the monitor can be configured to save changes to the device settings as a device profile.
- users can adjust monitor settings and parameter/measurement alarm limits.
- the user may save the settings as a device profile. This device profile becomes the new default settings and the saved (device profile) settings will be retained after a power cycle.
- the user may select a color for the device profile LED to associate with the saved profile.
- the device profile LED will illuminate with the selected color, allowing the user to verify at a glance that a device profile has been set. If changes are made to the device settings after the device profile feature has been enabled, the device profile LED will turn off, indicating a change from the device profile settings.
Abstract
Description
- The present application claims priority benefit under 35 U.S.C. §119(e) to U.S. Provisional Patent Application Ser. No. 61/126,268, filed May 2, 2008, titled Monitor User Interface; and U.S. Provisional Patent Application Ser. No. 61/050,205 filed May 3, 2008, titled Monitor Configuration System. All of the above cited provisional applications are hereby incorporated by reference herein.
- Pulse oximetry systems for measuring constituents of circulating blood have gained rapid acceptance in a wide variety of medical applications including surgical wards, intensive care and neonatal units, general wards, home care, physical training, and virtually all types of monitoring scenarios. A pulse oximetry system generally includes an optical sensor applied to a patient, a monitor for processing sensor signals and displaying results and a patient cable electrically interconnecting the sensor and the monitor. A pulse oximetry sensor has light emitting diodes (LEDs), typically one emitting a red wavelength and one emitting an infrared (IR) wavelength, and a photodiode detector. The emitters and detector are attached to a patient tissue site, such as a finger. The patient cable transmits drive signals to these emitters from the monitor, and the emitters respond to the drive signals to transmit light into the tissue site. The detector generates a signal responsive to the emitted light after attenuation by pulsatile blood flow within the tissue site. The patient cable transmits the detector signal to the monitor, which processes the signal to provide a numerical readout of physiological parameters such as oxygen saturation (SpO2) and pulse rate. Advanced physiological monitoring systems utilize multiple wavelength sensors and multiple parameter monitors to provide enhanced measurement capabilities including, for example, the measurement of carboxyhemoglobin (HbCO), methemoglobin (HbMet) and total hemoglobin (Hbt).
- Pulse oximeters capable of reading through motion induced noise are disclosed in at least U.S. Pat. Nos. 6,770,028, 6,658,276, 6,650,917, 6,157,850, 6,002,952, 5,769,785, and 5,758,644; low noise pulse oximetry sensors are disclosed in at least U.S. Pat. Nos. 6,088,607 and 5,782,757; all of which are assigned to Masimo Corporation, Irvine, Calif. (“Masimo”) and are incorporated by reference herein.
- Physiological monitors and corresponding multiple wavelength optical sensors are described in at least U.S. patent application Ser. No. 11/367,013, filed Mar. 1, 2006 and titled Multiple Wavelength Sensor Emitters and U.S. patent application Ser. No. 11/366,208, filed Mar. 1, 2006 and titled Noninvasive Multi-Parameter Patient Monitor, both assigned to Masimo Laboratories, Irvine, Calif. (“Masimo Labs”) and both incorporated by reference herein.
- Further, physiological monitoring systems that include low noise optical sensors and pulse oximetry monitors, such as any of LNOP® adhesive or reusable sensors, SofTouch™ sensors, Hi-Fi Trauma™ or Blue™ sensors; and any of Radical®, SatShare™, Rad-9™, Rad-5™, Rad-5v™ or PPO+™ Masimo SET® pulse oximeters, are all available from Masimo. Physiological monitoring systems including multiple wavelength sensors and corresponding noninvasive blood parameter monitors, such as Rainbow™ adhesive and reusable sensors and Rad-57™, Rad-87™ and Radical-7™ monitors for measuring SpO2, pulse rate, perfusion index, signal quality, HbCO and HbMet among other parameters are also available from Masimo.
- Advanced noninvasive physiological parameter monitors provide medical practitioners with substantial operational flexibility, including the ability to set parameters displayed, display format, alarm thresholds, alarm types, sensitivity and averaging times, to name just a few. Optimal settings vary with the monitoring application. Monitoring in a hospital environment may differ from that of an ambulance or out-patient clinic. Also different hospital wards servicing different types of patients with different medical care needs are likely to require different monitor settings. For example, ER monitoring requirements will likely differ from those of a surgical ward. Monitoring of neonatal patients will likely differ from monitoring of geriatric patients. Thus, the operational flexibility of these monitors is a challenge to medical staff and administrators at various facilities, especially if a monitor is used for multiple purposes and patient types or if monitors are frequently moved between locations within a large facility.
- A monitor configuration system meets this challenge in various respects. In an embodiment, a monitor configuration system advantageously provides a readily recognizable indication of the current default settings. This indication can be associated with a particular ward or patient group, as examples. In addition, a monitor can be programmed with any of multiple user-defined default settings, each associated with a unique configuration indication. In an embodiment, the monitor control panel and display provide hidden menus that allow technical support staff to quickly change configuration profiles to best suit the current monitor usage without risk of accidental configuration changes by medical staff. Also, technical staff can utilize manual procedures or programming aids to conveniently enter or modify one or more default settings.
- Advantageously, an aspect of a monitor configuration system allows users to change to default settings using front-panel keys or an external configuration application. This user-defined “configuration profile” overrides the factory default settings and is retained after a power cycle. A user may also associate a color and/or a display message with the profile, as a “configuration indicator,” which allows a user to verify at a glance which configuration profile is the default. In an embodiment, a front-panel colored light is a configuration indicator. If changes are made to the device settings after the configuration profile feature has been enabled, the front panel light will turn off, indicating a change from the saved profile settings. In other embodiments a colored plug-in memory, dongle or similar device programs the monitor settings and serves as a profile indicator.
- One aspect of a monitor configuration system communicates with a physiological sensor and includes a processor, for example, a digital signal processor (DSP) and an instrument manager processor. The physiological sensor can have emitters that transmit optical radiation into a tissue site and at least one detector that receives the optical radiation after attenuation by pulsatile blood flow within the tissue site. The DSP can communicate with the sensor and calculate physiological parameters responsive to the sensor. An instrument manager receives the calculated physiological parameters from the DSP, transmits the physiological parameters to a display and controls alarms based upon the physiological parameters. The instrument manager is responsive to a configuration profile that specifies DSP calculations, physiological parameter displays and alarms. The configuration indicator identifies the configuration profile. In various embodiments, the configuration indicator comprises a panel light. The instrument manager selects between a factory-default configuration profile and a user-specified configuration profile. The panel light displays a first color when the factory-default settings are selected and a second color when the user-specified settings are selected. The user-specified settings are manually defined. The panel light color for user-specified settings is manually defined. The configuration indicator comprises a top-mounted alphanumeric display.
- Another aspect of a monitor configuration system comprises a sensor having emitters that transmit optical radiation into a tissue site and at least one detector that receives the optical radiation after attenuation by pulsatile blood flow within the tissue site. A calculator communicates with the sensor and calculates physiological parameters responsive to the sensor. An instrument manager receives the calculated physiological parameters from the calculator, transmits the physiological parameters to a display and controls alarms based upon the physiological parameters. The instrument manager is responsive to a configuration profile with respect to calculator calculations, physiological parameter displays and alarms. In various embodiments the instrument manager reads the configuration profile via the I/O port. A memory device stores the configuration profile and is removably attached to the I/O port so as to communicate the configuration profile to the instrument manager. A color is affixed to at least a portion of the memory device. The color corresponds to the configuration profile. The memory device and its color are readily visible to a monitor user when the memory device is removably attached to the I/O port so as to designate the configuration profile to the user. A configuration profile routine executes on the instrument manager and writes the memory device with configuration profile settings.
- A further aspect of a monitor configuration system comprises a configuration profile of user-specified settings defined for a physiological monitor. The configuration profile is selected to override corresponding factory-specified settings. A color is associated with the configuration profile. The selected profile is indicated by displaying the associated color. The user-specified settings and the factory-specified settings each relate to at least one of calculating physiological parameters, displaying the physiological parameters and alarming based upon the physiological parameters. In various embodiments, the configuration profile is defined by reading the configuration profile into the physiological monitor. The selected profile is indicated by illuminating a portion of the physiological monitor with the color. The reading comprises downloading the configuration profile from an input/output (I/O) port. The illuminating comprises activating a colored panel light on the monitor. The selecting comprises receiving from a wireless device a code corresponding to the configuration profile and activating the configuration profile according to the code.
- An additional aspect of a monitor configuration system comprises a profile definition means for setting parameter measurement, display and alarm characteristics of a physiological monitor, a profile selection means for activating a defined profile and a profile indication means for cuing a monitor user as to the selected profile. In various embodiments the profile definition means comprises a menu means for manually entering profile settings. The profile selection means comprises a save means for specifying a defined profile as the monitor default settings. The profile indication means comprises a color selection means for associating a color with a saved profile and an illumination means for displaying the color. The profile definition means comprises a downloading means for transferring profile settings to the monitor via at least one of an I/O port and a docking port. The profile selection means comprises a wireless means for specifying a defined profile as the monitor default settings.
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FIGS. 1-5E are perspective views of physiological monitors utilizing various monitor configuration system embodiments; -
FIG. 1 is a standalone physiological monitor having a front-panel colored light and a top-mounted display as configuration indicators; -
FIG. 2 is a standalone physiological monitor having a color-coded plug-in configuration indicator; -
FIG. 3 is a removable handheld monitor having a front-panel colored light and a corresponding docking station having a top-mounted display configuration indicator; -
FIG. 4 is a physiological monitoring system and a corresponding plug-in module having a colored panel light and a colored monitor display as configuration indicators; -
FIGS. 5A-E is a physiological monitoring system including a removable satellite module, a docking handheld monitor and plug-ins each having configuration indicators; -
FIG. 6 is a perspective view of a physiological monitoring system responsive to a wall-mounted or a tag-mounted short-range wireless device for selection of a configuration profile; -
FIG. 7 is a hierarchical block diagram of a monitor configuration system; -
FIG. 8 is a detailed block diagram of a physiological measurement system that utilizes a monitor configuration system; -
FIG. 9 is a perspective view of a I/O port download embodiment for defining configuration profiles; -
FIG. 10 is a perspective view of a plug-in programming embodiment for defining configuration profiles; -
FIG. 11 is a detailed block diagram of a physiological monitoring system responsive to a short-range wireless device for selection of a configuration profile; -
FIGS. 12A-D are front, top and back views, respectively, of a horizontal monitor embodiment and a front view of a vertical monitor embodiment having configuration indicators; -
FIG. 13 is a general block diagram illustrating a tri-level configuration user interface, further illustrated inFIGS. 14-16 ; -
FIG. 14 is alevel 1 exemplar flow diagram; -
FIG. 15 is alevel 2 exemplar flow diagram; -
FIGS. 16A-B is alevel 3 exemplar flow diagram. -
FIG. 1 illustrates aphysiological measurement system 10 that utilizes a configuration indicator embodiment. Thephysiological measurement system 10 hasmonitor 10 and a multiple wavelengthoptical sensor 20. Thesensor 20 allows the measurement of various blood constituents and related parameters. Thesensor 20 is configured to communicate with amonitor sensor port 110 via apatient cable 30. Thesensor 20 is typically attached to a tissue site, such as a finger. Thepatient cable 30 transmits a drive signal from themonitor 100 to thesensor 20 and a resulting detector signal from thesensor 20 to themonitor 100. Themonitor 100 processes the detector signal to provide a numerical readout of measured blood parameters including oxygen saturation (SpO2), pulse rate (PR), carboxyhemoglobin (HbCO), methemoglobin (HbMet) and total hemoglobin (Hbt), to name a few.Displays 120 provide readouts, bar graphs or other visual presentations of the measured parameters. Aspeaker 130 or other audio transducer generates beeps, alarms or other audio presentations of the measured parameters. Monitor keys (buttons) 140 provide control over operating modes and alarms, to name a few. Asystem status light 160 indicates alarm status, data status and monitor mode. - As described in detail below, a user can determine the operational characteristics of the
monitor 100 by changing various factory default settings. A particular group of custom settings, described herein as a configuration profile, determines the physiological parameters that are measured, various options related to those measurements, how the physiological parameters are displayed, alarm thresholds for the physiological parameters and alarm types, to name a few. Many configuration profiles are possible for a monitor, and some profiles are more appropriate for a particular healthcare application or environment than others. A configuration indicator advantageously allows a user to quickly recognize that a particular configuration profile is the current default setting for that monitor. - As shown in
FIG. 1 , apanel light 150 displays a selected one of various colors, such as shown in TABLE 1. Advantageously, each color of thepanel light 150 can be associated with a unique configuration profile. Accordingly, medical staff using the monitor can readily recognize and discern the monitor's settings by observing the illumination color. As an example, pink can be associated with standardized ER settings, teal with surgical ward settings and blue with general ward settings. - The
panel light 150 illuminates with a color associated with a user-defined profile at power on. In one embodiment, thepanel light 150 glows and slowly cycles from bright to dim if a temporary change has been made to the user-defined profile or if defaults have been activated via thecontrol buttons 140. Thepanel light 150 returns to a solid state when settings are returned to the user-defined profile. In an embodiment, a factory default profile is associated with purple having RGB values of R 75,G 40 and B 55. In an embodiment, optional profile colors for user defined profiles are represented by the RGB codes listed in TABLE 1, below. -
TABLE 1 Colors and RGB Values COLOR DESCRIPTION RGB CODE Dark Purple 10 05 15 Electric Blue 25 65 40 Teal 15 65 15 Green 10 40 05 Pink 95 20 15 Light Pink 60 20 05 - Further shown in
FIG. 1 , a top-mounteddisplay 170, such as an LCD mini-screen, displays radio communication status, system status and, in an embodiment, a textual description of the current profile corresponding to thepanel light 150. This allows medical staff to verify the profile associated with a particular panel light color. For example, thedisplay 170 might indicate “ER,” “surgical,” or “general” corresponding to selected profiles for those wards. The monitor illustrated inFIG. 1 is described in further detail with respect toFIGS. 12A-D , below. -
FIG. 2 illustrates aphysiological measurement system 200 that utilizes a plug-in configuration indicator. In particular, a color-codedmemory device 250 is removably plugged into aconfiguration port 252. Thememory 250 is preloaded with a specific configuration profile, and themonitor 210 reads thememory 250 so as to transfer the corresponding settings into the monitor. Different color-coded memories may store different configuration profiles, i.e. user-selected monitor settings. A user can advantageously select a memory by color and plug thememory 250 into theconfiguration port 252 so as to quickly customize themonitor 210 for a particular medical application or healthcare environment. For example, red may represent a hospital emergency room (ER), yellow a surgical ward and green a general care ward. Accordingly, red, yellow and green-coded memories are loaded with monitor settings appropriate to the ER, surgical ward and general ward, respectively. A healthcare provider using themonitor 210 can then quickly determine if the monitor is configured appropriately for their purpose. Thus, thememory 250 serves both as a configuration defining device and as a configuration indicator. In other embodiments, color-coded dongles each having a memory, standard connectors and corresponding standard interface electronics can be plugged into a standardized monitor port, such as USB or RS-232. In an embodiment, color coded buttons are provided instead of, or in addition to the memories or dongles discussed above. The color coded buttons allow a user to quickly select a desired configuration. In an embodiment, a color coordinated or non-color coordinated light is provided on or next to each button, memory or dongle. The light corresponding to the selected profile is lit. -
FIG. 3 illustrates aphysiological measurement system 300 having a removablehandheld monitor 310 and acorresponding docking station 320. Thedocking station 320 may range in complexity from a simple charging station to an independent physiological measurement system that enhances the capabilities of the handheld when docked. For example, a docking station embodiment may upgrade the capabilities of other monitors, such as described in U.S. Pat. No. 6,584,336 titled Universal/Upgrading Pulse Oximeter, issued Jun. 24, 2003, assigned to Masimo and incorporated by reference herein. Apanel light 350 on the handheld 310 displays a selected color associated with a handheld configuration profile, such as described with respect toFIG. 1 , above. A top-mounteddisplay 360 on the docking station also provides a textual description of a current profile. In an embodiment, thedisplay 360 simply provides a textual description of the handheld configuration profile when docked. In an embodiment, thedisplay 360 indicates a pre-programmed docking station profile that is adopted by the handheld when docked, modifying thepanel light 350 accordingly. In an embodiment, the docking station profile is combined with the handheld profile when docked, modifying both thepanel light 350 and thedisplay 360 accordingly. In an embodiment, the docking station profile is downloaded to the handheld 310 when docked, as verified by thehandheld panel light 350. In this manner, thedocking station 320 functions as a profile defining device for the handheld 310. -
FIG. 4 illustrates aphysiological monitoring system 400 comprising a multi-parameter physiological monitoring system (MPMS) 410 and a corresponding plug-inmodule 440. TheMPMS 410 may be capable of measuring a wide range of physiological parameters according to various plug-in modules, such as pulse oximetry, blood pressure, ECG and capnography to name a few. As an example, a MPMS having plug-in modules is described in U.S. Pat. No. 6,770,028 titled Dual Mode Pulse Oximeter, issued Aug. 3, 2004, assigned to Masimo and incorporated by reference herein. Apanel light 450 on the plug-in 440 displays a selected color associated with a plug-in profile, such as described with respect toFIG. 1 , above. Amonitor display 420 also provides acolor profile indicator 460 and a corresponding textual description of a current profile. In an embodiment, thedisplay profile indicator 460 simply reflects the configuration profile of the plug-in. In an embodiment, thedisplay profile indicator 460 indicates a pre-programmed MPMS profile that is adopted by the plug-in 440 when plugged into the MPMS, modifying thepanel light 450 accordingly. In an embodiment, the MPMS profile is combined with the plug-in profile when docked, modifying both thepanel light 450 and thedisplay indicator 460 accordingly. In an embodiment, an MPMS configuration profile is downloaded to the plug-in, as verified by the plug-inprofile indicator 450. In this manner, theMPMS 410 functions as a profile defining device for the plug-in 440. -
FIGS. 5A-E is amulti-module monitor 500 including a display anddocking station 510, aremovable shuttle 520, ahandheld monitor 530 and plug-ins 540, all having correspondingprofile configuration indicators docking station 510 has a shuttle port that allows theshuttle 520 to dock. Theshuttle 520 has a handheld port that allows thehandheld monitor 530 to dock. Accordingly, the modular patient monitor 500 has three-in-one functionality including a handheld 530, a handheld 530 docked into ashuttle 520 as a handheld/shuttle and a handheld/shuttle docked into thedocking station 510. When docked, the three modules ofhandheld 530,shuttle 520 anddocking station 510 function as one unit. Plug-inmodules 540 expand parameter functionality. In an embodiment, thehandheld monitor 530 incorporates blood parameter measurement technologies including HbCO, HbMet, SpO2 and Hbt, and theshuttle station 520 incorporates non-blood parameters, such as intelligent cuff inflation (ICI), end-tidal CO2 (EtCO2), acoustic respiration rate (ARR), glucose, patient body temperature (Temp) and ECG, to name a few. A multi-module monitor is described in U.S. Pat. App. Pub. No. 2008/0108884 A1 titled Modular Patient Monitor, filed Sep. 24, 2007 and incorporated by reference herein. - As shown in
FIG. 5A-E , themonitor 500 is capable of measuring a wide range of physiological parameters according to a combination of plug-inmodules 540, aremovable shuttle 520, aremovable handheld 530 and adocking station 510. Thedocking station 510 can display acolor profile indicator 560 and a corresponding textual description of a current profile. Theshuttle 520 has acolor profile indicator 522. The handheld 530 has acolor profile indicator 532. Also, the plug-inmodules 540 each have individualcolor profile indicators 542. In an embodiment, thedocking station 510 andshuttle 520 simply reflect the configuration profile of what is docked. In an embodiment, a pre-programmed docking station profile is adopted, at least in part, by each layer of docked components, modifyingindividual profile indicators docking station 510 profile is combined with one or more of the profiles of each of the dockedcomponents configuration profile indicator 560 accordingly. In an embodiment, a docking station configuration profile is downloaded to one or more of the dockedcomponents component profile indicators docking station 510 functions as a configuration profile defining or programming device. -
FIG. 6 illustrates aphysiological monitor 100 that is responsive to a wireless device for configuration profile selection. In particular, multiple configuration profiles are pre-defined for themonitor 100, such as described in detail with respect toFIGS. 7-16 , below. Advantageously, a fixedwireless device 610 or amobile wireless device 620 communicates with themonitor 100 so as to select a particular one of the pre-defined configuration profiles. Themonitor 100 then activates that profile, i.e. utilizes the profile settings as the monitor default settings, and illuminates thepanel light 150 to a color that designates the active profile, as described above. The active profile may also be indicated by adisplay 170. The wireless device may use any of various short-range wireless technologies, such as RFID (Radio Frequency Identification) or Bluetooth® (Bluetooth SIG) or medium-range wireless technologies, such as Wi-Fi. - In an embodiment, one or more fixed wireless devices, such as a wall-mounted transmitter or
transceiver 610 define particular sections inside of a medical care facility according to the wireless device range and coverage. The wireless device(s) 610 within a particular section transmit a unique ID or code to any monitor located within that section. Themonitor 100 responds to that code to activate a pre-defined configuration profile associated with that section. For example, one or more wall-mountedwireless devices 610 may be located in each of an ER, ICU or surgical ward, to name a few. Amonitor 100 moved to or otherwise located within a particular section, such as an ER, will automatically activate the ER configuration profile and illuminate thepanel light 150 with a color indicating the ER configuration, e.g. red. If thesame monitor 100 is then moved to the ICU, it will receive an ICU code from a fixed wireless device located in the ICU and will automatically activate the ICU configuration profile and illuminate thepanel light 150 with a color indicating the ICU configuration, e.g. yellow. - In another embodiment, a mobile wireless device, such as incorporated within a personal ID badge or tag 620 transmits a unique ID or code associated with a particular medical care provider or group of providers or associated with technical support. In this manner, the appearance of a particular provider, such as a head physician or medical specialist, in proximity to the
monitor 100 triggers the monitor to temporarily activate a specific configuration profile suited to that person's needs as long as that person remains in proximity to the monitor. Alternatively, technical support could utilize thetag 620 to quickly change the configuration profile of a particular monitor. The ID badge ortag 620 may also have a button or switch that selectively activates the specific configuration profile when desired. Wireless activation of configuration profiles is described in further detail with respect toFIG. 11 , below. -
FIG. 7 illustrates amonitor configuration system 700 according to a functional hierarchy that includesdevice 701,code 702,configuration 703 and input/output (I/O) 704 levels. At thedevice level 701 is asensor 710 and amonitor 720 having the functional characteristics described with respect toFIG. 1 , above. At thecode level 702, a monitor has aparameter measurement function 730 and aconfiguration management function 740 implemented, for example, in code executing on one or more processors within themonitor 720.Parameter measurement 730 involves receiving a sensor signal, processing the sensor signal so as to derive various physiological parameters of interest and displaying the result.Configuration management 740 involves defining one ormore configuration profiles 750, selecting one of the definedprofiles 760 and indicating the selectedprofile 770 so that a monitor user can readily determine the default settings that determine the monitor characteristics. Configurable defaults for a patient monitor are described in U.S. Provisional Application Ser. No. 61/126,268 titled Monitor User Interface, which is cited above and incorporated by reference herein. - In particular, a configuration profile is a collection of user-defined default settings for a monitor specifying parameter measurement, display and alarm characteristics, to name a few. In particular, a configuration profile overrides factory defaults at power up. A
configuration indicator 770 is a readily visible cue confirming to medical staff that the monitor is operating according to a selectedprofile 760 or a factory default. In various embodiments, aconfiguration indicator 770 can be a color or an alphanumeric or both. As described above, acolor indicator 770 may be a colored light that illuminates with a user-defined color representing aspecific profile 760. Acolor indicator 770 may also be a colored device, such as a memory, dongle or button plugged into amonitor programming port 787. Also described above, analphanumeric indicator 770 may be a display of words or numbers that are either descriptive or are recognizable code associated with a selectedprofile 760. - A monitor's
profile definition 750 can be manually entered on front-panel keys (buttons) 782; transferred via short-range wireless technology, such as RFID or wireless personal area network (PAN) 784; defined on a PC and downloaded viacommunications port 785; programmed into a memory device and transferred to a monitor via aspecialized programming port 787; transferred to a monitor via local area network (LAN) or wide area network (WAN) 784, whether wired or wireless or downloaded from a docked device via adocking port 780. A configuration application executing on a PC may interactively prompt a user to define a configuration profile, which is then downloaded to one or more monitors according to any of the methods described above, or with respect toFIGS. 9-10 , below. -
FIG. 8 illustrates apatient monitoring system 800 including asensor 810 and aphysiological monitor 815 with configuration management features. Thesensor 810 is attached to a tissue site, such as afinger 10. Thesensor 810 includes a plurality ofemitters 812 irradiating thetissue site 10 with multiple wavelengths of light, and one ormore detectors 814 capable of detecting the light after attenuation by thetissue 10. Thesensor 810 transmits optical radiation at wavelengths other than or including the red and infrared wavelengths utilized in pulse oximeters. Themonitor 815 inputs a corresponding sensor signal and is configured to determine the relative concentrations of blood constituents other than or in addition to HbO2 and Hb, such as HbCO, HbMet, fractional oxygen saturation, Hbt and blood glucose to name a few. - The
monitor 815 has aprocessor board 820 and ahost instrument 830. Theprocessor board 820 communicates with thesensor 810 to receive one or more intensity signal(s) indicative of one or more physiological parameters. Thehost instrument 830 communicates with theprocessor board 820 to receive physiological parameter data calculated by theprocessor board 820 and to display or otherwise output that data. Thehost instrument 830 also communicates predetermined settings, described herein as a configuration profile, to theprocessor board 820. A configuration profile determines, in part, what parameters are displayed and how those parameters are calculated. - As shown in
FIG. 8 , theprocessor board 820 comprisesdrivers 821, a front-end 822, asensor port 824, a digital signal processor (“DSP”) 826 andparameter measurement firmware 828. In general, thedrivers 821 convert digital control signals into analog drive signals capable of drivingsensor emitters 812. The front-end 822 converts composite analog intensity signal(s) from light sensitive detector(s) 814 intodigital data 823 input to theDSP 826. Thedrivers 821 and front-end 822 are adapted to communicate via thesensor port 824, which is capable of connecting to thesensor 810. In an embodiment, theDSP 826 is adapted to communicate via thesensor port 824 with one ormore information elements 816 located on thesensor 810 and one or more cables connecting thesensor 810 to thephysiological monitor 815. Theprocessor board 820 may also include one or more microcontrollers in communications with theDSP 826 so as to monitor activity of theDSP 826 and communicate calculated parameters to thehost instrument 830. In an embodiment, theprocessor board 820 comprises processing circuitry arranged on one or more printed circuit boards capable of installation into themonitor 815, or capable of being distributed as some or all of one or more OEM components for a wide variety of host instruments monitoring a wide variety of patient information. - The
host instrument 830 includes aninstrument manager 840, auser interface 850, I/O ports 860 and in some embodiments adocking port 870. Thehost instrument 830 displays one or more of a pulse rate, plethysmograph data, perfusion index, signal quality, and values of blood constituents in body tissue, including for example, SpO2, carboxyhemoglobin (HbCO), methemoglobin (HbMet), total hemoglobin (Hbt), fractional oxygen saturation, blood glucose, bilirubin, or the like. Thehost instrument 830 may also be capable of storing or displaying historical or trending data related to one or more of the measured values or combinations of the measured values. - The
instrument manager 840 may be one or more microcontrollers that are in communications with theprocessor board 820, theuser interface 850, the I/O ports 860 and thedocking port 870. In particular, theinstrument manager 840 inputs calculated parameters and alarm conditions from theprocessor board 820 and outputs parameter values to thedisplays 851 and alarm triggers to theuser interface 850. Further, theinstrument manager 840 responds to user-actuatedkeys 853 and communicates with external devices via various I/O ports 860. Theinstrument manager 840 also executesconfiguration management 842 firmware. Configuration management defines and manages one or more configuration profiles that provide operational settings to theDSP 826 and define user interface characteristics among other functions, as described above with respect toFIG. 7 . - Advantageously, the
instrument manager 840 communicates with one or more of auser interface 850, I/O ports 860 or adocking port 870 to receive configuration profile data and, in some embodiments, to transmit indications of the default settings. I/O ports 860 may include one or more of acommunication port 861, aprogramming port 862 and anetworking port 863. Further, theinstrument manager 840 may communicate with an external device removable attached to adocking port 870. In one embodiment, a profile is defined via manually-actuatedkeys 853 and communicated to theinstrument manager 840. In another embodiment, a profile is defined in an external device, such as a PC, and communicated to theinstrument manager 840 via acommunication port 861, such as a USB or RS-232 interface. In yet another embodiment, a profile is defined in a characterization element having monitor settings stored in memory. The characterization element communicates the defined profile to theinstrument manager 840 via a programming I/O port 862. Among other functions, theinstrument manager 840 executesconfiguration management instructions 842 for downloading or otherwise determining one or more user-defined configuration profiles and for indicating the corresponding default settings. -
FIG. 9 illustrates aprofile programming embodiment 900 having amonitor 910 in communications with aPC 920, notebook, PDA or similar device running a configuration application program (AP). The configuration AP, for example, prompts a user through a menu of monitor default setting options. Once a complete set of options is selected, thePC 920 encodes the data as a user-defined profile and downloads the profile as default settings to themonitor 910. Alternatively, a set of predefined configuration profiles may be provided on aCD ROM 930 or similar storage media. A user then simply selects a desired profile via thePC 920, which downloads that profile to themonitor 910. - In other embodiments, a
monitor 910 may be factory delivered with a variety of configuration profiles, which are selected via configuration codes, menus or similar cataloging functions using front-panel keys 940. A selected profile is associated with a uniquelycolored panel light 950 and/or an identifying alphanumeric on a mini-screen 960 so that medical staff can quickly determine that the appropriate monitor defaults are active upon monitor power-up. -
FIG. 10 illustrates anotherprofile programming embodiment 1000 having amonitor 1010 in communications with acharacterization element 1060 via aprogramming port 1050. In this embodiment, a user-defined configuration profile is stored in acolored characterization element 1060, such as an EEPROM, EPROM, PROM or similar non-volatile memory device. Themonitor 1010 has a specialized programming orconfiguration port 1050 that electrically and mechanically accepts and communicates with thememory device 1060. Themonitor 1010 reads thecharacterization element 1060 to determine its default settings upon power-up. Thecharacterization element 1060 is specifically colored so as to provide a readily visible indication of the default profile stored within. The user-defined default profile is easily changed by removing onecharacterization element 1060 from theport 1050 and replacing it with a differently coloredcharacterization element 1060 selected from a preloaded set of memory devices. - Also shown in
FIG. 10 , aprofile programming device 1070 hasmultiple programming slots 1072 for mass programming profiles intocharacterization elements 1060. In particular, a profile is either defined directly in themonitor 1010 or communicated from an external device, such as aPC 1020. A profile may be directly programmed in thePC 1020 or loaded from aCD ROM 1030. ThePC 1020 communicates with theprogramming device 1070 to mass-produce characterization elements all having the same profile or each having different profiles depending on theprogramming slot 1072. In an embodiment, asingle characterization element 1060 may be programmed via themonitor 1010 while inserted into theport 1050. The profile programmed may be downloaded to themonitor 1010 from thePC 1020 or entered directly into themonitor 1010 via front-panel keys 1040. -
FIG. 11 illustrates aphysiological monitor 100 that is responsive to awireless device 50 for configuration profile selection, such as described with respect toFIG. 6 , above. Themonitor 100 has aninstrument manager 1110 that receives calculatedphysiological parameters 1112 from a digital signal processor (DSP) and providesdefault settings 1114 to the DSP, such as described with respect toFIG. 8 , above. The monitor 1100 has a profile lookup table 1120, awireless transceiver 1130 or receiver,predefined profiles 1140, and aprofile indicator 1150. Awireless device 50 is in communications with thewireless transceiver 1130 when thewireless device 50 is in the vicinity of themonitor 100. Thewireless device 50 may be a fixed device, such as a wall-mounted transceiver or transmitter that designates an area within a building or facility, such as described with respect toFIG. 6 , above. Alternatively, the wireless device may be a tag or card utilizing short range wireless transceiver or transmitter technology, such as RFID or Bluetooth®. - As shown in
FIG. 11 , thewireless device 50 transmits acode 1132 to thetransceiver 1130 that corresponds to one of thepredefined profiles 1140. Thetransceiver 1130 communicates theprofile code 1132 to theinstrument manager 1110. Theinstrument manager 1110 access the lookup table 1120 so as to determine a particular profile corresponding to thecode 1124. Theinstrument manager 1110 loads the selected profile as the monitor default settings and communicates at least some of thosesettings 1114 to the DSP. -
FIGS. 12A-D illustrate further details of amonitor 100 described above with respect toFIG. 1 . As shown inFIG. 12A , themonitor front panel 101 has asensor port 110, parameter displays 120, aspeaker 130,control buttons 140, apanel light 150 and astatus light 160. Thesensor port 110 accepts a patient cable 30 (FIG. 1 ) connector so as to communicate with a sensor 20 (FIG. 1 ). The parameter displays 120 provide numerical readouts of measured blood parameters such as oxygen saturation (SpO2), pulse rate (BPM) and total hemoglobin. Thespeaker 130 provides, for example, an audio indication of alarms. Thecontrol buttons 140 provide user control and selection of monitor features including power on/off 141,sensitivity 142,brightness 143,display 145,alarm silence 147 and alarm limits 148 and allow input of a configuration profile via up and down scrolling 149 and enter 144 buttons. Analarm status light 135 indicates high priority alarms. As shown inFIG. 12B , themonitor top panel 102 has anLCD display 170. As shown inFIG. 12C , the monitor backpanel 103 provides apower entry module 181, aserial output connector 182, anurse call connector 183 and aground connector 184.FIG. 12D illustrates avertical monitor 109 embodiment of themonitor 100 described with respect toFIG. 1 andFIGS. 12A-C , above. -
FIG. 13 illustrates a tri-level monitor user interface that utilizes front panel buttons (keys) to navigate through the menu selections. Advantageously, monitor settings that are typically adjusted most often for patient monitoring (level 1) are segregated from settings typically adjusted less often (level 2).Level 1 andlevel 2 settings are further segregated from advanced settings (level 3) that require a timed, combination button press to enter. In particular, this user interface allows a user to manually enter a configuration profile, such as described above, and to associate that profile with a color displayed by the panel light. - As shown in
FIG. 13 ,setup level 1 1320 contains the parameter and measurement settings that are adjusted most often includingalarm limits 1360,display brightness 1370, andsensitivity settings 1380.Setup level 2 1330 contains parameter and measurement settings that are not changed as frequently aslevel 1, including alarm volume, alarm silence, alarm delay, clear trend and button volume parameters.Setup level 3 1340 contains advanced parameter and measurement settings. Once a menu level is accessed, a front panel button (level 1 only) or the enter button (level 2 and 3) is used to move from one option to the next allowing repeated cycling through the options. The up and down buttons are used to adjust values within each option. The enter button is pressed to set the value. -
FIG. 14 illustrates alevel 1 example for setting alarm limits. The alarm limits button is pressed to access the alarm limits menu. The alarm limits button is used to access the alarm limits options and to move between options of % SpO2 LO 1410, % SpO2 HI 1420, Pulse rate (BPM)LO 1430, Pulse rate (BPM)HI 1440,PVI LO 1450 andPVI HI 1460. Up or down buttons are used to adjust the value to the desired setting. The alarm limits button is pressed to accept the setting and move to the next option. Once the last option is accessed, an additional press of the alarm limits button returns the device to an initial screen. The display button is pressed to exit at any time and return to the initial screen. -
FIG. 15 illustrates alevel 2 example for setting button volume. For button volume, the enter button is pressed. The settings options includedefault level 2 1510,level 1 1520, off 1540 andlevel 3 1530. Up or down button is used to move between settings and theenter button 1540 is used to accept the setting and move to the next menu screen. The display button is pressed to exit without saving the new setting and to return to the initial display screen. -
FIGS. 16A-B illustrate alevel 3 example for altering the factory defaults. To accesslevel 3 parameters/measurements, the enter button is held down and the down button is pressed for 5 seconds. After enteringlevel 3, the enter button is used to save new settings and move to the next menu. The user may cycle through the menu options by continuing to press the enter button. Pressing the display button exits the menu and returns the display to an initial display screen. The settings options are no change (do not adjust factory default settings) 1610, user default (set to user settings) 1625 and factory default (restore factory default settings) 1620. Up or down button is used to move between settings and the enter button is pressed to accept the setting and move to the next menu. The display button is pressed to exit without saving the new setting and to return to the home display screen. The factory default is set to this setting when configuring a device profile and selecting a color for the device profile LED. - The monitor can be configured to save changes to the device settings as a device profile. Using the button menu or an external configuration application, users can adjust monitor settings and parameter/measurement alarm limits. After changing settings, the user may save the settings as a device profile. This device profile becomes the new default settings and the saved (device profile) settings will be retained after a power cycle. The user may select a color for the device profile LED to associate with the saved profile. The device profile LED will illuminate with the selected color, allowing the user to verify at a glance that a device profile has been set. If changes are made to the device settings after the device profile feature has been enabled, the device profile LED will turn off, indicating a change from the device profile settings. Pressing the Up Arrow once will change the display from the default “Factory Default—Set”, to “User Default—Set” (see LCD display) 1610. The user can press the Enter Button again to save the settings, and the monitor will prompt the user to select a color (for the Device Profile LED) to associate with the saved profile. The default color is light blue. On the LCD display, a message alerts the user that light blue is selected, “User Default—light blue”. By using the up or down arrows, the user can select from a list of colors 1610-1690. The user selects and saves one color by pressing the Enter Button. The device profile light on the front panel will illuminate with the selected color. When user configured default settings are active, any changes to the default settings cause the device profile LED to turn off until the device is returned to the user configured default settings or powered off.
- A monitor configuration system has been disclosed in detail in connection with various embodiments. These embodiments are disclosed by way of examples only and are not to limit the scope of the claims that follow. One of ordinary skill in art will appreciate many variations and modifications.
Claims (29)
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US20200037966A1 (en) | 2020-02-06 |
US20160331332A1 (en) | 2016-11-17 |
US10292664B2 (en) | 2019-05-21 |
US11622733B2 (en) | 2023-04-11 |
JP2011519607A (en) | 2011-07-14 |
US20230320673A1 (en) | 2023-10-12 |
JP5575752B2 (en) | 2014-08-20 |
EP2278911A1 (en) | 2011-02-02 |
WO2009134724A1 (en) | 2009-11-05 |
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