Patent Application
20170185742
Patient monitoring systems may be used to monitor physiological parameters of patients undergoing diagnostic procedures, surgical procedures, and/or various other types of medical procedures. In various settings, it may also be desirable to deliver drugs to a patient during a procedure, such as via an IV and/or face mask, etc. Such drugs may include sedatives, anelgesics, amnestics, etc. In some instances, such drugs may be selected and/or combined to place a patient in a state of “conscious sedation” (in lieu of simply rendering a patient completely unconscious through a general anesthetic). Certain systems may also be used to automate the delivery of such drugs. For instance, such systems may be located in the same room where a medical procedure is performed, and may be coupled with a physiological monitoring system to automatically tailor the delivery of drugs based on patient parameters detected by the monitoring system.
Examples of such systems are disclosed in U.S. Pat. No. 6,745,764, entitled “Apparatus and Method for Providing a Conscious Patient Relief from Pain and Anxiety Associated with Medical or Surgical Procedures,” issued Jun. 8, 2004, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,833,213, entitled “Patient Monitoring and Drug Delivery System and Method,” issued Nov. 16, 2010, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,935,081, entitled “Drug Delivery Cassette and a Medical Effector System,” issued May 3, 2011, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2009/0292179, entitled “Medical System having a Medical Unit and a Display Monitor,” published Nov. 26, 2009, the disclosure of which is incorporated by reference herein; and U.S. Pub. No. 2010/0010433, entitled “Medical System which Controls Delivery of a Drug,” published Jan. 14, 2010, the disclosure of which is incorporated by reference herein.
One difficulty in current drug delivery settings is that patients may exhibit a wide variety of pharmacodynamic (“PD”) responses to drugs based upon numerous factors. Two apparently similar patients may react very differently to identical doses if certain factors are not properly considered for each unique patient, both in isolation and in combination with others factors. Such factors may include conditions measured in real-time, such as a patient's present heart rate and cardiac ejection fraction, as well as conditions that may be recorded as part of a patient's demographic data, such as a patient's height or weight, a past reaction to a particular drug, or other factors such as prior procedures and current medications. This demographic data can greatly influence the outcome of drug delivery and sedation techniques, as pre-existing conditions, medications, and other factors may increase or decrease a patient's sensitivity to a delivered drug. Additionally, the stimulus a patient receives may impact their PD response, as well as their tolerance to nociceptive stimuli.
While a variety of systems have been made and used for monitoring patients and delivering drugs to patients, it is believed that no one prior to the inventor(s) has made or used the technology as described herein.
It is believed the present invention will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements and in which:
The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the invention may be carried out in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the present invention, and together with the description serve to explain the principles of the invention; it being understood, however, that this invention is not limited to the precise arrangements shown.
The following description of certain examples of the technology should not be used to limit its scope. Other examples, features, aspects, embodiments, and advantages of the technology will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the technology. As will be realized, the technology described herein is capable of other different and obvious aspects, all without departing from the technology. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.
It is further understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. that are described herein. The following-described teachings, expressions, embodiments, examples, etc. should therefore not be viewed in isolation relative to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those of ordinary skill in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.
BMU (40) serves as a patient monitoring unit, monitoring various physiological parameters of a patient. As shown in
As shown in
In the present example, a patient's level of consciousness is detected by means of an Automated Responsiveness Monitor System (ARM), though like various other components described herein, an ARM system is merely optional and is not required. An exemplary ARM system is disclosed in U.S. Pub. No. 2005/0070823, entitled “Response Testing for Conscious Sedation Involving Hand Grip Dynamics,” published Mar. 31, 2005, the disclosure of which is incorporated by reference herein. The ARM system of the present example comprises a query initiate device and a query response device. The ARM system operates by obtaining the patient's attention with the query initiate device and commanding the patient to activate the query response device. The query initiate device may comprise any type of stimulus device such as a speaker via an earpiece (60), which provides an auditory command to a patient to activate the query response device. The query response device of the present example comprises is a handpiece (62) that can take the form of, for example, a toggle or rocker switch or a depressible button or other moveable member hand held or otherwise accessible to the patient so that the member can be moved or depressed by the patient upon the patient's receiving of the auditory signal or other instruction to respond. Alternatively, a vibrating mechanism may be incorporated into handpiece (62) that cues the patient to activate the query response device. For instance, in some versions, the query initiate device comprises a cylindrical handheld device (62), containing a small 12V DC bi-directional motor enabling the handheld device to vibrate the patient's hand to solicit a response.
After the query is initiated, the ARM system generates signals to reflect the amount of time it took for the patient to activate the query response device in response to the query initiate device. These signals are processed by a logic board located inside BMU (40) and are displayed upon either bedside touch screen assembly (42), procedure touch screen assembly (72) (
In some versions monitoring modules (54, 58, 64, 66) are easily replaceable with other monitoring modules in the event of malfunction or technological advancement. These modules (54, 58, 64, 66) include all of the necessary hardware to operate their respective peripherals. The above-mentioned patient modules (54, 58, 64, 66) are connected to a microprocessor-based electronic controller or computer (MLB) located within each of PRU (70) and BMU (40). The electronic controller or main logic board comprises a combination of available programmable-type microprocessors and other “chips,” memory devices and logic devices on various board(s) such as, for example, those manufactured by Texas Instruments (e.g., XK21E) and National Semiconductor (e.g., HKL72), among others. Various other suitable forms that modules (54, 58, 64, 66) and associated electronics may take will be apparent to those of ordinary skill in the art in view of the teachings herein.
Once BMU (40) and PRU (70) are connected via communication cable (20), ECG and capnography may be monitored, and supplemental oxygen may be delivered to the patient. It should be understood, however, that these connections may be made in the pre-procedure room to increase practice efficiency. By making these connections in the pre-procedure room, less time may be required in the procedure room connecting capnography, ECG and supplemental oxygen to PRU (70). Oral nasal cannula (46) and ECG leads (68) are connected directly to cable pass-through connection (24). Cable pass-through connection (24), located on BMU (40), is essentially an extension of communication cable (20), which allows the signals from ECG leads (68) and oral nasal cannula (46) to bypass BMU (40) and be transferred directly to PRU (70). It will be evident to those skilled in the art, however, that the BMU (40) could be configured to accept the ECG (48) and oral/nasal cannula (46) signals and process the signals accordingly to provide the information on screen (42) and supplemental oxygen to the patient in the pre-procedure room. Other examples of components, features, and functionality that may be incorporated into BMU (40) will be described in greater detail below; while still further examples of components, features, and functionality that may be incorporated into BMU (40) will be apparent to those of ordinary skill in the art in view of the teachings herein.
Referring now to
Memory card reader (78), which includes a slot in the outer casing of PRU (70), allows flash memory card (80) to be inserted and removed from PRU (70). Flash memory card (80) is a solid-state storage device used for easy and fast information storage of the data log generated by PRU (70). The data is stored so that it may be retrieved from flash memory card (80) at a later time. In some versions, memory card reader (78) accepts flash memory card (80) containing software to upgrade the functionality of patient care system (10). Again, as with other components described herein, memory card reader (78) may be modified, substituted, supplemented, or omitted as desired. In the present example, memory card reader (78) is supplemented with a data port (82). Data port (82) may include, but is not limited to, a standard serial port, a USB port, a RS232 port, an Ethernet port, or a wireless adapter (e.g., using IEEE 802.11n/g/b/a standard, etc.). Data port (82) may be used to link PRU (70) to an external printer to print a patient report or to transfer electronic files to a personal computer or mainframe. Examples of how data port (82) may be used to communicate with a centralized network system component will be apparent to those of ordinary skill in the art in view of the teachings herein.
PRU (70) delivers fluid to a patient via an infusion pump, such as a peristaltic infusion pump (84) (e.g., by B-Braun McGaw). Peristaltic infusion pump (84) is integrally attached to PRU (70), and uses peristaltic fingers to create a wavelike motion to induce fluid flow inside a flexible tube connected to a fluid reservoir. A drug cassette (86) is a generally rectangular shaped structure that is placed adjacent to peristaltic infusion pump (84). Drug cassette (86) of this example is made of a rigid thermoplastic such as, for example, polycarbonate. Drug cassette (86) has an internal cavity that houses IV tubing (22) made of a flexible thermoplastic such as, for example, polypropylene (e.g., Kelcourt). Drug cassette (86) receives tubing (22) via a port (88) and accurately and reliably positions exposed IV tubing (22) in contact with the peristaltic fingers of peristaltic infusion pump (84). IV tube set (22) attaches to a fluid vial (90), and a portion of the length of IV tube set (22) is contained within drug cassette (86). Another portion of IV tube set (22) lies external to drug cassette (86) to facilitate the interaction with peristaltic pump (84). IV tubing (22) is coiled within drug cassette (86) and has a length to reach a patient removed from PRU (70). A fluid detection sensor (not shown) may be mounted to an inner wall of drug cassette (86). Such a fluid detection sensor may comprise any one of known fluid sensors, such as the MTI-2000 Fotonic Sensor, or the Microtrak-II CCD Laser Triangulation Sensor both by MTI Instruments Inc. IV tube set (22) may run through the fluid detection sensor before exiting drug cassette (86). PRU (70) may include features operable to prime IV tubing (22) with relative ease for a user. Various examples of how such priming may be provided are disclosed in U.S. Pat. No. 7,833,213, the disclosure of which is incorporated by reference herein.
In the present example, drug cassette (86) includes just one vial (90). However, it should be understood that some versions of drug cassette (86) may include several vials (90). Such vials (90) may include the same drug. Alternatively, a plurality of vials (90) associated with a single drug cassette (86) may include a variety of different kinds of drugs. In other words, a single drug cassette (86) may be used to selectively deliver two or more drugs simultaneously and/or in a particular sequence. While vials (90) are used in the present example, it should be understood that any other suitable type of container may be used as will be understood by those of ordinary skill in the art in view of the teachings herein. It should also be understood that some versions of PRU (70) may be configured to receive two or more drug cassettes (86). Each such drug cassette (86) may be associated with a single drug (e.g., different drug cassettes (86) used for different drugs), or each drug cassette (86) may be associated with a combination of drugs (e.g., different drug cassettes (86) used for different combinations of drugs).
As also shown in
In order to ready PRU (70) for use in a procedure where a pharmacodynamic (PD) profile will be used to manage factors such as drug delivery, equipment configurations, and alarm thresholds, demographic information may be collected (block 500) to provide information that may be used to process and create (block 502) an initial risk based profile based upon one or more of patient history, physiology, or demographics. Real time monitoring of a patient's current physiological state (block 504) may then begin. While a patient is monitored in real time (block 504), information gathered from various monitors may be received by PRU (70) and used to create and maintain a PD profile (block 506) throughout a medical procedure (e.g., surgery). As the PD profile changes in response to monitored characteristics of the patient, the new PD profile may be applied (block 508) to the medical procedure in order to update the configuration of one or more devices being used in the medical procedure.
Maintaining (block 506) and applying (block 508) the PD profile may continue through the completion of a procedure, and may also continue after a medical procedure during a patient recovery time or until PRU (70) and its associated devices and monitors are removed from the patient. Examples of the manner in which a PD profile may be used include establishing or modifying safeguards in the control algorithm of system (10). For example, if a patient has a low ejection fraction, system (10) may increase the timeouts between doses, accounting for the increased circulation time. Another example is a dynamic scaling of calculated doses to a lean body moss indicator, recognizing that a sole weight based calculation for dosing may result in an increased plasma concentration for patients with a very high body mass index. Another example might be dose changes based on age, where dose values may be decreased for geriatric patients.
Once the medical procedure is complete and data is no longer being monitored in real time, one or more post procedure processes may occur (block 510) such as storing characteristics of the patient real time data for future use, storing the patients complete PD profile for future use, storing information relating to a clinician's interactions with PRU (70), including manual reconfigurations of the PD profile or manual refusal of automated PD profile changes. This may be useful in future medical procedures with a patient, where PRU (70) may be able to use the complete PD profile or portions of the real time data to more accurately determine an initial profile before real time monitoring begins. Additionally, PRU (70) may be able to use this data to determine that a particular clinician tends to be more conservative with PD profile configuration and application (block 508), and PRU (70) may create more conservative PD profiles or cease automatic profile application (block 508) entirely in response.
PRU (70) may also receive an objective risk factor (block 604). The objective risk factor is a characteristic determined by one or more members of an anesthesia care team, and may provide an indicator of the team's opinion of the patient's risk factor based upon initial observations. This risk factor could be represented as a number on a scale of risk factors, such as a number between 1 and 10 or 1 and 100, or as a general indicator such as high, medium or low. This risk factor could be based upon the opinions and experience of the members of the team, and in some situations may mirror the manual, automatic, or historic patient demographics, but in other situations may include additional unmeasured demographics such as a team member's observations of a particular patient's pallor, expressed nervousness relating to an upcoming procedure, expressed concerns based upon past sedation procedures, or other observable or expressed information relating to the patient that might influence the patient's reactions to sedation. After collecting or receiving one or more of the current demographics, historic demographics, and risk factor indicators, PRU (70) may process the demographics and objective risk factor to determine an initial profile.
The set of display configurations may include settings for visual displays of PRU (70), BMU (40), or other devices having displays, and may include settings controlling the type of information that is shown on each display. For example, a particular cumulative risk factor and initial profile may indicate that the most important information for the upcoming procedure is a patient's heart rate, and the system may therefore configure one or more displays to prominently display heart rate; while a different initial profile may instead indicate that a patient's blood pressure is most important, resulting in a display configuration that instead prominently features blood pressure readings. In a similar manner, any information measured by sensors may be displayed as would be advantageous for a particular cumulative risk factor and initial profile.
The set of dosing limits may include minimum and maximum delivery values for one or more drugs that may be automatically delivered through a drug delivery device (e.g., PRU (70)) or manually delivered by a clinician. An initial profile that indicates a low risk factor may allow for more liberal dosing limits to better manage patient discomfort, while an initial profile that indicates a high risk factor may enforce more conservative dosing limits that may sacrifice some level of patient comfort in exchange for patient safety. The particular dosing limits will vary widely based upon the drug being delivered, the procedure being performed, the risk factor and initial profile, and recent medical research, as well as subjective factors such as the desires of a particular institution where the technology is being used or the particular members of an anesthesia team using the technology, with such variations being apparent to one of ordinary skill in the art in light of the disclosure herein. Similarly, the set of drug delivery lockouts may include lockout limits to prevent manual intervention that would cause drug delivery to exceed or fall short of safe amounts, and will vary widely based upon the above factors.
The set of alarm thresholds may include a plurality of alarms relating to drug delivery or patient physiology, and may include triggers that will cause audible and/or visual alarms to occur when delivery of a particular drug falls outside a desired range, when patient heart rate or blood pressure falls outside of a desired range, when a procedure time exceeds a desirable period of time, or similar situations where it may be desirable to alert the anesthesia team to a particular occurrence or circumstance. As with dosing limits and delivery lockouts, the particular alarm thresholds may vary greatly based upon the drugs being delivered, the procedure being performed, the risk factor and initial profile, and recent medical research, as well as subjective factors such as the desires of a particular institution where the technology is being used or the particular members of an anesthesia team using the technology, with such variations being apparent to one of ordinary skill in the art in light of the disclosure herein.
After one or more revisions have been prepared based upon an initial profile and cumulative risk factor, some versions of this technology may cause PRU (70) or another display to show the changes that the system is preparing to make (block 712) based upon the determination of the initial profile. The proposed changes may be displayed (block 712) in such a way that one or more members of the anesthesia team may review them and then make manual adjustments, confirm, or refuse one or more the proposed changes (block 714) via an interface of PRU (70). In this manner, if PRU (70) displays an indication that the system is preparing to change the delivery rate of three different drugs based upon an initial profile and cumulative risk factor, a member of the anesthesia team may adjust the proposed delivery rate for a first drug, cancel the proposed delivery change for a second drug, and confirm the proposed delivery change for a third drug (block 714). Alternately, the clinician could, via a single button press within an interface, confirm or refuse all proposed changes (block 714).
As an example,
In other versions that queue data by type, all data relating to a patient's heart rate may be placed into a high priority queue (808), regardless of its origin, so that if two different sensors provide overlapping data sets relating to heart rate, the portions of the data sets relating to heart rate may be placed into a high priority queue (808) while portions of the data sets not relating to heart rate may be placed into a low priority queue (810).
In other versions that queue data by classification, certain events within data may be classified as high priority while other events from the same data set may be considered low priority. For example, with a sensor providing patient heart rate data, data indicating a heart rate within normal boundaries may be placed into a low priority queue (810) while data indicating a heart rate below normal boundaries may be placed into a high priority queue (808).
As queues (808, 810) are populated with data, one or more consumer processes (814) may be configured to select portions of data from one or more of the queues (808, 810) so that the consumer process (814) may process the data. Consumer processes may be configured to consume from queues (808, 810) in a variety of ways. For example, in the example of
In different versions, the consumer process (814) may select (block 904) from one or more queues (808, 810) based upon a ratio (i.e. select from high priority queue (808) four times for each one time it selects from a low priority queue (810)), or may be dedicated to a single queue (i.e. only select from high priority queues (808), or only select from low priority queues (810)), or other similar configurations that may be desirable based upon such factors as processing capability, multithread processing capability, the numbers and types of sensors providing real time data, cost and desired complexity of the profile device (812).
As events are selected (block 904) by the consumer process (814), the consumer process (814) will determine if the profile device (812) is currently maintaining a PD profile (block 906). Generally, during operation, the profile device (812) will always be maintaining an active PD profile, even if it is only based upon a small set of real time data. However, where, for example, the profile device (812) has only recently started to process real time data, or the profile device (812) has been manually reset or restarted, there may not be an existing PD profile (block 906). In such instances, the consumer process (814) may itself create, or cause another process of the profile device (812) to create, a new PD profile based upon the currently processed real time data (block 910). If there is an existing PD profile (block 906), the currently existing PD profile may be updated (block 908) based upon the new real time data.
PD profiles may track a patient's risk level throughout the procedure along a numerical scale, or may identify particular combinations of demographic factors as relating to particular PD profiles. For example, as real time data is processed and tracked within a PD profile, the real time data may indicate that a patient's cardiac and respiratory activity is steadily dropping to potentially dangerous levels. As this real time data is received and processed over time, the PD profile may steadily move along a numerical risk scale of, for example, 1 to 10 or 1 to 100, with each different point or each of several points resulting in a different set of changes to drug delivery and alarm configurations. Alternately, certain combinations of real time data may trigger certain PD profile based configurations, either in the alternative to or in combination with a numerical scale. For example, if real time data is received and processed indicating a specific range of heart rate, blood pressure, and breathing rate that have historically been identified as a dangerous physiological response to sedation, the PD profile may, rather than moving along a scale, trigger a set of changes to drug delivery and alarm thresholds that have been configured to address the specific real time data being received.
The following examples relate to various non-exhaustive ways in which the teachings herein may be combined or applied. It should be understood that the following examples are not intended to restrict the coverage of any claims that may be presented at any time in this application or in subsequent filings of this application. No disclaimer is intended. The following examples are being provided for nothing more than merely illustrative purposes. It is contemplated that the various teachings herein may be arranged and applied in numerous other ways. It is also contemplated that some variations may omit certain features referred to in the below examples. Therefore, none of the aspects or features referred to below should be deemed critical unless otherwise explicitly indicated as such at a later date by the inventors or by a successor in interest to the inventors. If any claims are presented in this application or in subsequent filings related to this application that include additional features beyond those referred to below, those additional features shall not be presumed to have been added for any reason relating to patentability.
A method comprising: (a) receiving a set of demographic information for a patient; (b) determining one or more cumulative risk factors based upon the set of demographic information; (c) configuring a set of medical devices with an initial profile based upon the one or more cumulative risk factors; (d) receiving a set of physiological information from a set of patient monitors, the set of physiological information describing one or more characteristics of a patient during a medical procedure; (e) maintaining, in real time, a pharmacodynamic profile based upon the set of physiological information; and (f) configuring the set of medical devices with a configuration profile based upon the pharmacodynamic profile.
The method of Example 1, wherein the set of demographic information comprises at least three of the following: (i) a patient height, (ii) a patient age, (iii) a patient's lean body mass, (iv) a patient body mass index, (v) a patient health classification, (vi) a patient ejection fraction, (vii) a prior medication history, (viii) an assessment of a patient's airway, (ix) a patient's gender, (x) a patient's ASA risk classification (I, II, III, IV, V), or (xi) an objective anesthesia risk factor.
The method of Example 2, wherein the objective anesthesia risk factor comprises an indication that a clinician considers the patient to be at high risk for sedation related complications or an indication that the clinician considers the patient to be at low risk for sedation related complications.
The method of Example 3, wherein the one or more cumulative risk factors is a numeric representation of the cumulative risk of sedation related complications as indicated by the set of demographic information.
The method of any one or more of Examples 1 through 4, wherein the initial profile comprises: (i) a drug delivery limitation setting, (ii) a drug delivery lockout setting, (iii) an alarm threshold setting, and (iv) a user display setting.
The method of any one or more of Examples 1 through 5, wherein the set of medical devices comprises a drug delivery device and a procedure room unit.
The method of any one or more of Examples 1 through 6, wherein the set of physiological information comprises: (i) a patient responsiveness indicator, (ii) a cardiorespiratory indicator, (iii) a patient pain indicator, and (iv) a clinician entered patient comfort indicator.
The method of Example 7, wherein the set of physiological information further comprises: (i) a drug infusion rate, (ii) a plasma concentration, and (iii) an effect site concentration.
The method of any one or more of Examples 1 through 8, wherein the pharmacodynamic profile is selected from the group consisting of a dose response curve and a table of drug delivery values and physiological responses.
The method of any one or more of Examples 1 through 9, wherein the configuration profile comprises: (i) a drug delivery limitation setting, (ii) a drug delivery lockout setting, (iii) an alarm threshold setting, and (iv) a user display setting.
The method of any one or more of Examples 1 through 10, further comprising the steps of: (a) displaying to a clinician the configuration profile before the set of medical devices are configured with the configuration profile; (b) receiving an indicator from the clinician that the configuration profile is acceptable; and (c) in response to receiving the indicator from the clinician, configuring the set of medical devices with the configuration profile.
The method of any one or more of Examples 1 through 11, wherein the configuration profile comprises a first medical device configuration and a second medical device configuration, the method further comprising the steps of: (a) displaying to a clinician the configuration profile before the set of medical devices are configured with the configuration profile; (b) receiving an indicator from the clinician that the first medical device configuration is acceptable; (c) receiving an indicator from the clinician that the second medical device configuration is not acceptable; and (d) configuring the set of medical devices with the first medical device configuration and discarding the second medical device configuration.
The method of any one or more of Examples 1 through 12, wherein the configuration profile is configured to cause the set of medical devices to provide a conservative sedation plan when the one or more cumulative risk factors indicates the patient is at a high risk of sedation related complications; wherein the configuration profile is configured to the cause the set of medical to provide a liberal sedation plan when the one or more cumulative risk factors indicates the patient is at a low risk of sedation related complications.
The method of Example 13, wherein the initial profile is configured to cause the set of medical devices to provide a conservative sedation plan when the one or more cumulative risk factors indicates the patient is at a high risk of sedation related complications; wherein the initial profile is configured to the cause the set of medical to provide a liberal sedation plan when the one or more cumulative risk factors indicates the patient is at a low risk of sedation related complications.
A method comprising: (a) receiving, at a profile device, a set of demographic information for a patient, from a medical record server; (b) determining one or more cumulative risk factors based upon the set of demographic information; (c) configuring a set of medical devices with an initial profile based upon the one or more cumulative risk factors; (d) receiving, at the profile device, a set of physiological information from a set of patient monitors, the set of physiological information being indicative of one or more biological characteristics of a patient during a medical procedure; (e) maintaining, in real time, a pharmacodynamic profile based upon the set of physiological information; and (f) configuring the set of medical devices with a configuration profile based upon the pharmacodynamic profile.
The method of Example 15, wherein the profile device comprises one or more of a procedure room unit or a bedside monitor unit.
The method of any one or more of Examples 15 through 16, wherein the set of medical devices comprises one or more of a drug delivery device, a procedure room unit, or a bedside monitor unit.
The method of any one or more of Examples 15 through 17, wherein the set of patient monitors comprises one or more of an automated responsiveness monitor, a bi-spectral index monitor, a blood pressure monitor, a skin galvanic sensor, or a clinician interface for indicating patient comfort level.
An apparatus for managing pharmacodynamic (PD) profiles, the apparatus comprising: (a) a profile device; (b) a medical record server in communication with the profile device; (c) a set of medical devices in communication with the profile device; and (d) a set of medical monitors configured to provide a set of real time data to the profile device, the set of real time data comprising a set of physiological information; wherein the profile device is configured to: (i) receive a set of demographic information from the medical record server, (ii) determine one or more cumulative risk factors based upon the set of demographic information, (iii) configure the set of medical devices with an initial profile based upon the one or more cumulative risk factors, (iv) receive the set of real time data from the set of patient monitors, (v) maintain, in real time, a PD profile based upon the set of physiological information, and (vi) configure the set of medical device with a configuration profile based upon the PD profile.
The apparatus of Example 19, wherein the initial profile is configured to cause the set of medical devices to provide a conservative sedation plan when the one or more cumulative risk factors indicates the patient is at a high risk of sedation related complications; wherein the initial profile is configured to the cause the set of medical to provide a liberal sedation plan when the one or more cumulative risk factors indicates the patient is at a low risk of sedation related complications.
It should be understood that any of the examples described herein may include various other features in addition to or in lieu of those described above. By way of example only, any of the devices herein may also include one or more of the various features disclosed in any of the various references that are incorporated by reference herein. It should also be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. that are described herein. The above-described teachings, expressions, embodiments, examples, etc. should therefore not be viewed in isolation relative to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those of ordinary skill in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.
It should further be understood that while various figures show certain steps occurring both in series and in parallel, this is not a requirement and any of the steps shown may occur either in series or in parallel, unless it is explicitly or implicitly stated otherwise. Further, it should be understood that when discussing that data is sent, received, transmitted, or similar terms, the sender of data may be memory or processor of a device, or a process executed by a device, and the receiver may be a different memory or processor of the same device, or a different process executed by the same device, such that a device may send and receive data within different components or processes of itself in order to organize or efficiently process data.
It should be appreciated that any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, embodiments, geometrics, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.
