The present disclosure relates to a medical sensor housing and in particular to an optical sensor housing for use in reflection mode photoplethysmography.
The technique of contact photoplethysmography (PPG) is used inter alia in the assessment of peripheral arterial disease. The technique requires optical sensor housings to be attached to the skin of a patient. Light emitted by a near infra-red emitter or an emitter emitting visible wavelength green or red light is scattered and absorbed by the microvasculature of the patient's body at the position of attachment of the sensor housing and back-scatter detected by an adjacent detector or set of detectors located within the sensor housing, the detector configured to detect the wavelength of light emitted by the emitter. PPG sensors are classified as either transmission mode or reflection (also known as adjacent) mode. It is known that reflection mode PPG can offer much more flexibility in where the sensor can be placed on the skin surface than do transmission mode sensors.
The sensor housings used in photoplethysmography are typically attached to the extremities of the patient's body, for example to the great toe/finger pad and ear lobe where pulses can usually be sensed easily. The most used sensor housings are in the form of a clip. One such clip is described in WO97/20497. Typically, such clips are intended for reuse.
To optimise the effectiveness of the photoplethysmography technique the applicants have found that applying a controlled pressure on the skin can be beneficial. Where the sensor exerts a controlled pressure on the skin, movement artefacts in the sensor output signal are reduced and probe amplitude increase is possible.
According to the present disclosure there is provided a sensing device comprising a sensor housing mounting sensor elements and an attachment member, the attachment member comprising first and second components, the first component configured to receive the sensor housing therein and to permit rotational movement between the attachment member and the sensor housing and to restrict relative movement between the attachment member and the sensor housing in the axial direction of the sensor housing, and the second component comprising a flexible membrane that is attachable to an underside of the first component, the flexible membrane extending at least in part beyond an outer edge of the first component, the flexible membrane comprising attachment means for attachment of the attachment member to a patient, and wherein the attachment member is adapted to allow passage of non-ionising radiation from the sensor housing to the patient.
Preferably, the non-ionising radiation is optical radiation or ultrasound radiation.
The attachment means may comprise at least one hook and loop type fastener.
Alternatively, the attachment means may comprise an adhesive surface at least to the side of the flexible membrane that is distal from the first component. The adhesive of the adhesive surface to the side of the flexible membrane that is distal from the first component preferably has an adhesion within a certain range, and adhesion is defined by a peel adhesion strength to steel in the range of 0.1-1.0 kg/25 mm width when adhered to steel (as measured using 3M measurement procedure “Adhesion to Steel, 180 deg peel”). More preferably, the adhesion defined by a peel adhesion strength to steel is within the range 0.125 kg/25 mm width to 0.6 kg/25 mm width.
Preferably, the part of the flexible membrane that extends beyond the outer edge of the first component comprises a plurality of tabs and more preferably at least two tabs, and still more preferably four tabs. The tabs may be spaced equidistantly. Where four tabs are provided they may be provided in pairs, each tab of a pair lying on the same axis. One pair of tabs may be more flexible than the other. For example, the tabs that are for wrapping around the digit may be very flexible, whereas the other pair of tabs may be relatively stiff. The tabs may include a series of graduated markings to aid placement of the device on the patient.
The attachment member may comprise a third component in the form of clip means, wherein the third component is shaped and dimensioned to receive the first component in a push-fit arrangement, and wherein, in use, the flexible membrane is located in-between the first component and the third component. Where the attachment member includes a third component, the flexible membrane attaches the third component to the patient and the first component is attachable to the third component in a push-fit arrangement. The third component also effectively attaches the flexible membrane to the underside of the first component.
Alternatively, the flexible membrane may be attached to the underside of the first component by adhesive.
Preferably, the flexible membrane has an adhesive surface at least in part to the side thereof that is proximal from the first component. Where the flexible membrane includes a plurality of tabs, or otherwise extends beyond the edge of the first component, such tabs or extensions do not have an adhesive surface to the side that is proximal to the first component.
The flexible membrane may comprise two flexible layers, a first layer for attachment to the underside of the first component and a second layer attached to the first layer and for attachment to the skin of a patient. Preferably, the first layer is provided with adhesive to both sides thereof. The adhesion of the surfaces of the first layer may be defined by a peel adhesion to low density polyethylene (LDPE) of 1.1 kg/25.4 mm to 1.5 kg/25.4 mm, for example 1.3 kg/25.4 mm.
Rather than attaching the flexible membrane to the underside of the first component by adhesive, the two parts may be joined using ultrasonic welding or other suitable techniques.
Advantageously, the flexible membrane provides an unbroken surface. Alternatively, the flexible membrane may have a hole centrally therein and positioned and dimensioned to align with the part of the sensor housing that mounts the sensor elements.
The flexible membrane at least in the region where radiation, for example infra-red light, is to pass exhibits low absorption of the wavelength of radiation passing.
The first component configured to receive the sensor housing therein and to permit rotational movement between the attachment member and the sensor housing and to restrict relative movement between the attachment member and the sensor housing in the axial direction of the sensor housing may comprise a plurality of clips which are resilient and which are so shaped and dimensioned as to grip the sensor housing when the sensor housing is mounted within the clips. Preferably, the clips are sufficiently resilient to allow the sensor housing to ride over free ends of the clips when the sensor housing is pressed into or out of the first component of the attachment member.
The first component of the attachment member may include a hole configured to receive a protruding part of the sensor housing.
When the sensor housing is mounted in the first component of the attachment member a protruding part of the sensor housing may extend through the hole in the first component. The protruding part of the sensor housing may extend beyond the surface of the first component that is distal from the sensor housing. More preferably, the flexible membrane is attached to the underside of the first component around the hole and the flexible membrane covers the hole.
The device of the present disclosure provides a secure fixation of a sensor to the skin of a patient and minimises torque applied to the skin as a result of the weight of the sensor housing and components attached thereto. Further, the device can provide for the application of a controlled pressure on the skin of the patient. The device also provides a physical barrier between the device and the skin of the patient, which allows the sensor housing and electronic components mounted therein to be re-used, the whole attachment member or the second component thereof being disposable. The device of the present disclosure is particularly useful in photoplethysmography, including bilateral PPG where symmetrical attachment of the probes to sites can reduce uncertainty in patient measurements. However, other sensors may be used. For example the sensor housing may house an ultrasound device or a laser Doppler flowmetry probe or a tissue oxygen sensor.
In the Drawings, which illustrate preferred embodiments of the medical sensor housing and associated disposable element of the present disclosure, and are by way of example:
Referring now to
The first component 5 is in the form of a clam shell and has a base 5b which has a central aperture 5c therein. The wall 5d of the aperture 5c is chamfered to match the shape of the part of the sensor housing 3 that mates with the aperture 5c. To the outside of the base 5b is a plurality of clips 5e, five in the illustrated example. The clips are so shaped and dimensioned as to grip the walls of the sensor housing 3. In the illustrated example, the component 5 is a one piece plastic moulding, the clips 5e being sufficiently resilient such that when the sensor housing 3 is pressed against the ends 5f of the clips 5e, the clips 5e bend outwards to permit the walls of the sensor housing 3 to ride over the ends 5f and then return substantially to the position shown in
The second component 6 comprises a flexible membrane which is attached to the underside of the first component 5 and which includes a plurality, four in the present example, of tabs 6b extending from a central part 6a, which is described in greater below in relation to
The underside of the second component 6 has an adhesive surface to provide for attachment to the skin of a patient. The adhesive surface may be provided by an adhesive layer applied to the underside of the second component 6, or by forming at least one layer of the second component of a material that is impregnated with adhesive. A peel off layer covering the underside of the second component 6 is typically provided. The second component 6 may alternatively be provided with a hook and loop type fastening means rather than an adhesive.
Referring now to
It is desirable that the sensor housing 3 should exert a force on the skin of the patient undergoing PPG testing, the force in a direction substantially perpendicular to the skin surface. This is achieved in part by the central portion 3c, through which the near infra-red light is emitted, reflected, and back-scattered, extending beyond the intermediate portion of the sensor housing 3. As mentioned above, the membrane 6 is attached to the underside of the first component 5 of the attachment member 4. The membrane 6 also extends over and preferably attaches to the surface 3f of the sensor housing 3.
When the assembled device 1 is attached to the digit 2 of a patient as shown in
The attachment member 4 holds the sensor housing 3 in position on a radial axis extending from the body part to which device 1 is attached. However, the clam shell arrangement of the first component 5 and in particular the clips 5e thereof allow the sensor housing 3 to rotate about the said radial axis. In this way the twisting forces resulting from the weight of the connecting cable 3h are not transmitted to the attachment member 4. In addition, the ability of the sensor housing 3 to rotate is particularly useful in bilateral PPG where the application of the sensor housings should be symmetrical.
The particular advantage of the embodiment illustrated in
In the sensor housing 3 illustrated in
The second component 6 illustrated in
As shown more clearly in
Number | Date | Country | Kind |
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1618756.9 | Nov 2016 | GB | national |
This application is the national phase of PCT Application No. PCT/GB2017/053342 filed on Nov. 7, 2017, which in turn claims priority to British Application No. 161875639 filed on Nov. 7, 2016, which are incorporated by reference in their entireties.
Filing Document | Filing Date | Country | Kind |
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PCT/GB2017/053342 | 11/7/2017 | WO | 00 |