The present application finds particular utility in medical patient temperature sensing systems. However, it will be appreciated that the described technique(s) may also find application in other types of temperature sensing systems, heat flux sensing systems, and/or other medical or industrial applications.
Reliable and accurate body temperature monitoring is of high importance in the clinical environment, both in high-acuity and in low-acuity settings. However, body temperature sensors that are currently available and that provide accurate readings are highly invasive (arterial line catheters, esophageal/rectal probes, etc.), while the non-invasive sensors have very poor measurement accuracy. Accordingly, temperature sensors are underutilized, and a large population of patients is not properly temperature-monitored.
One of the most crucial factors in obtaining an accurate core body temperature measurement is good skin contact. Any air pockets between the skin and sensor will result in unreliable readings. Classical zero-heat flow sensors have a flat configuration, and due to the electrical insulation tape used to conform to defibrillation requirements, such sensors are rather rigid. Normally, double sided medical grade adhesive is used to fix the sensor to the skin. In many circumstances, the patient will be moved, e.g. to change bed sheets, etc., and so the adhesive plays an important role in keeping the sensor attached to the forehead during any movements that may affect the sensor position. Due to the rigidity of the sensor, using adhesive only is insufficient to ensure that the whole sensor is in good contact with the skin, as the corners of the flat sensors are susceptible to becoming detached from the skin on a curved patient surface, such as a forehead. A headband can be used to apply additional pressure to the sensors to reduce this effect; however the problem still exists. Moreover, constant pressure applied to the forehead can become uncomfortable and may result in pressure wounds. Furthermore, due to the length of time the sensor is attached to the skin (e.g., 36 hours or more), it is desirable to inspect the skin under the sensor every few hours to check if there are any allergic skin reactions or pressure wounds caused by the sensor and headband. However, with adhesive, this can be inconvenient since once the sensor is peeled from the skin, the adhesive strength is reduced and the measurement is disrupted.
When using two or more thermistors to measure heat flux in a temperature sensor, accurate calibration of each thermistor is critical to determining when there is no heat flux flowing from the body to the surface, as well as for lateral heat loss compensation. Due to the resistance tolerance of off-the-shelf thermistors, individual calibration of each thermistor is typically required in order to accurately determine when zero heat flux has been reached. Individual calibration of thermistors is not only time consuming, but additional book-keeping is required to account for the thermistor coefficients of each individual thermistor, especially if the sensor consists of multiple thermistors.
Off-the-shelf thermistors typically have a resistance tolerance of 5%, which translates to approximately 1° C. interchangeability for a 10 kΩ thermistor. However, an accuracy of approximately 0.3° C. is called for. Therefore, in the clinical setting, the thermistor resistance tolerance is too inaccurate. To achieve the required accuracy, the thermistors are individually calibrated with an accurate calibration set-up. Individually calibrating thermistors is time consuming as the resistances of several temperature points are needed (e.g., a minimum of 10-15 points chosen in the range from 25° C. to 45° C.—the likely use case range).
There is an unmet need in the art for systems and methods that facilitate rapid, economical, and accurate patient core body temperature measurement, thereby overcoming the deficiencies noted above.
In accordance with one aspect, a system for monitoring a patient's core body temperature includes a curved temperature sensor, at least one releasably securing strip an outer surface of the sensor, a band that is coupled to the sensor by the at least one releasably securing strip and that secures the sensor to the patient, and an adhesive strip positioned along one edge of the interior side of the sensor that couples the interior side of the sensor to the skin of the patient.
In accordance with another aspect, a system for measuring core body temperature in a patient includes a heater to which current is applied to generate heat, a heat flux sensor below the heater, and a thermistor positioned between the heat flux sensor and the skin of the patient that has a resistance that is inversely variable with skin temperature. The system further includes a printed circuit board (PCB) comprising electronic circuitry that adjusts the current to the heater until a voltage across the heat flux sensor is zero, at which point the temperature at the skin of the patient is recorded as the core body temperature by the circuitry on the PCB.
In accordance with another aspect, a system for reducing calibration requirements in a patient temperature sensor includes a thermistor with a resistance that is inversely variable with patient body temperature, a linearizing resistor that is coupled to the thermistor in parallel, and a curve-shifting resistor coupled in series with the thermistor and the linearizing resistor.
In accordance with another aspect, a method of monitoring core body temperature in a patient includes applying an at least partially adhesive temperature sensor with a thermistor to the patient's forehead, and securing the temperature sensor to the patient's forehead using an adhesive strip and a removable headband.
One advantage is that core body temperature is measured inexpensively and accurately.
Another advantage resides in reducing patient skin irritation in the area of the sensor.
Another advantage resides in increasing ease of skin inspection beneath the sensor.
Another advantage resides in reducing a number of calibration points required to calibrate a sensor.
Another advantage resides in reducing a number of thermistors to obtain an accurate core body temperature reading.
Still further advantages of the subject innovation will be appreciated by those of ordinary skill in the art upon reading and understand the following detailed description.
The innovation may take form in various components and arrangements of components, and in various steps and arrangements of steps. The drawings are only for purposes of illustrating various aspects and are not to be construed as limiting the invention.
In one embodiment, two curved sensors 10 are attached to a headband to monitor patient temperature. In this case, the adhesive strip 16 may be placed on the top or bottom skin-side edge of each sensor, or on the interior skin-side edges (relative to each other, as shown in
In another embodiment, the sensor 10 is assembled on an arced jig or surface, and layers thereof are coupled together (e.g., using mechanical fasteners, chemical fasteners or epoxies, stitching, or the like) so that they each have a predetermined radius of curvature, as does the finished sensor. The predetermined radius of curvature is selected to be consistent with an average radius of curvature of a human forehead. In one embodiment, the radius of curvature is in the range of approximately 8 cm to approximately 15 cm. In another embodiment, the radius of curvature is smaller to accommodate a pediatric patient.
In one embodiment, double-sided medical grade adhesive tape is attached to the bottom side (the patient skin side) of the sensor. The adhesive strip 16 is applied only at one side of the sensor, and thereby acts as a hinge to allow medical staff easy access to the skin underneath the sensor. For instance, if a nurse or physician desires to check the skin beneath the sensor, the headband is unfastened and the sensor is gently lifted while remaining attached to the patient's forehead by the adhesive strip 16. In this manner, the patient's skin can be checked for pressure wounds or the like while ensuring that the sensor is properly repositioned when the headband is re-secured.
In this manner, a minimal amount of adhesive 16 is employed to hold the sensor 10 in a desired position on the patient's forehead while reducing skin irritation and increasing ease of skin inspection. The headband 14 provides sufficient pressure to the sensor to ensure good contact with the patient's skin to improve measurement accuracy. In one embodiment, a gel material is applied between the skin and the sensor to further facilitate achieving a good thermal contact surface and reducing skin irritation.
A heating element 39 (shown in cross-section, as hashed blocks) may also be positioned at the perimeter (e.g., lateral edges) of the heat flux sensor to act as a guard ring to reduce lateral heat losses. Due to the sensitivity of the heat flux sensor to heat flow, the electronics to measure the voltage from the heat flux sensor are mounted on a copper plated printed circuit board (PCB) 40 to ensure uniform temperature distribution is achieved as temperature gradients on the PCB are measured. Furthermore, the electronics may be shielded from any airflow due to the ambient to improve measurement accuracy.
The heat flux sensor 34 thus measures the amount of heat flux flowing from the body to the ambient air surrounding the sensor 34. The heater 32 is placed on top (e.g., on the non-patient side) of the heat flux sensor and controlled to ensure that no heat flux is flowing to the ambient (i.e., a zero voltage reading is measured). The thermistor 36 is placed below (e.g., on the patient side) the heat flux sensor at the skin 38 surface to provide a measure of the temperature at which zero heat flux occurs. This temperature is recorded as the core body temperature.
In one embodiment, the thermistor 36 is a 10 kΩ thermistor, although thermistors of other values may be employed with the described systems and methods, as will be appreciate by those of skill in the art.
It will be appreciated that the PCB 40 may include one or more processors or processing circuits that control the heater, monitor the heat flux sensor and/or the thermistor, and the like. Additionally, the PCB may include a memory component that stores data associated with performing the various functions described herein, as well as instructions for execution by the processor (s) in carrying out said functions. The PCB may be mounted remotely from the heater, heat flux sensor, and the thermistor, e.g., on an outer surface of the sensor 10 (e.g., the internal or skin-side surface).
In one example, the thermistor has a value of approximately 10 kΩ, the linearizing resistor has a value of approximately 3 kΩ, and the curve-shifting resistor has a value of approximately 0-1 kΩ. However, those of skill will appreciate that the foregoing values are illustrative in nature and that the described systems and methods are not limited thereto.
The innovation has been described with reference to several embodiments. Modifications and alterations may occur to others upon reading and understanding the preceding detailed description. It is intended that the innovation be construed as including all such modifications and alterations insofar as they come within the scope of the appended claims or the equivalents thereof.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/IB2009/055949 | 12/23/2009 | WO | 00 | 7/15/2011 |
Number | Date | Country | |
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61145605 | Jan 2009 | US |