CN116369850A - Patient monitoring device and alarm event analysis method - Google Patents

As shown in fig. 1, the patient monitoring device provided by the present invention includes a signal acquisition unit 10, a

20, and a

30. These components are interconnected by a bus system and/or other forms of connection mechanisms (not shown). It should be noted that the components and structures of the patient monitoring device shown in fig. 1 are exemplary only and not limiting, and that the patient monitoring device may have other components and structures as desired, including, for example, a

40 and a communication interface, etc.

The

40 is used to store various data and executable programs, such as system programs for the patient monitoring device, various application programs or algorithms for performing various specific functions, for storing patient monitoring device setup information, alarm rules based on physiological parameters, etc.

40 may include one or more computer program products that may include various forms of computer-readable storage media, such as

40 and/or

40. The

40 may include, for example, random access memory 40 (RAM) and/or cache memory 40 (cache), etc. The

40 may include, for example, a read only memory 40 (ROM), a hard disk, a flash memory, etc.

The

20 may be a Central Processing Unit (CPU), an image processing unit (GPU), an Application Specific Integrated Circuit (ASIC), a Field Programmable Gate Array (FPGA), or other form of processing unit having data processing capabilities and/or instruction execution capabilities, and may control other components in the patient monitoring device to perform desired functions. For example, the

20 can include one or more embedded

20,

20 cores,

20, logic circuits, hardware Finite State Machines (FSMs), digital signal processors 20 (DSPs), image processing units (GPUs), or combinations thereof.

20 may also be referred to as a controller.

The patient monitoring device may be any one of a monitor, a local central station, a remote central station, a cloud service system, and a mobile terminal, and the manner in which the corresponding signal acquisition unit 10 acquires the data of the physiological parameters of the patient is also different. The monitor may be a bedside monitor or a wearable monitor, for example, the patient monitoring device is a monitor, and the signal acquisition unit 10 may employ a sensor, where the sensor is used to monitor a physiological parameter of a patient, and obtain a physiological parameter signal corresponding to the physiological parameter. The physiological parameters may include various vital sign parameters, such as electrocardiograph, respiration, noninvasive blood pressure, blood oxygen saturation, pulse, body temperature, invasive blood pressure, end-of-breath carbon dioxide, respiratory mechanics, anesthetic gas, cardiac output, electroencephalogram dual-frequency index, etc., the data of the physiological parameters of the patient may be physiological parameter signals, the physiological parameter signals may be originally acquired electrical signals, and the corresponding physiological parameter signals may be visually displayed on the

30 through at least one of values, waveforms, and waveform variation trends. For another example, the patient monitoring device may be a local central station, a remote central station, a cloud service system or a mobile terminal, and the signal acquisition unit 10 is a communication device or a communication interface, and is used for being in communication connection with a monitor, so as to acquire the data of the physiological parameters of the patient from the monitor. Or, the patient monitoring device may be a local central station, a remote central station, a cloud service system or a mobile terminal, and the signal acquisition unit 10 is a communication device or a communication interface, and is used for communication connection with the monitor, so as to acquire the original signal acquired by the sensor of the monitor from the monitor, calculate to obtain the data of the physiological parameter of the patient, and transfer the obtained data of the physiological parameter of the patient to the monitor.

Taking the monitoring device of the present application as an example of a monitor, the monitor collects different physiological parameter signals (such as an electrocardiograph signal, a pulse oxygen signal, an invasive pressure signal, etc.) of a patient through different sensors, and the

20 is configured to: the physiological parameter signals are analyzed to obtain analysis results, and the signal waveforms and analysis results are displayed in real time by the

30, optionally, the analysis results include, but are not limited to, values of physiological parameters, trend graphs, etc., while the

20 is further configured to: and comparing the analysis result with a preset alarm rule (namely, alarm conditions), and generating an alarm event when the analysis result meets the alarm rule.

The alarm information corresponding to the alarm event may be presented through the

30, specifically, the

30 is configured to present at least a part of the alarm event in a real-time alarm manner, where when an alarm switch corresponding to a first part of the alarm event is set to be on, alarm information related to the first part of the alarm event is output; when the alarm switch corresponding to the second part of the alarm event is set to be in an alarm off state, alarm information related to the second part of the alarm event is not output, namely, the alarm switch of the alarm event which is displayed in real time is set to be in an alarm on state, and the alarm event which is set to be in an alarm off state is not displayed in real time. Wherein a first portion of the alarm events may be one or more of all alarm events generated by

20 with the alarm switches of the alarm events set to alarm on and a second portion of the alarm events may be one or more of all alarm events generated by

20 with the alarm switches of the alarm events set to alarm off. The alarm switch setting can be reasonably set according to the actual needs of users, and sometimes in order to avoid the problem of the disturbance of transition alarm, medical staff can turn off some alarm switches according to the actual conditions of patients, such as turn off a atrial fibrillation event alarm switch of atrial fibrillation patients, etc. Because the

30 of the monitoring device of the present application can still present the alarm event with the alarm switch set to alarm on in real time, but does not present the alarm event with the alarm switch set to alarm on, some meaningless alarms are reduced, the alarm frequency is reduced, and the alarm fatigue problem is reduced.

The

30 of the present application is configured for outputting information, such as visual information. The

30 may be a

30 having only a display function, or a

30 may be used. Illustratively, the

30 is configured to display the data of the physiological parameter on a main interface, which may be configured to display physiological parameter signals, such as physiological parameter waveforms, values, etc., and may display various information on different areas of the main interface.

The alarm information of the alarm event requiring real-time alarm can be presented on the main interface of the

30 in real time, for example, an alarm character string corresponding to the alarm information, a graphic mark and the like are presented in an alarm display area of the main interface, the display displays the alarm character string in a preset alarm level, and the alarm display area can present the base color of the corresponding level according to the level of the alarm event.

In one example, the monitoring device may also be provided with an alarm device, for example, the alarm device may alarm an alarm event of a real-time alarm, or alarm a condition of a patient, or the

20 may generate alarm information (e.g., an alarm signal) when a connection abnormality, an operation state abnormality, etc. occurs in each device of the monitor. The alarm means of the alarm device includes, but is not limited to, light, sound and other alarm means, and the specific form may be a flashing LED lamp, a buzzer, a speaker and the like, so as to draw attention and vigilance of an observer. In this way, real-time alerting may be implemented to prompt the user.

Further, the

20 of the present application is also configured to: the output alarm statistics instruction input by the user is acquired, for example, a 'review' hot key is arranged on the main interface, the user can enter the review interface through the 'review' hot key, and alarm statistics are called through overview controls and the like displayed on the review interface.

Further, the

20 of the present application is also configured to: counting the alarm events occurring in a preset alarm counting interval to obtain alarm counting information of the preset alarm counting interval, wherein the alarm counting information reflects the disease development condition of the patient, the alarm events can be preset type alarm events, and the alarm events can be alarms with an alarm setting switch being on or can also be alarms with the alarm setting switch being off or can also comprise the two types of alarms. The

20 may count the alarm event according to a predetermined statistics rule when generating the alarm event, and the user may retrieve alarm statistics information of a preset alarm statistics interval to view when reviewing the alarm event. Alternatively, in some embodiments, the

20 may also display the alarm event occurring in the preset alarm statistics interval after counting according to the output alarm statistics instruction. That is, the

20 may be performing statistics in real time or based on user instructions. The monitoring equipment can count the alarm event no matter whether the alarm switch is set to be on or off, and the unbinding of the alarm statistics and the alarm setting switch is realized, so that more detailed alarm statistics information can be provided, a user can review and check the statistics information conveniently, medical staff can know the development condition of the patient through the alarm statistics information, and further more reasonable judgment is made on the condition of the patient.

The

20 may perform statistics of the alarm information in any one or more of a plurality of statistical manners, for example, may count alarm information of the alarm event in a preset alarm statistics interval, so as to obtain a development condition of a patient condition in the preset alarm statistics interval, so that a medical staff can adjust a treatment scheme according to the development condition, for example, may also count alarm information of a predetermined type, for example, statistics of alarm information of atrial fibrillation, so as to obtain a development condition of the atrial fibrillation condition of the patient, and adjust the treatment scheme according to the condition, for example, use of drugs to control a ventricular rate. For another example, alarm information of a preset rhythm can be counted, for example, abnormal rhythms such as an early ventricular bivalve, an early ventricular trigeminal rhythm, an early atrial bivalve, an early atrial trigeminal rhythm and the like are counted, abnormal rhythms of a patient are obtained, for example, abnormal rhythms of a preset alarm counting interval are obtained, and a doctor can judge disease condition changes according to the alarm statistics information of the abnormal rhythms so as to adjust a treatment scheme according to the disease condition. In other embodiments, the combined alarm information may be counted to obtain alarm statistics, for example, the occurrence frequency and duration of QT interval prolongation alarm during atrial fibrillation, or the occurrence frequency of RR long interval during atrial fibrillation, to determine whether the illness is worsened.

Taking the atrial fibrillation event as an example, the

20 performs atrial fibrillation detection on the physiological parameter data acquired by the signal collector 10 to obtain an atrial fibrillation analysis result, compares the atrial fibrillation analysis result with a preset alarm rule, generates an alarm event (for example, the atrial fibrillation event) when the atrial fibrillation event is met, and the alarm setting switch corresponding to the atrial fibrillation event alarm is set to be on at the time t2, as shown in fig. 2 and fig. 4, the

30 presents alarm information corresponding to the atrial fibrillation event in real time at the area B of the display interface, as shown in fig. 2 and fig. 3, and the atrial fibrillation event occurs at the time t1, but the alarm setting switch corresponding to the atrial fibrillation event alarm is set to be off, although the atrial fibrillation event alarm is actually generated at this time, the

30 does not present alarm information corresponding to the atrial fibrillation event, for example, does not display the alarm information of the atrial fibrillation event at the area B.

Specifically, the atrial fibrillation event may be obtained by atrial fibrillation detection according to data of an electrocardiographic parameter, or may be obtained by atrial fibrillation detection according to other parameters, such as blood oxygen parameters, invasive blood pressure and/or monitoring data of noninvasive blood pressure, which is described in the former embodiment as an example. The

20 acquires the monitored data of the electrocardiograph parameters of the patient in real time through the signal collector 10, and the

20 performs atrial fibrillation detection on the monitored data of the electrocardiograph parameters in real time, and generates information of atrial fibrillation events and duration time periods of atrial fibrillation if the atrial fibrillation occurs. For example, the

20 performs noise processing on the monitored data of the electrocardiographic parameters in real time; p wave analysis is carried out to obtain the existence of P waves, the starting point, the peak point and the like of the P waves; f-jitter wave analysis is carried out to obtain the existence of f-jitter waves; carrying out RR interval irregularity analysis, specifically calculating RR interval length based on adjacent R waves, wherein the reciprocal is heart rate, carrying out irregularity analysis on a sequence formed by RR intervals in a preset period of time, and judging whether the heart rate of the current paragraph is absolutely uneven or not; performing heart beat classification to obtain heart beat classification results, wherein the heart beat classification results comprise: sinus, atrial, ventricular, and other categories of 4; by one or more analyses, information of the atrial fibrillation event, such as the starting time, stopping time and the like of the atrial fibrillation event, which occurs to the patient, is obtained, and information of the atrial fibrillation event, that is, alarm information, is stored.

For other alarm events, the

20 may be configured to generate an alarm event when the physiological parameter signal meets a preset alarm rule, and obtain alarm information of the alarm event, where the alarm information includes a start time and an end time of occurrence of the alarm event, and the

20 is configured to obtain alarm statistics according to the start time, the end time and the unit time of occurrence of the alarm event. In some embodiments, the alarm statistics are used to present the number of occurrences, duration duty cycles, and/or maximum single duration of the alarm event for one or more unit times within a preset alarm statistics interval. The unit time can be any time reasonably set according to actual needs, can be automatically preset by a system, can be input or changed by a user, and can be measured in minutes, hours and the like, and the unit time is the minimum unit time period in the embodiment. For example, the preset alarm statistics interval may be 1h, 0.5h or 2h, and the preset alarm statistics interval refers to a time period reasonably set according to the user requirement, for example, a first time of a certain month of a certain year is taken as a starting time to a second time of a certain month of a certain year is taken as an ending time, and a time period between the starting time and the ending time is the preset alarm statistics interval.

Continuing with the example of atrial fibrillation events, the

20 also calculates a duration of atrial fibrillation based on the starting and stopping moments of atrial fibrillation, and defines a atrial fibrillation load based on the duration of atrial fibrillation and the atrial fibrillation load per unit time, such as the longest duration of atrial fibrillation occurrence per unit time, the number of atrial fibrillation occurrences, or the percentage of the duration of atrial fibrillation, in this embodiment, the percentage of the duration of atrial fibrillation in unit time is referred to as the atrial fibrillation load (AF Burden).

In some embodiments, the alert statistics further include at least one of: optionally, the alarm information includes a start time and an end time of the occurrence of the alarm event, and the

20 is configured to obtain the alarm statistics information according to the start time and the end time of the occurrence of the alarm event, and count the total number of alarm events by the start time and the end time, and add the total time of occurrence of the alarm event, that is, the cumulative duration, generally, the cumulative for the same alarm event.

In order to present the alarm statistics described above, an overview control may also be provided at the review interface, for example, and the

20 may be further configured to control the

30 to display an alarm overview view in response to an operation instruction for the overview control, the alarm overview view being used to present the alarm statistics, for example, as shown in fig. 6, and the user may present the alarm overview view by clicking on "overview" of the interface shown in fig. 6 via an input device. The alarm overview view includes a target virtual key, such as a drop-down menu of "atrial fibrillation overview" in fig. 6, and when the input device receives an operation of clicking the target virtual key by a user, for example, in fig. 6, the "atrial fibrillation overview" is selected through the drop-down menu, and the

20 controls to display an atrial fibrillation comprehensive view (i.e. an alarm overview view of an atrial fibrillation event) on the

30, where the atrial fibrillation comprehensive view is displayed, and the atrial fibrillation monitoring period may be a preset alarm statistics interval or a period of time within the preset alarm statistics interval. When a doctor reviews the electrocardiosignals of the patient, the comprehensive view of atrial fibrillation can be checked only by one-key operation, the atrial fibrillation condition of the patient is further mastered, the display interface is not required to be switched back and forth, and the operation is convenient and quick.

The

20 may also obtain monitored data for other vital sign parameters, so the atrial fibrillation comprehensive view may also include waveforms for other vital sign parameters (e.g., pulse rate, blood oxygen, non-invasive blood pressure, respiration, body temperature, stroke volume, cardiac output, electrocardiogram ST segment, electrocardiogram QT interval, blood glucose, brain oxygen, urine volume, etc.). The waveform chart is used for reflecting the relation between time and quantity, for example, the waveform chart is a statistical chart taking time as a horizontal axis, observing a variable as a vertical axis and observing the trend and deviation of the variation of the variable. The observed variable of the vertical axis may be absolute amount, average value, incidence, etc. The trend graph of heart rate trend and other vital sign parameters reflects the change trend of vital sign parameters, and the trend graph can be one of a graph, a histogram, a bar graph, a box graph, a scatter graph, a line graph, a pie graph and a ring graph, or can be various combinations of the graph, the histogram, the bar graph, the box graph, the scatter graph, the line graph, the pie graph and the ring graph. Taking the trend graph of the heart rate as an example, the trend graph of the heart rate can not only show the change relation of the heart rate and time, but also show the extreme value, the mean value, the median value, the quantile and other numerical values of the heart rate in at least each minimum unit time period, and the numerical values can be displayed through scattered points, namely the heart rate information comprises: the scatter diagram is used for reflecting the heart rate value, the extreme value, the mean value, the median value and/or the quantile of heart rate at different moments in the preset atrial fibrillation monitoring period. Of course, the extremum, the mean, the median and the quantile of each time period can be connected through a broken line or a curve, that is, the heart rate information includes: the method is used for representing the curve graph or the line graph of the heart rate value, the extreme value, the mean value, the median value and/or the quantile of the heart rate at different moments in the preset atrial fibrillation monitoring period. Of course, the extremum, the mean, the median, and the quantile of each time period may be taken as a group, and one unit of the box chart (box chart) may be formed, that is, the heart rate information includes: and a box diagram for reflecting at least one of the extremum, the mean, the median and the quantile of the heart rate in different preset time periods in the preset atrial fibrillation monitoring period.

The

20 is further configured to count typical events during a preset atrial fibrillation event to obtain typical event statistics. As shown in fig. 5, typical event statistics include at least one of: atrial fibrillation with rapid ventricular rate times, atrial fibrillation with RR long intermittent times, extreme tachycardia times, extreme bradycardia times, first atrial fibrillation time, maximum heart rate atrial fibrillation time, and longest duration atrial fibrillation occurrence period. Typical events are usually events of great concern to doctors and are of clinical significance. The atrial fibrillation comprehensive view can also comprise an alarm event statistical chart in a preset atrial fibrillation monitoring period, the alarm event statistical chart can reflect various alarms generated in the process of monitoring a patient by the monitoring system, and of course, the atrial fibrillation comprehensive view also comprises an atrial fibrillation alarm, alarm events also belong to typical events, and the alarm event statistical chart can also be used as a part of the typical event statistical information and is displayed in the information statistical area of fig. 5.

Further, as shown in fig. 7, the present application further provides a

700 for analyzing an alarm event, which includes the following steps S710 to S760:

1. A patient care device, comprising:

a signal acquisition unit for acquiring a physiological parameter signal of at least one physiological parameter;

a memory for storing executable program instructions and for storing alarm rules based on the physiological parameter;

The processor is used for analyzing the physiological parameter signals to obtain analysis results, and comparing the analysis results with the alarm rules to generate alarm events;

the display is used for presenting at least one part of the alarm events in a real-time alarm mode, wherein when an alarm switch corresponding to a first part of the alarm events is set to be on, alarm information related to the first part of the alarm events is output; when an alarm switch corresponding to a second part of the alarm event is set to be in an alarm off state, alarm information related to the second part of the alarm event is not output;

the processor is further configured to:

acquiring an output alarm statistical instruction input by a user;

counting the alarm events occurring in a preset alarm counting interval to obtain alarm counting information of the preset alarm counting interval, wherein the alarm counting information reflects the disease development condition of the patient;

the display is also used for outputting the alarm statistical information.

2. The patient monitoring device of claim 1, wherein the alarm statistics are used to present the number of occurrences, duration duty cycles, and/or maximum single duration of the alarm event for one or more unit times within a preset alarm statistics interval.

3. The patient monitoring device of claim 2, wherein the alarm information includes a start time and an end time at which the alarm event occurred, the processor being configured to derive the alarm statistics based on the start time, the end time, and the unit time at which the alarm event occurred.

4. The patient monitoring device of claim 1 or 2, wherein the alarm statistics further comprise at least one of: the total number, the accumulated time length, the maximum single duration and/or the duty ratio of the accumulated time length of the alarm events in the preset alarm statistics interval occur in the preset alarm statistics interval.

5. The patient monitoring device of claim 4, wherein the alarm information includes a start time and an end time of occurrence of the alarm event, and wherein the processor is configured to derive the alarm statistics based on the start time and the end time of occurrence of the alarm event.

6. The patient monitoring device of claim 1, wherein the physiological parameter comprises an electrocardiographic parameter, the physiological parameter signal comprises an electrocardiographic parameter signal, the alarm event comprises an atrial fibrillation event, and the alarm statistics comprise one of an atrial fibrillation load, an atrial fibrillation number, an atrial fibrillation cumulative duration, a longest sustained atrial fibrillation duration, or any combination thereof, generated during the preset alarm statistics interval.

7. The patient monitoring device of claim 6, wherein the alarm statistics further comprise an atrial fibrillation load for one or more units of time over the preset alarm statistics interval and/or a mean value of the atrial fibrillation load over the preset alarm statistics interval.

8. The patient care device of any one of claims 1-7, wherein the alarm information comprises an alarm string characterizing the alarm event, the display displaying the alarm string at a predetermined alarm level.

9. The patient monitoring device of claim 1, wherein when the alarm event is an atrial fibrillation event, the alarm statistics include a number of occurrences and/or a duration of prolonged alarms for QT interval during the atrial fibrillation event; or alternatively

The alarm statistics include the number of occurrences of RR long intervals during the atrial fibrillation event.

10. The patient monitoring device of claim 1, wherein when the alarm event comprises an abnormal rhythmic alarm event, the alarm statistics further comprise abnormal rhythmic durations of the preset alarm statistics intervals, the abnormal rhythmic alarm event comprising one of: premature ventricular bivalve, premature ventricular trigeminal rhythm, premature atrial bivalve, and premature atrial trigeminal rhythm.

11. The patient monitoring device of any one of claims 1 to 10, wherein the display is configured to display an alarm overview view, the alarm overview view being configured to present the alarm statistics.

12. The patient monitoring device of claim 11, wherein when the alarm event is a first alarm event, the first alarm event is generated based on analysis of a first physiological parameter of the at least one physiological parameter, the at least one physiological parameter further comprising a second physiological parameter different from the first physiological parameter, alarm statistics of the first alarm event and statistics of the second physiological parameter are displayed simultaneously in an associated presentation in the alarm overview view, the statistics of the second physiological parameter being analyzed from the acquired second physiological parameter signal.

13. The patient monitoring device of claim 12, wherein the first alarm event is an atrial fibrillation event, the first physiological parameter is an electrocardiographic parameter, the second physiological parameter is a heart rate, and the statistical information of the second physiological parameter includes at least one of: a mean value of the heart rate per unit time during the atrial fibrillation event, a mean value of the heart rate during the atrial fibrillation event, a heart rate maximum value, or a heart rate minimum value.

14. The patient care device of claim 13, wherein the average of the heart rate over one or more unit times during the atrial fibrillation event is presented in a trend graph.

15. The patient monitoring device according to claim 13 or 14, wherein the alarm statistics further comprise atrial fibrillation load in one or more unit time within the preset alarm statistics interval presented in the form of a statistics map, the alarm overview view further being adapted to jointly display the trend graph corresponding to the mean value of the heart rate and the statistics graph corresponding to the atrial fibrillation load.

16. The patient monitoring device of claim 11, wherein the alarm overview view is further configured to display a waveform map of the second physiological parameter signal corresponding to the preset alarm statistics interval and identify an area of the waveform map corresponding to the occurrence of the atrial fibrillation event in a preset identification manner.

17. The patient care device according to any one of claims 11 to 16, wherein the alarm statistics are displayed in the alarm overview view in the form of text, numerical values and/or icons.

18. The patient monitoring device of any one of claims 1-17, wherein the display further has a monitoring main interface for displaying the physiological parameter signal and/or presenting the alarm information related to the first portion of the alarm event in real time.

19. A method of analyzing an alarm event, the method comprising:

acquiring a physiological parameter signal of at least one physiological parameter;

analyzing the physiological parameter signals to obtain analysis results, and comparing the analysis results with the alarm rules to generate alarm events;

presenting at least one part of the alarm events in a real-time alarm mode, wherein when an alarm switch corresponding to a first part of the alarm events is set to alarm on, alarm information related to the first part of the alarm events is output; when an alarm switch corresponding to a second part of the alarm event is set to be in an alarm off state, alarm information related to the second part of the alarm event is not output;

acquiring an output alarm statistical instruction input by a user;

counting the alarm events occurring in a preset alarm counting interval to obtain alarm counting information of the preset alarm counting interval, wherein the alarm counting information reflects the disease development condition of the patient;

and outputting the alarm statistical information.