GB2523880A

GB2523880A - Sensor

Info

Publication number: GB2523880A
Application number: GB1422577.5A
Authority: GB
Inventors: Graham Priestley
Original assignee: IMONSYS
Current assignee: IMONSYS
Priority date: 2013-12-19
Filing date: 2014-12-18
Publication date: 2015-09-09
Also published as: GB201322491D0

Abstract

A sensor device 19 comprises: first sensor module, associated with a first hand of a user, has at least one first sensor contact surface; and a second sensor module, associated with a second hand of the user has at least one second sensor contact surface, where a wired connection 21 connects the first and second sensor modules. The modules are provided with a plurality of sensors including: a pulse sensor (e.g. piezoelectric sensor, audio sensor, light sensor); an SpO2 sensor to measure pulse oximeter oxygen saturation; a temperature sensor; and at least one ECG electrode pair, wherein a first electrode is disposed in the first sensor module and a second electrode is disposed in the second sensor module. The device may include a third module 20 adapted to project into the outer ear canal of a user. The first module may include at least one finger socket in a recessed portion of a body which is formed integrally with the second sensor module. The second sensor contact surface may be located on an outer shell of said body. The pulse sensor and/or the SpO2 sensor may be a reflective photoplethysmography sensor.

Description

SENSOR

Field of the Invention

The present invention relates to a medical sensor device. In particular) the present invention relates to a mobile interactive wearable and untethered sensor device that enables monitoring of the physiological condition of a wearer and in particular collection of data relating to the vital signs of the wearer comprising data indications of at least some of blood pressure) pulse rate and cardiac function, body temperature and respiratory function. The invention in 1 0 the preferred case relates to a device adapted for displaying such collected data, and/ or storing of the data and/ or onward transmission of the data and for example communication of the same between a wearer and a third party.

The present invention in particular relates to a sensor device for the real time measurement and display of a wearer's vital sign readings which are most commonly used by medical professionals to assist in diagnosis. It is a particular feature of the invention that it is not limited to use by or with the intervention of or instruction of medical professionals but is suitable for non-expert use and for example home use by an individual. In a preferred case the sensor is further adapted to transmit collected data wirelessly, for example via a mobile telephone platform or similar, for interpretation, display, transmission to a medical practitioner or to a data engine for research purposes.

Background of the Invention

Medical Practitioners frequently need to gather a series of biometric readings in order to assist in the diagnosis of a patient's condition. These readings are taken with a variety of different instruments, notably thermometers, sphygmomanometers for blood pressure, multi-point electrocardiographs for diastolic and systolic heart beat readings and Pulse oximetry for oxygen saturation and pulse. The invention seeks to combine in one instrument the capability to take the following vital signs.

a) Core temperature.

b) Pulse c) Oxygen saturation [SPO2) d) EGG traces of systolic and diastolic heart beat [electrocardiography) e) Blood pressure An understanding of the existing methods employed to collect these readings is outlined below.

Temoerature A patient's temperature can now be taken quickly) by using a simple electronic thermometer. By placing it in the ear, core body temperature readings can be seen within 30 seconds. The process is considered non-invasive.

Blood uressure The blood pressure is recorded as two readings; a high systolic pressure, which is the maximal contraction of the heart, and the lower diastolic or resting pressure. A normal blood pressure would be 120 being the systolic over 80, the diastolic. The difference between the systolic and diastolic pressure is called the pulse pressure. The measurement of this pressure is now usually done with an aneroid or electronic sphygmomanometer. However the classic measurement device still in common use is a mercury sphygmomanometer, which employs a column of mercury measured off in millimetres. There is no natural normal' value for blood pressure, but rather a range of values that on increasing are associated with increased risks. These readings are guidelines, and must take into account other disease factors for diagnosis. Therefore, elevated blood pressure [hypertension] is variously defined when the systolic number is persistently over 140-160 mmHg. Low blood pressure [hypotension) is when the value fails to 85-l2OmmHg.

To take a patient's blood pressure, requires that the patient bares one arm to the shoulder and the practitioner then fits a suitable inflatable cuff around the upper arm. The cuff is then pumped up using a hand bulb to slow down the circulation to detect the build-up in pressure. The cuff is then allowed to deflate allowing the blood to flow freely, this method often employs the use of a stethoscope to interpret the auscultation (characteristic sounds) of the blood flow. This method can only be used by skilled practitioners. The sphygmomanometer instrument described above is bulky and requires calibrating on a regular basis. It takes in the region of 5 to 10 minutes to take blood pressure using these instruments.

Alternatively a modern Digital option using oscillometric measurements and electronic calculation rather than auscultation may be employed. This method is equally invasive, but will display readings on a built in screen in 3 to 4 minutes.

Oxygen saturation ISpO2l The level of oxygen present in the blood is a guideline measurement of the efficiency of the respiratory system. Low levels of oxygen can indicate the presence of a pulmonary dysfunction such as emphysema. To measure the oxygen levels, modern instruments such as finger pulse oximetry device are used. These are electronic devices, designed to allow the patients finger to be simply inserted in a tube arrangement, which employs light waves to detect the levels of oxygen carried in the haemoglobin of the blood. Oxygen levels are shown within a few seconds on a small display screen built in to the instrument.

These devices are considered non-invasive.

Electrocardiography In order to take a full Electrocardiography (ECG) reading, the patient is required to remove most of their clothing and a series of sensors (up to as many as 10) are placed around the chest and legs. The sensors are attached by wires to a central processing unit which interprets the sensor data and displays or prints a graph of the patient's heart activi, clearly showing systolic and diastolic readings. This process can only be conducted by a skilled clinician. It is an extremely invasive method) requiring the patient to be tethered', and to lie still during the whole process, which can take anything up to 30 minutes to complete.

ECG machines are expensive and bulky and considerable time is taken in siting the sensors exactly as recommended, however in practice, research shows that the readings differ somewhat depending on which clinician fitted the sensors.

Using the different instruments discussed above, it can be seen that to take a patients vital signs is a lengthy and invasive process. We must consider not only the cost of the individual instruments, but also the time taken by qualified 1 0 medical practitioners to complete these preliminary tests in order to arrive at a diagnosis. The human body is constantly changing to suit the immediate environment, therefore it must further be considered that the readings are taken individually over a period of time of anything up to 30 minutes, during which time the first readings taken will probably have changed.

It is an object of the present invention to provide a system that obviates and mitigates one or more of the disadvantages and limitations of the prior art.

Summary of the Invention

According to a first aspect of the present invention, there is provided a sensor device comprising: a first sensor module configured to locatable in association with a first hand of a user having at least one first sensor contact surface and configured to present the sensor contact surface in use to a part of the skin of the first hand of the user when so located; a second sensor module configured to be locatable in association with a second hand of a user and having at least one second sensor contact surface and configured to present the sensor contact surface in use to a part of the skin of a second hand of a user when so located; a wired connection between the ear module and the second module providing at least a conductive connection therebetween; the two modules together being provided with a plurality of sensors including at least the following: a pulse sensor adapted to monitor a heart rate associated with a user of the system; an Sp02 sensor adapted to monitor a pulse oximeter oxygen saturation associated with a user of the system; a temperature sensor to determine a body temperature of a user of the system; and the sensor device further comprising; at least one electrocardiographic electrode pair) one of which pair is disposed on the first module and the other of which pair is disposed on the second module; a data collection module adapted to collect data from each of the sensors.

The sensor device may further comprise a communication means adapted for wireless data transmission of the collected data so as to communicate the same in use to a receiver on a suitable remote data processing means.

The sensor device of the invention thus carries sensors which are together capable of obtaining data that can be interpreted for example in the manner discussed herein to give the following vital signs: a) Core temperature.

b) Pulse c) Oxygen saturation (Sp02) d) EGG traces of systolic and diastolic heart beat [electrocardiography) e) Blood pressure In use a patient uses a part of the skin of a first hand to make contact with the first sensor contact surface on the first module on the ear and a part of the skin of a second hand to make contact with the second sensor contact surface on the to complete a simple one lead ECG circuit.

The first module is a hand module configured to present a sensor contact surface in use to a part of the patient's hand. For example the first module is a hand-held module configured to be held by a user and having at least one sensor contact surface adapted to contact the skin of a user's hand when so held. The first module may include at least one finger plate configured to be held by a user's finger in use and having at least one first sensor contact surface adapted to contact the skin surface of a user's finger when so held. Conveniently for example the first module is adapted to present two opposed contact surfaces for example to be gripped between and contact a thumb and forefinger or other finger.

Additionally or alternatively the second module is preferaffly a hand-worn module adapted to be worn by a user and having at least one sensor contact surface adapted to contact the skin of a user's hand when so worn and is for example a finger module worn on the finger. For example the second module includes at least one finger socket configured to receive a user's finger in use and having at least one second sensor contact surface adapted to contact the skin surface of a user's finger when so received. Preferably the second module includes at least two finger sockets.

A user holds or wears the second module to complete a simple one lead ECG circuit between the two hands of the patient.

The sensor device may further comprise a third module having a projecting portion adapted to project into the outer ear canal of a user when inserted thereinto in use and having a third sensor contact surface disposed thereupon.

The third module may comprise an ear module adapted to be worn about the external outer ear and having a projecting portion adapted to project into the outer ear canal when so worn. In use, the third module is worn on a patient's ear.

The projecting portion may for example carry a temperature sensor.

The other sensors, the temperature sensor, pulse sensor and Sp02 sensor also provide data for the data collection system. This preferably works in conjunction with a wireless transmitter such as a wireless antenna to transmit the collected data to a suitable external remote data processing means for processing and in particular to derive the above vital signs not directly measured.

In a possible embodiment the first and second modules are formed integrally as respective parts of a single sensor body. The single sensor body for example has an outer shell carrying at least one first sensor contact surface and is optionally further provided with a recessed portion defining at least one finger socket configured to receive a user's finger in use and having at least one second sensor contact surface adapted to contact the skin surface of a user's finger when so received. The recessed portion for example defines at least two finger sockets.

In use, the patient holds the single sensor body in one hand and inserts a finger or fingers of the opposite hand so as to make skin contact with both respective hands and complete a simple one lead ECG circuit.

The single sensor body optionally further comprises a projecting portion adapted to project into the outer ear canal of a user when inserted thereinto in use and having a third sensor contact surface disposed thereupon. That is, the body comprises a third sensor module as above described.

The device of the invention is capable of collecting these data in real time, without requiring a patient to be tethered to a fixed system or to attend a medical facility, from the simple sensor array described. These data may be displayed on an integral display such as a screen located on a lid of the module or may be transmitted wirelessly via the communication means to a remote data processing means for further processing and analysis.

The particular advantage of the device is that it is essentially non-invasive, and does not require the intervention of a clinician. It does not require the use of complicated machines in a surgical environment. Instead, using a portable instrument, it becomes possible to obtain a simple indication and display all the indicated vital signs on a signal instrument and in real time as a basic patient monitoring procedure. Conditions requiring the more thorough intervention of a full diagnostic procedure, for instance using a full multiple lead ECG or other monitoring in a surgical environment, can be identified non-invasively and efficiently by such a monitoring procedure.

This can be contrasted with the use of full systems at present even for mere monitoring. Existing ECG instruments require the removal of various items of clothing in order to fit the appropriate electrodes. The taking of blood pressure using a sphygmomanometer requires bearing the arm to expose the bicep 1 5 mussel, and it is also an unpleasant sensation to have the circulation stopped for a few seconds. These devices would lie considered invasive. The small projecting ear piece module and the hand held module would be considered completely non-invasive.

It can be further seen that the use of conventional instruments in a clinical environment is time consuming and expensive. It is necessary not only to consider the cost of individual instruments, but also the time taken by qualified medical practitioners to complete these preliminary tests. The human body is constantly changing to suit the immediate environment and it must therefore further be considered that the readings taken individually over a period of time of anything up to 45 minutes may introduce inaccuracy.

In accordance with the present invention, the simple portable instrument will provide basic monitored readings without requiring a qualified medical practitioner on a much shorter time scale and thus complete such preliminary tests in a much more cost-effective and efficient manner. The data can then be transmitted onwards for diagnostic analysis, for example to identi!' where a more complete and more invasive clinician-led investigation is required.

A further advantage of the invention is that it allows for frequent and regular monitoring of the patient by themselves. By contrast, because of the length of time taken and the inconvenience to the user required to attend a medical facility to have full clinical readings taken in the conventional manner, the number of times any single individual has the data recorded is limited) and it is therefore a snap shot record only. By enabling frequent and regular monitoring of patient condition and thereby building up a much more detailed picture of the alteration in the readings over time, a better picture of the individual patient and of a population can be obtained. In addition, the effects of prescribed drugs etc. will be evidenced by changes in the readings.

The device of the invention is adapted to collect data and in the preferred case to view the data on an integral dispby and/ or to transmit the same wirelessly via the communication means to a remote data processing means for further processing and ana'ysis. It may further be adapted to up load to a data store for example to upload automatically to the patient's records for further reference.

This avoids any need for manual input which can be an extrem&y time consuming task and ties up valuable medical resource in conventional instrumentation. Data may readily be transmitted for example to a patient's hospital record, to a patient's general practitioner, to a cloud server (when suitably anonymized] to make it available for research etc. The invention offers the potential to coflect much larger quantities of population data.

The sensor device in the invention includes at least one pulse sensor adapted to monitor a heart rate associated with the user of the system. Optionally, a pulse sensor is provided on the each of the first and second modules.

The sensor device of the invention includes a sensor adapted to monitor a pu'se oximeter oxygen saturation associated with the user of the system. Optionally, a pulse oximeter oxygen saturation sensor is disposed on each of the first and second modules.

At least one electrocardiographical electrode pair is provided, one on each of the first and second modules to complete an ECG circuit A temperature sensor is provided to determine the core body temperature of the user of the system. This is preferably provided on the third, ear module where present.

In a preferred case, sensors on the third, ear module are provided on an external surface of the projecting portion adapted to projecting to the outer ear canal.

The sensors in each module, in particular in the preferred embodiment where each module forms an integral single sensor body, may be compactly located together in a housing and optionally additionally the data collection module and/ or the communication means may be compactly located together in a further housing or in the same housing The heart rate sensor may comprise a piezoelectric sensor, and audio sensor, or a light sensor which is for example a reflected light sensor. In a preferred case the heart rate sensor may comprise a red light and/ or infra-red sensor and/ or green light sensor. For example the sensor comprises a reflective photoplethysmography (PPGJ sensor.

The oxygen sensor may comprise a red light and/ or infra-red and/ or green light sensor. For example the sensor comprises a reflective photoplethysmography (PPGJ sensor.

In a possible embodiment, the heart rate and oxygen sensors may be of equivalent or identical type, for example being comprises by equivalent or identical red light and/ or infra-red and! or green light sensors such as PPG sensors. The respective sensor functions may in such case be embodied in a single sensor device. Alternatively plural sensors of equivalent or identical type maybe provided. In such a case different sensors may have specific functionality for the heart rate and oxygen function or may be adapted to perform either function selectively.

1 0 The temperature sensor is conveniently an infrared sensor.

At least one electrocardiographic electrode pair comprises an ECG electrode or sensor disposed on the first module and a counterpart ECG electrode or sensor disposed on the second module. For example in the preferred case where each module forms an integral single sensor body at least one electrocardiographic electrode pair comprises an ECG electrode or sensor disposed on the outside of the integral single sensor body and a counterpart ECG electrode or sensor disposed on the inside, for example in a finger socket therein. In use, the integral single sensor body is held in one hand and the fingers of the other are inserted, thus completing a single lead ECG circuit across the patient This is sufficient to give a simple single reading from which a QRS complex can be measured. This not only enables a basic ECG trace of systolic and diastolic heart beat to be generated, but also allows for a pulse transit time to be established. Since there is also a monitoring of heart rate, it is possible to use the data thereby generated via a suitable algorithm to determine blood pressure.

Thus, with the simple combination of electrodes provided a basic monitoring of all of the listed vital signs can be obtained, in a non-clinical and non-evasive manner, to provide a much more comprehensive set of data for the monitoring of a patient's condition, and to provide for a preliminary identification of conditions where a more comprehensive series of tests on more conventional equipment might be required.

In a more complete aspect the invention comprises a monitoring system is provided comprising the monitoring device of any preceding claim in combination with and adapted for data communication with a processing means adapted to receive collected data from the device.

A suitable processing means in a preferred case comprises an additional 1 0 programmable device including a central processor.

It is intended in accordance with the invention that a processing means, for example comprised in a central processor of an additional programmable device, is provided remotely from and in wireless data communication in use with, the portable monitoring device of the first aspect of the invention. The portable monitoring device of the first aspect of the invention acts in conjunction with the processing means, for example on the additional programmable device including a central processor, to constitute a system that is capable of processing the collected data and monitoring the condition of a user, and in particular to do so continuously in real time via wireless data communication between the portable monitoring device and the processing means, for example on the programmable device including a central processor. The invention does not necessarily exclude some processor functionality also on the portable monitoring device of the first aspect of the invention. In such a case it may be that the processor of the portable monitoring device and the processor of the remote processing means function together in use to constitute a system that is capable of processing the collected data and monitoring the condition of a user.

The suitable additional programmable device is conveniently a computing device. The additional programmable device might for example be a portable computing device such as a laptop, tablet, cell-phone etc., or a bespoke portable device into which the portable monitoring device may be placed in wireless communication for data communication and transfer.

The invention envisages any suitable wireless data connection being exploited between the portable monitoring device and the additional programmable device, for example wired or wireless, and for example including optical and audio connections etc., such as are already provided in accordance with routine standards on cell-phones, laptops, tablets and the like. Preferably it exploits an existing and standard connection already provided on such a programmable 1 0 device.

By implementation of suitable program instructions on the processor of the additional programmable device, a system maybe provided that is capable of processing the collected data and monitoring the condition of a user.

It will be understood generally that a data processing step performed by the processing means can be implemented at least in part by a suitable set of machine readable instructions, data or code loaded onto the processing means and that the processing means may be adapted to provide a determination of a perceived condition of the user by such programming.

These machine readaNe instructions, data or code may be loaded onto a processing means comprised in a general purpose computer, special purpose computer, or other programmable data processing device. These machine readable instructions, data or code may also be stored in a computer readable medium that can direct a computer or other programmable data processing device to function in a particular manner, such that the instructions stored in a computer readable medium produce an article of manufacture including a processing means to implement the second aspect of the invention.

The suitable programmable data processing device might for example be a portable computing device with a visual or other display capability such as a laptop, tablet, cell-phone etc., or a bespoke portable device.

In accordance with a third aspect, the invention comprises a set of such machine readable instructions such as computer program instructions, for example provided on a suitable data carrier, which maybe loaded onto a suitable programmable device so as when so loaded to cause the said programmable device to constitute in conjunction with a portable device of the first aspect of the invention a system in accordance with the second aspect of the invention. In a possible embodiment, the intended suitable programmable device is a mobile telecommunications device and the computer program instructions are provided as a mobile telecommunications application.

1 5 Further in accordance with the invention in a fourth aspect, a portable device of the first aspect of the invention is provided in combination with a set of computer program instructions in accordance with the third aspect of the invention. The invention in the fourth aspect thus comprises a kit of parts adapted for use with a suitable programmable device so as to convert the programmable device in combination with the portable device of the first aspect of the invention into a monitoring system in accordance with the second aspect of the invention. Preferably the suitable programmable device is a mobile telecommunications device and the computer program instructions are provided as a mobile telecommunications application.

Other preferred features of the third and fourth aspects of the invention will be understood by analogy with the description of the first and second aspects.

Preferably, the processing means is provided on a processing device and in particular a portable processing device as above discussed, which module additionally comprises a further communication means to enable the module to communicate remotely for example with a third party. In the preferred case the module may comprise a mobile device with a processor and an existing communication capability, for example a mobile telecommunications or mobile computing device, for example comprising a laptop, tablet, cell-phone etc. In such a case the further communication means is preferably implemented by the existing communication capability, for example via an established mobile telecommunications protocol.

The third party may be the user's support clinician or Doctor.

1 0 Preferably, the system comprises storage means to store data received from the sensors.

Preferably, the communication means comprises a wireless transceiver.

Brief Description of the Figures

The present invention will now be described by way of example only and with reference to the accompanying figures in which: Figure 1 is a schematic of an embodiment of the invention in use by a user; Figure 2 is a more detailed illustration of the two modules of the embodiment of Figure 1; FigureS shows some ideas for alternative embodiments of the invention; Figures 4 to9 illustrate an embodiment of the invention in which first and second hand modules are combined in a single integral body; Figures 10 to 13 illustrate the provision of a display means for the embodiment of figures4to 9; Figures 14 to 19 show alternative shapes for an embodiment of the invention in which first and second hand modules are combined in a single integral body.

Detailed Description of the Invention

Figure 1 is a schematic of an embodiment of the invention consisting of an ear piece that includes an ear module and a first hand module and a second hand module in the form of a hand-held fob. It is show in use by a user 1.

As shown in figure 1 the user 1 inserts earpiece 2 into the left ear and hokis it in place with the left hand 5. The part of the ear piece so contacted by the left hand thus serves as a first hand module. The part inserted into the era may also be provided with sensors to constitute a third, ear module. User 1 holds the fob 4 in the right hand 6. Earpiece 2 and fob 4 are connected by wire 3.

In this example) the sensor wireless communication interface (not shown) is contained within the earpiece 2. The sensors on the earpiece 2 are: Temperature sensor 7. ECG sensor 15 and ECG ground 10. PPG sensor Sand PPG sensor 10.

The fob 4 sensors are, PPG sensor 4 and ECG ground 11 and ECG sensor 12.

It is the combination of these sensors which allow the development of the necessary algorithms to calculate the range of vital signs.

Figure 2 shows the arrangement of the various sensors and their relative positions in the earpiece 2 and the fob 4 of the embodiment shown in figure 1.

The reference numbers follow those in figure 1.

The fob thus comprises a remote second hand-held module adapted to present two opposed contact surfaces for example to be gripped between and contact a thumb and forefinger in contact with a skin surface of the patient to complete with the ECG sensor and ground on the ear piece a simp'e one lead ECG circuit between the two hands of the user. This is a typically preferred arrangement but other arrangements are possible as shown for example in figure 3.

Figure 3A shows an alternate arrangement of the sensors, utilising a finger insert 16 as a second module instead of the fob 4.

Figure SB shows an option where an additional ear piece 17 is used as a second module instead of the fob 4. The earpieces 2 and 17 are connected by a wire 18 which maybe enclosed in a plastic cover pre formed to hold the earpieces 2 and 17 in position without the assistance from the wearer. This might find application for example in the immediate emergency monitoring of a patient who is unconscious or incapable.

Figure 3C shows an alternative to the fob 4 and earpiece 2 of the first embodiment Tube 19 contains sensors on the inside and on the outside surfaces. The device is held in the left hand 5. The user 1 inserts the finger of the right hand 6 to make contact. Thus, the outside surface forms a first module including sensors contacting the first hand and the inside surface forms a second module including sensors contacting the first hand. Earpiece 20 is used to detect core body temperature, which is linked by wire 21.

Figures 4 to 9 illustrate an embodiment of the invention in which the sensors are all located onto or into a single integral body. Such an embodiment provides for compactness, portability and ease of use, is especially suited to use by a non-clinician and for example a patient at home, and is especially preferred for many applications.

As illustrated in figure 4, an instrument is provided which has two components, the integral body 31 which carries all the sensors and a lid 32 which fits to the body when the instrument is not in use.

The body defines three sensor locations and may thus be seen as comprising integrally in a single whole unit three modu'es as above described.

First, the body 31 defines an outer shell, which as specifically illustrated in figure S carries the first EGG sensor 37. Second, the shell has two recessed portions each defining a finger socket configured to receive a user's finger. As is illustrated best in figure 7 each of these two finger sockets also carries sensors, respectively an ECG sensor 38, a PPG sensor 39, an ECG sensor ground contact and an additional PPG sensor 41. A third sensor location is defined at the end of the shell, as illustrated in figure 9, and shows the location of the thermometer 36.

Thus, the outer shell of the integral body unit 31 in effect comprises a first sensor module, the finger sockets in effect comprise a second sensor module and the end, preferably comprising a suitably shaped projecting portion designed and used to project into the outer ear canal of a user 33 when inserted in use, constitutes a third sensor module as above described.

Figure 5 illustrates the instrument in normal operation. The outer shell of the sensor body 31 is held in the user's left hand 34, so that an area of the palm of the left hand makes contact with the outer ECG sensor 37. Two fingers of the right hand 35 are inserted in the respective finger sockets defined within the shell so as to make contact respectively with the sensors 38, 39,40 and 41. In particular an ECG circuit is thereby completed between the left 34 and the right 35 hand across the trunk of the user.

The device additionally provides for a temperature sensor in a third sensor location which is designed for insertion into the ear in generally familiar manner, and figure 3 illustrates a user 33 using the device to take a core body temperature reading by inserting the end of the device 31 into the ear.

This single compact device thus performs all three functions of the first hand module the second hand module and the ear module represented in other embodiments, but in a single compact and integral unit which is particularly convenient for the intended application.

Figures 10 to 13 illustrate possible modifications which can be made to the lid 32 to give additional functionality to the complete instrument. Figure 10 shows the lid in an isometric view, which may then be used to contain additional functionality and wireless capability. For example a wireless transceiver and suitable power source, and for example a low energy module such as a BLE module and a suitable battery, maybe incorporated into the lid. In the figure 11 embodiment the inside of the lid has been modified to include additional sensors such as) in the illustrated embodiment, a blood glucose reader 46 and a fingerprint recognition sensor 45. These or other additional sensors or devices may be incorporated into the lid or into the sensor body to give additional functionality. Optionally for example a microphone may be incorporated giving a capability to detect respiration and, with a suitable wireless capability, give additional functionality as a wireless stethoscope.

Figures 12 and 13 illustrate the provision of a screen to display readings, in figure 12 provided internally to the lid and in figure 13 provided externally.

Figures 14 to 19 illustrate certain alternative possible external shapes for a body embodying the principles of this embodiment. Each external shape is designed to be conveniently handheld by the first hand on the outer surface, and to provide an appropriate arrangement of finger inserts. For example figure 14 illustrates a lozenge shape, figure 15 an elliptical shape, figure 16 a circular shape, figure 17 a square shape, figure 18 a triangular shape, and figure 19 a elongate shape which might be used for example to allow all the fingers of one hand to be inserted.

The system is referred to as "portable and un-tethered", which is to say that the wearer can go about their normal daily tasks unhindered.

The example sensor systems of the invention maybe adapted for remote and for example wireless communication with a remote processor, for example carried on a mobile telecommunications or mobile computing device, for example comprising a laptop, tablet, cell-phone etc. This enables a mode of operation in which the mobile communication device, such as a mobile telephone device, may be exploited to the frill to allow a portable detector device in accordance with the first aspect of the invention both to use the processor of the mobile communication device to process the data and to use the telephone communication abilities of the device to communicate automatically with a third party such as the support clinician by using the existing communication capability of the mobile communication device, for example via an established 1 0 mobile telecommunications protocol.

Throughout the specification, unless the context demands otherwise, the terms comprise' or include', or variations such as comprises' or comprising', includes' or including' will be understood to imply the inclusion of a stated 1 5 integer or group of integers, but not the exclusion of any other integer or group of integers.

Further modifications and improvements maybe added without departing from the scope of the invention herein described.

The above merely describes an example mode of operation, in which the mobile telephone device is exploited to the kill to allow a portable detector device in accordance with the first aspect of the invention both to use its processor to process the data and to use its communication abilities to communicate automatically with a third party such as the support clinician. Other modes of operation, especially those that exploit the ability of a system in accordance with the invention to effect continuous real time monitoring of the patient's condition in a simple and untethered but effective manner, will be readily envisaged.