JP6453433B2 - 遠隔医療装置アラーム - Google Patents
遠隔医療装置アラーム Download PDFInfo
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Description
本願は米国特許法第119条(e)に基づき、2010年11月8日に出願された「遠隔医療装置アラーム」と題された米国特許仮出願連続番号第61/411,189号に対
する優先権を主張し、その全体が引用によりここに援用される。
1.発明の分野
本発明は着用可能医療装置で使用するための遠隔アラームに向けられている。
使用の際、着用可能な除細動器や着用可能インスリンポンプなどの着用可能な医療装置は、可聴アラーム、音声プロンプトもしくはメッセージ、または視覚的メッセージを発して、患者または近くにいる人に医学的状態を知らせるために、ある問題を直すために何らかの行動を取るよう指示するために、助けを呼ぶために、患者または近くにいる人から情報を求めるために、または装置が正しく機能し続けるよう装置にフィードバックするために、機能する。たとえば、着用可能医療装置が着用可能除細動器である場合、患者が心臓の不整脈を起こしていると装置が判断すれば、装置はアラームおよび音声メッセージを出力し、患者に意識があることを示すためにその装置に備わっているボタンを押して保持することを患者に指示し、それにより除細動ショックを送ることを保留することを装置に指示する。患者が応答しなければ、装置は患者に意識がないと推測して処置の手順を進め、最終的に患者の体に一回以上の除細動ショックを送る。さらに、近くにいる人に警告やメッセージを与えて、その近くにいる人に医療アシストを呼ぶよう、または除細動ショックが送られるので近くにいる人が患者から離れるよう警告を出すことができる。
アラームやメッセージが患者や近くにいる人によって受取られない場合があることを出願人は認識している。たとえば、患者がベッドで寝ている場合、あまりにもぐっすり寝ているのでアラームや音声メッセージが患者を起こすほど十分大きくないことがある。代替的にまたは付加的に、着用可能医療装置のスピーカの部分が、寝具や衣服によってブロックまたは遮断され、それにより音量が下がって、患者または近くにいる人にアラーム、音声プロンプトまたはメッセージが聞こえないことがある。患者が目を覚ましている場合でも、うるさい環境では、アラームやメッセージが聞こえないこともある。
の動作を行なうよう構成され得る。たとえば電話メッセージを送って救急担当者に患者の身元、場所および医学的状態を知らせる、またはEメールを友人または身内に送るよう構成されてもよい。
)通信規格のいずれかを用いてRF信号を受取り、メッセージは音声メッセージ、サイレン、または音である。本実施の形態の別の局面に従い、着用可能医療装置は着用可能除細動器である。本実施の形態のさらなる局面に従い、メッセージは着用可能医療装置が提供できる音量よりも大きい音量で再生される。本実施の形態のさらなる局面に従い、遠隔アラームはメッセージの受取りに応答して点灯する高輝度電球を含む。
患者の所在地、および医学的緊急事態を特定する。
るために、第1の装置のインジケータをセットする動作とをさらに含む。
本発明は、以下の説明または図面に示されている構成の詳細およびコンポーネントの配置の用途に制限されるものではない。本発明は他の実施の形態が可能であり、さまざまな方法で実施または実行できる。さらに、ここで用いられる文言および用語は説明のためにあり、限定するものではない。「含む」、「備える」、「有する」、「含有する」、「係わる」およびこれらの変形などの使用は、後に記載されている項目およびその均等物ならびに付加的項目を含有することが意図される。
に取付けられ、制御ユニット120と電気的に結合される。着用可能医療装置100はさらに複数の治療電極114を含み、電極114は制御ユニットに電気的に結合され、治療的除細動ショックの処置が必要であると判断されたら、一回または複数の治療的除細動ショックを患者の体に送ることができる。図示されていないが、着用可能医療装置100はECG感知電極112以外のセンサであって、患者の生理学的状態または活動をモニタすることができる付加的センサを含むこともできる。たとえば、血圧、心拍数、胸郭インピーダンス、脈酸素濃度、呼吸数、心音、および患者の活動レベルを測定するセンサを含んでもよい。
さらに、セルラー(たとえば、2G、3G、および4G)ネットワークを介して着用可能医療装置から受取られた情報を無線で通信できるアンテナ135を含む。
社、Freescale社、およびARMホールディングス社などから商業的に入手できるプロセ
ッサを含む。着用可能除細動器に向けられる1つの例示的実施の形態において、少なくとも1つのプロセッサ310は、Intel(登録商標)PXA270プロセッサといった汎用
プロセッサやFreescale(登録商標)DSP56311デジタルシグナルプロセッサとい
った専用プロセッサを含むことができる。これは2010年7月9日に出願された「医療装置で節電するためのシステムおよび方法」と題される同時係属出願連続番号第12/833,096号(以降、′096出願)に記載されており、その全体が引用によりここに援用される。少なくとも1つのプロセッサ310は、たとえばECG感知電極112および治療電極114(図1)といった複数のセンサ325に電気的に結合されて、患者の医学的状態をモニタし、一部の実施の形態では、心臓の不整脈といった医学的状態の検出に応答して患者に医療処置を提供する。
、無線USBまたはZigBee(登録商標)といった、低コストおよび短距離(たとえば10メートル)通信に最適化された無線通信規格およびプロトコルを用いて遠隔アラーム200A、200Bと通信できる。他の実施の形態において、RFトランシーバ320は、無線イーサネット(登録商標)またはGSM(登録商標)といったより長い距離通信可能である通信規格およびプロトコルを用いて遠隔アラーム200A、200Bと通信してもよい。たとえば一実施の形態において、RFトランシーバ320は無線イーサネット(登録商標)を介してテレビまたはIpad(登録商標)といった大画面表示装置と通信して、着
用可能医療装置によって通信された状況、警告、またはお知らせを表示してもよい。特定の実施の形態において、コストが懸念される場合、または一方向の通信のみが所望の場合、無線RFトランシーバ320は、アナログ信号を送信可能な無線RFトランスミッタと置換えることができる。無線医療装置300は遠隔アラーム200A、200Bからメッセージを受取ることはできないが、本実施の形態は以下で説明するように、無線通信チャネルを介して情報を遠隔アラームに送ることができる。
ら入手できる汎用プロセッサまたは専用プロセッサであり得る。
コルと互換性を有する種類のトランシーバを含み得る。低コストが関心事であり、一方向の通信のみが必要な特定の実施の形態では、無線RFトランシーバ221は上記の遠隔アラーム200Aで説明したような無線RFレシーバと置換えることができ、その場合、遠隔アラーム200Bは着用可能医療装置によって送られるメッセージおよびアラームを受取ることはできるが、通信を着用可能医療装置300に返すことはできない。音声回路231は音声信号を音声出力装置235に提供可能ないずれかの音声回路であり得る。特定の実施の形態において、音声回路231は文字メッセージを可聴音声メッセージに変換可能な音声合成器を含んでもよい。
回路として、着用可能医療装置300に電力を与えるために用いることができる1つ以上の充電可能な電池を調整および充電できる電池充電および調整回路270やユーザインターフェイス290を挙げることができる。ユーザインターフェイス290はビジュアルタッチスクリーンディスプレイを含むことができ、その場合患者または近くにいる人は遠隔アラーム200Bと通信でき、さらに複数のボタンおよび/またはLEDを含んでもよい。さらに、コンピュータキーボードを遠隔アラーム200Bにつなぐためのコンピュータキーボードコネクタをも含んでもよい。ビジュアルタッチスクリーンディスプレイは、患者または近くにいる人と通信していない場合には時計または目覚まし時計として機能してもよい。代替的に、別のディスプレイを設けてアラームクロックの機能を実施してもよい。
ッチスクリーンディスプレイ上に文字の形で表示でき、これは単独で、または聴覚的に再生されるメッセージと併せて提示できる。このコードは、患者または近くにいる人に通信されるメッセージ、プロンプト、またはアラームの内容や長さ、メッセージの音量レベル、さらに患者または近くにいる人からの特定の応答があった場合にまたは応答がなかった場合に、どのような行動が取られるべきかを特定することができる。
ンターフェイス290のインジケータ(たとえば、LED)をセットして、次に可能な場合に患者に遠隔アラーム200Bとインターフェイスして、その情報を引出すことを促すことができる。不整脈が検出されて、治療的ショックが送られた場合でも、患者はこの事実を認知していないかも知れない。このような情報を引出すよう促されることにより、患者はこのような事象を認知することになる。このような事象の発生は、たとえばEメール、文字、または音声メールを介して、患者に、愛する者に、看護人に、または医療サービス提供者に通信されて、その事象の発生を知らせてもよい。重要ではあるが、着用可能除細動器が患者(または看護人)に通信するのに緊急でない他の種類の情報としては、1つ以上のセンサでの信号対ノイズ比の劣化(ただしこの場合のセンサの数は患者を保護するのに必要な十分な数よりも少ない)、1つ以上のセンサが外れているという検出(ただしこの場合もセンサの数は患者を保護するのに必要な十分な数よりも少ない)、低い電池状態ではあるが、患者をモニタおよび保護するのに必要なレベルよりは低くない状態、着用可能医療装置の装着帯110(図1)の適切な装着状態を得るためには装着帯110をきれいにする必要があるという警告などを挙げることができる。除細動器を含む他の種類の着用可能な医療装置では、重要であるが緊急ではないメッセージとして、薬を服用するというお知らせ、特定の時間に血糖値を測定するというお知らせ、バッテリ交換のお知らせまたは通常のバッテリ交換もしくは交換時期がとばされたという通知などを挙げることができる。
機能は一緒になって上記の機能を提供する多様な個別の装置間に分配されてもよい。たとえば、図3はいくつかの別個の装置410、420、430および440を含み、集合的に遠隔アラームとして動作する遠隔アラーム400を示す。図3で示されるように、一実施例において、遠隔アラーム400は、従来の壁の電源コンセントに直接差込むよう構成されているACレセプタクルアラームユニット410、患者のベッドもしくは椅子に隣接して、または患者のベッドのマットレスの下もしくは患者の椅子の座部または背中の部分のクッションの下に配置されるよう構成されている振動アラームユニット420、患者にとって都合のよい場所、たとえば患者のベッドまたは患者に隣接した小型テーブル上に配置されるよう構成されている遠隔応答ボタン430、および患者の愛する者または看護人が付けるよう構成されているアラームペンダント440を含む。
とを含む。図4では見えないが、イヤホン遠隔アラーム510は着用可能医療装置300から受取られた通信メッセージを可聴的に患者に通信するために、患者の外耳道近くに配置されるよう構成されるスピーカなどの音声出力装置を含む。イヤホン遠隔アラームはマイクをさらに含んでもよく、それによりイヤホン遠隔アラームはマイクで受取った音が増幅されて患者に伝えられる補聴器として付加的に働くものであってもよい。人間の耳は、患者の脈酸素濃度を測定するのに比較的適する場所であると考えられるので、イヤホン遠隔アラーム510は患者の脈酸素レベルをモニタする脈酸素センサ(図示されていない)を含んで、この情報を着用可能医療装置300(図2)に通信してもよい。一部の実施の形態において、イヤホン遠隔アラームは応答ボタン513を含んでもよく、この場合患者は心臓の不整脈が検出されて緊急ショックの警告に応答して、患者は自分に意識があることを示すことができる。
(登録商標)を含むことができる。ウォッチモニタ遠隔アラーム520は音声出力装置(図示されていない)を含むことができ、その場合アラームや可聴メッセージを患者に通信することができる。ウォッチモニタ遠隔アラームはさらに、ディスプレイ521上に表示することができる患者の脈拍、体温、または血液酸素レベルを検出するためのセンサ(ウォッチの裏面に配置され、図4では見えない)を含んでもよい。このような情報は、スクロールボタン522および523を用いて表示することができる。
Claims (24)
- 着用可能遠隔装置であって、
患者によってアクセス可能なユーザインターフェイスと、
着用可能除細動器と無線通信するための無線トランシーバと、
前記ユーザインターフェイスおよび前記無線トランシーバに結合されたプロセッサとを備え、前記プロセッサは、前記着用可能除細動器に関する少なくとも1つの装置情報と前記患者の心不整脈とに関する通知を、前記無線トランシーバを介して前記着用可能除細動器から受け取った通信に基づいて前記ユーザインターフェイスに提供させ、
前記プロセッサは、前記着用可能除細動器に関する前記装置情報と前記心不整脈とのうちの少なくとも1つの前記通知を直ちに通信すべきかどうかを判断して、前記通知を直ちに通信すべきという判断に応じて前記ユーザインターフェイスに前記通知を通信させ、前記通知が緊急のものではないという判断に応じて、前記ユーザインターフェイスに、前記通知に関する情報を、前記着用可能除細動器のメモリ内に記憶させるように構成される、着用可能遠隔装置。 - 前記無線トランシーバは、無線周波数トランシーバ、Bluetooth(登録商標)トランシ
ーバ、無線イーサネット(登録商標)トランシーバ、無線USBトランシーバ、およびZigBee(登録商標)トランシーバのうちの少なくとも1つを含む、請求項1に記載の着用可能遠隔装置。 - 前記ユーザインターフェイスは、ディスプレイ、ユーザ対話型ディスプレイ、ボタン、音声出力装置、および電気機械的振動器のうちの少なくとも1つを含む、請求項1または2に記載の着用可能遠隔装置。
- 前記ユーザインターフェイスは、前記患者から入力を受け付けるために前記着用可能遠隔装置の筐体に配置された1つ以上のボタンを含む、請求項1または2に記載の着用可能遠隔装置。
- 前記ユーザインターフェイスは、前記通知を認識するために前記患者によって駆動可能な、前記着用可能遠隔装置に配置された少なくとも1つのユーザ応答ボタンを含む、請求項1または2に記載の着用可能遠隔装置。
- 前記患者が前記通知を認識したことに応答して、前記着用可能遠隔装置は、前記通知の認識を前記着用可能除細動器に送信する、請求項5に記載の着用可能遠隔装置。
- 前記患者による前記認識がないことに応答して、前記プロセッサは、前記ユーザインターフェイスに、前記通知を異なる特性で繰り返させる、請求項5に記載の着用可能遠隔装置。
- 前記ユーザインターフェイスは、前記着用可能遠隔装置の筐体に配置されたディスプレイを含み、前記プロセッサは、前記ディスプレイに、前記着用可能除細動器に関する前記装置情報と、前記患者の前記心不整脈とのうちの少なくとも1つに関する視覚的通知を表示させる、請求項1または2に記載の着用可能遠隔装置。
- 前記ユーザインターフェイスは、前記着用可能遠隔装置に配置された音声出力装置を含み、前記プロセッサは、前記音声出力装置に、前記着用可能除細動器に関する前記装置情報と、前記患者の前記心不整脈とのうちの少なくとも1つに関する可聴の通知を提供させる、請求項1または2に記載の着用可能遠隔装置。
- 前記可聴の通知は、可聴アラームサイレンまたは音、音声メッセージ、および音声命令のうちの少なくとも1つを含む、請求項9に記載の着用可能遠隔装置。
- 前記ユーザインターフェイスは、前記着用可能遠隔装置の筐体に配置されたディスプレイをさらに含み、前記プロセッサは、さらに、前記ディスプレイに、前記着用可能除細動器に関する前記装置情報と前記心不整脈とのうちの少なくとも1つに関する視覚的通知を表示させる、請求項9に記載の着用可能遠隔装置。
- 前記通知は、前記着用可能除細動器に関する装置情報に関するものであり、前記装置情報は、前記着用可能な除細動器に電力を与えるバッテリの充電状態を識別する、請求項11に記載の着用可能遠隔装置。
- 前記通知は、前記着用可能除細動器に関する装置情報に関するものであり、前記装置情報は、前記着用可能な除細動器に関連する、ある程度の数のセンサが、前記患者の体から、外れたまたは接触していないということを識別する、請求項11に記載の着用可能遠隔装置。
- 前記通知は、前記患者の心不整脈に関連し、前記視覚的通知と前記可聴の通知とのうちの少なくとも1つは、前記心不整脈が検出されて、ショックが前記着用可能な除細動器によって届けられるべきであるということを示す、請求項11に記載の着用可能遠隔装置。
- 前記ユーザインターフェイスは、さらに、前記心不整脈に関連した前記通知に応答して前記患者の状態を前記着用可能除細動器に通信するために、前記患者によって駆動可能な、前記着用可能遠隔装置に配置された、少なくとも1つのユーザ応答ボタンを含む、請求項14に記載の着用可能遠隔装置。
- 前記視覚的通知と前記可聴の通知とのうちの少なくとも1つは、さらに、前記患者に、前記少なくとも1つのユーザ応答ボタンを駆動することを促進して、前記ショックが、前記着用可能除細動器によって届けられることを抑制する、請求項15に記載の着用可能遠隔装置。
- 前記少なくとも1つのユーザ応答ボタンを前記患者が駆動することに応答して、前記プロセッサは、前記着用可能除細動器が前記ショックを抑制するよう命令する通信を、前記無線トランシーバを通じて前記着用可能除細動器に送る、請求項16に記載の着用可能遠隔装置。
- 電話通信インターフェイス、セルラー通信インターフェース、および無線コンピュータネットワーク通信インターフェイスのうちの少なくとも1つをさらに備える、請求項15に記載の着用可能遠隔装置。
- 少なくとも1つのプロセッサは、さらに、前記電話通信インターフェイス、前記セルラー通信インターフェース、および前記無線コンピュータネットワーク通信インターフェイスのうちの前記少なくとも1つに、メッセージを、遠隔地の救急担当者、前記患者の医療サービス提供者、前記患者の愛する者または身内のうちの少なくとも1つに通信させる、請求項18に記載の着用可能遠隔装置。
- 前記メッセージは、前記患者の識別、前記患者の医学的状態、および前記患者の物理的位置のうちの少なくとも1つを識別する、請求項19に記載の着用可能遠隔装置。
- 前記着用可能遠隔装置はウォッチモニタである、請求項1に記載の着用可能遠隔装置。
- 前記着用可能遠隔装置に配置されたセンサをさらに備え、前記センサは、脈拍センサ、体温センサ、および血液酸素レベルセンサのうちの少なくとも1つを含む、請求項1−21のいずれか1項に記載の着用可能遠隔装置。
- 前記着用可能遠隔装置はイヤホンである、請求項1に記載の着用可能遠隔装置。
- 前記着用可能遠隔装置は首に着用するように構成されたペンダントである、請求項1に記載の着用可能遠隔装置。
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