U.S. patent application number 13/010653 was filed with the patent office on 2011-08-25 for wireless patient monitoring system.
This patent application is currently assigned to MASIMO CORPORATION. Invention is credited to Nicholas Evan Barker, Massi Joe E. Kiani, Gregory A. Olsen, James P. Welch.
Application Number | 20110208015 13/010653 |
Document ID | / |
Family ID | 44477078 |
Filed Date | 2011-08-25 |
United States Patent
Application |
20110208015 |
Kind Code |
A1 |
Welch; James P. ; et
al. |
August 25, 2011 |
WIRELESS PATIENT MONITORING SYSTEM
Abstract
A device for obtaining physiological information of a medical
patient can include a blood pressure device that can be coupled to
a medical patient and a wireless transceiver electrically coupled
with the blood pressure device. The wireless transceiver can
wirelessly transmit blood pressure data received by the blood
pressure device and physiological data received from one or more
physiological sensors coupled to the blood pressure device.
Inventors: |
Welch; James P.; (Mission
Viejo, CA) ; Kiani; Massi Joe E.; (Laguna Niguel,
CA) ; Olsen; Gregory A.; (Trabuco Canyon, CA)
; Barker; Nicholas Evan; (Laguna Beach, CA) |
Assignee: |
MASIMO CORPORATION
Irvie
CA
|
Family ID: |
44477078 |
Appl. No.: |
13/010653 |
Filed: |
January 20, 2011 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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12840209 |
Jul 20, 2010 |
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13010653 |
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61226996 |
Jul 20, 2009 |
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61259037 |
Nov 6, 2009 |
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61290436 |
Dec 28, 2009 |
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61350673 |
Jun 2, 2010 |
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Current U.S.
Class: |
600/301 |
Current CPC
Class: |
A61B 5/0205 20130101;
A61B 5/002 20130101; A61B 2562/222 20130101; A61B 5/7285
20130101 |
Class at
Publication: |
600/301 |
International
Class: |
A61B 5/00 20060101
A61B005/00 |
Claims
1. A patient monitoring system, the system comprising: a first
sensor configured to be coupled with a patient and to obtain first
physiological information from the patient, the first physiological
information reflecting a first physiological parameter of the
patient; a second sensor configured to be coupled with the patient,
the second sensor being a different type of sensor than the first
sensor, the second sensor further configured to obtain second
physiological information from the patient, the second
physiological information reflecting a second physiological
parameter of the patient; a cable hub configured to electrically
couple the first and second sensors with a blood pressure cuff, the
blood pressure cuff comprising a processor configured to receive
the first and second physiological information from the first and
second sensors; and the cable hub configured to selectively couple
one or more additional physiological sensors with the blood
pressure cuff.
2. The patient monitoring system of claim 1, wherein the one or
more additional physiological sensors comprises a brain sensor.
3. The patient monitoring system of claim 2, wherein the brain
sensor comprises one or more of the following: an optical sensor
and an electroencephalography (EEG) sensor.
4. The patient monitoring system of claim 1, wherein the first
sensor comprises an electrocardiograph (ECG) sensor.
5. The patient monitoring system of claim 1, wherein the first
sensor comprises an acoustic sensor.
6. The patient monitoring system of claim 1, wherein the first
sensor is an ear optical sensor and the second sensor is an
acoustic respiratory sensor.
7. A patient monitoring device comprising: a cable assembly
configured to be coupled with a plurality of physiological sensors,
the cable assembly comprising: a cable hub coupled with the first
cable section, the cable hub configured to selectively couple with
one or more of the plurality of physiological sensors operative to
obtain physiological information from the patient, and a cable
configured to couple to the cable hub and to a patient-worn device,
the patient-worn device configured to communicate the physiological
information to a physiological monitor.
8. The patient monitoring device of claim 7, wherein the cable hub
is configured to enable the physiological sensors to be selectively
connected and disconnected in response to different monitoring
needs for the patient.
9. The patient monitoring device of claim 7, wherein the
patient-worn device is connected to the physiological monitor with
a single monitor cable.
10. The patient monitoring device of claim 7, wherein the
patient-worn device is a wireless device configured to communicate
the physiological information to the physiological monitor.
11. The patient monitoring device of claim 10, wherein the wireless
device is configured to be coupled with a blood pressure cuff.
12. The patient monitoring device of claim 7, wherein the cable hub
is configured to couple with one or more of the following
physiological sensors: an electrocardiograph (ECG) sensor, an
acoustic sensor, an optical sensor, and an electroencephalography
(EEG) sensor.
13. A patient monitoring system, the system comprising: a first
sensor configured to be coupled with a patient and to obtain first
physiological information from the patient, the first physiological
information reflecting a first physiological parameter of the
patient; a second sensor configured to be coupled with the patient,
the second sensor being a different type of sensor than the first
sensor, the second sensor further configured to obtain second
physiological information from the patient, the second
physiological information reflecting a second physiological
parameter of the patient; and a cable hub configured to
electrically couple with the first and second sensors and to
provide the first and second physiological information to a
patient-worn device.
14. The patient monitoring system of claim 13, wherein the
patient-worn device comprises a wireless device configured to
provide the first and second physiological information to a
physiological monitor.
15. The patient monitoring system of claim 13, wherein the
patient-worn device is configured to be coupled with a monitor
cable that connects to the physiological monitor.
16. The patient monitoring system of claim 13, wherein patient-worn
device comprises a blood pressure cuff.
17. The patient monitoring system of claim 16, wherein the blood
pressure cuff comprises a wireless device configured to provide the
first and second physiological information to a physiological
monitor.
18. The patient monitoring system of claim 16, wherein the blood
pressure cuff is configured to couple to a monitor cable that
connects to the physiological monitor.
Description
RELATED APPLICATIONS
[0001] This application claims priority benefit under 35 U.S.C.
.sctn.120 to and is a continuation-in-part of U.S. patent
application Ser. No. 12/840,209, filed Jul. 20, 2010, entitled
"Wireless Patient Monitoring System," which claims the benefit of
priority under 35 U.S.C. .sctn.119(e) of the following U.S.
Provisional Patent Applications:
TABLE-US-00001 App. No. Filing Date Title Attorney Docket
61/226,996 Jul. 20, 2009 Wireless Blood MASIMO.730PR Pressure
Monitoring System 61/259,037 Nov. 6, 2009 Wireless Blood
MASIMO.730PR2 Pressure Monitoring System 61/290,436 Dec. 28, 2009
Acoustic MASIMO.763PR2 Respiratory Monitor 61/350,673 Jun. 2, 2010
Opticoustic Sensor MASIMO-P120
[0002] Each of the foregoing applications is incorporated by
reference in their entirety.
BACKGROUND
[0003] Hospitals, nursing homes, and other patient care facilities
typically include patient monitoring devices at one or more
bedsides in the facility. Patient monitoring devices generally
include sensors, processing equipment, and displays for obtaining
and analyzing a medical patient's physiological parameters such as
blood oxygen saturation level, respiratory rate, and the like.
Clinicians, including doctors, nurses, and other medical personnel,
use the physiological parameters obtained from patient monitors to
diagnose illnesses and to prescribe treatments. Clinicians also use
the physiological parameters to monitor patients during various
clinical situations to determine whether to increase the level of
medical care given to patients.
[0004] Blood pressure is one example of a physiological parameter
that can be monitored. Many devices allow blood pressure to be
measured by sphygmomanometer systems that utilize an inflatable
cuff applied to a person's arm. The cuff is inflated to a pressure
level high enough to occlude a major artery. When air is slowly
released from the cuff, blood pressure can be estimated by
detecting "Korotkoff" sounds using a stethoscope or other detection
means placed over the artery.
SUMMARY
[0005] In certain embodiments, a device for obtaining physiological
information of a medical patient can include a blood pressure
device that can be coupled to a medical patient and a wireless
transceiver electrically coupled with the blood pressure device.
The wireless transceiver can wirelessly transmit blood pressure
data received by the blood pressure device and physiological data
received from one or more physiological sensors coupled to the
blood pressure device. To further increase patient mobility, in
some embodiments, a single cable is also provided for connecting
multiple different types of sensors together.
[0006] For purposes of summarizing the disclosure, certain aspects,
advantages and novel features of the inventions have been described
herein. It is to be understood that not necessarily all such
advantages can be achieved in accordance with any particular
embodiment of the inventions disclosed herein. Thus, the inventions
disclosed herein can be embodied or carried out in a manner that
achieves or optimizes one advantage or group of advantages as
taught herein without necessarily achieving other advantages as can
be taught or suggested herein.
BRIEF DESCRIPTION OF THE DRAWINGS
[0007] Various embodiments will be described hereinafter with
reference to the accompanying drawings. These embodiments are
illustrated and described by example only, and are not intended to
limit the scope of the disclosure. In the drawings, similar
elements have similar reference numerals.
[0008] FIGS. 1A and 1B illustrate embodiments of wireless patient
monitoring systems;
[0009] FIGS. 2A and 2B illustrate embodiments of wireless patient
monitoring systems having a single cable connection system;
[0010] FIGS. 3A and 3B illustrates additional embodiment of patient
monitoring systems;
[0011] FIGS. 4A and 4B illustrate embodiments of an optical ear
sensor and an acoustic sensor connected via a single cable
connection system;
[0012] FIG. 5 illustrates an embodiment of a wireless transceiver
that can be used with any of the patient monitoring systems
described above;
[0013] FIGS. 6A through 6C illustrate additional embodiments of
patient monitoring systems; and
[0014] FIG. 7 illustrates an embodiment of a physiological
parameter display that can be used with any of the patient
monitoring systems described above.
[0015] FIG. 8 illustrates a further embodiment of a patient
monitoring system.
DETAILED DESCRIPTION
[0016] In clinical settings, medical sensors are often attached to
patients to monitor physiological parameters of the patients. Some
examples of medical sensors include blood oxygen sensors, blood
pressure sensors, and acoustic respiratory sensors. Typically, each
sensor attached to a patient is connected to a bedside monitoring
device with a cable. The more cables that couple the patient to the
bedside monitoring device, the more the patient's freedom of
movement can be restricted. In addition, cables pose a tripping
hazard to health care workers and make it difficult to perform
rapid transport to therapeutic areas such as the operating room
when emergency situations arise.
[0017] This disclosure describes embodiments of wireless patient
monitoring systems that include a wireless device coupled to a
patient and to one or more sensors. In one embodiment, the wireless
device transmits sensor data obtained from the sensors to a patient
monitor. By transmitting the sensor data wirelessly, these patient
monitoring systems can advantageously replace some or all cables
that connect patients to bedside monitoring devices. To further
increase patient mobility and comfort, in some embodiments, a
single cable connection system is also provided for connecting
multiple different types of sensors together.
[0018] These patient monitoring systems are primarily described in
the context of an example blood pressure cuff that includes a
wireless transceiver. The blood pressure cuff and/or wireless
transceiver can also be coupled to additional sensors, such as
optical sensors, acoustic sensors, and/or electrocardiograph
sensors. The wireless transceiver can transmit blood pressure data
and sensor data from the other sensors to a wireless receiver,
which can be a patient monitor. These and other features described
herein can be applied to a variety of sensor configurations,
including configurations that do not include a blood pressure
cuff.
[0019] FIGS. 1A and 1B illustrate embodiments of wireless patient
monitoring systems 100A, 100B, respectively. In the wireless
patient monitoring systems 100 shown, a blood pressure device 110
is connected to a patient 101. The blood pressure device 110
includes a wireless transceiver 116, which can transmit sensor data
obtained from the patient 101 to a wireless transreceiver 120.
Thus, the patient 101 is advantageously not physically coupled to a
bedside monitor in the depicted embodiment and can therefore have
greater freedom of movement.
[0020] Referring to FIG. 1A, the blood pressure device 110a
includes an inflatable cuff 112, which can be an oscilometric cuff
that is actuated electronically (e.g., via intelligent cuff
inflation and/or based on a time interval) to obtain blood pressure
information. The cuff 112 is coupled to a wireless transceiver 116.
The blood pressure device 110a is also coupled to a fingertip
optical sensor 102 via a cable 107. The optical sensor 102 can
include one or more emitters and detectors for obtaining
physiological information indicative of one or more blood
parameters of the patient 101. These parameters can include various
blood analytes such as oxygen, carbon monoxide, methemoglobin,
total hemoglobin, glucose, proteins, glucose, lipids, a percentage
thereof (e.g., concentration or saturation), and the like. The
optical sensor 102 can also be used to obtain a
photoplethysmograph, a measure of plethysmograph variability, a
measure of blood perfusion, and the like.
[0021] Additionally, the blood pressure device 110a is coupled to
an acoustic sensor 104a via a cable 105. The cable 105 connecting
the acoustic sensor 104a to the blood pressure device 110 includes
two portions, namely a cable 105a and a cable 105b. The cable 105a
connects the acoustic sensor 104a to an anchor 104b, which is
coupled to the blood pressure device 110a via the cable 105b. The
anchor 104b can be adhered to the patient's skin to reduce noise
due to accidental tugging of the acoustic sensor 104a.
[0022] The acoustic sensor 104a can be a piezoelectric sensor or
the like that obtains physiological information reflective of one
or more respiratory parameters of the patient 101. These parameters
can include, for example, respiratory rate, inspiratory time,
expiratory time, inspiration-to-expiration ratio, inspiratory flow,
expiratory flow, tidal volume, minute volume, apnea duration,
breath sounds, rales, rhonchi, stridor, and changes in breath
sounds such as decreased volume or change in airflow. In addition,
in some cases the respiratory sensor 104a, or another lead of the
respiratory sensor 104a (not shown), can measure other
physiological sounds such as heart rate (e.g., to help with
probe-off detection), heart sounds (e.g., S1, S2, S3, S4, and
murmurs), and changes in heart sounds such as normal to murmur or
split heart sounds indicating fluid overload. In some
implementations, a second acoustic respiratory sensor can be
provided over the patient's 101 chest for additional heart sound
detection. In one embodiment, the acoustic sensor 104 can include
any of the features described in U.S. Patent Application No.
61/141,584, filed Dec. 30, 2008, titled "Acoustic Sensor Assembly,"
the disclosure of which is hereby incorporated by reference in its
entirety.
[0023] The acoustic sensor 104 can also be used to generate an
exciter waveform that can be detected by the optical sensor 102 at
the fingertip, by an optical sensor attached to an ear of the
patient (see FIGS. 2A, 3), by an ECG sensor (see FIG. 2C), or by
another acoustic sensor (not shown). The velocity of the exciter
waveform can be calculated by a processor (such as a processor in
the wireless transceiver 120, described below). From this velocity,
the processor can derive a blood pressure measurement or blood
pressure estimate. The processor can output the blood pressure
measurement for display. The processor can also use the blood
pressure measurement to determine whether to trigger the blood
pressure cuff 112.
[0024] In another embodiment, the acoustic sensor 104 placed on the
upper chest can be advantageously combined with an ECG electrode
(such as in structure 208 of FIG. 2B), thereby providing dual
benefit of two signals generated from a single mechanical assembly.
The timing relationship from fidicial markers from the ECG signal,
related cardiac acoustic signal and the resulting peripheral pulse
from the finger pulse oximeters produces a transit time that
correlates to the cardiovascular performance such as blood
pressure, vascular tone, vascular volume and cardiac mechanical
function. Pulse wave transit time or PWTT in currently available
systems depends on ECG as the sole reference point, but such
systems may not be able to isolate the transit time variables
associated to cardiac functions, such as the pre-ejection period
(PEP). In certain embodiments, the addition of the cardiac
acoustical signal allows isolation of the cardiac functions and
provides additional cardiac performance metrics. Timing
calculations can be performed by the processor in the wireless
transceiver 120 or a in distributed processor found in an on-body
structure (e.g., such as any of the devices herein or below: 112,
210, 230, 402, 806).
[0025] In certain embodiments, the wireless patient monitoring
system 100 uses some or all of the velocity-based blood pressure
measurement techniques described in U.S. Pat. No. 5,590,649, filed
Apr. 15, 1994, titled "Apparatus and Method for Measuring an
Induced Perturbation to Determine Blood Pressure," or in U.S. Pat.
No. 5,785,659, filed Jan. 17, 1996, titled "Automatically Activated
Blood Pressure Measurement Device," the disclosures of which are
hereby incorporated by reference in their entirety. An example
display related to such blood pressure calculations is described
below with respect to FIG. 7.
[0026] The wireless transceiver 116 can transmit data using any of
a variety of wireless technologies, such as Wi-Fi (802.11x),
Bluetooth (802.15.2), Zigbee (802.15.4), cellular telephony,
infrared, RFID, satellite transmission, proprietary protocols,
combinations of the same, and the like. The wireless transceiver
116 can perform solely telemetry functions, such as measuring and
reporting information about the patient 101. Alternatively, the
wireless transceiver 116 can be a transceiver that also receives
data and/or instructions, as will be described in further detail
below.
[0027] The wireless receiver 120 receives information from and/or
sends information to the wireless transceiver via an antenna (not
shown). In certain embodiments, the wireless receiver 120 is a
patient monitor. As such, the wireless receiver 120 can include one
or more processors that process sensor signals received from the
wireless transceiver 116 corresponding to the sensors 102a, 102b,
104, and/or 106 in order to derive any of the physiological
parameters described above. The wireless transceiver 120 can also
display any of these parameters, including trends, waveforms,
related alarms, and the like. The wireless receiver 120 can further
include a computer-readable storage medium, such as a physical
storage device, for storing the physiological data. The wireless
transceiver 120 can also include a network interface for
communicating the physiological data to one or more hosts over a
network, such as to a nurse's station computer in a hospital
network.
[0028] Moreover, in certain embodiments, the wireless transceiver
116 can send raw data for processing to a central nurse's station
computer, to a clinician device, and/or to a bedside device (e.g.,
the receiver 116). The wireless transceiver 116 can also send raw
data to a central nurse's station computer, clinician device,
and/or to a bedside device for calculation, which retransmits
calculated measurements back to the blood pressure device 110 (or
to the bedside device). The wireless transceiver 116 can also
calculate measurements from the raw data and send the measurements
to a central nurse's station computer, to a pager or other
clinician device, or to a bedside device (e.g., the receiver 116).
Many other configurations of data transmission are possible.
[0029] In addition to deriving any of the parameters mentioned
above from the data obtained from the sensors 102a, 102b, 104,
and/or 106, the wireless transceiver 120 can also determine various
measures of data confidence, such as the data confidence indicators
described in U.S. Pat. No. 7,024,233 entitled "Pulse oximetry data
confidence indicator," the disclosure of which is hereby
incorporated by reference in its entirety. The wireless transceiver
120 can also determine a perfusion index, such as the perfusion
index described in U.S. Pat. No. 7,292,883 entitled "Physiological
assessment system," the disclosure of which is hereby incorporated
by reference in its entirety. Moreover, the wireless transceiver
120 can determine a plethysmograph variability index (PVI), such as
the PVI described in U.S. Publication No. 2008/0188760 entitled
"Plethysmograph variability processor," the disclosure of which is
hereby incorporated by reference in its entirety.
[0030] In addition, the wireless transceiver 120 can send data and
instructions to the wireless transceiver 116 in some embodiments.
For instance, the wireless transceiver 120 can intelligently
determine when to inflate the cuff 112 and can send inflation
signals to the transceiver 116. Similarly, the wireless transceiver
120 can remotely control any other sensors that can be attached to
the transceiver 116 or the cuff 112. The transceiver 120 can send
software or firmware updates to the transceiver 116. Moreover, the
transceiver 120 (or the transceiver 116) can adjust the amount of
signal data transmitted by the transceiver 116 based at least in
part on the acuity of the patient, using, for example, any of the
techniques described in U.S. Patent Publication No. 2009/0119330,
filed Jan. 7, 2009, titled "Systems and Methods for Storing,
Analyzing, and Retrieving Medical Data," the disclosure of which is
hereby incorporated by reference in its entirety.
[0031] In alternative embodiments, the wireless transceiver 116 can
perform some or all of the patient monitor functions described
above, instead of or in addition to the monitoring functions
described above with respect to the wireless transceiver 120. In
some cases, the wireless transceiver 116 might also include a
display that outputs data reflecting any of the parameters
described above (see, e.g., FIG. 5). Thus, the wireless transceiver
116 can either send raw signal data to be processed by the wireless
transceiver 120, can send processed signal data to be displayed
and/or passed on by the wireless transceiver 120, or can perform
some combination of the above. Moreover, in some implementations,
the wireless transceiver 116 can perform at least some front-end
processing of the data, such as bandpass filtering,
analog-to-digital conversion, and/or signal conditioning, prior to
sending the data to the transceiver 120. An alternative embodiment
may include at least some front end processing embedded in any of
the sensors described herein (such as sensors 102, 104, 204, 202,
208, 412, 804, 840, 808) or cable hub 806 (see FIG. 8).
[0032] In certain embodiments, the cuff 112 is a reusable,
disposable, or resposable device. Similarly, any of the sensors
102, 104a or cables 105, 107 can be disposable or resposable.
Resposable devices can include devices that are partially
disposable and partially reusable. Thus, for example, the acoustic
sensor 104a can include reusable electronics but a disposable
contact surface (such as an adhesive) where the sensor 104a comes
into contact with the patient's skin. Generally, any of the
sensors, cuffs, and cables described herein can be reusable,
disposable, or resposable.
[0033] The cuff 112 can also can have its own power (e.g., via
batteries) either as extra power or as a sole source of power for
the transceiver 116. The batteries can be disposable or reusable.
In some embodiments, the cuff 112 can include one or more
photovoltaic solar cells or other power sources. Likewise,
batteries, solar sources, or other power sources can be provided
for either of the sensors 102, 104a.
[0034] Referring to FIG. 1B, another embodiment of the system 100B
is shown. In the system 100B, the blood pressure device 110b can
communicate wirelessly with the acoustic sensor 104a and with the
optical sensor 102. For instance, wireless transceivers (not shown)
can be provided in one or both of the sensors 102, 104a, using any
of the wireless technologies described above. The wireless
transceivers can transmit data, raw signals, processed signals,
conditioned signals, or the like to the blood pressure device 110b.
The blood pressure device 110b can transmit these signals on to the
wireless transceiver 120. In addition, in some embodiments, the
blood pressure device 110b can also process the signals received
from the sensors 102, 104a prior to transmitting the signals to the
wireless transceiver 120. The sensors 102, 104a can also transmit
data, raw signals, processed signals, conditioned signals, or the
like directly to the wireless transceiver 120 or patient monitor.
In one embodiment, the system 100B shown can be considered to be a
body LAN, piconet, or other individual network.
[0035] FIGS. 2A and 2B illustrate additional embodiments of patient
monitoring systems 200A and 200B, respectively. In particular, FIG.
2A illustrates a wireless patient monitoring system 200A, while
FIG. 2B illustrates a standalone patient monitoring system
200B.
[0036] Referring specifically to FIG. 2A, a blood pressure device
210a is connected to a patient 201. The blood pressure device 210a
includes a wireless transceiver 216a, which can transmit sensor
data obtained from the patient 201 to a wireless receiver at 220
via antenna 218. In the depicted embodiment, the blood pressure
device 210a includes an inflatable cuff 212a, which can include any
of the features of the cuff 112 described above. Additionally, the
cuff 212a includes a pocket 214, which holds the wireless
transceiver 216a (shown by dashed lines). The wireless transceiver
216a can be electrically connected to the cuff 212a via a connector
(see, e.g., FIG. 5) in some embodiments. As will be described
elsewhere herein, the form of attachment of the wireless
transceiver 216a to the cuff 212a is not restricted to a pocket
connection mechanism and can vary in other implementations.
[0037] The wireless transceiver 216a is also coupled to various
sensors in FIG. 2A, including an acoustic sensor 204a and an
optical ear sensor 202a. The acoustic sensor 204a can have any of
the features of the acoustic sensor 104 described above. The ear
clip sensor 202a can be an optical sensor that obtains
physiological information regarding one or more blood parameters of
the patient 201. These parameters can include any of the
blood-related parameters described above with respect to the
optical sensor 102. In one embodiment, the ear clip sensor 202a is
an LNOP TC-I ear reusable sensor available from Masimo.RTM.
Corporation of Irvine, Calif. In other embodiments, the ear clip
sensor 202a is a concha ear sensor (see FIGS. 4A and 4B).
[0038] Advantageously, in the depicted embodiment, the sensors
202a, 204a are coupled to the wireless transceiver 216a via a
single cable 205. The cable 205 is shown having two sections, a
cable 205a and a cable 205b. For example, the wireless transceiver
216a is coupled to an acoustic sensor 204a via the cable 205b. In
turn, the acoustic sensor 204a is coupled to the optical ear sensor
202a via the cable 205a. Advantageously, because the sensors 202a,
204 are attached to the wireless transceiver 216 in the cuff 212 in
the depicted embodiment, the cable 205 is relatively short and can
thereby increase the patient's 201 freedom of movement. Moreover,
because a single cable 205 is used to connect both sensors 202a,
204a, the patient's mobility and comfort can be further
enhanced.
[0039] In some embodiments, the cable 205 is a shared cable 205
that is shared by the optical ear sensor 202a and the acoustic
sensor 204a. The shared cable 205 can share power and ground lines
for each of the sensors 202a, 204a. Signal lines in the cable 205
can convey signals from the sensors 202a, 204a to the wireless
transceiver 216 and/or instructions from the wireless transceiver
216 to the sensors 202a, 204a. The signal lines can be separate
within the cable 205 for the different sensors 202a, 204a.
Alternatively, the signal lines can be shared as well, forming an
electrical bus.
[0040] The two cables 205a, 205a can be part of a single cable or
can be separate cables 205a, 205b. As a single cable 205, in one
embodiment, the cable 205a, 205b can connect to the acoustic sensor
204a via a single connector. As separate cables, in one embodiment,
the cable 205b can be connected to a first port on the acoustic
sensor 204a and the cable 205a can be coupled to a second port on
the acoustic sensor 204a.
[0041] FIG. 2B further illustrates an embodiment of the cable 205
in the context of a standalone patient monitoring system 200B. In
the standalone patient monitoring system 200B, a blood pressure
device 210b is provided that includes a patient monitor 216b
disposed on a cuff 212b. The patient monitor 216b includes a
display 219 for outputting physiological parameter measurements,
trends, waveforms, patient data, and optionally other data for
presentation to a clinician. The display 219 can be an LCD display,
for example, with a touch screen or the like. The patient monitor
216b can act as a standalone device, not needing to communicate
with other devices to process and measure physiological parameters.
In some embodiments, the patient monitor 216b can also include any
of the wireless functionality described above.
[0042] The patient monitor 216b can be integrated into the cuff
212b or can be detachable from the cuff 212b. In one embodiment,
the patient monitor 216b can be a readily available mobile
computing device with a patient monitoring software application.
For example, the patient monitor 216b can be a smart phone,
personal digital assistant (PDA), or other wireless device. The
patient monitoring software application on the device can perform
any of a variety of functions, such as calculating physiological
parameters, displaying physiological data, documenting
physiological data, and/or wirelessly transmitting physiological
data (including measurements or uncalculated raw sensor data) via
email, text message (e.g., SMS or MMS), or some other communication
medium. Moreover, any of the wireless transceivers or patient
monitors described herein can be substituted with such a mobile
computing device.
[0043] In the depicted embodiment, the patient monitor 216b is
connected to three different types of sensors. An optical sensor
202b, coupled to a patient's 201 finger, is connected to the
patient monitor 216b via a cable 207. In addition, an acoustic
sensor 204b and an electrocardiograph (ECG) sensor 206 are attached
to the patient monitor 206b via the cable 205. The optical sensor
202b can perform any of the optical sensor functions described
above. Likewise, the acoustic sensor 204b can perform any of the
acoustic sensor functions described above. The ECG sensor 206 can
be used to monitor electrical activity of the patient's 201
heart.
[0044] Advantageously, in the depicted embodiment, the ECG sensor
206 is a bundle sensor that includes one or more ECG leads 208 in a
single package. For example, the ECG sensor 206 can include one,
two, or three or more leads. One or more of the leads 208 can be an
active lead or leads, while another lead 208 can be a reference
lead. Other configurations are possible with additional leads
within the same package or at different points on the patient's
body. Using a bundle ECG sensor 206 can advantageously enable a
single cable connection via the cable 205 to the cuff 212b.
Similarly, an acoustical sensor can be included in the ECG sensor
206 to advantageously reduce the overall complexity of the on-body
assembly.
[0045] The cable 205 in FIG. 2B can connect two sensors to the cuff
212b, namely the ECG sensor 206 and the acoustic sensor 204b.
Although not shown, the cable 205 can further connect an optical
ear sensor to the acoustic sensor 204b in some embodiments,
optionally replacing the finger optical sensor 202b. The cable 205
shown in FIG. 2B can have all the features described above with
respect to FIG. 2A.
[0046] Although not shown, in some embodiments, any of the sensors,
cuffs, wireless sensors, or patient monitors described herein can
include one or more accelerometers or other motion measurement
devices (such as gyroscopes). For example, in FIG. 2B, one or more
of the acoustic sensor 204b, the ECG sensor 206, the cuff 212b, the
patient monitor 216b, and/or the optical sensor 202b can include
one or more motion measurement devices. A motion measurement device
can be used by a processor (such as in the patient monitor 216b or
other device) to determine motion and/or position of a patient. For
example, a motion measurement device can be used to determine
whether a patient is sitting up, lying down, walking, or the
like.
[0047] Movement and/or position data obtained from a motion
measurement device can be used to adjust a parameter calculation
algorithm to compensate for the patient's motion. For example, a
parameter measurement algorithm that compensates for motion can
more aggressively compensate for motion in response to high degree
of measured movement. When less motion is detected, the algorithm
can compensate less aggressively. Movement and/or position data can
also be used as a contributing factor to adjusting parameter
measurements. Blood pressure, for instance, can change during
patient motion due to changes in blood flow. If the patient is
detected to be moving, the patient's calculated blood pressure (or
other parameter) can therefore be adjusted differently than when
the patient is detected to be sitting.
[0048] A database can be assembled that includes movement and
parameter data (raw or measured parameters) for one or more
patients over time. The database can be analyzed by a processor to
detect trends that can be used to perform parameter calculation
adjustments based on motion or position. Many other variations and
uses of the motion and/or position data are possible.
[0049] Although the patient monitoring systems described herein,
including the systems 100A, 100B, 200A, and 200B have been
described in the context of blood pressure cuffs, blood pressure
need not be measured in some embodiments. For example, the cuff can
be a holder for the patient monitoring devices and/or wireless
transceivers and not include any blood pressure measuring
functionality. Further, the patient monitoring devices and/or
wireless transceivers shown need not be coupled to the patient via
a cuff, but can be coupled to the patient at any other location,
including not at all. For example, the devices can be coupled to
the patient's belt (see FIGS. 3A and 3B), can be carried by the
patient (e.g., via a shoulder strap or handle), or can be placed on
the patient's bed next to the patient, among other possible
locations.
[0050] Additionally, various features shown in FIGS. 2A and 2B can
be changed or omitted. For instance, the wireless transceiver 216
can be attached to the cuff 212 without the use of the pocket 214.
For example, the wireless transceiver can be sown, glued, buttoned
or otherwise attached to the cuff using any various known
attachment mechanisms. Or, the wireless transceiver 216 can be
directly coupled to the patient (e.g., via an armband) and the cuff
212 can be omitted entirely. Instead of a cuff, the wireless
transceiver 216 can be coupled to a non-occlusive blood pressure
device. Many other configurations are possible.
[0051] FIGS. 3A and 3B illustrate further embodiments of a patient
monitoring system 300A, 300B having a single cable connecting
multiple sensors. FIG. 3A depicts a tethered patient monitoring
system 300A, while FIG. 3B depicts a wireless patient monitoring
system 300B. The patient monitoring systems 300A, 300B illustrate
example embodiments where a single cable 305 can be used to connect
multiple sensors, without using a blood pressure cuff.
[0052] Referring to FIG. 3A, the acoustic and ECG sensors 204b, 206
of FIG. 2 are again shown coupled to the patient 201. As above,
these sensors 204b, 206 are coupled together via a cable 205.
However, the cable 250 is coupled to a junction device 230a instead
of to a blood pressure cuff. In addition, the optical sensor 202b
is coupled to the patient 201 and to the junction device 230a via a
cable 207. The junction device 230a can anchor the cable 205b to
the patient 201 (such as via the patient's belt) and pass through
any signals received from the sensors 202b, 204b, 206 to a patient
monitor 240 via a single cable 232.
[0053] In some embodiments, however, the junction device 230a can
include at least some front-end signal processing circuitry. In
other embodiments, the junction device 230a also includes a
processor for processing physiological parameter measurements.
Further, the junction device 230a can include all the features of
the patient monitor 216b in some embodiments, such as providing a
display that outputs parameters measured from data obtained by the
sensors 202b, 204b, 206.
[0054] In the depicted embodiment, the patient monitor 240 is
connected to a medical stand 250. The patient monitor 240 includes
parameter measuring modules 242, one of which is connected to the
junction device 230a via the cable 232. The patient monitor 240
further includes a display 246. The display 246 is a user-rotatable
display in the depicted embodiment.
[0055] Referring to FIG. 3B, the patient monitoring system 300B
includes nearly identical features to the patient monitoring system
300A. However, the junction device 230b includes wireless
capability, enabling the junction device 230b to wirelessly
communicate with the patient monitor 240 and/or other devices.
[0056] FIGS. 4A and 4B illustrate embodiments of patient monitoring
systems 400A, 400B that depict alternative cable connection systems
410 for connecting sensors to a patient monitor 402. Like the cable
205 described above, these cable connection systems 410 can
advantageously enhance patient mobility and comfort.
[0057] Referring to FIG. 4A, the patient monitoring system 400A
includes a patient monitor 402a that measures physiological
parameters based on signals obtained from sensors 412, 420 coupled
to a patient. These sensors include an optical ear sensor 412 and
an acoustic sensor 420 in the embodiment shown. The optical ear
sensor 412 can include any of the features of the optical sensors
described above. Likewise, the acoustic sensor 420 can include any
of the features of the acoustic sensors described above.
[0058] The optical ear sensor 412 can be shaped to conform to the
cartilaginous structures of the ear, such that the cartilaginous
structures can provide additional support to the sensor 412,
providing a more secure connection. This connection can be
particularly beneficial for monitoring during pre-hospital and
emergency use where the patient can move or be moved. In some
embodiments, the optical ear sensor 412 can have any of the
features described in U.S. application Ser. No. 12/658,872, filed
Feb. 16, 2010, entitled "Ear Sensor," the disclosure of which is
hereby incorporated by reference in its entirety.
[0059] An instrument cable 450 connects the patient monitor 402a to
the cable connection system 410. The cable connection system 410
includes a sensor cable 440 connected to the instrument cable 250.
The sensor cable 440 is bifurcated into two cable sections 416,
422, which connect to the individual sensors 412, 420 respectively.
An anchor 430a connects the sensor cable 440 and cable sections
416, 422. The anchor 430a can include an adhesive for anchoring the
cable connection system 410 to the patient, so as to reduce noise
from cable movement or the like. Advantageously, the cable
connection system 410 can reduce the number and size of cables
connecting the patient to a patient monitor 402a. The cable
connection system 410 can also be used to connect with any of the
other sensors, patient-worn monitors, or wireless devices described
above.
[0060] FIG. 4B illustrates the patient monitoring system 400B,
which includes many of the features of the monitoring system 400A.
For example, an optical ear sensor 412 and an acoustic sensor 420
are coupled to the patient. Likewise, the cable connection system
410 is shown, including the cable sections 416, 422 coupled to an
anchor 430b. In the depicted embodiment, the cable connection
system 410 communicates wirelessly with a patient monitor 402b. For
example, the anchor 430b can include a wireless transceiver, or a
separate wireless dongle or other device (not shown) can couple to
the anchor 430b. The anchor 430b can be connected to a blood
pressure cuff, wireless transceiver, junction device, or other
device in some embodiments.
[0061] FIG. 5 illustrates a more detailed embodiment of a wireless
transceiver 516. The wireless transceiver 516 can have all of the
features of the wireless transceiver 516 described above. For
example, the wireless transceiver 516 can connect to a blood
pressure cuff and to one or more physiological sensors, and the
transceiver 516 can transmit sensor data to a wireless
receiver.
[0062] The depicted embodiment of the transceiver 516 includes a
housing 530, which includes connectors 552 for sensor cables (e.g.,
for optical, acoustic, ECG, and/or other sensors) and a connector
560 for attachment to a blood pressure cuff or other
patient-wearable device. The transceiver 516 further includes an
antenna 518, which although shown as an external antenna, can be
internal in some implementations.
[0063] In addition, the transceiver 516 includes a display 554 that
depicts values of various parameters, such as systolic and
diastolic blood pressure, SpO.sub.2, and respiratory rate (RR). The
display 554 can also display trends, alarms, and the like. The
transceiver 516 can be implemented with the display 554 in
embodiments where the transceiver 516 also acts as a patient
monitor. The transceiver 516 further includes controls 556, which
can be used to manipulate settings and functions of the transceiver
516.
[0064] FIGS. 6A through 6C illustrate embodiments of wireless
patient monitoring systems 600. FIG. 6A illustrates a patient
monitoring system 600A that includes a wireless transceiver 616,
which can include the features of any of the transceivers 216, 216
described above. The transceiver 616 provides a wireless signal
over a wireless link 612 to a patient monitor 620. The wireless
signal can include physiological information obtained from one or
more sensors, physiological information that has been front-end
processed by the transceiver 616, or the like.
[0065] The patient monitor 620 can act as the wireless receiver 220
of FIG. 2. The patient monitor 620 can process the wireless signal
received from the transceiver 616 to obtain values, waveforms, and
the like for one or more physiological parameters. The patient
monitor 620 can perform any of the patient monitoring functions
described above with respect to FIGS. 2 through 5.
[0066] In addition, the patient monitor 620 can provide at least
some of the physiological information received from the transceiver
616 to a multi-patient monitoring system (MMS) 640 over a network
630. The MMS 640 can include one or more physical computing
devices, such as servers, having hardware and/or software for
providing the physiological information to other devices in the
network 630. For example, the MMS 640 can use standardized
protocols (such as TCP/IP) or proprietary protocols to communicate
the physiological information to one or more nurses' station
computers (not shown) and/or clinician devices (not shown) via the
network 630. In one embodiment, the MMS 640 can include some or all
the features of the MMS described in U.S. Publication No.
2008/0188760, referred to above.
[0067] The network 630 can be a LAN or WAN, wireless LAN ("WLAN"),
or other type of network used in any hospital, nursing home,
patient care center, or other clinical location. In some
implementations, the network 210 can interconnect devices from
multiple hospitals or clinical locations, which can be remote from
one another, through the Internet, one or more Intranets, a leased
line, or the like. Thus, the MMS 640 can advantageously distribute
the physiological information to a variety of devices that are
geographically co-located or geographically separated.
[0068] FIG. 6B illustrates another embodiment of a patient
monitoring system 600B, where the transceiver 616 transmits
physiological information to a base station 624 via the wireless
link 612. In this embodiment, the transceiver 616 can perform the
functions of a patient monitor, such as any of the patient monitor
functions described above. The transceiver 616 can provide
processed sensor signals to the base station 624, which forwards
the information on to the MMS 640 over the network 630.
[0069] FIG. 6C illustrates yet another embodiment of a patient
monitoring system 600B, where the transceiver 616 transmits
physiological information directly to the MMS 640. The MMS 640 can
include wireless receiver functionality, for example. Thus, the
embodiments shown in FIGS. 6A through 6C illustrate that the
transceiver 616 can communicate with a variety of different types
of devices.
[0070] FIG. 7 illustrates an embodiment of a physiological
parameter display 700. The physiological parameter display 700 can
be output by any of the systems described above. For instance, the
physiological parameter display 700 can be output by any of the
wireless receivers, transceivers, or patient monitors described
above. Advantageously, in certain embodiments, the physiological
parameter display 700 can display multiple parameters, including
noninvasive blood pressure (NIBP) obtained using both oscillometric
and non-oscillometric techniques.
[0071] The physiological parameter display 700 can display any of
the physiological parameters described above, to name a few. In the
depicted embodiment, the physiological parameter display 700 is
shown displaying oxygen saturation 702, heart rate 704, and
respiratory rate 706. In addition, the physiological parameter
display 700 displays blood pressure 708, including systolic and
diastolic blood pressure.
[0072] The display 700 further shows a plot 710 of continuous or
substantially continuous blood pressure values measured over time.
The plot 710 includes a trace 712a for systolic pressure and a
trace 712b for diastolic pressure. The traces 712a, 712b can be
generated using a variety of devices and techniques. For instance,
the traces 712a, 712b can be generated using any of the
velocity-based continuous blood pressure measurement techniques
described above and described in further detail in U.S. Pat. Nos.
5,590,649 and 5,785,659, referred to above.
[0073] Periodically, oscillometric blood pressure measurements
(sometimes referred to as Gold Standard NIBP) can be taken, using
any of the cuffs described above. These measurements are shown by
markers 714 on the plot 710. By way of illustration, the markers
714 are "X's" in the depicted embodiment, but the type of marker
714 used can be different in other implementations. In certain
embodiments, oscillometric blood pressure measurements are taken at
predefined intervals, resulting in the measurements shown by the
markers 714.
[0074] In addition to or instead of taking these measurements at
intervals, oscillometric blood pressure measurements can be
triggered using ICI techniques, e.g., based at least partly on an
analysis of the noninvasive blood pressure measurements indicated
by the traces 712a, 712b. Advantageously, by showing both types of
noninvasive blood pressure measurements in the plot 710, the
display 700 can provide a clinician with continuous and
oscillometric blood pressure information.
[0075] FIG. 8 illustrates another embodiment of a patient
monitoring system 800. The features of the patient monitoring
system 800 can be combined with any of the features of the systems
described above. Likewise, any of the features described above can
be incorporated into the patient monitoring system 800.
Advantageously, in the depicted embodiment, the patient monitoring
system 800 includes a cable hub 806 that enables one or many
sensors to be selectively connected and disconnected to the cable
hub 806.
[0076] Like the patient monitoring systems described above, the
monitoring system 800 includes a cuff 810 with a patient device 816
for providing physiological information to a monitor 820 or which
can receive power from a power supply (820). The cuff 810 can be a
blood pressure cuff or merely a holder for the patient device 816.
The patient device 816 can instead be a wireless transceiver having
all the features of the wireless devices described above.
[0077] The patient device 816 is in coupled with an optical finger
sensor 802 via cable 807. Further, the patient device 816 is
coupled with the cable hub 806 via a cable 805a. The cable hub 806
can be selectively connected to one or more sensors. In the
depicted embodiment, example sensors shown coupled to the cable hub
806 include an ECG sensor 808a and a brain sensor 840. The ECG
sensor 808a can be single-lead or multi-lead sensor. The brain
sensor 840 can be an electroencephalography (EEG) sensor and/or an
optical sensor. An example of EEG sensor that can be used as the
brain sensor 840 is the SEDLine.TM. sensor available from
Masimo.RTM. Corporation of Irvine, Calif., which can be used for
depth-of-anesthesia monitoring among other uses. Optical brain
sensors can perform spectrophotometric measurements using, for
example, reflectance pulse oximetry. The brain sensor 840 can
incorporate both an EEG/depth-of-anesthesia sensor and an optical
sensor for cerebral oximetry.
[0078] The ECG sensor 808a is coupled to an acoustic sensor 804 and
one or more additional ECG leads 808b. For illustrative purposes,
four additional leads 808b are shown, for a 5-lead ECG
configuration. In other embodiments, one or two additional leads
808b are used instead of four additional leads. In still other
embodiments, up to at least 12 leads 808b can be included. Acoustic
sensors can also be disposed in the ECG sensor 808a and/or lead(s)
808b or on other locations of the body, such as over a patient's
stomach (e.g., to detect bowel sounds, thereby verifying patient's
digestive health, for example, in preparation for discharge from a
hospital). Further, in other embodiments, the acoustic sensor 804
can connect directly to the cable hub 806 instead of to the ECG
sensor 808a.
[0079] As mentioned above, the cable hub 806 can enable one or many
sensors to be selectively connected and disconnected to the cable
hub 806. This configurability aspect of the cable hub 806 can allow
different sensors to be attached or removed from a patient based on
the patient's monitoring needs, without coupling new cables to the
monitor 820. Instead, a single, light-weight cable 832 couples to
the monitor 820 in certain embodiments, or wireless technology can
be used to communicate with the monitor 820 (see, e.g., FIG. 1). A
patient's monitoring needs can change as the patient is moved from
one area of a care facility to another, such as from an operating
room or intensive care unit to a general floor. The cable
configuration shown, including the cable hub 806, can allow the
patient to be disconnected from a single cable to the monitor 820
and easily moved to another room, where a new monitor can be
coupled to the patient. Of course, the monitor 820 may move with
the patient from room to room, but the single cable connection 832
rather than several can facilitate easier patient transport.
[0080] Further, in other embodiments, the cuff 810 and/or patient
device 816 need not be included, but the cable hub 806 can instead
connect directly to the monitor wirelessly or via a cable.
Additionally, the cable hub 806 or the patient device 816 may
include electronics for front-end processing, digitizing, or signal
processing for one or more sensors. Placing front-end signal
conditioning and/or analog-to-digital conversion circuitry in one
or more of these devices can make it possible to send continuous
waveforms wirelessly and/or allow for a small, more user-friendly
wire (and hence cable 832) routing to the monitor 820.
[0081] The cable hub 806 can also be attached to the patient via an
adhesive, allowing the cable hub 806 to become a wearable
component. Together, the various sensors, cables, and cable hub 806
shown can be a complete body-worn patient monitoring system. The
body-worn patient monitoring system can communicate with a patient
monitor 820 as shown, which can be a tablet, handheld device, a
hardware module, or a traditional monitor with a large display, to
name a few possible devices.
[0082] Depending on the embodiment, certain acts, events, or
functions of any of the methods described herein can be performed
in a different sequence, can be added, merged, or left out all
together (e.g., not all described acts or events are necessary for
the practice of the method). Moreover, in certain embodiments, acts
or events can be performed concurrently, e.g., through
multi-threaded processing, interrupt processing, or multiple
processors, rather than sequentially.
[0083] The various illustrative logical blocks, modules, circuits,
and algorithm steps described in connection with the embodiments
disclosed herein can be implemented as electronic hardware,
computer software, or combinations of both. To clearly illustrate
this interchangeability of hardware and software, various
illustrative components, blocks, modules, circuits, and steps have
been described above generally in terms of their functionality.
Whether such functionality is implemented as hardware or software
depends upon the particular application and design constraints
imposed on the overall system. The described functionality can be
implemented in varying ways for each particular application, but
such implementation decisions should not be interpreted as causing
a departure from the scope of the disclosure.
[0084] The various illustrative logical blocks, modules, and
circuits described in connection with the embodiments disclosed
herein can be implemented or performed with a general purpose
processor, a digital signal processor (DSP), an application
specific integrated circuit (ASIC), a field programmable gate array
(FPGA) or other programmable logic device, discrete gate or
transistor logic, discrete hardware components, or any combination
thereof designed to perform the functions described herein. A
general purpose processor can be a microprocessor, but in the
alternative, the processor can be any conventional processor,
controller, microcontroller, or state machine. A processor can also
be implemented as a combination of computing devices, e.g., a
combination of a DSP and a microprocessor, a plurality of
microprocessors, one or more microprocessors in conjunction with a
DSP core, or any other such configuration.
[0085] The steps of a method or algorithm described in connection
with the embodiments disclosed herein can be embodied directly in
hardware, in a software module executed by a processor, or in a
combination of the two. A software module can reside in RAM memory,
flash memory, ROM memory, EPROM memory, EEPROM memory, registers,
hard disk, a removable disk, a CD-ROM, or any other form of storage
medium known in the art. An exemplary storage medium is coupled to
the processor such the processor can read information from, and
write information to, the storage medium. In the alternative, the
storage medium can be integral to the processor. The processor and
the storage medium can reside in an ASIC. The ASIC can reside in a
user terminal. In the alternative, the processor and the storage
medium can reside as discrete components in a user terminal.
[0086] Conditional language used herein, such as, among others,
"can," "may," "might," "could," "e.g.," and the like, unless
specifically stated otherwise, or otherwise understood within the
context as used, is generally intended to convey that certain
embodiments include, while other embodiments do not include,
certain features, elements and/or steps. Thus, such conditional
language is not generally intended to imply that features, elements
and/or steps are in any way required for one or more embodiments or
that one or more embodiments necessarily include logic for
deciding, with or without author input or prompting, whether these
features, elements and/or steps are included or are to be performed
in any particular embodiment.
[0087] While the above detailed description has shown, described,
and pointed out novel features as applied to various embodiments,
it will be understood that various omissions, substitutions, and
changes in the form and details of the device or process
illustrated can be made without departing from the spirit of the
disclosure. As will be recognized, certain embodiments of the
inventions described herein can be embodied within a form that does
not provide all of the features and benefits set forth herein, as
some features can be used or practiced separately from others. The
scope of the inventions is indicated by the appended claims rather
than by the foregoing description. All changes which come within
the meaning and range of equivalency of the claims are to be
embraced within their scope.
* * * * *