US20050066970A1 - Response testing for conscious sedation using cableless communication - Google Patents
Response testing for conscious sedation using cableless communication Download PDFInfo
- Publication number
- US20050066970A1 US20050066970A1 US10/671,183 US67118303A US2005066970A1 US 20050066970 A1 US20050066970 A1 US 20050066970A1 US 67118303 A US67118303 A US 67118303A US 2005066970 A1 US2005066970 A1 US 2005066970A1
- Authority
- US
- United States
- Prior art keywords
- patient
- response
- request
- controller
- assembly
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6813—Specially adapted to be attached to a specific body part
- A61B5/6825—Hand
- A61B5/6826—Finger
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1104—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb induced by stimuli or drugs
- A61B5/1106—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb induced by stimuli or drugs to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4821—Determining level or depth of anaesthesia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/683—Means for maintaining contact with the body
- A61B5/6838—Clamps or clips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/01—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes specially adapted for anaesthetising
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
- A61B5/083—Measuring rate of metabolism by using breath test, e.g. measuring rate of oxygen consumption
- A61B5/0836—Measuring rate of CO2 production
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/22—Ergometry; Measuring muscular strength or the force of a muscular blow
- A61B5/224—Measuring muscular strength
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/389—Electromyography [EMG]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6802—Sensor mounted on worn items
- A61B5/6803—Head-worn items, e.g. helmets, masks, headphones or goggles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6813—Specially adapted to be attached to a specific body part
- A61B5/6814—Head
- A61B5/6815—Ear
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/06—Respiratory or anaesthetic masks
- A61M16/0666—Nasal cannulas or tubing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/06—Respiratory or anaesthetic masks
- A61M16/0683—Holding devices therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
- A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
- A61M2016/0021—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with a proportional output signal, e.g. from a thermistor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3375—Acoustical, e.g. ultrasonic, measuring means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/35—Communication
- A61M2205/3546—Range
- A61M2205/3569—Range sublocal, e.g. between console and disposable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/35—Communication
- A61M2205/3576—Communication with non implanted data transmission devices, e.g. using external transmitter or receiver
- A61M2205/3592—Communication with non implanted data transmission devices, e.g. using external transmitter or receiver using telemetric means, e.g. radio or optical transmission
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
- A61M2230/205—Blood composition characteristics partial oxygen pressure (P-O2)
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/30—Blood pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/40—Respiratory characteristics
- A61M2230/43—Composition of exhalation
- A61M2230/432—Composition of exhalation partial CO2 pressure (P-CO2)
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/60—Muscle strain, i.e. measured on the user
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/63—Motion, e.g. physical activity
Abstract
A conscious sedation system and a response testing apparatus for a conscious sedation system. The response testing apparatus includes a request assembly and a response assembly. The request assembly communicates to a patient a request generated by a controller of the conscious sedation system for a predetermined response from the patient. The response assembly senses a response made by the patient to the request and communicates the response to the controller which analyses at least the response to determine a level of sedation of the patient. At least one of the request assembly and the response assembly includes a cableless communication device which communicates at least one of the request and the response between the controller and the patient.
Description
- The present invention relates generally to conscious sedation systems, and more particularly to a response testing apparatus for a conscious sedation system and to a conscious sedation system having a response testing apparatus.
- Known conscious sedation systems include a conscious sedation system disclosed in United States Patent Application Publication No. 2002/0017299. In that system, a controller generated a request for a predetermined response from a patient. The request was in the form of an auditory command which was received by a patient through an earphone in the ear of the patient or was in the form of a vibration signal which was received by the patient through a vibrator in a handpiece which was attached to the hand of the patient. The predetermined response to the request was the pushing of a button on the handpiece by the patient which closed a switch sending a signal to the controller. The controller analyzed medical information from the patient (such as blood pressure and other information) and analyzed the time delay between the request and the response to determine a level of sedation of the patient. When the time delay between the request and the response increased, the controller determined that the patient was in a deeper level of sedation and decreased the flow of a conscious sedation drug to the patient. It is known to have a number of volume settings for the auditory command and to initially manually raise the volume setting before the start of conscious sedation until a fully conscious patient says he or she can hear the auditory command. It is also known that doctors using a similar system have themselves asked the patient by name to squeeze the handpiece.
- What is needed is an improved conscious sedation system and/or component thereof and/or method therefor. This invention addresses those needs lacking in known conscious sedation systems and/or components thereof and/or methods therefor.
- A first expression of an embodiment of the invention is for a conscious sedation system including a controller and a response testing apparatus. The controller generates a request for a predetermined response from a patient and analyses at least a response made by the patient to the request to determine a level of sedation of the patient. The response testing apparatus includes a request assembly and a response assembly. The request assembly communicates to the patient the request generated by the controller. The response assembly senses the response and communicates the response to the controller. At least one of the request assembly and the response assembly includes a cableless communication device which communicates at least one of the request and the response between the controller and the patient.
- A second expression of an embodiment of the invention is for a response testing apparatus for a conscious sedation system. The response testing apparatus includes a request assembly and a response assembly. The request assembly communicates to a patient a request generated by a controller of the conscious sedation system for a predetermined response from the patient. The response assembly senses a response made by the patient to the request and communicates the response to the controller which analyses at least the response to determine a level of sedation of the patient. At least one of the request assembly and the response assembly includes a cableless communication device which communicates at least one of the request and the response between the controller and the patient.
- A third expression of an embodiment of the invention is identical to the previously described second expression with two added limitations. First, the cableless communication device includes a transmitter and a receiver. Second, the cableless communication device imposes a unique identifier on at least one of the transmitter and the receiver which prevents the cableless communication device from responding to crosstalk from other transmitters.
- The present invention has, without limitation, application in conscious sedation systems used during the performance of medical procedures such as colonoscopies, robotic-assisted surgery, etc.
-
FIG. 1-1 is a schematic diagram of a first embodiment of a first aspect of the present invention showing a conscious sedation system including a controller and including a response testing apparatus which includes a request assembly and a response assembly and which uses cableless communication; -
FIG. 1-2 is a side-elevational view of an example of a part of the request assembly ofFIG. 1-1 in the form of an auditory request assembly; -
FIG. 1-3 is a front-elevational view of an example of a part of the request assembly ofFIG. 1-1 in the form of a vibratory request assembly; -
FIG. 1-4 is a front-elevational view of an example of a part of the response assembly ofFIG. 1-1 in the form of a switch response assembly; -
FIG. 2-1 is a schematic diagram of a first embodiment of a second aspect of the present invention showing a conscious sedation system including a controller, a cannula, and a response testing apparatus which includes a request assembly supported by the cannula and which includes a response assembly; -
FIG. 2-2 is a perspective view of an example of the cannula ofFIG. 2-1 without the supported request assembly; -
FIG. 2-3 is a schematic diagram of a second embodiment of a second aspect of the present invention showing a conscious sedation system including a controller, a cannula, and a response testing apparatus which includes a request assembly and which includes a response assembly supported by the cannula; -
FIG. 2-4 is an enlarged schematic diagram of the response assembly and a portion of the cannula ofFIG. 2-3 ; -
FIG. 2-5 is a schematic diagram of a third embodiment of a second aspect of the present invention showing a conscious sedation system including a controller and including a response testing apparatus which includes a request assembly and which includes a cannula which is also used as a response assembly; -
FIG. 3-1 is a graph of a vibration set comprising vibratory pulses utilizing predetermined time intervals between pulses in applying the vibration stimuli; -
FIG. 3-2 is a graph of a vibration set comprising vibratory pulses utilizing predetermined duration of pulses in applying the vibration stimuli; -
FIG. 3-3 is a schematic diagram of an embodiment of a third aspect of the present invention showing a conscious sedation system including a controller and including a response testing apparatus which includes a request assembly and a response assembly; -
FIG. 3-4 is a block diagram of an embodiment of the method of the present invention using the conscious sedation system; -
FIG. 4-1 is a schematic diagram of a first embodiment of a fourth aspect of the present invention showing a conscious sedation system including a controller and including a response testing apparatus which includes a request assembly and a response assembly; -
FIG. 4-2 is a front-elevational view of an example of the response assembly ofFIG. 4-1 in the form of a handpiece; -
FIG. 4-3 is a schematic diagram of the handpiece ofFIG. 4-2 including three mutually orthogonal accelerometers; -
FIG. 4-4 is a front-elevational view of another example of the response assembly ofFIG. 4-1 in the form of a telemetry tracking system; -
FIG. 4-5 is a top planar view of an additional example of the response assembly ofFIG. 4-1 in the form of a touch pad; -
FIG. 5-1 is a schematic diagram of a first embodiment of a fifth aspect of the present invention showing a conscious sedation system including a controller and including a response testing apparatus which includes a request assembly and a response assembly; -
FIG. 5-2 is a front-elevational view of an example of the response assembly ofFIG. 4-1 in the form of a handpiece; -
FIG. 5-3 is a schematic diagram of the handpiece (without the band) ofFIG. 5-2 including a finger or thumb actuated plunger and including a force sensor; -
FIG. 5-4 is a schematic view a different handpiece which includes a resistance sensor; -
FIG. 5-5 is a schematic view of a different handpiece which includes a capacitance sensor; -
FIG. 5-6 is a schematic view of a different handpiece which includes a compliant air bladder; -
FIG. 6-1 is a schematic diagram of a first embodiment of a sixth aspect of the present invention showing a conscious sedation system including a controller and a response testing apparatus, wherein the response testing apparatus includes a request assembly and a response assembly, and wherein the request assembly includes a non-ear-canal-contacting speaker; -
FIG. 6-2 is a schematic front elevational view of a first example of the request assembly ofFIG. 6-1 including a speaker which communicates the request to the patient at least in part by bone conduction; -
FIG. 6-3 is a schematic side elevational view of a second example of the request assembly ofFIG. 6-1 including a speaker disposed in a pillow; -
FIG. 6-4 is a schematic perspective view of a third example of the request assembly ofFIG. 6-1 including a speaker disposed on the outside of a skull cap worn by the patient; -
FIG. 6-5 is a schematic perspective view of a fourth example of the request assembly ofFIG. 6-1 including a speaker connectable by a sound tube to the outside of a skull cap worn by the patient; -
FIG. 6-6 is a cross sectional view of a portion of the skull cap and a portion of the sound tube ofFIG. 6-5 connected to the skull cap; -
FIG. 7-1 is a schematic diagram of an embodiment of a seventh aspect of the present invention showing a conscious sedation system including a controller having an input for including a personalized message and a response testing apparatus which includes a request assembly and a response assembly; -
FIG. 8-1 is a schematic diagram of an embodiment of an eighth aspect of the present invention showing a conscious sedation system including a controller and including a response testing apparatus which includes a request assembly and a response assembly, wherein the response and/or request assembly is a finger movement response assembly; -
FIG. 8-2 is an embodiment of a finger movement response assembly in the form of a finger touch response apparatus; -
FIG. 8-3 is another embodiment of a finger movement response assembly in the form of a handpiece sensor mechanism; -
FIG. 9-1 is a schematic diagram of an embodiment of a ninth aspect of the present invention showing a conscious sedation system including a controller programmed to calibrate a patient's level of hearing and a response testing apparatus which includes a request assembly and a response assembly; -
FIG. 9-2 is a block diagram of an embodiment of the method of the present invention using the conscious sedation system involving automated audio calibration; -
FIG. 9-3 is a block diagram of another embodiment of the method of the present invention using the conscious sedation system automated audio calibration and determining the level of sedation in a patient; and -
FIG. 94 is a schematic diagram of an embodiment of the present invention showing a response testing apparatus including a sub-controller programmed to calibrate a patient's level of hearing, the response testing apparatus which includes a request assembly and a response assembly. - Before explaining the present invention in detail, it should be noted that the invention is not limited in its application or use to the details of construction and arrangement of parts illustrated in the accompanying drawings and description. The illustrative embodiments of the invention may be implemented or incorporated in other aspects, embodiments, variations and modifications, and may be practiced or carried out in various ways. Furthermore, unless otherwise indicated, the terms and expressions employed herein have been chosen for the purpose of describing the illustrative embodiments of the present invention for the convenience of the reader and are not for the purpose of limiting the invention.
- It is understood that any one or more of the following-described aspects, embodiments, expressions of embodiments, examples, methods, etc. can be combined with any one or more of the other following-described aspects, embodiments, expressions of embodiments, examples, methods, etc. For example, and without limitation, cableless communication can be used in combination with personalized audio requests, etc.
- It is also understood that while the following systems, methods, etc. apply to conscious sedation, such systems, methods, etc. have equal application to conscious and unconscious sedation with the appropriate choice of drug(s) and dose rate(s). In one example, such conscious and unconscious sedation system and/or method has the capability to bring the patient into unconscious sedation, to bring the patient into and out of conscious sedation, and/or to assess the patient as the patient moves into and out of deep sedation or consciousness. In one illustration, a deep sedation level or unconsciousness is indicated if a patient response to a stimuli is not detected. Further, the following discussion of conscious sedation also encompasses the conscious sedation portion of a system and/or method which provides both conscious and unconscious sedation. It is noted that conscious sedation includes conscious sedation where the patient is not responsive to stimuli (which is also known as deep sedation) and conscious sedation where the patient is responsive to stimuli.
- Conscious Sedation Involving Cableless Communication
- A first aspect of the invention relates to conscious sedation and cableless communication. Referring now to the drawings,
FIG. 1-1 illustrates a first embodiment of the first aspect of the invention. A first expression of the first embodiment is for aconscious sedation system 100 including acontroller 102 and a response testing apparatus 104 (whereinparts controller 102 generates a request for a predetermined response from apatient 106 and analyses at least a response made by thepatient 106 to the request to determine a level of sedation of thepatient 106. The response testing apparatus 104 includes a request assembly 108 (whereinparts parts patient 106 the request generated by thecontroller 102. The response assembly 110 senses the response and communicates the response to thecontroller 102. At least one of the request assembly 108 and the response assembly 110 includes a cableless communication device 112 and 113 (whereinparts parts controller 102 and thepatient 106. - Examples of cableless communication devices 112 and 113 include, without limitation, communication devices using: a radio frequency (RF) transmitter and receiver (such as those operating in the range of 0.1 mega hertz to 3 giga hertz), an ultrasonic transmitter and receiver, an infrared transmitter and receiver, and/or a visible-light transmitter and receiver, etc. Such cableless communication devices are known to the artisan.
- In one implementation of the first expression of the embodiment of
FIG. 1-1 , certain patient vital signs such as blood pressure, blood oxygen saturation (oximetry) and inhalation and exhalation carbon dioxide levels (capnometry) are electronically monitored (not shown inFIG. 1-1 ) and are also analyzed by thecontroller 102, in addition to the response from the response assembly 110, to determine a level of sedation of the patient. The term “controller”, without limitation, includes one controller and includes two or more spaced-apart subcontrollers, etc. - In one example of the first expression of the embodiment of
FIG. 1-1 , a user and/or thecontroller 102 determines a delivery schedule (including any interruption of delivery) of a conscious-sedation drug to thepatient 106 based at least in part on the determined level of sedation of thepatient 106. The drug delivery apparatus has been omitted fromFIG. 1-1 for clarity. A conscious sedation drug is a drug or drug combination which, in an efficacious amount, is capable of sedating thepatient 106 during a medical procedure (such as a colonoscopy) while keeping thepatient 106 conscious. Conscious sedation drugs, such as Propofol, are well known in the medical art. In one alternative, a user such as a doctor, instead of thecontroller 102, determines a delivery schedule of the conscious-sedation drug to thepatient 106 based at least in part on the determined level of sedation of thepatient 106. - In the same or a different example, the cableless communication device 112 and 113 includes a
transmitter receiver transmitter receiver transmitter RF transmitter receiver RF receiver RF transmitter RF transmitter RF receiver RF transmitter RF receiver RF transmitter RF receiver - In one configuration of the first expression of the embodiment of
FIG. 1-1 , theconscious sedation system 100 also includes aconsole 122, wherein thecontroller 102 is disposed in theconsole 122. In one variation, theconsole 122 is a procedure room console designed to stay in the medical procedure room. In another variation, theconsole 122 is a bedside console designed to be transported with the occupied hospital bed to the medical procedure room. In a further variation, the console has a first subconsole designed to stay in the medical procedure room and a second subconsole designed to be a bedside console. It is noted that a bedside console is disposed proximate the patient. In one configuration, the cableless communication takes place directly between a procedure room console and the patient. In another configuration, the cableless communication takes place directly between a procedure room console and a bedside console (with cable communication between the bedside console and the patient). In a further configuration, the cableless communication takes place directly between the bedside console and the patient. Other configurations are left to the artisan. - A second expression of the embodiment of
FIG. 1-1 is for a response testing apparatus 104 for aconscious sedation system 100. The response testing apparatus 104 includes a request assembly 108 and a response assembly 110. The request assembly 108 communicates to a patient 106 a request generated by acontroller 102 of theconscious sedation system 100 for a predetermined response from thepatient 106. The response assembly 110 senses a response made by thepatient 106 to the request and communicates the response to thecontroller 102 which analyses at least the response to determine a level of sedation of thepatient 106. At least one of the request assembly 108 and the response assembly 110 includes a cableless communication device 112 and 113 which communicates at least one of the request and the response between thecontroller 102 and thepatient 106. - In one example of the second expression of the embodiment of
FIG. 1-1 , the request assembly 108 includes a cableless communication device 112 which communicates the request from thecontroller 102 to thepatient 106. In one variation, the cableless communication device 112 includes anRF transmitter 118 and includes anRF receiver 120 in wireless communication with theRF transmitter 118 and disposed proximate thepatient 106. In one modification, the request assembly 108 verifies that the request was received by the RF receiver 120 (such as by using an accelerometer or a switch indicating a request in the form of vibration from a vibrator has been received or such as by using a microphone indicating a request in the form of a sound from a speaker has been received and sending a verification signal back to the controller) as is within the capabilities of the artisan. In the same or a different modification, the request assembly 108 includes a battery-operatedportion 124, and the request assembly 108 monitors the battery condition of the battery-operatedportion 124. It is noted that the term “battery” includes a cell and a series of cells. - In one implementation of the request assembly 108, the request assembly 108 is an
auditory request assembly 126 as shown inFIG. 1-2 . Theaudible request assembly 126 includes aspeaker 128, and the RF receiver 120 (omitted fromFIG. 1-2 for clarity) is used to activate thespeaker 126 to produce an audible request to thepatient 106. In one variation, thespeaker 128 is an earphone 130 (such as one which clips on an ear lobe) disposable proximate an ear of thepatient 106. In one modification, theRF receiver 120 is disposed within or on the earphone housing. In another modification, the RF receiver is disposed on a headset and the RF receiver is wired to the earphone which is supported by the headset. - In another implementation of the request assembly 108, the request assembly 108 is a
vibratory request assembly 132 as shown inFIG. 1-3 . Thevibratory request assembly 132 includes avibrator 134, and the RF receiver 120 (omitted fromFIG. 1-3 for clarity) is used to activate thevibrator 134 to produce a tactile request to thepatient 106. In one variation, thevibrator 134 is disposed in ahandpiece 136, and thehandpiece 136 is disposable proximate a hand of thepatient 106. - In the same or a different example of the second expression of the embodiment of
FIG. 1-1 , the response assembly 110 includes a cableless communication device 113 which communicates the response from thepatient 106 to thecontroller 102. In one variation, the cableless communication device 113 includes atransmitter 115 which is anRF transmitter 119 disposed proximate thepatient 106 and includes areceiver 117 which is anRF receiver 121 in wireless communication with theRF transmitter 119. In one modification, the response assembly 110 verifies that the response was received by theRF receiver 121 as is within the capabilities of the artisan. In the same or a different modification, the response assembly 110 includes a battery-operatedportion 125, and the response assembly 110 monitors the battery condition of the battery-operatedportion 125. - In one implementation of the response assembly 110, the response assembly 110 is a
switch response assembly 138 as shown inFIG. 1-4 . Theswitch response assembly 138 includes ahandpiece 140 disposable proximate a hand of thepatient 106. Thehandpiece 140 includes aswitch 142, and the response includes thepatient 106 activating theswitch 142 whereby a signal is sent by the RF transmitter 119 (omitted fromFIG. 1-4 for clarity). In one variation, thehandpiece 140 and thehandpiece 136 are the same handpiece which includes both thevibrator 134 and theswitch 142. - In one configuration of the second expression of the embodiment of
FIG. 1-1 , the request assembly 108 includes a cableless communication device 112 which communicates the request from thecontroller 102 to thepatient 106, and the response assembly 110 includes a cableless communication device 113 which communicates the response from thepatient 106 to thecontroller 102. In one variation, thetransmitter 114 of the cableless communication device 112 of the request assembly 108 is disposed on or in theconsole 122, and thereceiver 117 of the cableless communication device 113 of the response assembly 110 is disposed on or in theconsole 122. - A third expression of the embodiment of
FIG. 1-1 is a response testing apparatus 104 for aconscious sedation system 100. The response testing apparatus 104 includes a request assembly 108 and a response assembly 110. The request assembly 108 communicates to a patient 106 a request generated by acontroller 102 of theconscious sedation system 100 for a predetermined response from thepatient 106. The response assembly 110 senses a response made by thepatient 106 to the request and communicates the response to thecontroller 102 which analyses at least the response to determine a level of sedation of thepatient 106. At least one of the request assembly 108 and the response assembly 110 includes a cableless communication device 112 and 113 which communicates at least one of the request and the response between thecontroller 102 and thepatient 106. The cableless communication device 112 and 113 includes atransmitter receiver transmitter transmitter receiver - In one example of the third expression of the embodiment of
FIGS. 1-1 , the unique identifier (which in one option includes the serial number of one or more components) is a proximity-triggered unique identifier imposed when thetransmitter receiver transmitter RF transmitter receiver RF receiver RF transmitter transmitter receiver transmitter receiver - Advantages and benefits of one or more of the expressions of the embodiment of
FIG. 1-1 include elimination of cables in the medical procedure room which allows the medical procedure (including surgery) to be performed with less wiring clutter between the patient 106 and theconsole 122. Cableless communication means the patient is less likely to become entangled in cords and means greater reliability due to fewer connections. Cableless communication provides for easier user setup as no cable connections need be made. It is noted that it is easier to design equipment to meet electrical safety requirements using cableless communication than using cables. In the unique identifier example, imposing unique identifiers allows, in one implementation, anyhandpiece console 122. - Conscious Sedation Involving a Cannula
- A second aspect of the invention relates to conscious sedation and involves a cannula. A cannula is a well known medical device which is used for monitoring the breathing of a patient and which is placed on the face of the patient proximate the nose and/or mouth of the patient. Referring now to the drawings,
FIG. 2-1 illustrates a first embodiment of the second aspect of the invention. A first expression of the first embodiment is for aconscious sedation system 200 including acontroller 202, acannula 204, and a response testing apparatus 206 (whereinparts controller 202 generates a request for a predetermined response from apatient 208 and analyses at least a response made by thepatient 208 to the request to determine a level of sedation of thepatient 208. Thecannula 204 is disposable on the face of thepatient 208 proximate at least one of the nose and the mouth of thepatient 208 for monitoring the breathing of the patient. The response testing apparatus 206 includes arequest assembly 210 and aresponse assembly 212. Therequest assembly 210 communicates to thepatient 208 the request generated by thecontroller 202. Theresponse assembly 212 senses the response and communicates the response to thecontroller 202. At least a part of at least one of the request andresponse assemblies cannula 204. The terminology “supported by the cannula” means supported at least in part by the cannula. - An example of a
cannula 204 is shown inFIG. 2-2 wherein the cable/tube 214 operatively connecting thecannula 204 to thecontroller 202 has been removed. Theheadband 216 of thecannula 204 is used to secure thecannula 204 on the face of thepatient 208. In one use, thecannula 204 is used to monitor the inhalation and exhalation carbon dioxide levels (capnometry) of thepatient 208 and/or the pressure of the patient's inhalation and exhalation and optionally delivers oxygen to the patient. It is noted that at least a part of therequest assembly 210 is supported by thecannula 204 in the first embodiment shown inFIG. 2-1 . - In one implementation of the first expression of the embodiment of
FIG. 2-1 , certain patient vital signs such as blood pressure, blood oxygen saturation (oximetry) and inhalation and exhalation carbon dioxide levels (capnometry) are electronically monitored and are also analyzed by thecontroller 202, in addition to the response from theresponse assembly 212, to determine a level of sedation of the patient. The term “controller”, without limitation, includes one controller and includes two or more spaced-apart subcontrollers, etc. An example of aresponse assembly 212 inFIG. 2-1 is a handpiece which has a switch and which is secured to the hand of thepatient 208. Other examples include a chest band to monitor a deep breath. - In one example of the first expression of the embodiment of
FIG. 2-1 , a user and/or thecontroller 202 determines a delivery schedule (including any interruption of delivery) of a conscious-sedation drug to thepatient 208 based at least in part on the determined level of sedation of thepatient 208. The drug delivery apparatus has been omitted fromFIG. 2-1 for clarity. A conscious sedation drug is a drug or drug combination which, in an efficacious amount, is capable of sedating thepatient 208 during a medical procedure (such as a colonoscopy) while keeping thepatient 208 conscious. Conscious sedation drugs, such as Propofol, are well known in the medical art. In one alternative, a user such as a doctor, instead of thecontroller 202, determines a delivery schedule of the conscious-sedation drug to thepatient 208 based at least in part on the determined level of sedation of thepatient 208. - In the same or a different example, the
request assembly 210 includes afirst vibrator 218 supported by thecannula 204. In one variation, thefirst vibrator 218 produces a tactile request to the face of thepatient 208. In one modification, thefirst vibrator 218 is disposed in thecannula 204. The terminology “disposed in the cannula” means disposed at least in part in the cannula. In a different modification, thefirst vibrator 218 is disposed on thecannula 204. In one arrangement, therequest assembly 210 includes asecond vibrator 220 disposable to produce a tactile request to a site on thepatient 208 other than to the face of thepatient 208. In one application, thecontroller 202 at least compares responses of the patient to tactile requests from the first andsecond vibrators first vibrator 218 is the only vibrator of therequest assembly 210 producing a tactile request. - A second embodiment of the second aspect of the present invention is for a
conscious sedation system 222 and is shown inFIGS. 2-3 and 2-4. In a first expression of the second embodiment, theconscious sedation system 222 includes acontroller 224, acannula 226, and a response testing apparatus 228 (whereinparts request assembly 230 and includes aresponse assembly 232. At least a part of the response assembly is supported by thecannula 226. - In one implementation of the second embodiment, the predetermined response is a
patient 208 head-generated response. In one variation, thepatient 208 head-generated response is a patient-generated vocal response, and theresponse assembly 232 includes a sound detector 234 (such as a microphone) supported by thecannula 226. In one modification, thecontroller 224 at least uses at least one of the intensity and the tonal qualities of the vocal response in determining the level of sedation of thepatient 208. In another variation, thepatient 208 head-generated response is a patient-generated head movement response, and theresponse assembly 232 includes amotion sensor 236 supported by thecannula 226. In a further variation, thepatient 208 head-generated response is a patient-generated breathing response, and theresponse assembly 232 includes a breathing sensor 238 (such as a pressure sensor) and/or a breathing-detection tube supported by thecannula 226. In one illustration employing a breathing-detection tube, the breathing sensor is operatively connected to the tube and is located remote from the cannula. In one modification, the patient-generated breathing response includes at least one of a yawn and a breath deeper than an immediate previous breath. In the same or a different modification, thebreathing sensor 238 detects the pressure of the exhaled breathing of thepatient 208. Examples ofrequest assemblies 230 inFIG. 2-3 include a handpiece having a vibrator and secured to the hand of thepatient 208 and an earphone speaker disposed in the ear of thepatient 208. Other request assemblies include vibrators supported by a blood pressure cuff, supported by a pulse oximeter disposable on a finger or ear lobe of the patient, or supported by another medical device. Additional request assemblies include vibrators placed upon the face, head, neck, or upper spine of the patient. - In one configuration, not shown, the cannula supports at least a part of the request assembly and at least a part of the response assembly. In one example, the
first vibrator 218 and at least one of thesound detector 234, themotion sensor 236, and thebreathing sensor 238 are supported by the same cannula. - An alternate expression of either or both of the first and second embodiments of the second aspect of the invention, which will be described for simplicity using only the part numbers of the first embodiment of
FIG. 2-1 , is for a cannula and response testing assemblage 240 (whereinparts conscious sedation system 200. The cannula and response testing assemblage 240 includes acannula 204 and includes a response testing apparatus 206. Thecannula 204 is disposable on the face of apatient 208 proximate at least one of the nose and the mouth of thepatient 208 for monitoring the breathing of the patient. The response testing apparatus 206 includes arequest assembly 210 and aresponse assembly 212. Therequest assembly 210 communicates to the patient 208 a request generated by acontroller 202 of theconscious sedation system 200 for a predetermined response from thepatient 208. Theresponse assembly 212 senses a response made by thepatient 208 to the request and communicates the response to thecontroller 202 which analyses at least the response to determine a level of sedation of thepatient 208. At least a part of at least one of the request andresponse assemblies cannula 204. - In one example of the cannula and response testing assemblage 240, the request assembly includes a
first vibrator 218 supported by thecannula 204. In the same or a different example, the response is apatient 208 head-generated response, and at least a part of the response assembly is supported by the cannula. In one variation, the response assembly includes at least one of a sound detector, a motion sensor, a breathing sensor, and a breathing-detection tube supported by the cannula. - A third embodiment of the second aspect of the present invention is for a
conscious sedation system 242 and is shown inFIG. 2-5 . Theconscious sedation system 242 includes acontroller 244 and a response testing apparatus 246 (whereinparts controller 244 generates a request for a predetermined breathing response from apatient 208 and analyses at least a breathing response made by thepatient 208 to the request to determine a level of sedation of thepatient 208. The response testing apparatus 246 includes arequest assembly 248 and acannula 250. Therequest assembly 248 communicates to thepatient 208 the request generated by thecontroller 244. Thecannula 250 is disposable on the face of thepatient 208 proximate at least one of the nose and the mouth of thepatient 208 for monitoring the breathing of thepatient 208, wherein thecannula 250 is operatively connected to thecontroller 244. - In one example of the third embodiment, a user and/or the
controller 244 determines a delivery schedule (including any interruption of delivery) of a conscious-sedation drug to thepatient 208 based at least in part on the determined level of sedation of thepatient 208. - It is noted that unnumbered lines in the figures which emanate from the
controller - In one employment, the controller analyses the sound intensity and/or tonal qualities of the sound response for use in determining the level of sedation of the patient. Examples include predetermined vocal sounds which include one or more words, phrases, sighs, yawns, groans, etc. Baseline vocal sound responses from the patient before the start of sedation may be used to train the
controller 244 to recognize vocal sound responses from the patient before and during patient sedation. Advantages of a vocal sound response include such a response being easier to make for a more deeply sedated patient than activating a switch on a handpiece. Also, some patients due to infirmity, physical handicap, etc. may be able to make a vocal response but be unable to activate a switch on a handpiece. - Advantages and benefits of one or more of the expressions of the embodiments of
FIGS. 2-1 to 2-5 include elimination of an independent support for at least a part of the request assembly and/or the response assembly of the response testing apparatus by making dual use of the cannula when a cannula is used in a conscious sedation system. In the vibrator request example, a vibratory tactile request to the face of a patient is easier for a more deeply sedated patient to perceive (as the face is more sensitive to touch) than a vibratory tactile request to the hand of a patient. In the patient head-generated response example, a patient made sound, head movement, or breathing response to a request from the controller is easier for a more deeply sedated patient to make than activating a switch on a handpiece. - In an expansion of the second aspect of the invention, the response is a patient made vocal sound, and the response assembly is not limited to being supported by the cannula. In this expanded second aspect of the invention, the sound detector need only be able to detect patient made vocal sounds. The type of sound detector is left to the artisan. In one example, a microphone is disposable proximate the mouth of the patient. In one application, the microphone is disposed on the hospital bed proximate the face of the patient. In another application, the microphone is disposed on a bedside stand. In a further application, the microphone is disposed on the patient or the patient's hospital gown. Other applications are left to the artisan. In another example, a sound tube extends from proximate the patient's face to a remotely-located sound detector. In a further example, the microphone picks up patient made sounds by bone conduction. Other examples are left to the artisan.
- Time Variant Vibration Stimulus Response for a Conscious Sedation System
- A third aspect of the invention relates to conscious sedation and the application of discrete vibration pulses to determine the level of sedation in a patient. The invention is a system and method of applying discrete vibration pulses and altering the time intervals between pulses and the duration of the pulses to determine the level of sedation in a patient. In the prior art, the level of sedation in a patient is determined by applying a vibration stimuli to the sedated patient and assessing the patient's response to the stimuli. If the patient does not respond, the intensity of the stimuli is increased until the patient responds to the stimuli. The intensity of the stimuli required to generate the patient's response is correlated with the patient's level of sedation. One disadvantage in this method is that the level of intensity required to generate a response from the patient may be extremely high. In the case of a handpiece, the vibration stimuli may be so intense that it is difficult for the sedated patient to hold onto to, let alone, respond to the stimuli by squeezing the handpiece.
- Accordingly, in one embodiment of the present invention, a method for determining the level of sedation in a patient utilizes the time interval of the vibration stimuli thereby obviating the need to use the intensity stepping approach used in the prior art. In essence, the patient's ability to discern vibratory time-dependent patterns can be used to determine the patient's level of sedation. For example, in a time interval analysis, a set of vibration stimuli comprises several vibratory pulses which are applied to the patient with a predetermined time interval between each pulse. When the patient is not sedated or less sedated, the patient may be able to discern the distinct pulses, whereas when the patient is more sedated, the patient's ability to discern distinct pulses may be reduced. Referring to
FIG. 3-1 , a sample set of three pulses is applied with a predetermined time spaced in between each pulse. The time between the first pulse and the second pulse is T1 and the between the second pulse and third pulse is T2. A less sedated patient may be able to discern the three individual pulses, whereas when the patient becomes more sedated, he may only recognize two of the three pulses because of the reduced ability to discern the time interval spaced between the pulses. Further, when the patient becomes even more sedated, his ability to discern the time interval spaced between the pulses may be reduced to the extent that the patient is only able to discern the set of three pulses as one whole pulse. Thus, this ability to discern the time interval between each distinct pulse correlates with the patient's level of sedation. As the patient becomes more sedated, the greater the time interval is required between each pulse for the patient to discern the distinct pulses. Accordingly, the time intervals between the pulses of each set of stimuli may be modified to be greater or less for subsequent sets to analyze the patient's response to the sets and to correlate the response to the patient's level of sedation. Although the time interval ranges will vary with the patient, the interval may range from 0.05 to 15.0 seconds. More typically, the interval ranges from 0.3 to 1.0 seconds. In one embodiment of the invention, the range is 0.5 to 0.7 seconds. In one typical protocol that might be used to monitor sedation, the time interval between each pulse may be initiated at about 0.4 seconds. If the patient detects the distinct pulses, the time interval between the pulses is decreased to 0.2 seconds. If the patient does not detect the distinct pulses, the time interval between the pulses is increased to 0.6 seconds. - In another embodiment of the present invention, a method for determining the level of sedation in a patient utilizes the duration of the pulses of the vibration stimuli thereby obviating the need to use the intensity stepping approach used in the prior art. Referring to
FIG. 3-2 , the vibration set contains three vibratory pulses, wherein each pulse has a predetermined duration D1, D2 and D3. The duration of the pulses in each set can be the same or different and can be modified to be greater or less in subsequent sets. In essence, the patient's ability to discern the duration of the vibratory pulses can be used to determine the patient's level of sedation. For instance, a pulse that is 0.5 second in duration may be recognized by a patient who is not sedated or less sedated but when the patient becomes more sedated, he may not be able to discern the 0.5 second pulse stimuli but may instead require a pulse with a longer duration, such as a one second pulse, in order to discern it. Accordingly, the patient's ability to discern a pulse with a prescribed duration can be used to assess the patient's level of sedation. The greater the duration of the pulse necessary for the patient to discern the pulse, the more sedated the patient. In a more preferred embodiment of the invention, the vibratory pulse is a “crisp” or sharp pulse; crisp pulses are more alerting and stimulating and are more able to evoke a response from the sedated patient. In the prior art, after the vibratory pulse is applied, the pulse glides to a halt, i.e. gradually decreasing from its highest intensity to its lowest intensity. However, in the present invention, the pulses that are applied are sharp pulses that come to a halt almost immediately, wherein the time it takes to go from its highest intensity to its lowest intensity is about 0.1 second. This is achieved by employing a braking device such as an electrical brake or a brake clutch to provide prompt cessation. Furthermore, the time it takes for the pulse to go from its lowest intensity to its highest intensity is less than about 0.1 second. This enables the request unit to send a crisp pulse of a predetermined duration to assess the patient's level of sedation. Although the duration ranges of the pulses will vary with the patient, the duration may range from 0.1 to 15 seconds. More typically, the duration ranges from 0.5 to 1.0 seconds. In one embodiment of the invention, the range is 0.5 to 1.0 second. In one typical protocol that might be used to monitor sedation, the duration of each pulse may be initiated at about 0.6 second. If the patient detects the distinct pulses, the duration of the pulses is decreased to 0.4 second. If the patient does not detect the distinct pulses, the duration between the pulses is increased to 0.9 second. - In another manifestation of the invention, both the time interval and the duration of the pulse sets may be used in conjunction to assess the patient's response and determine the level of sedation of the patient. A set of vibration stimuli comprising vibratory pulses of predetermined duration for each pulse and predetermined time intervals between each pulse is applied to the patient. The patient then responds to the set of vibration stimuli. A subsequent set of vibration stimuli can be applied to generate a subsequent response by the patient. The subsequent set of vibration stimuli can be the same or modified from the previous set by either altering the duration and/or time interval. In yet a further embodiment of the invention, the individual vibratory pulses can be intensity modulation or frequency modulation pulses. More specifically, an intensity modulation pulse is a vibratory pulse that has a variable intensity within the individual pulse itself. A frequency modulation pulse is a vibratory pulse that has a variable frequency within the individual pulse itself. Either intensity and frequency modulation pulses may be incorporated with the time interval between and/or duration of the pulses in order to assess the level of sedation of a patient. An embodiment of a method of the invention as shown in
FIG. 3-4 comprises applying a first stimuli to a patient who has received, is receiving or is about to receive a conscious sedation drug, instructing the patient to respond to the stimuli, monitoring a patient's response to the stimuli, applying an additional stimuli to the patient when the patient has received, is receiving or is about to receive a dose of a conscious sedation drug, wherein the additional stimuli can be the same or different as the first stimuli, monitoring the patient's response to the additional stimuli, repeating the steps of applying the additional stimuli and monitoring the patient's response to the additional stimuli to determine the patient's level of sedation. Furthermore, the patient's initial or previous response may be used as a baseline for comparison to the present response. - Note that
FIGS. 3-1 and 3-2 are only examples vibration sets; the vibration sets can contain any number of pulses and the time interval between each of the pulses T1, T2 and so forth and the duration of each pulse D1, D2 and so forth can be the same or different and adjusted to greater or less in subsequent sets of vibration stimuli to determine the level of sedation of the patient. - Referring to the drawings,
FIG. 3-3 illustrates yet another embodiment of the third aspect of the invention. The embodiment is for aconscious sedation system 300 including acontroller 302 and aresponse testing apparatus 304. The controller generates a request for a predetermined response from apatient 306, the request comprising a vibration stimuli set having a vibratory pulses having predetermined time interval(s) between each of the pulses and predetermined duration(s) for each pulse. The controller analyses at least a response generated by thepatient 306 to the request to determine a level of sedation of thepatient 306. Theresponse testing apparatus 304 includes arequest assembly 308 and aresponse assembly 310. Therequest assembly 308 communicates to thepatient 306 the request generated by thecontroller 302. - In one implementation of the embodiment of
FIG. 3-3 , certain patient vital signs such as blood pressure, blood oxygen saturation (oximetry) and inhalation and exhalation carbon dioxide levels (capnometry) are electronically monitored and are also analyzed by thecontroller 302, in addition to the response from theresponse assembly 310, to determine a level of sedation of the patient. The term “controller”, without limitation, includes one controller and includes two or more spaced-apart subcontrollers, etc. Examples ofrequest assemblies 308 inFIG. 3-3 include a handpiece having a vibrator and secured to the hand of thepatient 306 and an earphone speaker disposed in the ear of thepatient 306. Other request assemblies include vibrators supported by a blood pressure cuff, supported by a pulse oximeter disposable on a finger or ear lobe of the patient, or supported by another medical device. Additional request assemblies include vibrators placed upon the face, head, neck, or upper spine of the patient. - In one example of the expression of the embodiment of
FIG. 3-3 , thecontroller 302 determines a delivery schedule of a conscious sedation drug to thepatient 306 based at least in part on the determined level of sedation of thepatient 306. The drug delivery apparatus has been omitted fromFIG. 3-3 for clarity. A conscious sedation drug is a drug or drug combination which, in an efficacious amount, is capable of sedating thepatient 306 during a medical procedure (such as a colonoscopy) while keeping thepatient 306 conscious. Conscious sedation drugs, such as Propofol, are well known in the medical art. In one alternative, a doctor, instead of thecontroller 302, determines a delivery schedule of the conscious sedation drug to thepatient 306 based at least in part on the determined level of sedation of thepatient 306 i.e. as determined by the described embodiments. - Conscious Sedation Involving a Hand Motion Patient Response
- A fourth aspect of the invention relates to conscious sedation and involves a hand motion patient response. Referring now to the drawings,
FIG. 4-1 illustrates a first embodiment of the fourth aspect of the invention. A first expression of the first embodiment is for aconscious sedation system 400 including acontroller 402 and a response testing apparatus 404 (whereinparts controller 402 generates a request for a predetermined hand motion response from apatient 406 and analyses at least a hand motion response made by thepatient 406 to the request to determine a level of sedation of thepatient 406. The response testing apparatus 404 includes arequest assembly 408 and aresponse assembly 410. Therequest assembly 408 communicates to thepatient 406 the request generated by thecontroller 402. Theresponse assembly 410 senses the hand motion response and communicates the hand motion response to thecontroller 402. - By “hand motion” is meant translation and/or rotation of a hand of the
patient 406. In some applications of the fourth aspect of the invention, hand motion is translation and/or rotation of the palm of the hand. Such palm motion may or may not be accompanied by movement of one or more fingers and/or thumb relative to the palm of the hand. In one variation, such palm motion is substantially without any finger/thumb movement relative to the palm. Examples of body movement of apatient 406 undergoing conscious sedation which results in, or can result in, hand motion include, without limitation, bending of the wrist, rotation of the forearm, bending of the elbow, and motion of the upper arm. - In one implementation of the first expression of the embodiment of
FIG. 4-1 , certain patient vital signs such as blood pressure, blood oxygen saturation (oximetry) and inhalation and exhalation carbon dioxide levels (capnometry) are electronically monitored and are also analyzed by thecontroller 402, in addition to the response from theresponse assembly 410, to determine a level of sedation of the patient. The term “controller”, without limitation, includes one controller and includes two or more spaced-apart subcontrollers, etc. Examples ofrequest assemblies 408 inFIG. 4-1 include a handpiece having a vibrator and secured to the hand of thepatient 406 and an earphone speaker disposed in the ear of thepatient 406. Other request assemblies include vibrators supported by a blood pressure cuff, supported by a pulse oximeter disposable on a finger or ear lobe of the patient, or supported by another medical device. Additional request assemblies include vibrators placed upon the face, head, neck, or upper spine of the patient. In one design, acable 412 operatively connects thecontroller 402 to therequest assembly 408, and acable 414 operatively connects theresponse assembly 410 to thecontroller 402. - In one example of the first expression of the embodiment of
FIG. 4-1 , a user and/or thecontroller 402 determines a delivery schedule (including any interruption of delivery) of a conscious-sedation drug to thepatient 406 based at least in part on the determined level of sedation of thepatient 406. The drug delivery apparatus has been omitted fromFIG. 4-1 for clarity. A conscious sedation drug is a drug or drug combination which, in an efficacious amount, is capable of sedating thepatient 406 during a medical procedure (such as a colonoscopy) while keeping thepatient 406 conscious. Conscious sedation drugs, such as Propofol, are well known in the medical art. In one alternative, a user such as a doctor, instead of thecontroller 402, determines a delivery schedule of the conscious-sedation drug to thepatient 406 based at least in part on the determined level of sedation of thepatient 406. - A first example of the
response assembly 410 includes ahandpiece 416, as shown inFIG. 4-2 , wherein thehandpiece 416 sends a signal to thecontroller 402 when thehandpiece 416 is moved. In one application, thehandpiece 416 is attachable to the hand of thepatient 406, such as through use of aband 418. In one variation, thehandpiece 416 includes at least oneaccelerometer FIG. 4-3 . In one modification, thehandpiece 416 includes three mutually-orthogonal accelerometers - In one implementation of the
handpiece 416, thecontroller 402 analyzes at least the position and/or orientation and/or changes therein of thehandpiece 416 to determine the level of sedation of thepatient 406. In the same or a different implementation, thecontroller 402 analyzes at least the velocity of thehandpiece 416 to determine the level of sedation of thepatient 406. In the same or a different implementation, thecontroller 402 analyzes at least the acceleration of thehandpiece 416 to determine the level of sedation of thepatient 406. In one variation, thecontroller 402 analyzes at least two of the position, the velocity, and the acceleration of thehandpiece 416 to determine the level of sedation of thepatient 406. In one modification, thecontroller 402 analyzes at least the position, the velocity, and the acceleration of thehandpiece 416 to determine the level of sedation of thepatient 406. In one application, thecontroller 402 creates a time path of the movement of thehandpiece 416 and compares the deviation of that time path from a predetermined time path of the predetermined hand motion response to determine the level of sedation of thepatient 406. - In one construction of the
handpiece 416, thehandpiece 416 includes other types of motion sensors or position sensors in place of or in addition to an accelerometer-type of motion sensor. Such other motion sensors include tilt sensors, micromachined gyroscopes, compasses, etc. Such other position sensors include a telemetry transponder, etc. - In one employment of the first expression of the embodiment of
FIG. 4-1 , the predetermined hand motion response is the patient 406 moving a hand toward another part of the body. In one variation, the hand (such as the hand including an extended finger) is moved toward the nose. In one modification, theresponse assembly 410 includes a proximity sensor (not shown) which sends a signal to thecontroller 402 when the distance between the hand (such as the distance of the extended finger of the hand) and the nose is within a predetermined distance. Such signal is used by the controller to indicate that thepatient 406 is at a level of consciousness defined, at least in part, by the predetermined “hand-to-body-part” hand motion response. In a different employment, the predetermined hand motion response is the patient 406 moving a hand (such as the hand including an extended finger) to trace out a figure such as the figure “8”. In one modification, theresponse assembly 410 includes one ormore accelerometers controller 402 in determining if the hand motion response is close enough to the predetermined hand motion response to indicate that thepatient 406 is at a level of consciousness defined, at least in part, by the predetermined “figure-tracing” hand motion response. - In one combination of hand motion requests, the
controller 402 makes two requests. One request is for thepatient 406 to move a hand toward another part of the body. The other request is for thepatient 406 to move a hand to trace out a figure. Thecontroller 402 at least analyzes the responses from the two requests to determine the level of sedation of the patient. In one example, a patient who passes the “figure-tracing” request but fails the “finger-to-body-part” request is considered by the controller 402 (with other inputs used by the controller for determining the level of sedation being equal) to be at a deeper level of sedation than a patient who passes both requests. - In an expansion of the fourth aspect of the invention, the response is not limited to a hand motion response but includes a series of requests for different types of predetermined responses. In one employment, such series is in an ascending or a descending order of difficulty for a patient to give an acceptable (i.e., acceptable as determined by the controller 402) response. The acceptable response for different types of predetermined responses corresponds (with other inputs used by the controller for determining the level of sedation being equal) to different levels of sedation of the patient. One example of such a series includes requests for: “figure tracing”, “hand-to-body-part”, switch activation on a handpiece within a predetermined time since the request, double-clicking a button on a handpiece within a predetermined time interval, and any movement of a handpiece. Other examples are left to the artisan.
- A second expression of the embodiment of
FIG. 4-1 is for aconscious sedation system 400 including acontroller 402 and a response testing apparatus 404. Thecontroller 402 generates a request for a predetermined hand motion response from apatient 406, analyses at least a hand motion response made by thepatient 406 to the request to determine a level of sedation of thepatient 406, and generates a feedback signal which is communicated (in one example by a “clicker” 426 in the handpiece 416) to thepatient 406 when the hand motion response from thepatient 406 meets a predetermined criteria. The response testing apparatus 404 includes arequest assembly 408 and aresponse assembly 410. Therequest assembly 408 communicates to thepatient 406 the request generated by thecontroller 402. Theresponse assembly 410 senses the hand motion response and communicates the hand motion response to thecontroller 402. - In one example of the second expression of the embodiment of
FIG. 4-1 , thecontroller 402 changes the predetermined criteria between two requests and at least analyzes the responses from the two requests to determine the level of sedation of thepatient 406. For example, apatient 406 who passes a two-inch proximity criteria for a hand to nose request but fails a one-inch proximity criteria is considered by the controller 402 (with other inputs used by the controller for determining the level of sedation being equal) to be at a deeper level of sedation than a patient who passes both criteria. - A third expression of the embodiment of
FIG. 4-1 is for a response testing apparatus 404 for aconscious sedation system 400. The response testing apparatus 404 includes arequest assembly 408 and aresponse assembly 410. Therequest assembly 408 communicates to a patient 406 a request generated by acontroller 402 of theconscious sedation system 400 for a predetermined hand motion response from thepatient 406. Theresponse assembly 410 senses a hand motion response made by thepatient 406 to the request and communicates the hand motion response to thecontroller 402 which analyzes at least the hand motion response to determine a level of sedation of thepatient 406. - In one example of the third expression of the embodiment of
FIGS. 4-1 , theresponse assembly 410 senses at least one of a translation and a rotation of the hand of thepatient 406. - A first example of the
response assembly 410 includes a motion detector (such as anaccelerometer - A second example of the
response assembly 410, shown inFIG. 4-4 , includes atelemetry tracking system 428 for tracking hand motion of thepatient 406. In one construction, thetelemetry tracking system 428 includes atransponder 430 attachable to the hand of thepatient 406. In one variation, thetransponder 430 is attachable to a finger of the hand wherein the patient has been told, in making the predetermined hand motion response, to move the hand without moving the finger relative to the palm of the hand. In this construction, thetelemetry tracking system 428 additionally includes threereceivers 432 wherein each receiver receives a signal from thetransponder 430 as is understood by the artisan. - A third example of the
response assembly 410, shown inFIG. 4-5 , includes atouch pad 434 disposable proximate the hand of thepatient 406. In one variation, thetouch pad 434 is disposed on the hospital bed occupied by thepatient 406. Other locations for thetouch pad 434 are left to the artisan. In one construction, the touch pad converts hand contact of thepatient 406 to position information of the touched site on thetouch pad 434 and communicates such positional information to thecontroller 402. - Advantages and benefits of one or more of the expressions of the embodiment and examples, etc. of
FIGS. 4-1 to 4-5 include a finer determination of the level of sedation of a patient undergoing a medical procedure involving conscious sedation. Also, hand motion responses are easier for a patient undergoing conscious sedation to make than activating a switch on a handpiece. It is noted that hand motion responses do not require grip strength and are easier for patients to make whose grip strength is impaired. Eliminating switches provides for greater reliability as switches need to be sealed against moisture and debris. - Conscious Sedation Involving Dynamics of a Hand Grip Patient Response
- A fifth aspect of the invention relates to conscious sedation and involves the dynamics of a hand grip patient response. Referring now to the drawings,
FIG. 5-1 illustrates a first embodiment of the fifth aspect of the invention. A first expression of the first embodiment is for aconscious sedation system 500 including acontroller 502 and a response testing apparatus 504 (whereinparts controller 502 generates a request for a predetermined hand grip response from apatient 506 and analyses at least a dynamic variable of a hand grip response made by thepatient 506 to the request to determine a level of sedation of the patient. The response testing apparatus 504 includes arequest assembly 508 and aresponse assembly 510. Therequest assembly 508 communicates to thepatient 506 the request generated by thecontroller 502. Theresponse assembly 510 senses the dynamic variable of the hand grip response and communicates the dynamic variable to thecontroller 502. - By “hand grip response” is meant the response of a patient using a hand, or one or more fingers and/or a thumb thereof, to squeeze or exert pressure. Examples of a hand grip response include, without limitation, a patient using a hand to squeeze or try to squeeze a handpiece and a patient using a finger to depress a plunger. By “sensing a dynamic variable” is meant sensing the varying value of a dynamic variable. A “dynamic variable” includes, without limitation, applied force (or pressure), the time rate of the applied force (or pressure), the distance moved, the velocity of movement, and the acceleration of movement. A “dynamic variable” does not include a switch which is either activated or not activated and does not include the time between a request and a response or the time between two responses.
- In one implementation of the first expression of the embodiment of
FIG. 5-1 , certain patient vital signs such as blood pressure, blood oxygen saturation (oximetry) and inhalation and exhalation carbon dioxide levels (capnometry) are electronically monitored and are also analyzed by thecontroller 502, in addition to the response from theresponse assembly 510, to determine a level of sedation of the patient. The term “controller”, without limitation, includes one controller and includes two or more spaced-apart subcontrollers, etc. Examples ofrequest assemblies 508 inFIG. 5-1 include a handpiece having a vibrator and secured to the hand of thepatient 506 and an earphone speaker disposed in the ear of thepatient 506. Other request assemblies include vibrators supported by a blood pressure cuff, supported by a pulse oximeter disposable on a finger or ear lobe of the patient, or supported by another medical device. Additional request assemblies include vibrators placed upon the face, head, neck, or upper spine of the patient. In one design, acable 512 operatively connects thecontroller 502 to therequest assembly 508, and acable 514 operatively connects theresponse assembly 510 to thecontroller 502. - In one example of the first expression of the embodiment of
FIGS. 5-1 , a user and/or thecontroller 502 determines a delivery schedule (including any interruption of delivery) of a conscious-sedation drug to thepatient 506 based at least in part on the determined level of sedation of thepatient 506. The drug delivery apparatus has been omitted fromFIG. 5-1 for clarity. A conscious sedation drug is a drug or drug combination which, in an efficacious amount, is capable of sedating thepatient 506 during a medical procedure (such as a colonoscopy) while keeping thepatient 506 conscious. Conscious sedation drugs, such as Propofol, are well known in the medical art. In one alternative, a user such as a doctor, instead of thecontroller 502, determines a delivery schedule of the conscious-sedation drug to thepatient 506 based at least in part on the determined level of sedation of thepatient 506. - In one design of the first expression of the embodiment of
FIG. 5-1 , theresponse assembly 510 senses a nerve signal sent by the brain of thepatient 506 to activate a muscle which is used by thepatient 506 to make a hand grip response. In one variation, one or more electrodes are applied to the hand, wrist, etc. and are monitored for EMG (electromyography) or other neural activity, wherein, in one embodiment, the electrodes are part of a handpiece. In one modification, the EMG activity/intensity, when the patient squeezes a handpiece, is considered by thecontroller 502 to be proportional to the level of sedation of the patient (with other inputs used by the controller in determining the level of sedation being equal), as can be appreciated by those skilled in the art. It is noted that the electrode can detect a weak attempt of the patient to make a hand grip response, including a patient response with no detectable movement but detectable muscle fiber firing. - In another design of the first expression of the embodiment of
FIG. 5-1 , theresponse assembly 510 includes ahandpiece 516, as shown inFIGS. 5-2 . Thehandpiece 516 is disposable in a hand of thepatient 506. Thehandpiece 516 senses the dynamic variable of the hand grip response and communicates the dynamic variable to thecontroller 502. In one application, thehandpiece 516 is attachable to the hand of thepatient 506, such as through use of aband 518. - In one arrangement, the
handpiece 516 senses the force of the hand grip response. In one construction, thehandpiece 516 includes aforce sensor 520 as shown inFIG. 5-3 , wherein thecontroller 502 at least analyzes at least one of the amount of force of the hand grip response and the time variation of the amount of force of the hand grip response to determine the level of sedation of thepatient 506.Force sensors 520 include, without limitation, a strain gauge, a variable force resistor, and a piezo device as can be appreciated by the artisan. Force sensors can be placed on or in the handpiece to react to a squeeze of the hand and can be placed in the handpiece to react to the finger or thumb displacement of a plunger. - In the same or a different construction, the
handpiece 516 includes adisplacer 522, and thecontroller 502 at least analyzes at least one of the distance that thedisplacer 522 is moved, the velocity of thedisplacer 522, and the acceleration of thedisplacer 522 to determine the level of sedation of thepatient 506. In one variation, thecontroller 502 analyzes at least two of the distance, the velocity, and the acceleration of thedisplacer 522 to determine the level of sedation of thepatient 506. In one modification, thecontroller 502 analyzes at least the distance, the velocity, and the acceleration of thedisplacer 522 to determine the level of sedation of thepatient 506. In one application, thedisplacer 522 is a finger or thumb displacedplunger 524 wherein the plunger is spring loaded, otherwise equipped, to return to its original non-depressed position when the patient is not displacing the plunger. - In one enablement of the first expression of the embodiment of
FIG. 5-1 , thecontroller 502 generates a feedback signal which is communicated (in one example by a “clicker” 526 (such as, for example, a solenoid or displaceable diaphragm) in the handpiece 516) to thepatient 506 when the hand grip response from thepatient 506 meets a predetermined criteria. - In the same or a different enablement, the
controller 502 changes the predetermined criteria between two requests and at least analyzes the hand grip responses from the two requests to determine the level of sedation of thepatient 506. For example, apatient 506 who passes a two-millimeter per second velocity criteria for a finger displacedplunger 524 but fails a four-millimeter per second velocity criteria is considered by the controller 502 (with other inputs used by the controller for determining the level of sedation being equal) to be at a deeper level of sedation than a patient who passes both criteria. - In the same or a different enablement, the
handpiece 516 is adjustable (or automatically adapts) in compliance and/or size to respond to one of a lower hand grip force and/or size and a higher hand grip force and/or size. This enables thesame handpiece 516 to be used by a patient having a weak grip and by a patient having a strong grip. In one variation, a motor (not shown) having an adjustable biasing voltage resists the motion of theplunger 524, wherein the biasing voltage is set low to respond to a patient with a weaker grip (e.g., one to five pounds of hand grip force) and is set high to respond to a patient with a stronger grip (e.g., twenty to thirty pounds of hand grip force). In one modification, a high-to-low resistance adjustment is made to take place when thepatient 506 reaches an acceptable hand grip response so that the following “collapse” of thehandpiece 516 acts as a feedback to thepatient 506 indicating a successful hand grip response. - A second expression of the embodiment of
FIG. 5-1 is for a response testing apparatus 504 for aconscious sedation system 500. The response testing apparatus 504 includes arequest assembly 508 and aresponse assembly 510. Therequest assembly 508 communicates to a patient 506 a request generated by acontroller 502 of theconscious sedation system 500 for a predetermined hand grip response from thepatient 506. Theresponse assembly 510 senses a dynamic variable of a hand grip response made by thepatient 506 to the request and communicates the dynamic variable to thecontroller 502 which analyzes at least the dynamic variable to determine a level of sedation of thepatient 506. - In one example of the second expression, the dynamic variable is chosen from the group consisting of the amount of force of the hand grip response, the time variation of the amount of force of the time grip response, the distance of the hand grip response, the velocity of the hand grip response, and the acceleration of the hand grip response. In one variation, the
response assembly 510 senses the amount of force of the hand grip response, and thecontroller 502 calculates the time variation of the amount of force of the time grip response. In the same or a different variation, theresponse assembly 510 senses the distance of the hand grip response, and thecontroller 502 calculates the velocity (i.e., the time variation of the distance) and/or the acceleration (i.e., the time variation of the velocity). - In the same or a different example, a user and/or the
controller 502 determines a delivery schedule of a conscious-sedation drug to thepatient 506 based at least in part on the determined level of sedation of the patient. - A third expression of the embodiment of
FIG. 5-1 is for aresponse assembly 510 for a response testing apparatus 504 for aconscious sedation system 500, wherein the response testing apparatus 504 includes arequest assembly 508 which communicates to a patient 506 a request generated by acontroller 502 of theconscious sedation system 500 for a predetermined hand grip response from thepatient 506. Theresponse assembly 510 includes ahandpiece 516 which senses a dynamic variable of a hand grip response made by thepatient 506 to the request and which communicates the dynamic variable to thecontroller 502 which analyzes at least the dynamic variable to determine a level of sedation of thepatient 506. - In one example of the third expression of the embodiment of
FIGS. 5-1 , theresponse assembly 510 includes a resistance handpiece 528 (seen inFIG. 5-4 ) which includes anelectrical resistance sensor 530 having twoelectrodes resistance handpiece 528, wherein the skin (or glove) exerts a variable pressure on the twoelectrodes patient 506 between the twoelectrodes patient 506 grips theresistance handpiece 528 with a stronger force, more of the skin contacts the twoelectrodes electrical resistance sensor 530. In one variation, at least one of the twoelectrodes - In another example of the third expression of the embodiment of
FIG. 5-1 , theresponse assembly 510 includes a capacitance handpiece 536 (seen inFIG. 5-5 ) which includes anelectrical capacitance sensor 538 and twoconductors conductors - In an additional example of the third expression of the embodiment of
FIG. 5-1 , theresponse assembly 510 includes an air-bladder handpiece 544 (seen inFIG. 5-6 ) which includes acompliant air bladder 546, wherein thecontroller 502 analyzes at least the air pressure within theair bladder 546 to determine the level of sedation of thepatient 506. In one variation, the air-bladder handpiece 544 includes apressure sensor 548 which is disposed within theair bladder 546 and which sends a signal to thecontroller 502 corresponding to the air pressure within theair bladder 546. In an extension of the air-bladder concept, not shown, the air-pressure-movable protrusion of a thin area of the air bladder is used to activate a switch to signal the controller that a hand grip response has been made by the patient. - Advantages and benefits of one or more of the expressions of the embodiment and examples, etc. of
FIGS. 5-1 to 5-6 include a finer determination of the level of sedation of a patient undergoing a medical procedure involving conscious sedation. In one application, the change in the determined levels of sedation over time (i.e., the rate of sedation) is computed and used to predict the level of sedation at a future time. The motor-biased handgrip example allows a handgrip to be adjusted to accommodate the different grip strengths of different patients. In those examples which eliminate external switches, such switch elimination provides for greater reliability as switches need to be sealed against moisture and debris. - Conscious Sedation Involving a Non-Ear-Canal-Contacting Speaker
- A sixth aspect of the invention relates to conscious sedation and involves a non-ear-canal-contacting speaker. Referring now to the drawings,
FIG. 6-1 illustrates a first embodiment of the sixth aspect of the invention. A first expression of the first embodiment is for aconscious sedation system 600 including acontroller 602 and a response testing apparatus 604 (whereinparts controller 602 generates a request for a predetermined response from apatient 606 and analyses at least a response made by thepatient 606 to the request to determine a level of sedation of thepatient 606. The response testing apparatus 604 includes arequest assembly 608 and aresponse assembly 610. Therequest assembly 608 audibly communicates to thepatient 606 the request generated by thecontroller 602 and includes a non-ear-canal-contactingspeaker 612. Theresponse assembly 610 senses the response and communicates the response to thecontroller 602. - In one construction, a
cable 611 operatively connects thecontroller 602 to therequest assembly 608 and acable 613 operatively connects theresponse assembly 610 to thecontroller 602. In one variation, theresponse assembly 610 includes a handpiece (not shown) which senses a response of the patient to the request (such as sensing the patient pushing a button or moving the handpiece). In another variation, theresponse assembly 610 includes a sound detector (e.g., a microphone) which senses a vocal response made by the patient to the request (such as sensing the patient speaking). Other variations of theresponse assembly 610 are left to the artisan. - In one example of the
speaker 612 ofFIG. 6-1 , thespeaker 612 is afirst speaker 614 as shown inFIG. 6-2 . Thefirst speaker 614, when disposed on thepatient 606 proximate a bone of thepatient 606, audibly communicates the request to thepatient 606 at least in part by bone conduction of audible sound. - A first method of the invention, employing the
first speaker 614, is for audibly communicating to a patient 606 a request generated by acontroller 602 of aconscious sedation system 600 for a predetermined response from thepatient 606, wherein thecontroller 602 analyzes at least a response made by thepatient 606 to the request to determine a level of sedation of thepatient 606. One step includes obtaining afirst speaker 614. Another step includes disposing thefirst speaker 614 proximate a bone of thepatient 606. An additional step includes audibly communicating to thepatient 606 the request made by thecontroller 602 at least in part by bone conduction of audible sound using thefirst speaker 614. - In one employment of the first method, the
first speaker 614 is disposed upon the skin or scalp of thepatient 606 in the mastoid or skull area or elsewhere such as the neck or shoulder area. Thefirst speaker 614, utilizing an acoustic transducer vibrator, provides vibration/sound in the audible frequency range. The sounds are perceived primarily by thepatient 606 via bone conduction which bypasses the tympanic membrane of the ear and directly vibrates the cochlea of the ear for thepatient 606 to hear the sounds. - In another example of the
speaker 612 ofFIG. 6-1 , thespeaker 612 is asecond speaker 616 as shown inFIG. 6-3 . In this example, therequest assembly 608 also includes a pillow 618, wherein thesecond speaker 616 is disposed in the pillow 618. In one variation, anacoustic coupling gel 638 is disposed in the pillow 618. Thecable 611 is also shown inFIG. 6-3 . - A second method of the invention, employing the
second speaker 616, is for audibly communicating to a patient 606 a request generated by acontroller 602 of aconscious sedation system 600 for a predetermined response from thepatient 606, wherein thecontroller 602 analyzes at least a response made by thepatient 606 to the request to determine a level of sedation of thepatient 606. One step includes obtaining asecond speaker 616. Another step includes obtaining a pillow 618. An additional step includes disposing thesecond speaker 616 in the pillow 618. A further step is disposing the pillow 618 proximate the head of thepatient 606. An added step includes audibly communicating to thepatient 606 the request made by thecontroller 602 using thesecond speaker 616. - In an additional example of the
speaker 612 ofFIG. 6-1 , thespeaker 612 is athird speaker 620 as shown inFIG. 6-4 . In this example, therequest assembly 608 also includes askull cap 622. Thethird speaker 620 is attached to the outside of theskull cap 622. When theskull cap 622 is worn on the head of thepatient 606, the inside of theskull cap 622 covers an ear of thepatient 606 and thethird speaker 620 is substantially aligned with the ear canal of thepatient 606. - A third method of the invention, employing the
third speaker 620, is for audibly communicating to a patient 606 a request generated by acontroller 602 of aconscious sedation system 600 for a predetermined response from thepatient 606, wherein thecontroller 602 analyzes at least a response made by the patient to the request to determine a level of sedation of thepatient 606. One step includes obtaining athird speaker 620. Another step includes obtaining askull cap 622. An additional step includes attaching thethird speaker 620 to the outside of theskull cap 622 so that, when theskull cap 622 is worn on the head of thepatient 606, the inside of theskull cap 622 covers an ear of thepatient 606 and thethird speaker 620 is substantially aligned with the ear canal of thepatient 606. A further step is disposing theskull cap 622 on the head of thepatient 606. An added step includes audibly communicating to thepatient 606 the request made by thecontroller 602 using thethird speaker 620. - In a further example of the
speaker 612 ofFIG. 6-1 , thespeaker 612 is afourth speaker 624 as shown inFIG. 6-5 . In this example, therequest assembly 608 also includes askull cap 626 and atube connector 628 attached to the outside of theskull cap 626 as shown inFIGS. 6-5 and 6-6. Thetube connector 628 includes a sound-tube attachment site 630 and includes asound passageway 632 extending from the outside of theskull cap 626 to the sound-tube attachment site 630. In one design, asound tube 634 is operatively connected to thefourth speaker 624 and to the sound-tube attachment site 630. Other examples of a non-ear-canal-contactingspeaker 612 are left to the artisan and include, without limitation, a hospital-bed-supported speaker and a floor-stand-supported speaker. - A fourth method of the invention, employing the
fourth speaker 624, is for audibly communicating to a patient 606 a request generated by acontroller 602 of aconscious sedation system 600 for a predetermined response from thepatient 606, wherein thecontroller 602 analyzes at least a response made by thepatient 606 to the request to determine a level of sedation of thepatient 606. One step includes obtaining afourth speaker 624. Another step includes obtaining askull cap 626 and atube connector 628 attached to the outside of theskull cap 626, wherein thetube connector 628 includes a sound-tube attachment site 630 and asound passageway 632 extending from the outside of theskull cap 626 to the sound-tube attachment site 630, and wherein, when theskull cap 626 is worn on the head of thepatient 606, the inside of theskull cap 626 covers an ear of thepatient 606 and thesound passageway 632 at the outside of theskull cap 626 is substantially aligned with the ear canal of thepatient 606. An additional step includes obtaining asound tube 634. A further step includes operatively connecting thesound tube 634 to thefourth speaker 624 and to the sound-tube attachment site 630. Yet another step is disposing theskull cap 626 on the head of thepatient 606. An added step includes audibly communicating to thepatient 606 the request made by thecontroller 602 using thefourth speaker 624. - A second expression of the embodiment of
FIG. 6-1 is for arequest assembly 608 for a response testing apparatus 604 for aconscious sedation system 600, wherein theconscious sedation system 600 includes acontroller 602 which generates a request for a predetermined response from apatient 606. Therequest assembly 608 includes a non-ear-canal-contactingspeaker 612 which audibly communicates to thepatient 606 the request generated by thecontroller 602. - In one example of the second expression of the embodiment of
FIG. 6-1 , thespeaker 612 is afirst speaker 614 as shown inFIG. 6-2 . In this example, thefirst speaker 614, when disposed on thepatient 606 proximate a bone of thepatient 606, audibly communicates the request to thepatient 606 at least in part by bone conduction of audible sound. In one implementation utilizing thefirst speaker 614, therequest assembly 608 also includes aheadband 636, thefirst speaker 614 is attached to theheadband 636, and, when theheadband 636 is worn by thepatient 606, thefirst speaker 614 contacts a side of the head of thepatient 606 above the ear. In another implementation, thefirst speaker 614 is attached to the patient using double-sided adhesive tape or an elastomeric band or a metallic band. In one construction, thefirst speaker 614 is devoid of any sound-emitting opening. - In another example of the second expression, the
speaker 612 is asecond speaker 616 as seen inFIG. 6-3 . In this example, therequest assembly 608 also includes a pillow 618, and thesecond speaker 616 is disposed in the pillow 618. In one variation, therequest assembly 608 also includes anacoustic coupling gel 638 or an elastomeric pad disposed in the pillow 618. Examples ofacoustic coupling gels 638 are left to the artisan. In one utilization, when the head of thepatient 606 is disposed against the pillow 618, the sound path between thesecond speaker 616 and the ear of thepatient 606 is substantially defined by theacoustic coupling gel 638. In one modification, therequest assembly 608 also includes a single-use pillow cover (not shown) which covers the pillow 618 and which is exchanged with another single-use pillow cover before use by the next patient. - In an additional example of the second expression, the
speaker 612 is athird speaker 620 as seen inFIG. 64 . In this example, therequest assembly 608 also includes askull cap 622, thethird speaker 620 is attached (either fixedly attached or removably attached such as with adhesive tape) to the outside of theskull cap 622, and, when theskull cap 622 is worn on the head of thepatient 606, the inside of theskull cap 622 covers an ear of thepatient 606 and thethird speaker 620 is substantially aligned with the ear canal of thepatient 606. In one implementation utilizing thethird speaker 620, therequest assembly 608 also includes a cable connector 640 (such as a socket or a plug) attached (either fixedly attached or removably attached such as with adhesive tape) to the outside of theskull cap 622 and includes acord 642 operatively connecting (such as being hard wired to) thecable connector 640 and thethird speaker 620. In another variation, not shown, thecord 642 is omitted and thecable connector 640 is attached directly to thethird speaker 620. In one arrangement, therequest assembly 608 also includes acable 611, wherein thecable 611 is operatively connectable to the controller 602 (such as being hard wired to the controller 602) and to the cable connector 640 (such as being connectable to thecable connector 640 via a mating socket/plug 646). In one extension of the example of thethird speaker 620, with or without contact of thethird speaker 620 with the ear canal of thepatient 606, theskull cap 622 has one or more sound holes (not shown) between thethird speaker 620 and the ear canal of thepatient 606. - In a further example of the second expression, the
speaker 612 is afourth speaker 624 as seen inFIGS. 6-5 and 6-6. In this example, therequest assembly 608 also includes askull cap 626 and atube connector 628 attached (either fixedly attached or removably attached such as with adhesive tape) to the outside of theskull cap 626. In this example, thetube connector 628 includes a sound-tube attachment site 630 and includes asound passageway 632 extending from the outside of theskull cap 626 to the sound-tube attachment site 630. In one implementation, when theskull cap 626 is worn on the head of thepatient 606, the inside of theskull cap 626 covers an ear of thepatient 606 and thesound passageway 632 at the outside of theskull cap 626 is substantially aligned with the ear canal of thepatient 606. In one arrangement, therequest assembly 608 also includes asound tube 634, wherein thesound tube 634 is operatively connectable to thefourth speaker 624 and to the sound-tube attachment site 630. In one variation, theskull cap 626 has one or more sound holes (not shown) between thetube connector 628 and the ear canal of thepatient 606. In another variation, theskull cap 626 is omitted and the end of thesound tube 634 distant thefourth speaker 624 is disposed proximate (including in) the ear canal of the patient. - In one construction involving the third and/or
fourth speaker 620/624, theskull cap 622/626 includes aplastic film 648 having a periphery and anelastic band 650 attached to theplastic film 648 proximate the periphery as found in some shower caps. In an alternate construction, not shown, theskull cap 622/626 has a swimming-cap type of construction. Other constructions are left to the artisan. In one extension of the third and/or fourth speaker 620-624, with or without contact of the speaker with the ear canal, the third and/orfourth speaker 620/624 has a food-worker-hair-net type of construction. - A third expression of the embodiment of
FIG. 6-1 is for arequest assembly 608 for a response testing apparatus 604 for aconscious sedation system 600, wherein theconscious sedation system 600 includes acontroller 602 which generates a request for a predetermined response from apatient 606. Therequest assembly 608 includes a non-ear-canal-contactingspeaker 612/624 which audibly communicates to thepatient 606 the request generated by thecontroller 602. Therequest assembly 608 also includes a sound tube 634 (as seen inFIG. 6-5 ) having one end disposable proximate an ear canal or a microphone of an assistive hearing device (such as a hearing aide) of thepatient 606 and having another end disposable proximate thespeaker 612/624. In one variation, the one end is disposable in the ear canal of thepatient 606. In one arrangement, thespeaker 612/624 is attachable to, or supportable by, the bed of thepatient 606 or by an IV pole. - Any one or more of the previous embodiments, expressions, and methods can be extended, as appropriate, to provide sound to both ears of the patient, as can be appreciated by the artisan. In one variation, a switch or switches are provided to turn on and shut off providing sound to each ear of the patient.
- Advantages and benefits of one or more of the expressions (but not necessarily extensions thereof) of the embodiments of
FIGS. 6-1 to 6-6 include not having direct contact of the speaker with the ear canal of thepatient 606. This design eliminates secretions of the ear canal of the patient from entering thespeaker 612 which otherwise would have to be cleaned between patient use. Because no device enters the ear canal, this design provides more comfort for the patient and is compatible with patients with hearing aids. In the example employing thefirst speaker 614, no ear of thepatient 606 is covered by any apparatus of therequest assembly 608 adding to patient comfort and allowing the doctor to communicate with the patient, if desired, without having to remove a headset or an earphone from the ear or ears of the patient. In the example employing thesecond speaker 616, embedding a speaker in a pillow allows, in one arrangement, use of a replaceable (including a single-use) pillow cover. Any single-use device eliminates the need for cleaning between patient use. In the example employing thethird speaker 620, having askull cap 622 with attachedthird speaker 620 andcord connector 640 allows, in one arrangement, a single-use skull cap 622 employing an inexpensive or removably-attachable third speaker 620 (and optionally cord connector 640). In the example employing thefourth speaker 624, the use of a removably-attachable sound tube 634 to connect with theskull cap 626 allows, in one arrangement, a single-use skull cap 626 employing an inexpensive or removably-attachable tube connector 628. It is noted that a non-ear-canal-contacting speaker accommodates hearing-impaired patients by communicating with an assistive hearing device, such as a hearing aid, worn by such patients. - Conscious Sedation Involving Personalized Audio Requests
- It is known in conscious sedation that when a patient is sedated and receives an audio stimulus request, the patient is more responsive to the audio request when there is a personalized message, the personalized message having a voice, word, phrase or sound with which the patient is familiar especially one which has a personal association or is emotionally evoking with the patient. Examples of personalized messages that the patient is more responsive to include a message addressing the patient by his name or a message using a voice that the patient is familiar with such as a family member or a doctor. Other examples of messages may be sounds that are attention-getting with a particular focus from the patient's perspective such as a dog bark or a siren.
- A seventh aspect of the invention relates a conscious sedation system which generates an audio request with a personalized message.
FIG. 7-1 illustrates an embodiment of the seventh aspect of the invention. An embodiment of the invention is for aconscious sedation system 700 including acontroller 702 and aresponse testing apparatus 704, wherein thecontroller 702 generates a request for a predetermined response generated by thepatient 706 to the request, and wherein the controller includes an input 712 wherein a personalized message can be included in the request. Theresponse testing apparatus 704 includes arequest assembly 708 and aresponse assembly 710. Therequest assembly 708 communicates to thepatient 706 the request generated by thecontroller 702, the request having a personalized message. Theresponse assembly 710 is used by thepatient 706 to generate the response and communicates the response to thecontroller 702. - In an embodiment of the invention, the input 712 can be a keypad or touch screen or other input device, wherein the patient's information is put into the controller. The keypad or touch screen may contain a text-to-speech software so that the patient's information can be converted to speech through voice synthesis and included in the personalized message. By addressing the sedated patient by name in the form of a personalized message, the patient is more likely to respond to the request. In addition to addressing the patient by name, the personalized message can also include a command such as “please squeeze your hand” or “please release your hand.” The message can be used to instruct the patient on how to respond to various audible, tactile or other stimulation encountered during the procedure. Accordingly, the personalized message can be a supplement to or part of the request or it can be the request itself.
- Another embodiment is an input that includes a microphone to enter the patient's information or a message to be included in the personalized message. The microphone further allows voices of specific persons to be recorded into the personalized message. For instance, a the patient's doctor or relative or a person to whom the patient is acquainted may record his own voice into a personalized message. In this way, the sedated patient is more likely to respond when he hears the familiar voice. In a preferred embodiment, the personalized message is recorded and saved as a wav file in the controller memory. The controller can then output the wav file or a combination of wav files as the personalized message. For instance, the controller may combine a wav file for “mister” or “misses” with a wav file containing the patient's name incorporating them into a personalized message. In another manifestation of the preferred embodiment, voice recognition software is used to convert the patient's name and information into text to be displayed on the screen for data entry, which may be manually corrected. The patient's name may be used later for playback as a request. The personalized message can also be manually or automatically revised during the procedure to reduce the tendency for the patient to adapt to the audio stimulus. The personalized message can be adapted automatically to change words in accordance with preset selections or in accordance with the patient's response; For example, the words which produce the greatest or most reliable patient response through the procedure may be used to assure a greater likelihood of getting a response as the patient becomes more deeply sedated. Other examples of personalized messages include those that have a directly relevant contextual tonal message, such as a voice speaking in a unique dialect or accent pattern particular to the patient; this provides for enhanced interest and comprehension versus a more generic version of the same language which leads to more effective audio stimulation. The personalized message may also be linguistically adapted for patients residing in specific localities of a region. Finally, the audio stimulus may also be a sound or song with which the patient is familiar.
- In a further embodiment of the invention, the personalized message may be stored as memory in either the controller or the response testing assembly, wherein the memory is either digital or analog. The personalized message may be transferable from the controller to the response testing assembly by cable or wireless means and vice versa. In one manifestation of an embodiment of the invention, the message may be played in accordance with a predetermined time schedule. For example, it may be synchronized to occur in conjunction with the onset of each request or vibration period or it may utilize an adaptive audio stimulation timing in accordance with the patient's responsiveness such as not issuing the message unless successive vibrational attempts have failed to obtain a patient response. This reduces the tendency for the patient to habituate to the audio stimulation.
- In yet a further embodiment of the invention, the input may be an auxiliary input signal connector for the user to input voice or sound data from an external source such as an external microphone or an external audio source. The audio source may be an analog audio source such as a tape recorder or a digital source such as CD, MP3 etc. Further, the system may include a CD or tape player for accepting input from a storage media that contains components of the personalized message.
- In the example of the expression of the embodiment of
FIG. 7-1 , thecontroller 702 determines a delivery schedule of a conscious sedation drug to thepatient 706 based at least in part on the determined level of sedation of thepatient 706. The drug delivery apparatus has been omitted fromFIG. 7-1 for clarity. A conscious sedation drug is a drug or drug combination which, in an efficacious amount, is capable of sedating thepatient 706 during a medical procedure (such as a colonoscopy) while keeping thepatient 706 conscious. Conscious sedation drugs, such as Propofol, are well known in the medical art. In one alternative, a doctor, instead of thecontroller 702, determines a delivery schedule of the conscious sedation drug to thepatient 706 based at least in part on the determined level of sedation of thepatient 706. - Conscious Sedation Using Finger Movement Response Assembly
- An eighth aspect of the invention relates to finger movement response testing for conscious sedation.
FIG. 8-1 illustrates an embodiment of the eighth aspect of the invention. An embodiment of the invention is for aconscious sedation system 800 including acontroller 802 and aresponse testing apparatus 804. Thecontroller 802 generates a request for a predetermined response from apatient 806 to the request to determine a level of sedation of thepatient 806 Theresponse testing apparatus 804 includes arequest assembly 808 and aresponse assembly 810. In a manifestation of the invention, either theresponse assembly 810 or therequest assembly 808 is a finger attachable apparatus. The finger attachable apparatus can be aresponse assembly 810 wherein the response is generated by the movement of the patient's fingers or the finger attachable apparatus can be arequest assembly 808 wherein the request is generated via the controller. In a further manifestation the finger attachable apparatus is both a response assembly and a request assembly in the response testing apparatus. - In one embodiment of the invention, the finger attachable apparatus is a finger touch response apparatus as shown in
FIG. 8-2 . The finger attachable apparatus comprises afirst finger receptacle 812 and asecond finger receptacle 814 that are attachable onto the patient's fingers. Thereceptacles member 816 that hold thereceptacles member 816 has astrain gage 822 located in the middle. At the ends of thereceptacles electrical contacts finger receptacles receptacles receptacles member 816 of a predetermined stiffness so that the receptacles do not inadvertently contact each other and can only contact each other when a sufficient force is applied by bringing the fingers together. At the end of the receptacles areelectrical contacts - In a further embodiment of the invention, the biasing
member 816 has a strain gage that measures the amount of force the patient is applying in attempting to contact or contacting the receptacles by bringing the fingers together. Although the patient may not succeed in bringing the receptacles into contact, the amount of force the patient applies in his attempt can be measured. The higher the level of sedation of the patient, the less force he is able to generate in bringing the receptacles into contact with each other. Accordingly, the amount of force generated by the patient is correlated with the patient's level of sedation. Nevertheless, there is a minimum threshold force that the patient must apply in order for a response to be registered. Once that threshold force is exceeded, the strain gage continuously measures the amount of force that is applied. If the minimum threshold force is not met by the patient, there is no registered response. - In another embodiment of the invention, the finger attachable apparatus in
FIG. 8-3 is a handpiece fingercurl sensor mechanism 830 wherein the mechanism has fixed point sensors comprisingfinger sensors 834,knuckle sensors 836 and apalm stimulation source 838 to detect the curling movement of the patient's fingers towards the palm. The sensors are attached along the length of the fingers and the palm to detect the bending motion when the patient curls the fingers towards the palm. The handpiece finger curl sensor mechanism can be fitted onto the hand and comprises sensors that coincide with the fingers, knuckles and palm. The handpiece fingercurl sensor mechanism 830 can be used as a response system, request system or both. As a request system, thepalm stimulation source 838 can provide a stimulus to the patient's hand. As a response system, the patient responds by curling at least one or more fingers towards the palm or closing his hand over the palm stimulation source; a response can also be generated by uncurling the at least one or more finger away from the palm. In a further embodiment of the invention, the palm stimulation source is in the shape of a cylinder or sphere and is located in the palm of the hand wherein the patient generates a response by closing his hand over the palm stimulation source. The sensors measure the change in distance between the various locations on the hand. In yet a further embodiment of the invention, the handpiece is a glove that fits over the hand. The glove is stretchable so that the fingers are able to be curled towards the palm. The amount of stretch can also be measured by the sensors. The patient's ability to curl his fingers and/or close his hand diminishes as the patient becomes more sedated. Accordingly, the amount of finger curl or stretch by the patient correlates with the level of sedation of the patient. - The sensors of the finger curl sensor mechanism can be linear-displacement sensors (such as magnetometers or inductive sensors), a mercury-filled tube acting as a strain gage, or even electrodes monitoring changes in surface impedance. However, it should be noted that the sensors are not limited to the ones mentioned. The handpiece finger curl sensor mechanism also can be a glove such as a latex-free Nitrile glove. The response can also be selected from a series of sensors or from a collective response from various sensors.
- In one example of the expression of the embodiment of
FIG. 8-1 , thecontroller 802 determines a delivery schedule of a conscious sedation drug to thepatient 806 based at least in part on the determined level of sedation of thepatient 806. The drug delivery apparatus has been omitted fromFIG. 8-1 for clarity. A conscious sedation drug is a drug or drug combination which, in an efficacious amount, is capable of sedating thepatient 806 during a medical procedure (such as a colonoscopy) while keeping thepatient 806 conscious. Conscious sedation drugs, such as Propofol, are well known in the medical art. In one alternative, a doctor, instead of thecontroller 802, determines a delivery schedule of the conscious sedation drug to thepatient 806 based at least in part on the determined level of sedation of thepatient 806. - Conscious Sedation Involving Automated Audio Calibration
- It is known that when a patient is sedated, his ability to discern audio stimulus is reduced. Therefore, in a conscious sedation system, the patient's ability to discern various levels of audio stimulus correlates with the patient's level of sedation. The higher the level of audio stimulus required for the patient to discern and generate a response, the more sedated the patient. However, because each patient has different initial levels of hearing, a baseline level of hearing needs to be established in order to use audio stimulus in assessing the patient's level of sedation. For example, one non-sedated patient may be able to discern a low level audio stimulus while another non-sedated patient may need a higher level of audio stimulus in order to discern or hear the stimulus. Accordingly, a baseline level of hearing needs to be established with each individual patient before using audio stimulus in a conscious sedation system to determine the patient's level of sedation by monitoring the patient's response to the audio stimulus.
- In the prior art, the patient's baseline, namely the minimum threshold audio stimulus level at which the patient is able to hear the audio request in order to generate a response, is established manually. The doctor manually increases the intensity of the audio stimulus until the patient hears the stimulus and generates a request. The level of intensity at which the patient discerns the audio request is the baseline that will be used to in the conscious sedation system. Once this baseline is calibrated, it is used in the conscious sedation system to assess the level of sedation of the patient.
- A ninth aspect of the invention relates to an audio calibration setting for a conscious sedation system.
FIG. 9-1 illustrates an embodiment of the ninth aspect of the invention. An embodiment of the invention is for aconscious sedation system 900 including acontroller 902 and aresponse testing apparatus 904, wherein thecontroller 902 is programmed to generate a request for a predetermined response from apatient 906 to the request, and wherein thecontroller 902 analyzes the response or lack thereof generated by the patient in order to calibrate the patient's level of hearing based on the patient's response to the request to establish a baseline audio stimulus and further to determine a level of sedation of thepatient 906. Theresponse testing apparatus 904 includes arequest assembly 908 and aresponse assembly 910. The request generated can be a discrete or continuous audio stimulus. - Referring to
FIG. 9-2 , in another embodiment of the invention, a method for the automated audio calibration of a patient in a conscious sedation system is disclosed wherein thecontroller 902 generates a request to the patient, the request being an audio stimulus of very low amplitude. Thecontroller 902 monitors the patient's predetermined response to the request. If the patient does not respond to the request because the amplitude of the stimuli is too low for the patient to perceive, another request is generated to the patient, the request being a slightly higher amplitude than the previous request. The process is repeated until the patient generates a predetermined response to the request. Once the response is generated, the controller records the level of stimulus at which the patient responded and calibrates the patient's baseline level of hearing based on the level of stimulus to which the patient responded. Once the patient's baseline level of hearing is established and recorded by the controller, the baseline is used as the initial stimulus level in assessing the level of sedation of the patient. - In a further embodiment of the invention as shown in
FIG. 9-3 , a method for the automated audio calibration of a patient's level of hearing and further determining the patient's level of sedation is taught. Once the baseline stimulus is established, an audio stimulus is generated to the patient based on the baseline stimulus by applying a first audio stimulus to the patient who has received, is receiving or is about to receive a conscious sedation drug. The patient is then instructed to respond to the audio stimulus. The patient's response to the audio stimulus is monitored and an additional audio stimulus is applied to the patient when the patient has received, is receiving or is about to receive a dose of a conscious sedation drug. The additional audio stimulus can be the same or different as the first audio stimulus. The patient's response to the additional audio stimulus is monitored again and the patient's level of sedation is assessed based on the patient's response. The steps of applying additional audio stimulus and monitoring the patient's response can be repeated to determine the patient's level of sedation. - Another expression of the embodiment of the invention is for a
response testing apparatus 904 for a conscious sedation system. Referring toFIG. 9-4 , theresponse testing apparatus 904 includes arequest assembly 908, aresponse assembly 910, and a sub-controller 914 wherein the sub-controller 914 calibrates the patient's level of hearing based on the patient's response to establish a baseline level of hearing. The sub-controller 914 analyzes the response or lack thereof generated by thepatient 906 in order to calibrate the patient's level of hearing based on the patient's response or lack thereof to the request to establish a baseline and further to determine a level of sedation of thepatient 906. The sub-controller 914 monitors the patient's predetermined response to the request. If the patient does not respond to the request because the amplitude of the stimulus is too low for the patient to perceive, another request is generated to the patient, the request being a slightly higher amplitude than the previous request. The process is repeated until the patient generates a predetermined response to the request. Once the response is generated, the sub-controller 914 records the level of stimulus at which the patient responded and calibrates the patient's baseline level of hearing based on the level of stimulus to which the patient responded. Once the patient's baseline level of hearing is established and recorded by the sub-controller, the baseline is used as the initial stimulus level in assessing the level of sedation of the patient. - In one example of the embodiment of
FIG. 9-1 , thecontroller 902 determines a delivery schedule of a conscious sedation drug to thepatient 906 based at least in part on the determined level of sedation of thepatient 906. The drug delivery apparatus has been omitted fromFIG. 9-1 for clarity. A conscious sedation drug is a drug or drug combination which, in an efficacious amount, is capable of sedating thepatient 906 during a medical procedure (such as a colonoscopy) while keeping thepatient 906 conscious. Conscious sedation drugs, such as Propofol, are well known in the medical art. In one alternative, a doctor, instead of thecontroller 902, determines a delivery schedule of the conscious sedation drug to thepatient 906 based at least in part on the determined level of sedation of thepatient 906. - It is understood that any one or more of the previously-described aspects, embodiments, expressions of embodiments, examples, methods, etc. can be combined with any one or more of the other previously-described aspects, embodiments, expressions of embodiments, examples, methods, etc. For example, and without limitation, cableless communication can be used in combination with personalized audio requests, etc.
- The foregoing description of several aspects of the invention has been presented for purposes of illustration. It is not intended to be exhaustive or to limit the invention to the precise forms and procedures disclosed, and obviously many modifications and variations are possible in light of the above teaching. For example, as would be apparent to those skilled in the art, the disclosures herein of the conscious sedation systems, components thereof and methods therefor have equal application in robotic assisted surgery taking into account the obvious modifications of such systems, components and methods to be compatible with such a robotic system.
Claims (24)
1. A conscious sedation system comprising:
a) a controller which generates a request for a predetermined response from a patient and which analyses at least a response made by the patient to the request to determine a level of sedation of the patient; and
b) a response testing apparatus including:
(1) a request assembly which communicates to the patient the request generated by the controller; and
(2) a response assembly which senses the response and which communicates the response to the controller,
wherein at least one of the request assembly and the response assembly includes a cableless communication device which communicates at least one of the request and the response between the controller and the patient.
2. The conscious sedation system of claim 1 , wherein a user and/or the controller determines a delivery schedule of a conscious-sedation drug to the patient based at least in part on the determined level of sedation of the patient.
3. The conscious sedation system of claim 1 , wherein the cableless communication device includes a transmitter and a receiver in cableless communication with the transmitter, and wherein the cableless communication device imposes a unique identifier on at least one of the transmitter and the receiver which prevents the cableless communication device from responding to crosstalk from other transmitters.
4. The conscious sedation system of claim 3 , wherein the unique identifier is manually-triggered, or is automatically proximity-triggered when the transmitter and the receiver are brought into proximity to each other, or requires both manual and proximity triggering.
5. The conscious sedation system of claim 1 , also including a console, wherein the controller is disposed in the console.
6. A response testing apparatus for a conscious sedation system comprising:
a) a request assembly which communicates to a patient a request generated by a controller of the conscious sedation system for a predetermined response from the patient; and
b) a response assembly which senses a response made by the patient to the request and which communicates the response to the controller which analyses at least the response to determine a level of sedation of the patient,
wherein at least one of the request assembly and the response assembly includes a cableless communication device which communicates at least one of the request and the response between the controller and the patient.
7. The response testing apparatus of claim 6 , wherein the request assembly includes a cableless communication device which communicates the request from the controller to the patient.
8. The response testing apparatus of claim 7 , wherein the cableless communication device includes an RF transmitter and includes an RF receiver in wireless communication with the RF transmitter and disposed proximate the patient.
9. The response testing apparatus of claim 8 , wherein the request assembly verifies that the request was received by the RF receiver.
10. The response testing apparatus of claim 8 , wherein the request assembly includes a battery-operated portion, and wherein the request assembly monitors the battery condition of the battery-operated portion.
11. The response testing apparatus of claim 8 , wherein the request assembly includes a speaker, and wherein the RF receiver is used to activate the speaker to produce an audible request to the patient.
12. The response testing apparatus of claim 11 , wherein the speaker is an earphone disposable proximate an ear of the patient.
13. The response testing apparatus of claim 8 , wherein the request assembly includes a vibrator, and wherein the RF receiver is used to activate the vibrator to produce a tactile request to the patient.
14. The response testing apparatus of claim 13 , wherein the vibrator is disposed in a handpiece, and wherein the handpiece is disposable proximate a hand of the patient.
15. The response testing apparatus of claim 6 , wherein the response assembly includes a cableless communication device which communicates the response from the patient to the controller.
16. The response testing apparatus of claim 15 , wherein the cableless communication device includes an RF transmitter disposed proximate the patient and includes an RF receiver in wireless communication with the RF transmitter.
17. The response testing apparatus of claim 16 , wherein the response assembly includes a handpiece disposable proximate a hand of the patient, wherein the handpiece includes a switch, and wherein the response includes the patient activating the switch whereby a signal is sent by the RF transmitter.
18. The response testing apparatus of claim 6 , wherein the request assembly includes a cableless communication device which communicates the request from the controller to the patient, and wherein the response assembly includes a cableless communication device which communicates the response from the patient to the controller.
19. A response testing apparatus for a conscious sedation system comprising:
a) a request assembly which communicates to a patient a request generated by a controller of the conscious sedation system for a predetermined response from the patient; and
b) a response assembly which senses a response made by the patient to the request and which communicates the response to the controller which analyses at least the response to determine a level of sedation of the patient,
wherein at least one of the request assembly and the response assembly includes a cableless communication device which communicates at least one of the request and the response between the controller and the patient,
wherein the cableless communication device includes a transmitter and a receiver in cableless communication with the transmitter, and
wherein the cableless communication device imposes a unique identifier on at least one of the transmitter and the receiver which prevents the cableless communication device from responding to crosstalk from other transmitters.
20. The response testing apparatus of claim 19 , wherein the unique identifier is manually-triggered, or is automatically proximity-triggered when the transmitter and the receiver are brought into proximity to each other, or requires both manual and proximity triggering.
21. The response testing apparatus of claim 19 , wherein the transmitter is an RF transmitter, and wherein the receiver is an RF receiver in wireless communication with the RF transmitter.
22. The response testing apparatus of claim 21 , wherein the cableless communication device selects the operating frequency of at least one of the transmitter and the receiver which prevents the cableless communication device from responding to crosstalk from other transmitters.
23. The response testing apparatus of claim 21 , wherein the cableless communication device selects a digital code for at least one of the transmitter and the receiver which prevents the cableless communication device from responding to crosstalk from other transmitters.
24. The response testing apparatus of claim 19 , also including a lockout which prevents use of the cableless communication device unless the imposition of the unique identifier has been successfully verified.
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/670,453 US7261106B2 (en) | 2003-09-25 | 2003-09-25 | Response testing for conscious sedation utilizing a cannula for support/response |
US10/670,489 US20050070812A1 (en) | 2003-09-25 | 2003-09-25 | Time variant vibration stimulus response for a conscious sedation system |
US10/671,183 US20050066970A1 (en) | 2003-09-25 | 2003-09-25 | Response testing for conscious sedation using cableless communication |
US10/673,660 US20050070822A1 (en) | 2003-09-25 | 2003-09-29 | Response testing for conscious sedation utilizing a hand motion response |
EP04255829A EP1518580A3 (en) | 2003-09-25 | 2004-09-24 | System for determining the level of sedation in a patient |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/670,453 US7261106B2 (en) | 2003-09-25 | 2003-09-25 | Response testing for conscious sedation utilizing a cannula for support/response |
US10/670,489 US20050070812A1 (en) | 2003-09-25 | 2003-09-25 | Time variant vibration stimulus response for a conscious sedation system |
US10/671,183 US20050066970A1 (en) | 2003-09-25 | 2003-09-25 | Response testing for conscious sedation using cableless communication |
US10/673,660 US20050070822A1 (en) | 2003-09-25 | 2003-09-29 | Response testing for conscious sedation utilizing a hand motion response |
Publications (1)
Publication Number | Publication Date |
---|---|
US20050066970A1 true US20050066970A1 (en) | 2005-03-31 |
Family
ID=34705307
Family Applications (4)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/670,489 Abandoned US20050070812A1 (en) | 2003-09-25 | 2003-09-25 | Time variant vibration stimulus response for a conscious sedation system |
US10/671,183 Abandoned US20050066970A1 (en) | 2003-09-25 | 2003-09-25 | Response testing for conscious sedation using cableless communication |
US10/670,453 Expired - Fee Related US7261106B2 (en) | 2003-09-25 | 2003-09-25 | Response testing for conscious sedation utilizing a cannula for support/response |
US10/673,660 Abandoned US20050070822A1 (en) | 2003-09-25 | 2003-09-29 | Response testing for conscious sedation utilizing a hand motion response |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/670,489 Abandoned US20050070812A1 (en) | 2003-09-25 | 2003-09-25 | Time variant vibration stimulus response for a conscious sedation system |
Family Applications After (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/670,453 Expired - Fee Related US7261106B2 (en) | 2003-09-25 | 2003-09-25 | Response testing for conscious sedation utilizing a cannula for support/response |
US10/673,660 Abandoned US20050070822A1 (en) | 2003-09-25 | 2003-09-29 | Response testing for conscious sedation utilizing a hand motion response |
Country Status (2)
Country | Link |
---|---|
US (4) | US20050070812A1 (en) |
EP (1) | EP1518580A3 (en) |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20060042632A1 (en) * | 2004-08-31 | 2006-03-02 | Bishop Gregory D | Apparatus for monitoring a patient during drug delivery |
WO2006133495A1 (en) * | 2005-06-14 | 2006-12-21 | Resmed Limited | Methods and apparatus for improving cpap patient compliance |
US20070079444A1 (en) * | 2005-10-07 | 2007-04-12 | Ward Deborah | Infant nesting device |
US8528552B2 (en) | 2008-12-01 | 2013-09-10 | Dräger Medical GmbH | SPO2 control with adaptive linear compensation |
US8676529B2 (en) | 2011-01-31 | 2014-03-18 | Covidien Lp | Systems and methods for simulation and software testing |
US8788236B2 (en) | 2011-01-31 | 2014-07-22 | Covidien Lp | Systems and methods for medical device testing |
Families Citing this family (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB2420635B (en) * | 2004-10-12 | 2006-11-29 | Angus Mark Ford-Robertson | A timing device |
US20060204937A1 (en) * | 2005-03-01 | 2006-09-14 | Josie Grignon | Method for emotional learning and well-being |
CN101024106A (en) * | 2006-02-17 | 2007-08-29 | 雷斯梅德有限公司 | Touchless control system for breathing apparatus |
US8088077B2 (en) * | 2006-05-16 | 2012-01-03 | Board Of Trustees Of Southern Illinois University | Tinnitus testing device and method |
US20090163828A1 (en) | 2006-05-16 | 2009-06-25 | Board Of Trustees Of Southern Illinois University | Tinnitus Testing Device and Method |
US20110040204A1 (en) * | 2006-10-19 | 2011-02-17 | The Regents Of The University Of California | Neurological stimulation and analysis |
US20080177152A1 (en) * | 2007-01-24 | 2008-07-24 | Donofrio William T | Response testing for conscious sedation utilizing a non-ear-canal-contacting speaker |
US9521963B2 (en) * | 2008-05-13 | 2016-12-20 | Ric Investments, Llc | Respiratory component measurement system with indicating elements |
US20090292226A1 (en) * | 2008-05-21 | 2009-11-26 | Ethicon Endo-Surgery, Inc. | Medical system and method employing a drug delivery assembly |
FR2939630B1 (en) * | 2008-12-12 | 2012-11-09 | Univ Rennes | DEVICE FOR DETERMINING A STATE OF STRESS IN A LIVING SUBJECT, METHOD AND CORRESPONDING COMPUTER PROGRAM PRODUCT |
US8894585B2 (en) * | 2010-01-04 | 2014-11-25 | William M. Hasbun | Portable diagnostic instrument and a method for its use |
US9092559B2 (en) | 2011-08-16 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Drug delivery system with open architectural framework |
US10542903B2 (en) * | 2012-06-07 | 2020-01-28 | Masimo Corporation | Depth of consciousness monitor |
US20160007878A1 (en) * | 2014-07-12 | 2016-01-14 | Washington University | Device and method for monitoring pain |
NO20160684A1 (en) * | 2016-04-22 | 2017-10-23 | Grasp As | Measurement device for detecting and measuring pain |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5614887A (en) * | 1995-06-07 | 1997-03-25 | Buchbinder; Dale | Patient monitoring system and method thereof |
US20020017296A1 (en) * | 1998-06-03 | 2002-02-14 | Hickle Randall S. | Apparatus and method for providing a conscious patient relief from pain and anxiety associated with medical or surgical procedures |
US20020017300A1 (en) * | 2000-06-13 | 2002-02-14 | Hickle Randall S. | Apparatus and method for mask free delivery of an inspired gas mixture and gas sampling |
US6415439B1 (en) * | 1997-02-04 | 2002-07-02 | Microsoft Corporation | Protocol for a wireless control system |
US20020188259A1 (en) * | 2001-05-21 | 2002-12-12 | Scott Laboratories, Inc. | Smart supplies, components and capital equipment |
Family Cites Families (17)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5027828A (en) * | 1989-11-21 | 1991-07-02 | N. K. Biotechnical Engineering Company | Sensory discriminator having body-contacting prongs |
US5195531A (en) * | 1991-03-01 | 1993-03-23 | Bennett Henry L | Anesthesia adequacy monitor and method |
US5191896A (en) * | 1991-06-28 | 1993-03-09 | Medoc Ltd. | Apparatus for measuring threshold sensitivity to a stimulus |
US5645077A (en) * | 1994-06-16 | 1997-07-08 | Massachusetts Institute Of Technology | Inertial orientation tracker apparatus having automatic drift compensation for tracking human head and other similarly sized body |
JP3276536B2 (en) * | 1995-07-12 | 2002-04-22 | 株式会社群馬コイケ | Synchronization control device and respiratory sensor in gas supply device |
DE19549165A1 (en) * | 1995-12-29 | 1997-07-03 | Juergen Heitmann | Determination of hearing data |
SE508357C2 (en) * | 1996-01-02 | 1998-09-28 | Kay Laserow | Measuring instruments for measuring pain and a method for measuring pain with a measuring instrument |
US5999856A (en) * | 1997-02-21 | 1999-12-07 | St. Croix Medical, Inc. | Implantable hearing assistance system with calibration and auditory response testing |
US7565905B2 (en) * | 1998-06-03 | 2009-07-28 | Scott Laboratories, Inc. | Apparatuses and methods for automatically assessing and monitoring a patient's responsiveness |
US6496585B1 (en) * | 1999-01-27 | 2002-12-17 | Robert H. Margolis | Adaptive apparatus and method for testing auditory sensitivity |
JP2000342690A (en) * | 1999-06-09 | 2000-12-12 | Nippon Colin Co Ltd | Anesthetic depth monitoring device |
US6834436B2 (en) * | 2001-02-23 | 2004-12-28 | Microstrain, Inc. | Posture and body movement measuring system |
KR20080096855A (en) * | 2001-06-13 | 2008-11-03 | 컴퓨메딕스 리미티드 | Methods and apparatus for monitoring consciousness |
WO2003011358A2 (en) * | 2001-07-31 | 2003-02-13 | Scott Laboratories, Inc. | Apparatuses and methods for titrating drug delivery |
US20030189492A1 (en) * | 2002-04-04 | 2003-10-09 | Harvie Mark R. | Monitoring, alarm and automatic adjustment system for users of oxygen and compressed air |
US7089927B2 (en) * | 2002-10-23 | 2006-08-15 | New York University | System and method for guidance of anesthesia, analgesia and amnesia |
WO2004105601A1 (en) * | 2003-05-06 | 2004-12-09 | Everest Biomedical Instruments | Anesthesia and sedation monitoring system and method |
-
2003
- 2003-09-25 US US10/670,489 patent/US20050070812A1/en not_active Abandoned
- 2003-09-25 US US10/671,183 patent/US20050066970A1/en not_active Abandoned
- 2003-09-25 US US10/670,453 patent/US7261106B2/en not_active Expired - Fee Related
- 2003-09-29 US US10/673,660 patent/US20050070822A1/en not_active Abandoned
-
2004
- 2004-09-24 EP EP04255829A patent/EP1518580A3/en not_active Withdrawn
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5614887A (en) * | 1995-06-07 | 1997-03-25 | Buchbinder; Dale | Patient monitoring system and method thereof |
US6415439B1 (en) * | 1997-02-04 | 2002-07-02 | Microsoft Corporation | Protocol for a wireless control system |
US20020017296A1 (en) * | 1998-06-03 | 2002-02-14 | Hickle Randall S. | Apparatus and method for providing a conscious patient relief from pain and anxiety associated with medical or surgical procedures |
US20020017299A1 (en) * | 1998-06-03 | 2002-02-14 | Hickle Randall S. | Apparatus and method for providing a conscious patient relief from pain and anxiety associated with medical or surgical procedures |
US20050112325A1 (en) * | 1998-06-03 | 2005-05-26 | Scott Laboratories, Inc. | Drug delivery in association with medical or surgical procedures |
US20020017300A1 (en) * | 2000-06-13 | 2002-02-14 | Hickle Randall S. | Apparatus and method for mask free delivery of an inspired gas mixture and gas sampling |
US20020188259A1 (en) * | 2001-05-21 | 2002-12-12 | Scott Laboratories, Inc. | Smart supplies, components and capital equipment |
Cited By (23)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7935081B2 (en) | 2004-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Drug delivery cassette and a medical effector system |
US7970631B2 (en) | 2004-08-31 | 2011-06-28 | Ethicon Endo-Surgery, Inc. | Medical effector system |
US20090133699A1 (en) * | 2004-08-31 | 2009-05-28 | Nalagatla Anil K | Oral nasal cannula |
US20060042636A1 (en) * | 2004-08-31 | 2006-03-02 | Nalagatla Anil K | Oral nasal cannula |
US20060042633A1 (en) * | 2004-08-31 | 2006-03-02 | Bishop Gregory D | Infusion pump |
US20060081257A1 (en) * | 2004-08-31 | 2006-04-20 | Ross Krogh | Single use drug delivery components |
US20060081258A1 (en) * | 2004-08-31 | 2006-04-20 | Nalagatla Anil K | Drug delivery cassette |
US20060081259A1 (en) * | 2004-08-31 | 2006-04-20 | Bruggeman Paul J | Medical effector system |
US20060106345A1 (en) * | 2004-08-31 | 2006-05-18 | Flaker Richard W | Drug delivery cassette and a medical effector system |
US8146591B2 (en) | 2004-08-31 | 2012-04-03 | Ethicon Endo-Surgery, Inc. | Capnometry system for use with a medical effector system |
US20060042634A1 (en) * | 2004-08-31 | 2006-03-02 | Nalagatla Anil K | Device for connecting a cannula to a medical effector system |
US20060042631A1 (en) * | 2004-08-31 | 2006-03-02 | Martin James F | Apparatus to deliver oxygen to a patient |
US20060042632A1 (en) * | 2004-08-31 | 2006-03-02 | Bishop Gregory D | Apparatus for monitoring a patient during drug delivery |
US7727194B2 (en) | 2004-08-31 | 2010-06-01 | Ethicon Endo-Surgery, Inc. | Drug delivery cassette |
US7837651B2 (en) | 2004-08-31 | 2010-11-23 | Ethicon Endo-Surgery, Inc. | Infusion pump |
WO2006133495A1 (en) * | 2005-06-14 | 2006-12-21 | Resmed Limited | Methods and apparatus for improving cpap patient compliance |
US10758690B2 (en) | 2005-06-14 | 2020-09-01 | ResMed Pty Ltd | Methods and apparatus for improving CPAP patient compliance |
US9227032B2 (en) | 2005-06-14 | 2016-01-05 | Resmed Limited | Method and apparatus for improving CPAP patient compliance |
US7587772B2 (en) * | 2005-10-07 | 2009-09-15 | Ward Deborah | Infant nesting device |
US20070079444A1 (en) * | 2005-10-07 | 2007-04-12 | Ward Deborah | Infant nesting device |
US8528552B2 (en) | 2008-12-01 | 2013-09-10 | Dräger Medical GmbH | SPO2 control with adaptive linear compensation |
US8676529B2 (en) | 2011-01-31 | 2014-03-18 | Covidien Lp | Systems and methods for simulation and software testing |
US8788236B2 (en) | 2011-01-31 | 2014-07-22 | Covidien Lp | Systems and methods for medical device testing |
Also Published As
Publication number | Publication date |
---|---|
US20050070822A1 (en) | 2005-03-31 |
EP1518580A3 (en) | 2005-04-13 |
US20050066971A1 (en) | 2005-03-31 |
US7261106B2 (en) | 2007-08-28 |
EP1518580A2 (en) | 2005-03-30 |
US20050070812A1 (en) | 2005-03-31 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20090105607A1 (en) | Automated audio calibration for conscious sedation | |
US7261106B2 (en) | Response testing for conscious sedation utilizing a cannula for support/response | |
US7198605B2 (en) | Response testing for conscious sedation utilizing a non-ear-canal-contacting speaker | |
AU2004296732B2 (en) | Sleep guidance system and related methods | |
US20120052469A1 (en) | Nasal flow device controller | |
US11590313B2 (en) | Smart relaxation mask | |
US20050070823A1 (en) | Response testing for conscious sedation involving hand grip dynamics | |
JP4494985B2 (en) | Heart rate and respiratory information collection device | |
KR101579364B1 (en) | Wireless Earhook Earset/Earphone concealing electrodes and acquisition system of electroencephalograph for brain monitoring and brain-computer interface | |
US20080177152A1 (en) | Response testing for conscious sedation utilizing a non-ear-canal-contacting speaker | |
US20050070824A1 (en) | Response testing for conscious sedation using finger movement response assembly | |
Costantini et al. | Towards the enhancement of body standing balance recovery by means of a wireless audio-biofeedback system | |
US20120232422A1 (en) | Response testing for conscious sedation utilizing a non-ear-canal-contacting speaker | |
US20050070814A1 (en) | Personalized audio requests for conscious sedation | |
JP2005169081A (en) | Response of time variant vibration stimulus for conscious sedation system | |
RU2565652C1 (en) | Method for analogue signal release for assessing functional state of listener using headphones | |
CN210204730U (en) | Multipurpose physiological detection system | |
US20170110019A1 (en) | Apparatus and Method for Brain Training | |
TWM566551U (en) | Multi-purpose physiological inspection device and system | |
JP7339083B2 (en) | Electroencephalogram measurement device | |
US20220301685A1 (en) | Ear-wearable device and system for monitoring of and/or providing therapy to individuals with hypoxic or anoxic neurological injury | |
US20230277116A1 (en) | Hypoxic or anoxic neurological injury detection with ear-wearable devices and system | |
EP4014881A1 (en) | Device for monitoring physiological data and system comprising such device | |
JPH0542806Y2 (en) | ||
RU147845U1 (en) | HEADPHONES FOR REMOVING ANALOGUE SIGNALS AND THE FOLLOWING DETERMINATION OF THE FUNCTIONAL STATE OF THE HEARING |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |