Thermal Imaging Device Performing Image Analysis To Facilitate Early Detection Of Distal Extremity Altered Perfusion States

Abstract

A thermal imaging extremity abnormal perfusion detector system includes a computer processor configured to receive, analyze and store thermal images and a thermal imaging camera communicatively coupled to the processor, and configured to take at least one of photograph and video thermal images and output the thermal images to the processor. The camera is configured to be secured adjacent a patient workspace that is shaped to contain a patient; and points the thermal imaging camera at the workspace such that, responsive to taking at least one thermal image, the at least one thermal image contains the patient who is placed within the workspace. The computer processor is configured to analyze the at least one thermal image and determine from the at least one thermal image a difference in thermal states indicating altered perfusion in an extremity of the patient.

Claims

1. A thermal imaging extremity altered perfusion detector system, comprising: a computer processor configured to receive and to at least temporarily store thermal images; and a thermal imaging camera communicatively coupled to the computer processor and configured to take at least one of photograph and video thermal images and output the thermal images to the computer processor, the thermal imaging camera: configured to be secured adjacent a patient workspace that is shaped to contain a patient; and pointing the thermal imaging camera at the patient workspace such that, responsive to taking at least one thermal image, the at least one thermal image contains at least a portion of the patient who is placed within the patient workspace; wherein the computer processor is configured to analyze the at least one thermal image and determine from the at least one thermal image a difference in thermal states indicating altered perfusion in at least one of the extremities of the patient.

2. The system according to claim 1, wherein the computer processor is one of a smart phone and a tablet.

3. The system according to claim 1, wherein the thermal imaging camera is a forward-looking infrared camera.

4. The system according to claim 2, wherein the thermal imaging camera is a forward-looking infrared camera and, together with the computer processor, form a transportable IR camera system configured to acquire and to at least temporarily store the at least one thermal image.

5. The system according to claim 4, wherein: the at least one thermal image comprises an image of at least a portion of the patient; and the transportable IR camera system is configured to analyze the at least one thermal image and thereby determine altered perfusion of at least one of the extremities of the patient.

6. The system according to claim 5, wherein the transportable IR camera system is configured to perform real-time instantaneous monitoring of the at least one of the extremities.

7. The system according to claim 5, wherein the at least one thermal image is a video.

8. The system according to claim 5, wherein the transportable IR camera system is configured to acquire the at least one thermal image at least one of manually, periodically, and continually.

9. The system according to claim 5, wherein the transportable IR camera system is configured to store the at least one thermal image at least one of locally and remotely.

10. The system according to claim 1, wherein the thermal imaging camera comprises a thermal imager configured to obtain thermal images in the form of at least one of stills and video.

11. The system according to claim 10, wherein the computer processor comprises software and is configured to analyze the at least one of stills and video and to determine an altered perfusion state of the patient with the software.

12. The system according to claim 11, wherein the computer processor is configured to analyze the at least one of stills and video in real-time.

13. The system according to claim 1, wherein the computer processor is a first computer processor, and which further comprises a second computer processor separate from the first computer processor and communicatively connected to the first computer processor through at least one communications link, the second computer processor being configured to analyze the at least one of stills and video, to determine an altered perfusion state of the patient, and to output the altered perfusion state.

14. The system according to claim 13, wherein the second computer processor communicates through the at least one communications link an indication of the altered perfusion state of the patient.

15. The system according to claim 12, wherein the at least one communications link comprises the internet cloud and the second computer processor comprises at least one of a mainframe, a server, a desktop, and a laptop.

16. The system according to claim 1, wherein the computer processor analyzes the difference in thermal states to indicate at least one of impeding sepsis, bilateral decreasing temperature, and unilateral decreasing temperature.

17. The system according to claim 14, wherein the indication of the altered perfusion state includes at least one of impeding sepsis, bilateral decreasing temperature, and unilateral decreasing temperature.

18. The system according to claim 1, further comprising an electronic medical record of the patient, the computer processor being configured to integrate the difference in thermal states into the electronic medical record in real time and to drive real time alarms for appropriate altered perfusion states.

19. The system according to claim 1, further comprising markers configured to be placed on the extremities of the patient as registering locations, the computer processor being configured to determine the difference in thermal states at least one of at and adjacent the markers.

20. The system according to claim 1, wherein the computer processor is configured: to determine data comprising at least one of a temperature of the patient's skin, a location of temperature on one or more extremities, a temperature of one extremity compared to another extremity, and trends of the detected temperatures; and to analyze the determined data and to determine if a trend the determined data is within a previously determined normal variation.

21. A thermal imaging extremity altered perfusion detector system, comprising: a smartphone configured to receive and to at least temporarily store thermal images; markers configured to be placed on the extremities of the patient as registering locations; and a thermal imaging camera communicatively coupled to the computer processor and configured to take at least one of photograph and video thermal images and output the thermal images to the smartphone, the thermal imaging camera: configured to be secured adjacent a patient workspace that is shaped to contain a patient; and pointing the thermal imaging camera at the patient workspace such that, responsive to taking at least one thermal image, the at least one thermal image contains at least a portion of the patient who is placed within the patient workspace; wherein the smartphone is configured: to analyze the at least one thermal image and determine from the at least one thermal image a difference in thermal states at least one of at and adjacent the markers indicating altered perfusion in at least one of the extremities of the patient in real-time; based upon the determined difference, to communicate an indication of the altered perfusion state of the patient indicating at least one of impeding sepsis, bilateral decreasing temperature, and unilateral decreasing temperature; and to integrate the altered perfusion state into an electronic medical record of the patient.

22. An imaging extremity altered perfusion detector system, comprising: a computer processor configured to receive and to at least temporarily store electronic images; and an imaging camera communicatively coupled to the computer processor and configured to take at least one of photograph and video images and output the images to the computer processor, the imaging camera: configured to be secured adjacent a patient workspace that is shaped to contain a patient; and pointing the imaging camera at the patient workspace such that, responsive to taking at least one image, the at least one image contains at least a portion of the patient who is placed within the patient workspace; wherein the computer processor is configured to analyze the at least one image and determine from the at least one image a difference in states indicating altered perfusion in at least one of the extremities of the patient.

23. The system according to claim 22, wherein the at least one of photograph and video images are at least one of radio, microwave, thermal, visible, ultraviolet, sonography, computed tomography, magnetic resonance imaging, x-ray, and gamma ray images.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0042] The accompanying figures, where like reference numerals refer to identical or functionally similar elements throughout the separate views, which are not true to scale, and which, together with the detailed description below, are incorporated in and form part of the specification, serve to illustrate further various embodiments and to explain various principles and advantages all in accordance with the systems, apparatuses, and methods. Advantages of embodiments of the systems, apparatuses, and methods will be apparent from the following detailed description of the exemplary embodiments thereof, which description should be considered in conjunction with the accompanying drawings in which:

[0043] FIG. 1 is a perspective view color photograph from a prior art thermal imaging camera of a patient who has reduced skin perfusion in a left hand;

[0044] FIG. 2 is a perspective view photograph of a prior art forward-looking infrared camera for a smartphone;

[0045] FIG. 3 is a perspective view photograph of the infrared camera of FIG. 2 attached to an exemplary embodiment of a smartphone;

[0046] FIG. 4 is a perspective view of an exemplary embodiment of the systems, processes, and methods described herein with the smartphone and the infrared camera of FIG. 3 mounted to an enclosure of a patient bed for an infant patient, the camera being pointed at the infant patient and the bed being in any of a hospital, at home, or another location:

[0047] FIG. 5 is a perspective view color photograph from the exemplary systems, processes, and methods of FIG. 4 with the infrared camera examining the infant patient who does not have reduced skin perfusion in either hand or foot extremities;

[0048] FIG. 6 is a perspective view color photograph from the exemplary systems, processes, and methods of FIG. 4 with the infrared camera of FIG. 3 of an infant patient who has reduced skin perfusion in a right foot;

[0049] FIG. 7 is a flow diagram of an exemplary embodiment of a process utilizing the transportable IR camera system; and

[0050] FIG. 8 is an exemplary embodiment of a data communication diagram utilizing the transportable IR camera system.

DETAILED DESCRIPTION OF THE EMBODIMENTS

[0051] As required, detailed embodiments of the systems, apparatuses, and methods are disclosed herein; however, it is to be understood that the disclosed embodiments are merely exemplary of the systems, apparatuses, and methods, which can be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the systems, apparatuses, and methods in virtually any appropriately detailed structure. Further, the terms and phrases used herein are not intended to be limiting; but rather, to provide an understandable description of the systems, apparatuses, and methods. While the specification concludes with claims defining the features of the systems, apparatuses, and methods that are regarded as novel, it is believed that the systems, apparatuses, and methods will be better understood from a consideration of the following description in conjunction with the drawing figures, in which like reference numerals are carried forward.

[0052] In the following detailed description, reference is made to the accompanying drawings which form a part hereof, and in which are shown by way of illustration embodiments that may be practiced. It is to be understood that other embodiments may be utilized and structural or logical changes may be made without departing from the scope. Therefore, the following detailed description is not to be taken in a limiting sense, and the scope of embodiments is defined by the appended claims and their equivalents.

[0053] Alternate embodiments may be devised without departing from the spirit or the scope of the invention. Additionally, well-known elements of exemplary embodiments of the systems, apparatuses, and methods will not be described in detail or will be omitted so as not to obscure the relevant details of the systems, apparatuses, and methods.

[0054] Before the systems, apparatuses, and methods are disclosed and described, it is to be understood that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. The terms “comprises,” “comprising,” or any other variation thereof are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. An element proceeded by “comprises . . . a” does not, without more constraints, preclude the existence of additional identical elements in the process, method, article, or apparatus that comprises the element. The terms “including” and/or “having,” as used herein, are defined as comprising (i.e., open language). The terms “a” or “an”, as used herein, are defined as one or more than one. The term “plurality,” as used herein, is defined as two or more than two. The term “another,” as used herein, is defined as at least a second or more. The description may use the terms “embodiment” or “embodiments,” which may each refer to one or more of the same or different embodiments.

[0055] The terms “coupled” and “connected,” along with their derivatives, may be used. It should be understood that these terms are not intended as synonyms for each other. Rather, in particular embodiments, “connected” may be used to indicate that two or more elements are in direct physical or electrical contact with each other. “Coupled” may mean that two or more elements are in direct physical or electrical contact (e.g., directly coupled). However, “coupled” may also mean that two or more elements are not in direct contact with each other, but yet still cooperate or interact with each other (e.g., indirectly coupled).

[0056] For the purposes of the description, a phrase in the form “A/B” or in the form “A and/or B” or in the form “at least one of A and B” means (A), (B), or (A and B), where A and B are variables indicating a particular object or attribute. When used, this phrase is intended to and is hereby defined as a choice of A or B or both A and B, which is similar to the phrase “and/or”. Where more than two variables are present in such a phrase, this phrase is hereby defined as including only one of the variables, any one of the variables, any combination of any of the variables, and all of the variables, for example, a phrase in the form “at least one of A, B, and C” means (A), (B), (C), (A and B), (A and C), (B and C), or (A, B and C).

[0057] Relational terms such as first and second, top and bottom, and the like may be used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. The description may use perspective-based descriptions such as up/down, back/front, top/bottom, and proximal/distal. Such descriptions are merely used to facilitate the discussion and are not intended to restrict the application of disclosed embodiments. Various operations may be described as multiple discrete operations in turn, in a manner that may be helpful in understanding embodiments; however, the order of description should not be construed to imply that these operations are order dependent.

[0058] As used herein, the term “about” or “approximately” applies to all numeric values, whether or not explicitly indicated. These terms generally refer to a range of numbers that one of skill in the art would consider equivalent to the recited values (i.e., having the same function or result). In many instances these terms may include numbers that are rounded to the nearest significant figure. As used herein, the terms “substantial” and “substantially” means that, when comparing various parts to one another, the parts being compared are equal to or are so close enough in dimension that one skill in the art would consider the same. Substantial and substantially, as used herein, are not limited to a single dimension and specifically include a range of values for those parts being compared. The range of values, both above and below (e.g., “+/−” or greater/lesser or larger/smaller), includes a variance that one skilled in the art would know to be a reasonable tolerance for the parts mentioned.

[0059] It will be appreciated that embodiments of the systems, apparatuses, and methods described herein may be comprised of one or more conventional processors and unique stored program instructions that control the one or more processors to implement, in conjunction with certain non-processor circuits and other elements, some, most, or all of the functions of the systems, apparatuses, and methods described herein. The non-processor circuits may include, but are not limited to, signal drivers, clock circuits, power source circuits, and user input and output elements. Alternatively, some or all functions could be implemented by a state machine that has no stored program instructions, or in one or more application specific integrated circuits (ASICs) or field-programmable gate arrays (FPGA), in which each function or some combinations of certain of the functions are implemented as custom logic. Of course, a combination of these approaches could also be used. Thus, methods and means for these functions have been described herein.

[0060] The terms “program,” “software,” “software application,” and the like as used herein, are defined as a sequence of instructions designed for execution on a computer system or programmable device. A “program,” “software,” “application,” “computer program,” or “software application” may include a subroutine, a function, a procedure, an object method, an object implementation, an executable application, an applet, a servlet, a source code, an object code, any computer language logic, a shared library/dynamic load library and/or other sequence of instructions designed for execution on a computer system.

[0061] Herein various embodiments of the systems, apparatuses, and methods are described. In many of the different embodiments, features are similar. Therefore, to avoid redundancy, repetitive description of these similar features may not be made in some circumstances. It shall be understood, however, that description of a first-appearing feature applies to the later described similar feature and each respective description, therefore, is to be incorporated therein without such repetition.

[0062] FIG. 2 illustrates an exemplary embodiment of the systems, processes, and methods utilizing the infrared spectrum of a prior art forward-looking infrared camera 10 made by FLIR® and sold under the name “Flir ONE PRO-iOS Pro-Grade Thermal Camera for Smartphones”. The hardware and software taking the thermal images is referred to herein collectively as a thermal imager or a thermal imager of the camera 10. This is only one exemplary embodiment of a camera 10 as various other imaging devices can perform the same or similar data acquisition to determine normal/abnormal perfusion. FIG. 3 illustrates an exemplary embodiment of a transportable camera system 20 with the camera 10 communicatively connected to a computer processor 22, here in the form of a smartphone and, together in an exemplary embodiment, forming a transportable infrared (IR) camera system. This is only one exemplary embodiment of the transportable camera system 20 as various other portable and transportable processing devices can perform the same or similar data acquisition, thermal or otherwise. For example, a portable processing device can include a tablet (e.g., an iPad) and a transportable processing device can include a mobile computer, the latter being attached, for example, to an arm that can be secured to a patient's bed or on a cart and able to be rolled up to a patient as desired.

[0063] Described now are exemplary embodiments. Referring now to the figures of the drawings in detail and first, particularly to FIG. 4, there is shown an exemplary embodiment of a transportable camera system 20 that is based on thermal imaging. Before the advent of smartphones and to the miniaturization of forward-looking infrared cameras, components that could take IR images of a person included large and expensive desktop computers and equally large and expensive IR cameras. If the user wanted to detect and analyze those images, large computer systems were required. These systems were too bulky and expensive to be mounted at each patient's bed. Now, with smartphones being ubiquitous and with IR cameras 10 being so compact and inexpensive (and other cameras in a different electromagnetic spectrum), it becomes possible to mount a complete, transportable camera system 20 at each patient's bedside. Further, advances in digital signal processing, as it applies to the electronic images that are output by such cameras 10, allow the transportable camera system 20 to perform real-time instantaneous monitoring and assessment of a patient in a manner that was not heretofore possible. In use, the transportable camera system 20 in the infrared embodiment takes thermal images (including both stills and video), either manually, periodically, or continually, and with an app or another form of software, stores the thermal images locally and/or remotely. Where the software is resident on the transportable camera system 20, it can be an app, a program, or firmware, or a combination of any of these; where the software is resident on a server or another separate computer accessible through a communications link, for example, through the internet cloud, it can be an app, a program, or firmware, or a combination of any of these.

[0064] In an exemplary process for carrying out a monitoring and analysis method in a neonatal intensive care unit (NICU) 40, a patient 30 is admitted and is placed in a NICU bed 42, which can be referred to as a patient workspace. To detect abnormal perfusion of the patient's legs (for example with a thermal imaging camera), one or more of the transportable IR camera systems 20 are placed at a foot of the bed 42 to observe both legs of the patient 30. In an exemplary embodiment, easy-to-detect IR markers 50 are placed on one or more extremities as indicators of the anatomy upon which the transportable camera system 20 will focus. Exemplary registering locations for these markers 50 include knee markers 52, one or more toe markers 54 on opposite feet, one or more sole markers 56 on the soles of the patient's feet 32, and/or one or more hand markers 58, examples of each are shown in FIG. 5. Software in the transportable camera system 20 is programmed to make a number of determinations based on at least one image received (photo and/or video). The determinations can be periodic, at a user's command, or in real time, for example. Various exemplary determinations by the software include, but are not limited to: [0065] defining bilateral temperature of the patient's skin (e.g., difference in temperature of the patient's hands and/or fingers and/or feet and/or toes); and/or [0066] defining the location of temperature on one or more extremities and/or locations on those extremities; and/or [0067] defining the temperature of one extremity compared to the other extremity; and/or [0068] defining trends of these detected temperatures.
The thermal image of FIG. 6, for example, shows the two feet 32 of an infant patient having vastly different temperature readings. With such measurements, analysis in terms of comparing data extracted from the image (or these images) becomes possible. For example, software (which can include artificial intelligence or expert systems) analyzes the detected/measured data and determines if the instantaneous reading and/or trend is/are within a previously determined normal variation (compared to a predefined temperature or a core temperature in the EMR) or is indicating an alarming sign of bilateral or unilateral extremity altered perfusion. In the example of FIG. 6, the temperature comparison of the soles of the two feet 32 will indicate instantaneous decreased temperature as compared to the other foot 32 and unilateral decreasing temperature over time, which indicates a serious condition of arterial or venous occlusion, e.g., from an embolus or vascular trauma. In an exemplary embodiment, all data is recorded in the EMR and alarms are triggered as programmed by the system, the user, and/or the facility.

[0069] An exemplary process for carrying out real-time, instantaneous monitoring and assessment of a patient 30 admitted to the ICU, for example, is described with regard to FIG. 7. In Step 100, one or more transportable camera systems 20 are placed adjacent a patient's bed (e.g., at a foot of the bed to observe both feet and/or legs of the patient 30). In the exemplary embodiment, the camera systems 20 are thermal imaging cameras. If desired, in Step 200, markers 50 are placed on the patient as indicators of anatomy (e.g., knees 52, shins 52/54/56, toes 54, soles 56); these are the registering locations. The camera(s) 10 and the associated processing device(s) 22 of the transportable camera system(s) 20 are programmed to determine the bilateral temperature of the patient's skin (e.g., at the registering location(s) and/or adjacent the marker location(s)) and temperature is taken from the images in Step 300. This allows the transportable camera system 20 to determine the location of temperature on one or more extremities and, therefore, to determine the temperature of one extremity and compare it to the temperature of the other extremity (or to a predefined temperature value) and, in storing this data (permanently or temporarily), to also determine trends of the detected temperature(s), which occurs in Step 400. Software and/or firmware (which can include AI or expert systems) analyses the detected/measured and digitally processed data and determines if the trend is within previously determined variations (e.g., within a defined “normal” state and/or rate of change). Any detection outside the expected or predefined variations, therefore, indicate various altered pathological perfusion conditions, which indication is performed in Step 500. Particular data and/or data trends may indicate (through pre-defined stored conditional data) one or more particular pathological states. Such trends might, for example, include abrupt decrease in perfusion in one extremity or more, which indicates the possibility of acute arterial occlusion. Another trend may indicate decreasing perfusion bilaterally over time, which indicates decreasing cardiac output. Alternatively or additionally, a determined trend may indicate bilateral increase in perfusion, which indicates loss of vascular integrity and impending sepsis. With this data and/or trend(s), in step 600, the software determines what kind of medically different causes of temperature variation is occurring presently, for example: [0070] increase in temperature bilaterally (impeding sepsis); or [0071] bilateral decreasing temperature (decreasing cardiac output); or [0072] unilateral decreasing temperature (arterial of venous occlusion, from an embolus or vascular trauma).
One exemplary process includes the software comparing calculated or determined data to the patient's core temperature, which the medical staff 80 had stored or periodically stored/stores in the EMR. In another exemplary embodiment, the software determines if a trend is an alarming sign of bilateral or unilateral extremity altered perfusion. If any triggering event occurs, in Step 700, the transportable camera system 20 alerts medical staff 80 in real-time. In an exemplary embodiment, all thermal data is recorded in the EMR and alarms are triggered as programmed or desired. The process continues in real-time as long as the medical staff 80 desire.

[0073] FIG. 8 illustrates the movement of information or data collected by the transportable camera system 20 in the embodiment using electromagnetic imaging techniques within any part(s) of the spectrum. The patient 30 is in the patient workspace 44 and the transportable camera system 20 is located to point the camera 10 at the patient workspace 44 so that the patient 30 remains within the viewable area 12 of the camera 10. The camera 10 periodically and/or continually takes photos and/or video and communicates this image/these images to the processor 22 of the transportable camera system 20. Either the transportable camera system 20 (using the processor 22 onboard) and/or software in the cloud 70 (using a second processor off-board and associated with the transportable camera system 20) analyzes the data and determines and/or calculates corresponding extremity temperature(s) and/or trend(s) (e.g., for each photo or frame of a video). An exemplary association of the transportable camera system 20 to the second separate processor is through a communications link 72, which can include communication through the internet cloud 70. In such an exemplary embodiment, the transportable camera system 20 communicates (wirelessly or wired) to the EMR 60 either in a direct link 62 (e.g., Bluetooth®) or through the internet cloud 70. Then, either the system 20 (using the processor 22) or software in the cloud 70 associated with the system 20 determines the status of that data as being normal (previously determined normal variation) or as requiring attention or alarm. The EMR 60 communicates with medical staff 80 so that appropriate action can be taken as desired. In FIG. 8, the EMR 60 is shown as separate from the transportable camera system 20. In an exemplary embodiment, the EMR 60 is integrated within the transportable camera system 20.

[0074] It is noted that various individual features of the inventive processes and systems may be described only in one exemplary embodiment herein. The particular choice for description herein with regard to a single exemplary embodiment is not to be taken as a limitation that the particular feature is only applicable to the embodiment in which it is described. All features described herein are equally applicable to, additive, or interchangeable with any or all of the other exemplary embodiments described herein and in any combination or grouping or arrangement. In particular, use of a single reference numeral herein to illustrate, define, or describe a particular feature does not mean that the feature cannot be associated or equated to another feature in another drawing figure or description. Further, where two or more reference numerals are used in the figures or in the drawings, this should not be construed as being limited to only those embodiments or features, they are equally applicable to similar features or not a reference numeral is used or another reference numeral is omitted.

[0075] The foregoing description and accompanying drawings illustrate the principles, exemplary embodiments, and modes of operation of the systems, apparatuses, and methods. However, the systems, apparatuses, and methods should not be construed as being limited to the particular embodiments discussed above. Additional variations of the embodiments discussed above will be appreciated by those skilled in the art and the above-described embodiments should be regarded as illustrative rather than restrictive. Accordingly, it should be appreciated that variations to those embodiments can be made by those skilled in the art without departing from the scope of the systems, apparatuses, and methods as defined by the following claims.