PATIENT SUPPORT APPARATUS HAVING VITAL SIGNS AND SEPSIS DISPLAY APPARATUS
20250176900 ยท 2025-06-05
Assignee
Inventors
- Stacey A. Fitzgibbons (DeWitt, NY, US)
- Jotpreet Chahal (Fayetteville, NY, US)
- Craig M. Meyerson (Syracuse, NY, US)
Cpc classification
A61B5/02055
HUMAN NECESSITIES
A61B5/7275
HUMAN NECESSITIES
A61B5/706
HUMAN NECESSITIES
G16H10/60
PHYSICS
International classification
A61B5/00
HUMAN NECESSITIES
G16H10/60
PHYSICS
G16H50/30
PHYSICS
Abstract
A patient support apparatus includes a sensor capable of detecting vital signs and includes structures for monitoring the vital signs and providing local and/or remote indications to caregivers if the vital signs fall outside of acceptable limits.
Claims
1.-10. (canceled)
11. A patient support apparatus comprising a frame configured to support a patient, a controller coupled to the frame, the controller being configured to receive an input signal that is used by the controller in determining whether the patient supported by the fame is septic, and a projector coupled to the frame and to the controller, the controller being configured to generate an output signal in response to the input signal, the output signal causing the projector to project an image onto a floor adjacent the frame to indicate that the patient is septic.
12. The patient support apparatus of claim 11, wherein the image comprises a timer showing an amount of time that has elapsed since the patient was determined to be septic.
13. The patient support apparatus of claim 12, wherein the image further comprises a color coded area adjacent the timer to indicate the septic status of the patient.
14. The patient support apparatus of claim 11, wherein the image comprises a countdown timer showing an amount of time left in a sepsis protocol that is implemented by caregivers after the patient is determined to be septic.
15. The patient support apparatus of claim 14, wherein the sepsis protocol is a three hour protocol or a six hour protocol.
16. The patient support apparatus of claim 14, wherein the image further comprises a color area adjacent the countdown timer to indicate the septic status of the patient.
17. The patient support apparatus of claim 11, further comprising a graphical user interface coupled to the frame, the image projected onto the floor comprising a first timer that shows a time relating to the patient's septic status, and the controller causing the graphical user interface to display a second timer which also shows the time.
18. The patient support apparatus of claim 17, wherein the first and second timers each comprise a countdown timer and wherein the time relating to the patient's septic status comprises an amount of time left in a sepsis protocol that is implemented by caregivers after the patient is determined to be septic.
19. The patient support apparatus of claim 17, wherein the controller further causes the graphical user interface to display protocol status information regarding procedures performed on the patient after the patient was determined to be septic.
20. The patient support apparatus of claim 19, wherein the protocol status information comprises one or more iconic representations pertaining to the procedures performed on the patient since after the patient was determined to be septic.
21. The patient support apparatus of claim 11, wherein the image projected onto the floor comprises a first timer that shows a time relating to the patient's septic status, and wherein the controller is configured to communicate with an external nurse call station to cause a second timer on the nurse call station to also show the time relating to the patient's septic status.
22. The patient support apparatus of claim 21, wherein the first and second timers each comprise a countdown timer and wherein the time relating to the patient's septic status comprises an amount of time left in a sepsis protocol that is implemented by caregivers after the patient is determined to be septic.
23. The patient support apparatus of claim 11, wherein the image projected onto the floor comprises a first timer that shows a time relating to the patient's septic status, and wherein the controller is configured to communicate with a mobile device transported by a caregiver to cause a second timer on the mobile device to also show the time relating to the patient's septic status.
24. The patient support apparatus of claim 23, wherein the first and second timers each comprise a countdown timer and wherein the time relating to the patient's septic status comprises an amount of time left in a sepsis protocol that is implemented by caregivers after the patient is determined to be septic.
25. The patient support apparatus of claim 11, wherein the input signal received by the controller is used by the controller to calculate a sepsis risk assessment score, and, if the sepsis risk assessment score is at or above a predetermined value, the controller generates the output signal.
26. The patient support apparatus of claim 25, further comprising a vital sign sensor carried by the frame and wherein the input signal comprises a vital sign of the patient that is detected by the vital sign sensor and that is used by the controller to calculate the sepsis risk assessment score.
27. The patient support apparatus of claim 26, wherein the vital sign sensor comprises one or more of the following: a heart rate sensor, a respiration rate sensor, a blood pressure sensor, and a temperature sensor.
28. The patient support apparatus of claim 26, wherein the input signal received by the controller further comprises patient data stored in an electronic medical record (EMR) of the patient and transmitted to the patient support apparatus from an EMR system, and wherein the sepsis risk assessment score is calculated by the controller based on the patient data received from the EMR system and the vital sign of the patient that is detected by the vital sign sensor.
29. The patient support apparatus of claim 11, wherein the input signal received by the controller comprises a sepsis risk assessment score that is transmitted to the patient support apparatus from a computer that is remote from the patient support apparatus.
30. The patient support apparatus of clam 29, wherein the risk assessment score comprises a quick sequential (sepsis-related) organ failure assessment (qSOFA) score and/or a systematic inflammatory response syndrome (SIRS) score.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0035] The detailed description particularly refers to the accompanying figures in which:
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[0044]
DETAILED DESCRIPTION
[0045] Referring to
[0046] The sepsis protocol includes a list of actions or procedures that should be administered to the patient within a three hour period and a six hour period beginning at the time the patient is diagnosed with sepsis or otherwise determined to be septic. For example, within the three hour protocols and timeframe, the following actions should be taken: 1) obtain blood cultures, 2) obtain a lactate measurement, 3) administer broad spectrum antibiotics, and 4) administer fluids crystalloid. Within a six hour protocol and timeframe, the following additional actions should be taken: 1) administration of vasopressors for non-responsive resuscitation, 2) maintaining adequate central venous pressure (CVP) and mixed venous oxygen content (CvO2) levels, and 3) obtaining a second lactate measurement if the first lactate measurement was high. Compliance with the sepsis protocols can increase the patient's chance of survival after being diagnosed with sepsis. The sepsis-status notification system 110 is configured to increase compliance with the protocols by notifying the caregiver and others near the patient if the patient is at-risk or diagnosed with sepsis, an amount of time that has passed, and a status of the actions that need to be completed for compliance with the protocols.
[0047] Sepsis may be detected using risk assessments that may vary between each healthcare facility. Some non-limiting examples of scores used to determine if a patient is at-risk for sepsis include a quick sequential (sepsis-related) organ failure assessment score (qSOFA) and/or systematic inflammatory response syndrome score (SIRS). Each method includes a set of criteria such as vital signs and/or other conditions that are defined by pre-established acceptable limits and are triggered when the patient deviates from those acceptable limits. Other examples of assessments or tests used to determine if a patient is at risk for sepsis are described in U.S. Provisional Patent Appl. No. 62/655,385, filed Apr. 10, 2018, which is expressly incorporated by reference herein. The sepsis-status notification system 110 may be programmed to operate with any assessment, test, or score criteria relating to sepsis including those that evolve as medical procedures advance.
[0048] When determining the patient's qSOFA or SIRS score, a point is assigned for each vital sign and/or other medical condition that deviates from the accepted pre-established limits. When either the qSOFA score or the SIRS score reach a predetermined value, the patient is flagged as being at-risk for sepsis. The qSOFA score is defined within a range of 0-3 points. To determine the qSOFA score, the patient is assigned one point for each deviation from the following accepted pre-established limits: 1) respiratory rate greater than or equal to 22 breaths per minute, 2) systolic blood pressure less than or equal to 100 mm Hg, and 3) a change in mental status (e.g. Glasgow Coma Scale less than 15). If a patient is assigned at least 2 points on the qSOFA score, the patient is at-risk for sepsis.
[0049] The SIRS score is defined within a range of 0-4. To determine the SIRS score, the patient is assigned one point for each deviation from the following accepted pre-established limits: 1) a body temperature greater than 100.4 degrees Fahrenheit or less than 96.8 degrees Fahrenheit, 2) a heart rate greater than 90 bpm 3) a respiratory rate greater than 20 breaths per minute, and 4) a white blood cell count greater than 12,000 cells/mm.sup.3, less than 4000 cells/mm.sup.3, or greater than 10% immature (band) forms. If a patient is assigned at least 2 points on the SIRS score, the patient is at-risk for sepsis.
[0050] In the illustrative embodiment, the hospital bed 10 further includes at least one sensor 102 mounted to a deck section of the hospital bed 10 and a control system 104 coupled to the sensor 102 as shown in
[0051] In the illustrative embodiment, the sensor 102 is a non-contact vital signs monitoring sensor available from EarlySense Inc., 135 Beaver Street Suite 307, Waltham, MA 02452. It provides a signal indicative of vital signs, such as, for example, a detected heart rate and a signal indicative of a detected respiration rate that is processed by the control system 104. This sensor 102 is described in greater detail in U.S. Patent Pub. No. 2018/0184984 which is expressly incorporated herein for the purpose of describing a suitable sensor used to detect patient vital signs. The sensor 102 may be mounted in multiple locations on either the fixed seat deck 32 or head deck 28 as suggested in
[0052] In other embodiments, additional sensors may be wearable by the patient and communicatively connected to the control system 104 to provide signals indicative of vital signs of the patient. Alternatively, the wearable device or sensor may be specifically designed to detect the presence of sepsis such that the scoring methods described above are omitted and/or used in conjunction with the wearable device.
[0053] As shown in
[0054] At step 120, the control system 104 may determine that additional tests should be performed to determine definitively if the patient is septic and send a command signal to cause the sepsis-status notification system 110 to indicate such information to a caregiver. Alternatively, the control system 104 may send a command signal as soon as the patient is determined to be at-risk for sepsis to cause the sepsis-status notification system 110 to indicate to a caregiver that the patient is septic and start monitoring the protocols.
[0055] Once the patient is determined to be at-risk or diagnosed with sepsis, the control system 104 sends a command signal to the sepsis-status notification system 110 to cause the sepsis-status notification system 110 to provide the indication to the caregiver at step 122. The indication notifies the caregiver that the patient is septic and notifies the caregiver of a status of the patient's protocols. The indication provided by the sepsis-status notification system 110 may include a visual indication or an audible indication. Additionally, the indication may be displayed on or around the hospital bed 10 or transmitted wirelessly to a remote location through the hospital network 108. At step 124, the sepsis monitoring unit 100 continues monitoring and updating the indications provided by the sepsis-status notification system 110 in real time until administration of the protocols is completed.
[0056] The view shown in
[0057] The hospital bed 10 includes a base frame 20 which supports a lift system 22. The lift system 22 engages the base and an upper frame 24 such that the lift system 22 moves the upper frame 24 vertically relative to the base frame 20. The lift system 22 includes a head end linkage 27 and a foot end linkage 29. Each of the linkages 27 and 29 are independently is configured and may be operated to cause the hospital bed 10 to move into a tilt position which is when the head end 14 of the upper frame 24 is positioned lower than the foot end 12 of the upper frame 24. The hospital bed 10 may also be moved to a reverse tilt position with the foot end 12 of the upper frame 24 is positioned lower than the head end 14 of the upper frame 24.
[0058] The upper frame 24 supports a load frame 26. The load frame 26 supports a head deck 28 which is movable relative to the load frame 26. The load frame 26 also supports an articulated seat deck 30 (seen in
[0059] The foot deck 34 includes a first portion 36 and a second portion 38, which moves relative to the first portion 36 to vary the size of the foot deck 34. The second portion 38 moves generally longitudinally relative to the first portion 36 to vary the longitudinal length of the foot deck 34 and, thereby, the longitudinal length of the hospital bed 10.
[0060] A foot panel 40 is supported from the second portion 38 and extends vertically from an upper surface 42 of the second portion 38 to form a barrier at the foot end 12 of the hospital bed 10. A head panel 44 is positioned on an upright structure 46 of the base frame 20 and extends vertically to form a barrier at the head end 14 of the hospital bed 10. A left head siderail 48 is supported from the head deck 28 and is moveable between a raised position shown in
[0061] The hospital bed 10 also includes a left foot siderail 58 and a right foot siderail 60, each of which is supported directly from the load frame 26. Each of the siderails 48, 50, 58, and 60 are is configured to be lowered to a position below the upper surface 52. It should be noted that when the head deck 28 is moved, the head siderails 48 and 50 move with the head deck 28 so that they maintain their relative position to the patient. This is because both of the head siderails 48 and 50 are supported by the head deck 28.
[0062] Referring to the left head siderail 48 shown in
[0063] As shown in
[0064] The sepsis-status notification system 110 displays indications that the patient is septic using a plurality of device as shown in
[0065] As shown in
[0066] In one example, when the SIRS, qSOFA, or other sepsis assessment score is below their predetermined values, the notification system 110 may cause the devices to display a green color to signal to the caregiver that the patient does not have sepsis. Once either of the SIRS, qSOFA, or another sepsis assessment score exceeds their predetermined value, the notification system 110 may cause the devices to display a red color to signal that the patient has been diagnosed with sepsis and action is needed. In some embodiments, the notification system 110 projects an image 83 and the colors on the floor around the hospital bed so that a caregiver may be able to see the data in real time at a distance. In other embodiments, the image 83 and/or the colors may be flashed in the appropriate respective color.
[0067] As shown in
[0068] The timer 87 is illustratively embodied as a countdown timer 87 that begins counting at the time the sepsis monitoring unit 100 first determines that the patient is septic. However, in another embodiment, the timer 87 may measure time elapsed after the sepsis monitoring unit 100 first determines that the patient is septic. The timer 87 may count down from three hours indicating that the patient is within the sepsis three hour protocol administration. After completion of the three hour protocol administration the control system 104 may update the timer 87 to track the sepsis six hour protocol administration. The control system 104 may issue additional indications during protocol administration to remind caregivers of actions that need to be completed within each protocol. In some embodiments, the additional indications are provided in response to the timer 87 reaching a predetermined time in the protocol. In other embodiments, the additional indications are provided in response to updates in the patient's treatment of sepsis, such as, for example, upon completion of one of the actions required during protocol administration.
[0069] As shown in
[0070] As shown in
[0071] The action list 84 may display the status of each of the actions in several different ways as shown in
[0072] As shown in
[0073] In operation, the notification system 110 is configurable to allow or prevent the indication capabilities of the devices 66, 68, 70, 72. A caregiver may choose to disable the devices in the notification system 110 when the caregiver determines that the operation of the devices 66, 68, 70, 72 is unnecessary or would be problematic with a particular patient. In an effort to avoid unnecessary alert conditions, detection and notification system 160 utilizes a process 360 shown in
[0074] In some cases, the notification system 110 may go into an alert state relative to the patient exiting the bed as disclosed in the PCT application WO2016/196403 which is expressly incorporated by reference for the teaching of a patient exit detection system. However, alerts related to vital signs would be invalid and, in embodiments where the process 360 is applied, will cause the alerts to be ignored. However, if the patient is determined to be in bed at step 364, the controller 166 proceeds to step 368 and informs the notification system 110 that vital signals are expected from the sensor 102. The process 360 then proceeds to step 370 and the notification system 110 operates normally.
[0075] In some embodiments, the controller 166 may determine from the load cells 330, 332, 334, and 336 that a patient is in a particular location on the bed 10. If more than one sensor 102 is present on the bed 10, then the controller 166 may use the information regarding the patient location to discount one or more of the sensor 102 signals to ensure that the best signal is being considered in the determination of the vital signs. In addition, the controller 166 may consider the angle of the head deck 28 in making the determination as to which of multiple sensors 102 should be used in the analysis. For example, if the head deck 28 is raised to an extreme angle, then a sensor 102 positioned in a back section may be discounted or disregarded.
[0076] Although certain illustrative embodiments have been described in detail above, variations and modifications exist within the scope and spirit of this disclosure as described and as defined in the following clauses and claims.