How to Make a “Medical Monitor with an Emotional Stress And/Or Pain Indicator”

How to Make a “Medical Monitor with an Emotional Stress And/Or Pain Indicator”

How to Upgrade a Medical Monitor to Include the New Vital Signs of Emotional Stress And/Or Pain

Recently, an article was published titled "Medical Monitor with an Emotional Stress and/or Pain Indicator - an Idea Ahead of Its Time". This article introduced the concept of a Patient's Bedside Medical Monitor that has an "Emotional Stress/Pain Indicator". This indicator could change color depending on the emotional state or pain level of the patient.

There does not seem to be such a device invented yet. Will you be the first to invent this device?

NEW - Please see First Working Model using Skin Conductance.  See How to Make this Model here.  Other models coming soon using Heart Rate Variability.  

 

The following public information might help in the design of such a device. Internet links to this information are at the end of this article.

• First, Texas Instruments has general "Patient Monitoring Design" information. Particularly note how modern monitors have RS-232, USB, or other types of communication ports. In addition, many monitors have wireless capabilities. This communication ability could provide the opportunity to make an aftermarket add-on Stress/Pain Indicator using the existing Medical Monitor without modification.
• The "Dash 3000/4000/5000™ Patient Monitor Service Manual - Software Version 6.5 or later" shows a typical monitor with software to process the information derived from the various sensors on the patient. To add a Stress/Pain Indicator to an existing Patient Monitor, one would probably have to change the software and add an indicator, but maybe you know better.
• The "Universal Medical Monitor System (UMM)" might give engineers some ideas on how to interface to existing monitors.
• The "Medical Monitor Interface" discussion on the Internet Discussion Group might give engineers and experimenters tips and networking opportunities.
• The NASA "Space-Proven Medical Monitor: The Total Patient-Care Package" might give design ideas. Since this was a government project, the hardware/software design details are probably in the public domain.
• The article "Changes in a surgical stress index in response to standardized pain stimuli during propofol-remifentanil infusion" shows how one kind of Surgical Stress Index Software was used to monitor a patient's stress level. Perhaps this software information could help software engineers develop code to display Stress/Pain on a Medical Monitor.
• The European Patent EP1057151B1 shows one version of a "Microprocessor based bed patient monitor". Microprocessors are reprogrammable and typically process the information from patient sensors and display this information in a usable format.
• World Patent Application WO2009063463 shows one version of "Pain Monitoring Using Multidimensional Analysis Of Physiological Signals". Physiological Signals are essentially Vital Signs, as displayed on most Medical Monitors. Vital signs could be used to detect and display emotional stress and/or pain in patients connected to Medical Monitors.
• European Patent EP1704817B1 shows a "Device for the determination of clinical stress of a subject in pulse oximetry". Pulse Oximetry and Heart Rate are typically measured together these days as vital signs. Clinical Stress is a technical term and is related to Surgical Stress. Pain is a type of emotional stress. Emotional stress can also be caused by a medical treatment, procedure, or even poor "bedside manner". Emotional stress or pain activates the sympathetic nervous system, which affects the vital signs.
• World Patent Application WO2009116872 shows "Apparatus for monitoring the autonomous nervous system of a sedated patient". The Autonomic Nervous System is another name for the Sympathetic Nervous System. The autonomic nervous system responds to pain and/or emotional stress.
• U.S. Patent 6,571,124 shows "Apparatus and method for monitoring skin conductance and method for controlling a warning signal". Skin conductance is usually not measured by medical monitors today. Perhaps future monitors will have this capability. Skin conductance is used to monitor the emotional state of a person. This same principle is used in polygraphs and biofeedback monitors. Essentially, when someone gets nervous or stressed, they perspire, especially in the palms of the hands. This perspiration is caused because the sympathetic nervous system has been activated. Some event has occurred wherein the person is mentally deciding whether to "fight or flight". This patent essentially shows one way to make a pain detector and indicating device.
• U.S. Patent Application 20080076094 shows a "System And Method For Facilitating Adjustment Of An Oral Appliance". Typically, heart rate, oxygen saturation, and skin conductance are used to detect pain, as well as emotional stress. This document shows one way how to minimize the emotional stress and/or pain of a patient during a medical procedure.
• Finally, the article "Medical Monitor with an Emotional Stress and/or Pain Indicator" mentions how an open-source microcontroller, such as Arduino, could be used to implement this device. Open-source hardware, software, and support community are readily available to any engineer or experimenter worldwide to implement such a device.
• Of course, wireless technology could provide portable sensing and indication, either locally on the patient or remotely at a nurse's station. Perhaps, it could look something like a bracelet measuring physiological signs and the emotions behind these vital signs. With this device, medical personnel could know when someone is in distress, whether the patient says so or not.

For more information:

• Patient Monitoring Design - "Integrated multi-parameter portable patient monitoring with OMAP from Texas Instruments".
• Dash 3000/4000/5000™ Patient Monitor Service Manual - Software Version 6.5 or later
• Universal Medical Monitor System (UMM)
• "Medical Monitor Interface" on sci.med.informatics - Internet Discussion Group
• Space-Proven Medical Monitor: The Total Patient-Care Package
• Changes in a surgical stress index in response to standardized pain stimuli during propofol-remifentanil infusion - See "Methods" for Surgical Stress Index Software
• Microprocessor based bed patient monitor - European Patent EP1057151B1
• Pain Monitoring Using Multidimensional Analysis Of Physiological Signals - WO2009063463
• Device for the determination of clinical stress of a subject in pulse oximetry - European Patent EP1704817B1
• Apparatus for monitoring the autonomous nervous system of a sedated patient - WO2009116872
• Apparatus and method for monitoring skin conductance and method for controlling a warning signal - U.S. Patent 6,571,124
• System And Method For Facilitating Adjustment Of An Oral Appliance - U.S. Patent Application 20080076094
• Medical Monitor with an Emotional Stress And/or Pain Indicator - an Idea Ahead of Its Time

From all this information, it might be viewed as obvious that one skilled in the art of engineering could make a "Medical Monitor with an Emotional Stress and/or Pain Indicator".

 

Takeaways:

• Emotional Stress and Pain are the new Vital Signs being considered by many modern healthcare professionals.
• Medical or Patient Monitors could detect and provide an indication of Emotional Stress and/or Pain.
• This detection and indication could be part of the monitor itself or housed within an after-market add-on unit dependent on the monitor for information.
• With such a device, the patient could have an indication of his or her own stress and/or pain level. The patient could then learn how to reduce their stress and/or pain using biofeedback techniques.

Disclaimer - Article is for information only and is not medical advice. Seek professionals as needed. The public information sources are provided to stimulate innovation only.