Real Time Monitoring Of Human Heartbeat

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02 Nov 2017

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Abstract—A remote compact sensor system for the detection of human vital signs (heartbeat and respiration rate) is presented. It consists of four sensors which are used to monitor the health of the patient and the surrounding environment. HSM20, LM35 LM358 and MAR953-00 are the sensors which are used to detect the patient and his surrounding conditions. GPS and GSM system are used to know the condition of the patient and to track down the position of the patient. With this system in case of emergency the doctor can monitor the patient health condition from different location.

Introduction

RECENTLY, the health-care sensor for the remote monitoring of the human heartbeat and respiration rate receives an attraction [1]. This remote sensor can be equipped in the home for long-period monitoring of the patient and in the bed for managing comfortable sleeping. If the sensor is applied to the mobile application, the sensor needs to portable and compact, maintaining the accuracy of the detection.

For every 1 degree Centigrade rise in temperature the Sensor (LM35) gives a output of 10mv

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For every 1%RH the sensor (HSM20G) gives a output of 35mv.

The respiration sensor (MAR953-00) detects breathing by monitoring the expansion and contraction during inhalation and exhalation. The resulting signal looks like a wave that moves up and down with each breath. The software uses the wave pattern to calculate the respiration period (duration), rate and amplitude.

Patient Monitor System Architecture

Methods

Overview of the System

The aim of this study is to design and implement a mobile system for monitoring vital signs, and to facilitate the continuous monitoring of patients during transport. Fig. 1 shows the architecture of the proposed system. The telemedicine system consists mainly of two parts—1) the mobile unit, which is set up around the patient to acquire the patient’s physiological data, 2) the management unit, which enables the medical staffs to telemonitor the patient’s condition in real-time. The management unit is from either a fixed computer within an existing hospital network or a mobile laptop via WLAN. The major design requirements of the mobile unit are as follows: 1) it should be portable and lightweight, which means easy to carry; 2) it should have power autonomy of more than 60 min to support patient transport; 3) it should have a user friendly interface; 4) it should collect and display critical biosignals, including three-lead ECG, HR, and SpO ; 5) it should record patient information and data; and 6) it should support wireless communication. On the other hand, the design requirements of the management unit are as follows: 1) it must have an easy-to-use interface; 2) it must display critical biosignals and analysis of data; 3) it must record, retrieve, and manage

patient information and data (local database); and 4) it must be connectable to the Internet to transmit data and distribute information. Furthermore, at the consultation terminals such as wireless PDAs or laptops, the medical staffs can use them either to monitor the physiological parameters and waveforms of a remote patient online or to access his or her case history through the wireless connection to the management unit.

Wireless connection in the studied hospital has been established by WLAN technology (IEEE 802.11b) [6] with speeds up to 11 Mb/s. An access point acts as a wireless bridge for the network data to be transmitted to and received from the existing wired hospital network. With multiple access points linked to a wired network, it allows efficient sharing of network resources throughout an entire building. The distance set between each access point was less than 30mbecause of the radius of indoor coverage for typical WLAN and regional geography limitation. Devices with WLAN interface can roam among the access points.

The transmission of data between a mobile unit and a management unit is implemented by the client server architecture. In the proposed design, the mobile unit serves as the client end and the management unit serves as the server end. Communication depends on the transmission control/Internet protocol

Mobile Unit

The The mobile unit in this study is comprised of a designed vital-sign signals acquisition module and a Pocket PC (HP iPAQ H5450). Multiple vital-sign parameters, which include the three-lead ECG, SpO , and HR, can be measured by this unit. Fig. 2 shows the design architecture of this mobile unit. This signals acquisition module acquires the three-lead ECG and dual-wavelength photoplethysmographic (PPG) signals, and converts them into digital data. Through an RS232 connection, the Pocket PC receives the physiological data and computes the SpO and HR parameters. According to user commands, the mobile unit can display waveforms in real-time, store data locally, and trigger an alarm. With regard to remote monitoring, the Pocket PC transfers these physiological data to a remote management unit in real-time by its built-in WLAN device.

Design Architecture in Mobile Unit

Module for Acquiring Vital-Sign Signals: Fig. 3 shows the diagram of the designed vital-sign signals acquisition module. The vital-sign signals acquisition module consists of ECG signal conditioning circuits, pulse oximeter analog circuits, and a microcontroller. This module is powered by four rechargeable AA batteries and is packaged as a jacket of the Pocket PC. The core control unit of the module is an 8-bit microcontroller, PIC16F877, which has an on-chip eight-channel 10-bit analog-to-digital converter (ADC). The three-lead ECG signals were amplified with a gain of 700, filtered (0.5–50 Hz), and then fed into the inputs of the ADC in the microcontroller. The pulse oximeter analog circuits were designed based on the principles of spectrophotometry and optical plethysmography to measure SpO [7], and a Nellcor oxygen sensor (DS-100A, finger probe) was used to measure the PPG signals. The signals determined by two light-emitting diodes (infrared and red) are first demultiplexed, then separately amplified, and finally separated into dc and ac components (IRAC, IRDC, RAC, and RDC), which are used to calculate pulse rate and the oxygen saturation in the blood. The microcontroller digitizes the signals with a sampling frequency of 200 Hz and transmits the ECG and PPG data to the Pocket PC through the serial port. The baud rate is 115.2 kb/s. Optical coupling is used in the serial communication to separate the power supply of the signal acquisition module from that of Pocket PC, reducing power interference.

2) Program on the Pocket PC: A system program, developed by Microsoft embedded visual C++, was installed on the Pocket PC to monitor the vital signs. This program records users’ information and displays the HR, SpO , ECG, and PPG waveforms sent from the signal acquisition module. Raw data can be stored into the built-in memory of the Pocket PC and transmitted to a remote management unit via the WLAN. In

Architecture of the Management Unit

long-term store-and-forward mode, the raw data are stored into the extended secure digital (SD) memory (256 MB) of the Pocket PC. The waveforms are plotted in window with an area of 200 150 pixels. The amplitude resolution is 0.04 mV/pixel for the three-lead display and 0.0125 mV/pixel for the single-lead display. When the frame displays 4 s of ECG data, the temporal resolution is 0.02 s/pixel. Besides, the sound reflecting each heart beat can be pronounced by the speaker of Pocket PC. In addition, this program is installed in the medical staffs’ PDAs for receiving and displaying the physiological parameters and waveforms of a remote patient under monitoring through the wireless connection to the management unit.

Management Unit

Fig. 5 shows the architecture of the management unit. The management unit consists mainly of a fixed personal computer or a laptop, and the management program. The management unit can be set in many spots depending on different applications of telemonitoring. It is normally located in the nurse’s station, and provides a user-friendly interface for telemonitoring a patient’s vital-sign signals. The management terminal can receive patients’ physiological data from the remote mobile units via the WLAN or the Internet. The management program is implemented on a Windows 2000 platform and developed by the Borland C++ builder. The program receives the data from the mobile unit, displays HR, SpO , three-lead ECG, and PPG waveforms on the terminal screen, and stores the data in the local database. In this work, a MySQL database system is set up to manage the raw data of ECGs and PPGs, patients’ information, and the doctors’ diagnosis. The database can also be accessed from authorized terminals through the hospital network and the Internet. Moreover, the vital-sign signal can be delivered in real-time to a mobile platform for sharing data. The waveforms are plotted in a 600 448 pixels window, which shows 6 s of ECG data. The default resolutions of amplitude and time are approximately 0.015 mV/pixel and 0.01 s/pixel, respectively. The program also supports the selection of leads, the replay of waveforms, analysis of raw data, and the scaling of amplitude and time. Both mobile unit and management unit have an alarm setting window which enables the medical staff to set up the alarm threshold of SpO and HR individually according to the physiological status of the patient. When the recorded vital signs are beyond the preset limits, the mobile unit would trigger an alarm automatically and a warning message window will pop-up on the screen.

Architecture of the Management Unit

Evaluation of System

The system was evaluated in the following phases.

1) Technical Verification: First, the developed pulse oximeter was calibrated by an index pulse oximeter simulator (Bio-Tek product; SpO range: 35%–100%; HR range: 30–250 bpm), whereas the accuracy of the ECG monitor was verified by the medSim 300 Patient Simulator (Dynatech Nevada, Inc.). Then, the functions of the PDA-based pulse oximeter and the ECG monitor, as well as the transmission of data between the mobile unit and the central management unit were tested. Twenty healthy volunteers, including eleven males (with an average age of 29.7 11 years old) and nine females (with an average age of 29.6 10 years old), were involved in the test. Three-lead ECG signals and PPG signals were acquired simultaneously. All results were recorded locally and were transmitted to the remote central management unit for 5 min to confirm the quality of the signals and the error rate of data transmission between the two units. Two different probes, one of the designed pulse oximeter and the other of the commercial pulse oximeter BCI-3304 (product of BCI, Inc.) were connected to different fingers of the same volunteer and then operated simultaneously to compare SpO and HR readings over 5 min. During the first minute, the volunteers breathed normally. They were then required to hold their breath for one minute, and then breathe normally until the end of the test.

2) Clinical Test and User Survey: The complete system was demonstrated at National Taiwan University Hospital (NTUH). In the test scenario, each patient was transported from the intensive care unit (ICU) to a radiographic examination room. The mobile unit was placed beside the patient, which enables the medical personnel to observe the patient’s physiological condition and check the connection of the electrodes. The mobile unit transmits the patient’s vital-sign signals to the management unit via the WLAN, allowing medical staffs to monitor online the patient’s data during transport. During the radiographic examination, the mobile unit was placed next to the patient, and a laptop was set up at the control station to monitor the real-time data from the mobile unit.

According to the test scenario, a survey was conducted to elicit the operators’ opinions on the wireless PDA-based physiological monitoring system in three areas—1) mobility (size and weight), 2) usability, and 3) performance of the overall system on intrahospital transport. A questionnaire with a five-point Likert scale (from 5 = completely satisfied to 1 = completely unsatisfied) was used to rate the performance of the overall system on intrahospital transport. Also, the mobility and usability of the wireless PDA-based monitoring system were compared with the currently used monitoring device (Agilent M3046A) in intrahospital transport at NTUH. The satisfaction of mobility was evaluated in relation to two statements of weight and size and that of usability was estimated by easy operation and easy monitoring. The outcomes of these four statements were represented as a ten-point scale (from 1 = completely unsatisfied, to 10 = completely satisfied). Intrahospital transport scenarios were tested over a one month period in the emergency department. Fifty medical personnel, including 30 nurses and 20 doctors, used the wireless patient monitoring system and answered the questionnaire. The staffs included 14 males and 36 females with ages in the range 23–50 years old (mean SD ) and with 1–25 years (mean SD ) of experience in emergency medical care.

Results

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Conclusion

A mobile patient monitoring system was designed, developed, and tested. A pulse oximeter was integrated with a threelead ECG monitor on a wireless PDA platform, which provides real-time and store-and-forward modes. The monitor in the new system has a significantly reduced size and weight, and thus, improves the portability of the monitoring device. Besides,WLAN also greatly increases the flexibility and usability for telemonitoring. The clinical evaluation reveals that this mobile patient monitoring system is user-friendly, convenient, and feasible for patient transport.



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