Unit 6- Patient monitoring system and biotelemetry

1. Unit 6. Patient monitoring system
and biotelemetry
6.1 ECG Monitoring
6.2 B.P monitoring
6.3 ICU monitoring instruments
6.4 Biotelemetry for general use
6.5 The components of a biotelemetry system
6.6 Design of a system.
6.7 Multichannel system
6.8 Frequency modulation techniques in telemetry link
6.9 Real time processing
6.10 Telemetry in operating room
6.11 Sports physiology studies through telemetry
BY- SANJU SAH
St. Xavier’s college, Maitighar, Kathmandu
Department of Microbiology

2. 6.1 ECG Monitoring
• The most important physiological monitored
in hospital are heart rate and morphology or
shape of ECG.
• To detect arrhythmias or change in heart rate.
• Special monitors known as cardiac monitors
are used.
• Also known as cardiosope.

4. 6.2 B.P monitoring
• BP is most often measured and intensively
studied parameter in medical science.
• Pressure measurement are vital indication in
successful in treatment.
• Type
– Direct method
– Indirect method: Non invasive BP monitoring.

6. Direct method
• S catheter or needle type electrode type
probe is inserted through vein or artery.
• Two types of probe
– With sensor mounted in the tip of probe
– Fluid filled catheter type:- pressure exerted on its
fluid filled column to external transducer
• Gives information likes stroke volume,
duration of systole, ejection time.

8. ADVANTAGE OF IABP
• continuous beat-to-beat pressure measurement, close
monitoring of critically ill patients on vasoactive drugs
• Pulse waveform analysis provides other important
hemodynamic parameters
• reduces the risk of tissue injury and neuropraxias in
patients who will require prolonged blood pressure
measurement
• allows frequent arterial blood sampling
• more accurate than NIBP, especially in the extremely
hypotensive or the patient with arrhythmias.

9. ICU monitoring instruments
• Repeated or continuous observations or
measurements of the patient, his or her physiological
function, and the function of life support equipment,
for the purpose of guiding management decisions,
including when to make therapeutic interventions,
and assessment of those interventions is known as
patient monitoring
• Required for accurately acquiring and assimilating
information about patient under care.
• Capability of providing an immediate alarm in events of
abnormalities.

10. Patient Monitoring in ICUs
• Categories of patients who need physiologic
monitoring:
1. Patients with unstable physiologic regulatory systems;
• Example: a patient whose respiratory system is suppressed by a
drug overdose or anesthesia.
2. Patients with a suspected life-threatening condition;
• Example: a patient who has findings indicating an acute
myocardial infarction (heart attack).
3. Patients at high risk of developing a life-threatening
condition;
• Example: patients immediately post open-heart surgery, or a
premature infant whose heart and lungs are not fully developed.
4. Patients in a critical physiological state;
• Example: patients with multiple trauma or septic shock.

11. ICU Instruments
• Patient Monitors:- To monitor vitals of the
patients which includes ECG, BP(IBP/NIBP),
SPO2, respiration rate, temperature etc.
• Syringe and infusion pumps: to deliver drugs
and nutrition to the patient in a controlled
and precise dose.
• Ventilators: For artificial respiration in the
patients who can not breath on their own.

12. • Defibrillators: to deliver shock in case of
cardiac abnormality like fibrillation, systole
etc.
• Arterials blood gas Analyzer: To analyze the
blood gas level in arterial blood of the
patients.

13. • 6.4 Biotelemetry for general use
• 6.5 The components of a biotelemetry system
• 6.6 Design of a system.
• 6.7 Multichannel system
• 6.8 Frequency modulation techniques in
telemetry link
• 6.9 Real time processing
• 6.10 Telemetry in operating room
• 6.11 Sports physiology studies through telemetry

14. Biotelemetry
• Use of telemetry methods in order to
remotely observe, document and measure
certain physiological functions.
• Measurements in biotelemetry can be
categorized in two category:
– Bioelectric variables: ecg, eeg etc
– Physiological variables: Bp, temperature etc.

15. The components of a biotelemetry
system
• The Transmitter: Physiological variables are obtained
form the subject, passed through a stage of
amplification and processing circuits that includes
generation of subcarrier and a modulation stage for
transmission.
Block Diagram of Transmitter.

16. • The Receiver: receiver consist of a tuner to
select the transmitting frequency, a
demodulator to separate the signal from the
carrier wave and a means of display or
recording the signal.
Block diagram of receiver circuit

17. Design of a system
• Most biotelemetry systems involves the use of
radio transmission.
• Radio transmission involve transmission of RF
carrier.
• RF carrier is a high frequency sinusoidal signal
which, when applied to an appropriate
transmitting antenna, is propagated in the
form of electromagnetic waves.

18. Types of Modulation
• Amplitude modulation
Amplitude modulation (AM) is
a modulation technique used in
electronic communication, most
commonly for transmitting
information via a radio carrier
wave. In amplitude modulation,
the amplitude (signal strength) of
the carrier wave is varied in
proportion to the waveform being
transmitted.
• Frequency modulation
Frequency modulation (FM) is the
encoding of information in a carrier
wave by varying the instantaneous
frequency of the wave. This contrasts
with amplitude modulation, in which
the amplitude of the carrier wave
varies, while the frequency remains
constant.

19. Single Channel and Multichannel
System
• Single Channel System:
– Single parameter is transmitted
– E.g ECG, temperature
• Multichannel System:
– Simultaneous transmission of several parameters
– Multiplexing technique is used.

20. Multichannel System
• Multiplexing technique
– Frequency division
Frequency-division
multiplexing (FDM) is a scheme in
which numerous signals are
combined for transmission on a
single communications line or
channel. Each signal is assigned a
different frequency(subchannel)
within the main channel.
– Time division
Time-division multiplexing (TDM)
is a method of transmitting and
receiving independent signals over
a common signal path by means of
synchronized switches at each end
of the transmission line so that
each signal appears on the line
only a fraction of time in an
alternating pattern.