International Conference on Sensors and Related Networks

SENNET’09
VIT, Vellore, India. December 7-10

AUTOMIZED INTENSIVE CARE UNIT (AICU)

S Mithun Ganesh1 and A Mohamed Nadeem2
1
Thiagarajar College of Engineering mg1390@gmail.com
2
Thiagarajar College of Engineering mhmdndm@gmail.com

Abstract
In today world health is one of the main issues and the need for equipment to perform various tests and supervise
the health status of a patient is increasing. And the latter becomes very vital for a patient in the Intensive Care Unit
(ICU). Hereby we aim at building a comprehensive automation unit to supervise the health status of a patient
through Supervisory Control and Data Accusation (SCADA) system aided by a microcontroller and a number of
sensors to acquire data. Having this automation system buildup the patient in ICU need not be taken care by a
nurse or any other responsible person throughout the clock. Here the nurse can stay in a room where she will
receive alarm signals or any message signal through the SCADA system and then she can respond to the signals
without being with concerned patient. Also investment of the system is one time and thereby our goal of reducing the
human error and automizing the medical industry is achieved to some extent.

Keywords— ICU, SCADA, Microcontroller, Sensor

1. INTRODUCTION

Intensive care unit (ICU) equipment includes patient monitoring, respiratory and cardiac support, pain management ,
emergency resuscitation devices, and other life support equipment designed to care for patients who are seriously injured,
have a critical or life-threatening illness, or have undergone a major surgical procedure, thereby requiring round the clock
care and monitoring.

Hereby our bid to build an automized ICU is to acquire data from sensors, monitor them in emergency conditions, store the
data and report the status is discussed. The present system where a nurse for a bed looks after the patient can be made error
free with minimum human resources aided by SCADA based automation.

The status of patients is monitored using various sensor or sensors. The output of sensors is fed to either SCADA system
or a microcontroller which complement each other in operation. The SCADA sends alarm or message signals to a
concerned person’s electronic device like mobile phones or watch designed for this specific purpose. In addition a
technician will be supervising the entire ICU through the SCADA monitor.

2. SCADA
A properly designed SCADA system saves time and money by eliminating the need for service personnel to visit each site
for inspection, data collection/logging or make adjustments.

2.1 Subsystems of SCADA

A Human-Machine Interface or HMI provides processed results to the technician monitoring. A Supervisory (computer)
system gathers data and communicates to the special external electronic devices. Remote Terminal Units (RTUs) are
control unit that converts analog data from sensors to digital data for the supervisory system. Links connecting the
supervisory system to the remote terminal units.

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3. MICROCONTROLLER
A microcontroller is a computer-on-a-chip or a single-chip computer. The microcontroller has its support circuits like
crystal oscillator, timers, watchdog timer, serial and analog I/O devices built embedded in.

Microcontroller here is a part of some of the sensors used i.e. it not only acquires the data from sensor but itself is a part of
sensor.

4. SENSORS
A sensor is a device that receives a stimulus and responds with an electrical signal. The stimulus is the quantity, property,
or condition that is sensed and converted into electrical signal. The purpose of a sensor is to respond to some kind of an
input physical property (stimulus) and to convert it into an electrical signal which is compatible with electronic circuits. By
electrical, we mean a signal which can be channeled, amplified, and modified by electronic devices. The sensor’s output
signal may be in the form of voltage, current, or charge. Therefore, a sensor has input properties (of any kind) and electrical
output properties.

The sensors we presently discuss are grouped into two based on their application.

1. Measure and monitor health parameters

2. Monitor the parameters external to patient

4.1 SENSOR BASED MONITORING DEVICES

4.1.1 Blood Pressure Monitor
Blood pressure is the force of the blood pushing against the walls of the arteries. Your blood pressure is at its highest
(systolic pressure) when the heart beats, pumping the blood. When the heart is at rest (diastolic pressure), between beats,
your blood pressure falls.

Working

Blood pressure monitors can use Korotkoff, Oscillometry, or Pulse Transit Time methods to measure blood pressure. They
employ a pressure cuff, pump, and transducer to measure blood pressure and heart rate in three phases: Inflation,
Measurement, and Deflation.

The pressure transducer produces the output voltage proportional to the applied differential input pressure. The output
voltages of the pressure transducer range from 0 to 40 mV, which need to be amplified so that the output voltage of the DC
amplifier has a range from 0 to 5V. Thus, we need a high-gain amplifier. Then the signal from the DC amplifier will be
passed on to the band-pass filter. The DC amplifier amplifies both DC and AC component of the signal. The filter is
designed to have large gain at around 1-4 Hz and attenuate any signal that is out of the pass band. The AC component from
filter is important for determining when to capture the systolic/diastolic pressures and heart rate of the patient. The final
stage of the front end is an AC coupling stage, after which the signal is sent to analog to digital converters, and digitized.

The digital measurements of pressure and heart rate are performed by the control unit .. The analog circuit is used to
amplify both the DC and AC components of the output signal of pressure transducer so that we can use the MCU to process
the signal and obtain useful information about the patient's health.

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4.1.2 Pulse Oxymeter

Pulse oximetry is a non-invasive method allowing the monitoring of the oxygenation of a patient's hemoglobin. Although
pulse oxymeter is used to monitor oxygenation, it cannot determine the metabolism of oxygen, or the amount of oxygen
being used by a patient.

Working

A sensor is placed on a thin part of the patient's anatomy, usually a fingertip or earlobe, and a light containing both red and
infrared wavelengths is passed from one side to the other. Changing absorbance of each of the two wavelengths is
measured, allowing determination of the absorbance due to the pulsing arterial blood alone, excluding venous blood, skin,
bone, muscle, fat, and fingernail polish. Based upon the ratio of changing absorbance of the red and infrared light caused
by the difference in color between oxygen-bound and oxygen unbound blood hemoglobin, a measure of oxygenation (the
per cent of hemoglobin molecules bound with oxygen molecules) can be made.

Typically it has two pairs of small light-emitting diodes (LED’s) facing a photodiode through a translucent part of the
patient's body, usually a fingertip or an earlobe. One pair of LED is red, with wavelength of 660 nm, and the other is
infrared, 905, 910, or 940 nm.

4.1.3 Apnea monitor

The monitoring of breathing dynamics is an essential diagnostic tool in various clinical environments, such as sleep
diagnostics, intensive care and neonatal monitoring. Here we present a method for monitoring the respiratory patterns of
the patients.

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Working

The microcontroller based apnea monitor consists of a sensor system interfaced with a microcontroller to detect the apnea
from the heat changes in the oro-nazal air flow. The amplified signal obtained from the patient is applied to the
microcontroller. After converting the signal into digital form, it is transferred to the computer by using the RS232 serial
port to make possible to investigate the relation between the EEG or ECG signals with respiration patterns.

Oro-nazal air flow is measured with heat sensitive electrodes named as nasal thermistor and located on the both nostril and
mouth arc. Thermistor is a semi-conductor device whose resistance changes with temperature. The resistance of thermistor
is equal to R=7.63 Ω at the room conditions. The changes in the resistance of thermistor is averagely equal to R= 6.5 Ω
during the exhale and R= 7.7 Ω during the inhale depending upon the respiration heat of the patient

4.2 EXTERNAL SENSORS

4.2.1 Level Sensors (for glucose drips, blood feeder, urine collector…)
Fiber-optic sensors can be used quite effectively as proximity and level detectors. A liquid-level detector with two fibers
and a prism is shown below. It utilizes the difference between refractive indices of air (or gaseous phase of a material) and
the measured liquid. When the sensor is above the liquid level, a transmitting fiber (on the left) sends most of its light to the
receiving fiber (on the right) due to a total internal reflection in the prism. However, some light rays approaching the prism
reflective surface at angles less than the angle of total internal reflection are lost to the surroundings. When the prism
reaches the liquid level, the angle of total internal reflection changes because the refractive index of a liquid is higher than
that of air. This results in a much greater loss in the light intensity, which can be detected at the other end of the receiving
fiber. The light intensity is converted into an electrical signal by any appropriate photo detector like a photomultiplier.

4.2.2 Temperature Sensors – Infrared thermometers

Infrared thermometers measure temperature from a distance. This distance can be many miles or a fraction of an inch.

Infrared thermometers work based on a phenomenon called black body radiation. Anything at a temperature above absolute
zero has molecules inside of it moving around. The higher the temperature, the faster the molecules move. As they move,
the molecules emit infrared radiation--a type of electromagnetic radiation below the visible spectrum of light. As they get
hotter, they emit more infrared, and even start to emit visible light which can be focused, reflected or absorbed. Infrared
thermometers usually use a lens to focus infrared light from one object onto a detector called a thermopile. The thermopile
absorbs the infrared radiation and turns it into heat. The more infrared energy, the hotter the thermopile gets. This heat is
turned into electricity. The electricity is sent to a detector, which uses it to determine the temperature of whatever the
thermometer is pointed at. The more electricity, the hotter the object is.

The ear drum has about the same temperature as the inside of the body, but it is very sensitive. Touching the ear drum
could damage it, so an infrared thermometer measures its temperature from close by less than an inch away.

4.2.3 Oxygen Cylinder Monitor

The Oxygen cylinder bears a label showing how many liters it contains when full. The pressure on the pressure gauge will
show, usually in gross divisions from full to empty, how full the cylinder is. But there is no indication of how much volume
is in the cylinder at a particular moment. The concept for oxygen cylinder monitor is derived from the famous formula
PV/T = constant, where P is pressure in the cylinder, V is the volume of the cylinder, and T is the temperature. As volume
is a constant and temperature is usually constant in the hospital environment, the pressure gauge can provide an accurate

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reading for volume as well as for pressure. For oxygen, its critical temperature is –119°C, and it is kept in a gaseous form
in the cylinder. These calculations are rounded intentionally to some value (e.g., 5 min) less as a safety margin.

5. PATIENT IN ICU

6. TABULAR REPRESENTATION OF THE AUTOMIZED MONITORING SYSTEM

Safe Precaution Emergency

SCADA monitor Green Yellow Red

Color
representation

Alarm or message No Alarm or Precaution Alarm Emergency Alarm

signal message signal or message signal or message signal

7. CONCLUSION
Hence, we have discussed the monitoring of some critical parameters through our SCADA based system, in a similar
way other critical parameters can also be monitored. By selecting reliable sensors and designing a proper SCADA
system, the automized ICU monitoring can have many advantages and satisfy our needs.

The patient does not care about your science; what he wants to know is can he believe the physician?

With our system the answer is definitely YES!

REFERENCE

[1] Handbook of Modern Sensors by Jacob Fraden.

[2] Clinical Intensive Care and Acute Medicine by Ken Hillman and Gillian Bishop.
[3] ICU Book by L Paul Marino.