Apparatus, system and method for capturing video of a human patient suitable for cardiac, respiratory or cardiopulmonary condition monitoring - Patents.com

Abstract

An apparatus for capturing video of a human patient suitable for cardiac, respiratory or cardiopulmonary condition monitoring includes an electronic imaging device, the imaging device positionable relative to the patient's neck such that electronic video of the patient's neck can be captured. The apparatus also includes a position indicator external to the patient's body, the position indicator configured for repeatable and stably positioning on the patient's body relative to an anatomical portion of the patient's torso, the position indicator connected to the imaging device. The apparatus also includes a reference element, the reference element positionable relative to the patient's neck by positioning the position indicator.

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to and the benefit of U.S. Provisional Patent Application No. 63 / 228,071, entitled “Apparatus and Method for Capturing a Video of a Human Patient Suitable for Monitoring a Cardiac, Respiratory, or Cardiorespiratory condition,” filed July 31, 2021, the disclosure of which is incorporated by reference in its entirety herein.

[0002] The present technology relates to apparatus and methods for monitoring a cardiac, respiratory or cardiopulmonary condition in a patient, which in some embodiments may include systems and devices for capturing patient image data for monitoring jugular venous pressure height. [Background technology]

[0003] Joint carotid artery pressure (JVP) or JVP height is a clinical sign that is evaluated for a variety of applications including the assessment of heart failure (HF) and volume overload on the heart.

[0004] The internal jugular vein (IJV) descends from the angle of the jaw to the middle of the clavicle at the posterior border of the sternocleidomastoid muscle. The IVJ carries blood from the brain, skull, face, and neck to the superior vena cava and ultimately the right atrium of the heart. Assessment of carotid artery pressure (JVP) and right atrial pressure can be done by observing the blood column that distends the IJV when the body, head, and neck are at a particular angle to the horizontal. Assessment of the JVP is a standard procedure in clinical settings, performed by physicians as part of a patient's physical examination. During the examination, the vertical distance between the sternal angle and the top of the IJV's pulsation point is measured. In some cases, a hepatojugular reflux test may be performed, for example, by compressing the right upper quadrant of the abdomen, above the liver, to force more blood into the right atrium and raise the JVP. Hepatojugular reflux can be used to confirm the jugular venous extension point (e.g., by noticing an upward movement of the IJV in response).

[0005] To measure the vertical distance between the sternal angle and the top of the IJV pulsation point, a horizontal line is formed from the highest IJV pulsation point to intersect with a vertical line erected perpendicular to the ground through the sternal angle of Louis. Typically, these "lines" consist of a straight object, usually easily available, such as a ruler. The distance between the sternal angle and the intersection of these two lines is measured along the vertical line. The sum of this measured distance plus 5 cm, which is obligatorily added due to the fixed relationship between the outer surface of the patient's body and the midpoint of the right atrium (if measured when the patient is at a 30 degree angle), represents the patient's average JVP. For example, Figure 1 shows a patient lying in bed at a reclining angle A (e.g., about 30 degrees). The sternal angle (H SA ) and the height of the blood column at the IJV (H IJV ) + 5cm is the vertical distance between the JVP (H in Figure 1) JVP ).

[0006] Normal mean jugular venous pressure (i.e., 5 cm plus vertical height in cm above the sternal angle), determined as described above, is 6 cm to 8 cm H2O. Deviations from this normal range may reflect, for example, hypovolemia (i.e., mean venous pressure less than, for example, about 5 cm H2O) or hypervolemia (i.e., mean suprathrust pressure greater than, for example, about 8 cm H2O). Elevated JVP, as assessed by an experienced physician, suggests early volume overload and may predict clinical deterioration and aid in therapeutic decisions in HF.

[0007] Currently, JVP as described above can only be determined in a clinical setting. In effect, this limits the regularity with which an outpatient's JVP can be measured, and thus patients are usually reluctant to return to a clinical setting frequently. In addition to the inconvenience of doing so, patients who will need to undergo more frequent JVP monitoring are typically elderly and have mobility problems, either age-related or otherwise. Nevertheless, for some such patients, it may be more beneficial to have their JVP monitored more frequently than by making regular visits to a clinical setting. Summary of the Invention [Problem to be solved by the invention]

[0008] It would therefore be desirable to have systems, devices and methods that can be used (at least) outside of a clinical environment to gather information that allows for the determination of a person's JVP. [Means for solving the problem]

[0009] The systems, devices and methods described herein enable monitoring of various patient conditions, including, for example, JVP. In some embodiments, such monitoring can occur outside of a clinical setting, while in other cases, such monitoring can occur in a hospital or clinical setting, or other suitable setting.

[0010] In some embodiments, an apparatus for monitoring a cardiac, respiratory or cardiopulmonary condition of a patient may include an electronic imaging apparatus or device. The imaging apparatus is positionable relative to the patient's neck so as to capture electronic video of the patient's neck. The apparatus also includes a position indicator on the exterior of the patient's body, the position indicator being structured for repeatable and stably positioning on the patient's body relative to an anatomical site on the patient's torso. The position indicator is connected to the imaging apparatus. The apparatus also includes a reference element, the reference element being positionable relative to the patient's neck by positioning the position indicator.

[0011] In some embodiments, a method for monitoring a cardiac, respiratory or cardiopulmonary condition may include an electronic imaging device or imaging apparatus positionable relative to the patient's neck to capture an electronic video of the patient's neck, a position indicator external to the patient's body connected to the imaging device and configured for repeatable, stable positioning on the patient's body relative to an anatomical site on the patient's torso, and a reference element positionable relative to the patient's neck by positioning of the position indicator, the method including positioning the device relative to the patient such that the imaging device is positionable relative to the patient's neck to capture an electronic video of the patient's neck. The method includes positioning the position indicator at a stable position on the patient's body relative to the anatomical site on the patient's torso, whereby at least one of the reference element and the imaging device is positioned relative to the patient's neck such that the patient's neck and at least a portion of the reference element can be captured in the electronic video by the imaging device without movement of the imaging device. The method further includes causing the imaging device to capture the electronic video.

[0012] Although the systems, devices and methods described herein are primarily described with reference to monitoring a patient's JVP, it is understood that such systems, devices and methods are not limited to monitoring (including determining) JVP, but may also be used to measure other physiological conditions of a patient, including, for example, heart rate, respiratory rate, blood pressure trends, oxygen saturation, or carotid (arterial) pulsation. Other embodiments of the present technology are also suitable for monitoring respiratory effort (e.g., normal and / or distressed). In some embodiments, the systems, devices and methods described herein may also be used to monitor patients with conditions such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), combined CHF and COPD, asthma, and dialysis (e.g., peritoneal dialysis and hemodialysis). Some embodiments of the present technology may also be used to monitor patients with conditions such as cardiac tamponade, conditions that cause elevated intracardiac pressure, and cases where excessive circulating blood volume is a problem (e.g., septic shock after volume resuscitation with intravenous (IV) fluids).

[0013] In some implementations, the embodiments described herein include (i) an electronic imaging device, (ii) a position indicator external to the patient's body, and (iii) a reference element. The general purpose of the electronic imaging device is to capture an image (e.g., an image of the neck) that is suitable for monitoring the monitored condition. The general purpose of the position indicator is to assist in properly positioning the camera frame so that within the camera frame is an object (e.g., the patient's neck) that is suitable for monitoring the monitored condition to be captured by the imaging device. The general purpose of the reference element is to provide a reference having known characteristics (e.g., size, shape, distance, etc.) that allows one or more mathematical calculations related to the monitored condition to be performed. As will be appreciated by those skilled in the art, each of the above elements may have purposes other than the general purpose stated above.

[0014] In some embodiments, when monitoring JVP, the device is used and functions in the following manner: The patient (or the person helping the patient) prepares for the monitoring session by setting the location where the monitoring session will take place (e.g., if the location has not remained at the correct setting from the last time monitoring took place). For example, the patient (or the person helping the patient) can place a 30 degree wedge pillow on a flat surface such as a bed. The patient (or the person helping the patient) then places the device of the present technology on a flat surface near the patient's upper torso (e.g., near the patient's shoulder). Once the device is powered on, the patient (or the person helping the patient) then takes a location indicator and places the location indicator on a specific anatomical site on the patient's torso (e.g., the patient's suprarenal notch). In some embodiments, the location indicator may have been previously customized (e.g., calibrated to the patient) for the patient, such as by a clinician.

[0015] In some embodiments, the position indicator, the reference element and the electronic imaging device are mechanically linked to each other, coupled to each other, or integrated into a single assembly, for example on a movable arm of the device. Moving the position indicator to its correct or desired position also moves the reference element and the electronic imaging device to their correct or desired positions. In the correct or desired position, the electronic imaging device can be positioned relative to the patient's neck such that the electronic imaging device can capture video of the area of ​​the patient's neck where the jugular vein distension is visible. In the correct position, the reference element can be positioned relative to the patient's neck such that (i) the reference element is also within the frame of the electronic imaging device, (ii) it can be captured on video, and (iii) mathematical calculations can be made from the captured video to calculate the patient's JVP.

[0016] One advantage of the embodiments presented herein is that the device does not need to be positioned exactly in the same place each time a monitoring session takes place. The use of position indicators and their connections to other components of the device means that the video captured by the electronic imaging device during each monitoring session can be used to calculate the JVP despite the fact that the device itself may not be in the same position as in the previous monitoring session. This is because the reference element provides a known reference that makes such a calculation possible.

[0017] Another advantage of the embodiments described herein is that a clinician does not need to be present during the monitoring session and / or the monitoring session does not need to take place in a clinical environment. The design of the device ensures that each of the components is correctly positioned. Video captured from the session can be processed by a computer or manually by a human, for example to determine the JVP. This processing does not need to take place at the location where the monitoring session takes place (e.g., the patient's residence). The captured video can be processed by any conventional method and / or device and transmitted to a location where the JVP can be determined. In this regard, monitoring sessions can take place much more frequently than if the patient had to travel to a clinical environment for each monitoring session.

[0018] The electronic imaging device may generally be any imaging device capable of taking electronic images, whose size, shape, and principles of operation are otherwise compatible with the rest of the device (as described below). For example, in some embodiments, a conventional smartphone camera device (or a similar device or a device operating on the same principles) may be used. In the context in which the device is used to monitor the patient's JVP, the electronic imaging device may be positioned relative to the patient's neck such that it can capture electronic video of the patient's neck (so as to capture engorgement of the patient's IJV). An example of such a positioning is described above.

[0019] The position indicator may be a structure that is repeatably and stably positionable on the patient's body relative to an anatomical location on the patient's torso. Often, this is accomplished by sizing and shaping at least a portion of the position indicator to match the size and shape of a particular anatomical location on the patient's body. Examples of such anatomical locations are the patient's sternum, sternal angle, manubrium, clavicular head, and cervical notch (or commonly referred to as the suprasternal notch). Thus, for example, if the anatomical location is the patient's cervical notch, the position indicator may have a bulb sized to fit snugly within the cervical notch. In some embodiments, the position indicator has replaceable patient contacting elements, thus allowing the position indicator to be customized for a patient (e.g., to accommodate size variations between patients, anatomical location variations) to facilitate repeatable and stable positioning of the position indicator on the patient's torso. Additionally or alternatively, in some embodiments, the position indicator has at least one adjustable patient contacting element. If present, the adjustable patient contacting element can also assist in repeatable and stable positioning of the position indicator on the patient's torso. In other embodiments, the entire position indicator may additionally or alternatively be a replaceable element, for example one that serves a similar purpose.

[0020] In some embodiments, the position indicator is connected to an imaging device. This connection may be a connection of the position indicator to the imaging device that (at least in part) causes the imaging device to image the correct elements within the imaging device's frame so that they can be captured on video. Such elements may be, for example, a particular part or portion of the patient's body (e.g., the patient's neck) and also a part or portion or the entirety of a reference element (e.g., depending on the design and / or structure of the reference element). Such elements may also include, for example, a part or portion or the entirety of the position indicator itself, or the design, use, operation of the device. For example, in some embodiments, the position indicator may be used together with the reference element in a mathematical calculation.

[0021] In the context of this embodiment, the position indicator can be connected to the imaging device in any number of ways that are not otherwise incompatible with the rest of the device's structure and function. For example, in various embodiments, the connection between the position indicator and the imaging device can be one of mechanical, electronic, electromechanical, magnetic, adhesive, etc. By way of example, in some embodiments, the connection between the two can be a simple mechanical connection such that physically moving the position indicator moves the imaging device. In such a case, for example, the device can be structured such that when the position indicator is physically moved to an anatomical site on the patient's torso and then stabilized and properly positioned, the imaging device moves with the position indicator in a substantially simultaneous manner, and then when the position indicator itself is finally properly positioned, it stops in a suitable position to capture the video that needs to be captured. Again, by way of example, in such a case, in some embodiments, the two are simply fixedly connected to each other, while in other embodiments, the two can be connected to each other via a more complex movable mechanical linkage.

[0022] In some embodiments, in addition to or instead of a mechanical connection, the position indicator and the imaging device may be electronically connected to each other (e.g., directly or indirectly by a computer processor). For example, the position indicator may transmit an electronic signal that would allow its spatial position to be located or determined, and the imaging device may be moved to the appropriate position by an appropriate motor. Such electronic signals may be transmitted wired or wirelessly. In another example, the patient may be prompted to transmit a signal that the position indicator is correctly positioned, for example by a patient-activated switch (e.g., on the position indicator), and the imaging device (together with the processor of the computing device) may use machine vision and artificial intelligence to position itself. In some embodiments, the imaging device, such as a camera with high resolution and wide field of view, may be mounted on a wall. The wide field of view may capture the patient's neck. The patient or user may place the position indicator and / or fiducials in the patient's suprasternal notch and press a button to activate the imaging device. The wide field of view of the imaging device does not require the imaging device to move, and the JVP may be estimated while imaging the fiducials.

[0023] In some embodiments, the connection between the position indicator and the imaging device includes a member fixedly attached to the position indicator. The member may be alignable with respect to landmarks on the patient's torso during positioning of the position indicator with respect to anatomical sites on the patient's torso. In this manner, the member may facilitate correct positioning of the position indicator. For example, the member may be straight or have a straight portion, and during correct positioning of the position indicator, the member or its straight portion may be aligned to be positioned longitudinally centrally along the patient's sternum. Such an arrangement is shown and described in more detail with reference to FIG. 12.

[0024] In some embodiments, the reference element is positionable relative to the patient's neck by positioning the position indicator. In some embodiments, the reference element is of known size and shape. Knowing these characteristics allows processing (e.g., mathematical and / or geometric calculations) to be performed (e.g., automatically by a processor in a computing device) on the captured images. For example, if it is the patient's JVP that is being monitored, the reference element is structured to allow the technique to determine the JVP from video captured by an imaging device.

[0025] In some embodiments, the reference element is a physical object or part of a physical object, for example in an embodiment in which the patient's JVP is monitored, the reference elements may be three parallel rods of known dimensions and spacing.

[0026] In different embodiments, the relationship of the reference element to the position indicator may vary. In some embodiments, the reference element is separate from the position indicator (although it may be connected to a different part of the device to which the position indicator itself is connected). In some embodiments, the reference element is physically connected to the position indicator. In some embodiments, the reference element is the position indicator. In some embodiments, the reference element extends from the position indicator. In some embodiments, the reference element is mechanically coupled to the position indicator by others. For ease of use, in some embodiments, the reference element is correctly positioned once the position indicator is correctly positioned relative to an anatomical site on the patient's torso. In other embodiments, the reference element may require positioning after the position indicator is positioned.

[0027] In some embodiments, the reference element need not be a physical object. For example, the reference element can be structured electromagnetic radiation projected, for example, onto the patient's neck. In one embodiment in which the patient's JVP is monitored, the reference element can be three parallel lines of visible light projected onto an appropriate area of ​​the patient's neck. As mentioned above, the relationship between the reference element and the position indicator varies from embodiment to embodiment. For example, in some embodiments, the reference element can be projected from the position indicator itself, while in other embodiments, the reference element can be projected from another part of the apparatus or even from a separate, cooperating device. In another embodiment, the reference element can be projected from a device that is mechanically coupled to the position indicator.

[0028] In some embodiments, the reference elements may have markings that can facilitate mathematical calculations to be performed. For example, in some embodiments, the markings on the reference elements may be one or more measurement scales (e.g., centimeters). In some embodiments, the markings may include numbers. In some embodiments, the markings may include different patterns, colors, or other distinctions in the structured electromagnetic radiation.

[0029] In most embodiments, where it is the patient's JVP that is monitored, the position indicator is connected to the imaging device such that when the position indicator is positioned on the patient's body relative to an anatomical location on the patient's torso, both the patient's neck and at least a portion of the reference element can be simultaneously captured on video by the imaging device without any movement of the imaging device. In some such embodiments, this can make such determinations simpler, since there is no movement of the imaging device to take into account in determining the JVP. In some embodiments, the imaging device may move during video capture (e.g., moving along a slight arc) and the necessary determinations of the JVP may be made by taking such movement into account in those determinations, or by ignoring such movement. In some embodiments, precise determinations are not necessary, e.g., an approximation or simplification may be sufficient to estimate the JVP.

[0030] In some embodiments, the imaging device may capture more of the reference element in the video, in which case the greater capture of the reference element may allow for a more accurate determination of the JVP.

[0031] In some embodiments, when the position indicator is positioned on the patient's body with reference to an anatomical location on the patient's torso, the position indicator is connected to the imaging device such that both the patient's neck and the entire reference element can be simultaneously captured on video by the imaging device without movement of the imaging device. In some embodiments, the entire reference element does not need to be captured in the video to make the necessary determination of the JVP. In other embodiments, the entire reference element may need to be captured in the video to facilitate the determination of the JVP.

[0032] The systems, devices and methods described herein are not limited to devices having a single imaging device, a single position indicator, and / or a single reference element, and in some embodiments, devices of the present technology may have multiple imaging devices, multiple position indicators, and / or multiple reference elements.

[0033] For example, as described above with reference to Figure 1, the patient's neck includes the patient's IJV and external jugular vein (EJV). When the patient's JVP is monitored, a position indicator can be connected to the imaging device such that when the position indicator is positioned on the patient's body relative to anatomical locations on the patient's torso, both (i) an area of ​​skin on the neck overlying at least one of the patient's IJV and EJV, and (ii) at least a portion of the reference element (e.g., sufficient to determine the location of the IVJ and / or EJV relative to the reference element to determine the JVP) can be simultaneously captured in video by the imaging device without movement of the imaging device.

[0034] In some embodiments, the position indicator comprises a sensor for sensing at least one physiological parameter of the patient. In the context of the present technology, the sensor can be one or more of any number of types and kinds of sensors. Some non-limiting examples include contact sensors, electrocardiogram (ECG) electrodes, pulse oximeters (PPG), temperature sensors, electrodermal sensors, etc. For example, a contact sensor may be used to transmit a signal that the position indicator is positioned on the patient's body. In some embodiments, the contact sensor may be provided along with an accelerometer having a signal that can be used to determine whether the position indicator is moving (and thus not yet stably positioned on the patient's body even though the contact sensor is transmitting a signal). In some embodiments, the device may comprise or be operably coupled to a processor programmed to automatically initiate the capture of video based on receiving an appropriate signal from the contact sensor and / or the accelerometer. Thus, in some embodiments, the sensor is in electronic communication with the imaging device. In another embodiment, the accelerometer can be used to determine the angle of the patient relative to a horizontal reference axis.

[0035] In some embodiments, the sensor can be synchronized with data from the imaging device, thus coordinating the captured video with the data from the sensor in some embodiments. In a non-limiting example, if the sensor is an ECG electrode or a pulse oximeter, the imaging device can collect data in synchronization with the signal from the sensor.

[0036] In some embodiments, the times when sensor data is recorded and when image (e.g., video) data from the imager are both known or determinable by the device in absolute and / or relative time. For example, in some embodiments, the sensor's clock can be used to gate the imager (or vice versa). In other embodiments, a processor can generate a clock signal that gates both the imager and the sensor. In still other embodiments, the same clock signal is used to time stamp both the imager and the sensor data, and the data are time-aligned in a post-processing step.

[0037] In some embodiments, the sampling rate of the sensor (or sensors, if multiple sensors are present) may be a multiple of the sampling rate of the imager. As an example, in some embodiments, the ratio of sensor data sampling rate to imager data sampling rate is 2:1. Thus, the sensor data will be sampled at T1, T2, T3, T4, T5, etc., while the imager data will only be sampled at T1, T3, T5, etc. (each T n and T n+1 is constant). In such examples, the sensor data can be used to aid in interpreting the imager data. In other embodiments, other ratios of different sensor sampling rates can be used, for example, about 0.5:1, about 1:1, about 2:1, about 3:1, about 4:1, about 5:1, about 10:1, including all subranges and values ​​therebetween.

[0038] In some embodiments, the device has a sensor that provides information regarding a determination of an angle of inclination of the position indicator when the position indicator is stably positioned on the patient's body relative to an anatomical location on the patient's torso. In some such embodiments, the sensor is at least one of an accelerometer and / or a gyroscope that is fixedly oriented relative to the position indicator. Also, in some such embodiments, the sensor is located within the position indicator itself and is in electronic communication with the device's processor (or a remote processor). As described above, when measuring JVP, the patient may be inclined to a certain known angle (e.g., about 10 degrees to about 90 degrees from horizontal, or about 30 degrees to about 60 degrees from horizontal). In some embodiments, this angle is maintained approximately constant each time the patient's JVP is monitored, for example, by having the patient lie on a wedge-shaped pillow having a set angle. In other embodiments, this angle need not be constant, and the JVP is calculated (or estimated) taking into account the patient's current angle at the time the data is collected (e.g., using trigonometry and / or data collected by the gyroscope and / or accelerometer). In some embodiments, the angle of the long axis of the patient's neck relative to the horizontal may differ from the angle of the patient's body. Thus, in some embodiments, a still image of the neck may be used, for example in conjunction with image processing, to determine the long axis of the neck, and this angle of the neck may be combined with the angle of the body to provide a more accurate estimate of the JVP.

[0039] In some embodiments, the device is structured to rest on the patient's torso when in use and when capturing video. In some such embodiments, for example, if the device is repeatedly and stably positioned on the patient (as described above), the angle of the patient can (possibly) be calculated or estimated from the angle of the device (e.g., via gyroscope and / or acceleration data). The accelerometer and / or gyroscope can be located within the device (e.g., anywhere within the portion that is positioned on the patient's body).

[0040] In some embodiments, a portion of the device is shaped to conform to a portion of the patient's torso such that the portion rests on the patient's torso when the device is in use to capture video, In some such embodiments, a device so structured may facilitate repeatable and stable positioning of the device (as described above), thereby improving reliability of the data.

[0041] In some embodiments, the apparatus further includes an articulated arm having a first end movably connected to the base station and a second end movably connected to the imaging device.

[0042] In some embodiments, the device further includes at least two electrodes for contacting the patient's skin to generate an electrocardiogram (ECG) signal. In some embodiments, one or more of the electrodes may contact the patient's skin due to positioning of one of the other elements of the device. For example, in some embodiments, the electrodes may be positioned on the location indicator such that when the location indicator is properly positioned on the patient's body, the electrodes contact the person's skin. In some embodiments, one or more of the electrodes are positioned on the device such that they are contactable by the patient during use (e.g., during capture of image data). For example, in some embodiments, one of the electrodes may be on a hand grip spaced apart from the location indicator, such that the patient's hand can contact the electrode when the patient positions the location indicator (e.g., grips the hand grip) to capture image data.

[0043] In some embodiments, the device includes a microphone. The microphone may be used, for example, to capture the audio of the patient's voice when the patient is speaking. In some embodiments, this is the case, for example, when the device includes appropriate hardware and software to enable a call to another person (e.g., a clinician) at a distance. Additionally or alternatively, the device may include appropriate hardware and software for providing computer-controlled voice instructions to the patient and for recording or otherwise processing information spoken back by the patient. Additionally or alternatively, the microphone (or one of the microphones, if the device has multiple microphones) may be in contact with the skin of the patient's body and used to capture sounds made by the patient's body (e.g., heart sounds, such as those from the opening and closing of heart valves, respiratory sounds, such as from air entering and leaving the lungs, and / or blood flow sounds from blood flowing in and / or through blood vessels). The microphone may be in electronic communication with a processor, for example, for storage of captured sounds and / or transmission of such sounds over a communication link.

[0044] In some embodiments, the device includes a speaker. In some embodiments, this may be the case, for example, when the device includes appropriate hardware and software to enable communication with another person (e.g., a clinician) at a distance. Additionally or alternatively, the device may include appropriate hardware and software for providing audible instructions to the patient, by computer-controlled voice and / or otherwise. Additionally or alternatively, the speaker (or multiple speakers, if there are multiple) may be used to enable the patient to hear body sounds captured by the microphone.

[0045] In some embodiments, the device further includes a patient-actuated (or user-actuated) sensor element operably connected to the imaging device, e.g., for controlling video capture by the imaging device. In some embodiments, for example, the patient-actuated sensor element may be a button that the patient presses to indicate that the patient is ready to begin a monitoring session. In some such embodiments, the button may directly initiate the monitoring session, while in other embodiments, the button may indirectly initiate the monitoring session (e.g., by initiating a computer process that initiates the monitoring session when the time arrives, e.g., after a predetermined time). As one non-limiting example, the patient-actuated sensor elements may be located in any suitable location on the device, e.g., on a position indicator, a movable part, or a base, and may be in electronic communication with each other (either directly or indirectly via a processor).

[0046] In some embodiments, the device further includes (i) a processor in electronic communication with the imaging device, (ii) an information storage medium in electronic communication with the processor, and (iii) a wireless transceiver in electronic communication with the processor. In some such embodiments, the device may be capable of connecting to a network, such as the Internet, for example, by a wired connection via an Ethernet port and / or by a mobile communication (cellular) network or WI-FI™.

[0047] In some embodiments, the device includes (i) an electromagnetic radiation source that provides electromagnetic radiation in at least the near infrared (NIR) spectrum, and (ii) a filter that allows selective passage of electromagnetic radiation in the NIR spectrum to the imaging device. In some such embodiments, a device constructed in this manner helps reduce problems associated with artificial ambient lighting, such as artificial ambient lighting that can introduce noise into the signal due to flicker.

[0048] In some embodiments, the electronic imaging device is a first electronic imaging device, and the device further includes a second electronic imaging device fixed in a predetermined position relative to the first electronic imaging device. In some such embodiments, having two imaging devices fixed and spaced a known distance from each other may enable stereoscopic vision or depth sensing, for example by calculation of a disparity map (or difference map). This may enable the generation of a 3D model of the imaged structure (e.g., the neck).

[0049] Also, in some such embodiments, the first electronic imaging device can be a near-infrared (NIR) spectrum imaging device and the second electronic imaging device can be a visible light spectrum imaging device. In some such embodiments, the NIR spectrum imaging device captures images in grayscale, while the visible light spectrum imaging device captures images in color. Thus, the two imaging devices provide different information that can be useful for image processing, segmentation, and / or feature identification. For example, different images can be generated from different spectra, which can be useful for evaluating different features in the image data (e.g., one feature may be better captured by NIR and another feature may be better captured by visible light). The color information combined with the NIR information can aid in feature identification and / or segmentation of different objects (e.g., clothing from skin, body contours from background).

[0050] In some embodiments in which the patient's JVP is monitored, the reference element has a predetermined dimension that represents the height of the column of blood in the patient's jugular vein relative to at least one of the patient's sternal angle and a grossly immovable anatomical feature of the patient's torso, as determinable by a computer processor from the captured electronic video. In some such embodiments, the grossly immovable anatomical feature of the patient's torso is one of the patient's clavicular head, the cervical notch, and the sternum. In some embodiments, the height of the column of blood in the jugular vein relative to at least one of the patient's sternal angle and a grossly immovable anatomical feature of the patient's upper body is determinable by the processor from the captured electronic video without reference to a different image of the patient's neck at the time the electronic video was captured and / or without the need to fix the imaging device in a precise position relative to the patient's neck. In one example, the determination of the height of the JVP can rely on the reference element being of known size. With a known size, this allows for conversion between pixels (e.g., of the video captured by the imaging device) and physical distance. The video can be examined by a clinician to determine the location of the beat at the IJV. The distance or vertical height can be calculated using the number of pixels and the patient's angle (e.g., measured by the device's accelerometer). This can be done every time a JVP assessment is made using a captured video without reference to another image (e.g., a previously captured image where all of the distances between the various elements in the image are known).

[0051] In some embodiments, the imaging device does not directly contact the patient. In some embodiments, the imaging device is not held in a fixed position by a mechanical connection to the patient's body.

[0052] In another aspect, an implementation of the present technology provides a method of capturing electronic video of a human patient suitable for monitoring a cardiac, respiratory or cardiopulmonary condition with an apparatus including: (a) an electronic imaging device positionable relative to a patient's neck so as to capture electronic video of the patient's neck; (b) a position indicator external to the patient's body, the position indicator constructed for repeatable and stable positioning on the patient's body relative to an anatomical site on the patient's torso and connected to the imaging device; and (c) a reference element positionable relative to the patient's neck by positioning the position indicator, the method including: (i) positioning the apparatus relative to the patient so as to position the imaging device relative to the patient's neck so as to capture electronic video of the patient's neck; (ii) positioning the position indicator at a stable position on the patient's body relative to the anatomical site on the patient's torso, thereby positioning at least one of the reference element and the imaging device relative to the patient's neck such that the patient's neck and at least a portion of the reference element can be simultaneously captured in the electronic video by the imaging device without movement of the imaging device; and (iii) capturing the electronic video by the imaging device.

[0053] In some implementations, positioning the position indicator at a stable position on the patient's body relative to an anatomical site on the patient's torso causes both the reference element and the imaging device to be positioned relative to the patient's neck such that the patient's neck and at least a portion of the reference element can be captured in electronic video by the imaging device simultaneously without movement of the imaging device.

[0054] For a better understanding of the present technology, as well as other aspects and further features thereof, reference is made to the following description taken in conjunction with the accompanying drawings, in which: [Brief description of the drawings]

[0055] [Figure 1]FIG. 1 shows a view of a patient lying in bed at an angle and illustrates the perpendicular distance on the patient's IJV relative to the sternal angle that can be used to determine the patient's JVP height. [Figure 2A] FIG. 1 is a schematic block diagram illustrating a system for measuring a patient's JVP, according to one embodiment. [Figure 2B] FIG. 1 is a schematic block diagram illustrating a system for measuring a patient's JVP, according to one embodiment. [Figure 3A] 1A-1C are schematic diagrams illustrating various configurations of a sensing device and a base of a system for measuring JVP, according to embodiments. [Figure 3B] 1A-1C are schematic diagrams illustrating various configurations of a sensing device and a base of a system for measuring JVP, according to embodiments. [Figure 3C] 1A-1C are schematic diagrams illustrating various configurations of a sensing device and a base of a system for measuring JVP, according to embodiments. [Figure 4] FIG. 1 is a schematic block diagram illustrating a sensing device for measuring a patient's JVP positioned on the patient's supine notch (SN), according to one embodiment. [Diagram 5] 1 is a schematic flow chart illustrating a method for measuring a patient's JVP using a system including a sensing device and a base, according to one embodiment. [Figure 6] 1 is an isometric view of a device for capturing video of a human patient's neck suitable for monitoring the patient's JVP, according to one embodiment. The device is shown in a stored configuration. The isometric view captures the top, front, and right sides of the device. [Figure 7] FIG. 7 is an isometric view of the device shown in FIG. 6, showing the top, front and left sides of the device. [Figure 8] FIG. 7 is an isometric view of the device shown in FIG. 6, showing the top, back and right sides of the device. [Figure 9] 7 is a top, front and right isometric view of the device of FIG. 6, the device being shown in an operational configuration. [Figure 10]10 is an isometric view of the top, front and left sides of the device of FIG. 6 in the operational configuration shown in FIG. 9. [Figure 11] 7A-7C are isometric close-up views of the camera and light unit of the device of FIG. 6 taken from the top, right and rear of the camera and light unit. [Figure 12] FIG. 7 is a schematic diagram showing a patient with the camera and ride unit of the device of FIG. 6 on his / her torso in the appropriate operating position, taken from a first angle. [Figure 13] FIG. 2 is a front view illustrating a sensing device for measuring a patient's JVP, according to one embodiment. [Figure 14A] FIG. 14 is a bottom view of the detection device of FIG. 13. [Figure 14B] FIG. 14 is a rear view of the detection device of FIG. 13. [Figure 15A] FIG. 1 is a front isometric view showing a sensing device for measuring a patient's JVP, according to one embodiment. [Figure 15B] FIG. 15B is a top view showing the sensing device of FIG. 15A being held in a patient's hand, according to one embodiment. [Figure 16] FIG. 1 is a front isometric view showing a base for receiving a sensing device used to measure a patient's JVP, according to one embodiment. [Figure 17A] FIG. 17 is a top view showing the base of FIG. 16. [Figure 17B] FIG. 17 is a rear elevational view of the base of FIG. 16. [Figure 18] FIG. 17C is an isometric view of the system of FIGS. 17A-17B with a sensing device communicatively coupled thereto. [Figure 19A] 1A and 1B are front and rear isometric views, respectively, showing a system for measuring a patient's JVP including a sensing device operably coupled to and resting on a base, according to one embodiment. [Figure 19B] 1A and 1B are front and rear isometric views, respectively, showing a system for measuring a patient's JVP including a sensing device operably coupled to and resting on a base, according to one embodiment. [Figure 20]FIG. 19C is an exploded view showing the base of FIGS. 19A and 19B. [Figure 21] 1 is a schematic block diagram illustrating a system for measuring a patient's JVP, including a sensing device and a base, according to one embodiment. [Figure 22] 1 is a schematic block diagram illustrating a system for measuring a patient's JVP, including a sensing device and a base, according to one embodiment. [Figure 23] FIG. 13 shows a still image produced by an imaging assembly of a system for measuring a patient's JVP, which diagrammatically illustrates the relationship between variable neck rotations and lines in the still image plane, according to one embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0056] The systems, devices and methods described herein enable monitoring of various patient conditions, including, for example, JVP, and in some embodiments, the systems, devices and methods can be configured to enable monitoring in settings outside of a clinic, such as, for example, in a patient's home.

[0057] Referring to the figures, Figure 2A is a schematic block diagram of a system 100 for measuring a patient's JVP and / or other physiological parameters or conditions, according to one embodiment. The system 100 includes a sensing device 110, which may include an imaging assembly 112, a positioning element 118, and optionally an accelerometer or gyroscope 114 and / or one or more additional sensors 116. The system 100 includes a base 120, which may include a memory 122, a processor 124, a communication interface 126, and an input / output (I / O) device 128. The sensing device 110 is configured to measure the patient's JVP. The sensing device 110 may be operably coupled to the base 120 and may be configured to measure the JVP based on an actuation signal received from the base and to transmit a signal corresponding to the measured JVP to the base 120, as described herein.

[0058] Although described as being configured to measure a patient's JVP, in some embodiments, system 100 or any other system or sensing device described herein may be configured to measure or monitor carotid (arterial) pulsation, respiratory effort (normal and / or distressed), or may be used to monitor patients suffering from CHF, COPD, asthma, dialysis (both peritoneal and hemodialysis), cardiac tamponade, conditions resulting in elevated intracardiac pressure, cases in which excessive circulating blood volume is an issue (e.g., septic shock after volume resuscitation with IV fluids), or any other disease or condition. All such measurements, determinations, or diagnoses are contemplated and should be considered within the scope of the present disclosure.

[0059] The sensing device 110 may include a housing (not shown) within which the components of the sensing device, such as the imaging assembly 112, the accelerometer or gyroscope 114, the sensor and / or the positioning element 118, may be disposed, coupled, integrated, or integrally formed. The imaging assembly 112 is configured to capture a single image, a set of images, and / or a video of a portion of the patient's body (e.g., the patient's neck). For example, the imaging assembly 112 may be used to capture an image, a set of images, or a video of the patient's neck in an area of ​​the neck where the IJV engorgement is visible to determine the patient's JVP. In various embodiments, the imaging assembly 112 may include one or more imaging devices, such as, for example, a charged coupled device (CCD) camera, configured to capture an image and / or a video of a portion of the patient's body. In some embodiments, the imaging assembly 112 may also include one or more lenses (e.g., concave and / or convex lenses) and / or one or more filters (e.g., optical filters, software filters such as high pass filters, low pass filters, band pass filters, etc.) to facilitate image capture (e.g., at different wavelengths), reduce noise, and / or increase imaging focus. The imaging assembly 112 may be positionable relative to the patient's neck such that it is capable of capturing images and / or video of the patient such that it can capture engorgement of the patient's IJV, thereby capturing the patient's JVP. The imaging assembly 112 may generate a signal indicative of the captured image and communicate the signal to the base 120 (e.g., a processor 124 included in the base 120).

[0060] In some embodiments, the imaging assembly 112 may also include a light source or illumination mechanism (e.g., a source of electromagnetic radiation such as one or more light emitting diodes (LEDs)) for illuminating a portion of the patient's body (e.g., the neck). The light source can be configured to generate sufficient illumination for the cameras of the imaging assembly 112 to image the patient's body. In some embodiments, the illumination mechanism can be configured to generate light for capturing one or more images or videos. For example, the illumination mechanism can be configured to illuminate an area for optical imaging.

[0061] In some embodiments, the illumination mechanism may be configured to generate a reference element to provide a reference having known characteristics (e.g., size, shape, distance, etc.) that may enable, for example, a determination of the JVP (e.g., by one or more mathematical calculations). For example, the illumination mechanism may be configured to project electromagnetic radiation (e.g., visible, infrared, or ultraviolet (UV) light) in the form of a reference image or reference element onto the patient's neck within the field of view of an imaging device included in the imaging assembly 112. In some embodiments, the reference image may include one or more lines of projected light (e.g., three parallel lines or other suitable markings) onto an appropriate area of ​​the patient's neck. In some embodiments, the reference image may have markings that may facilitate mathematical calculations to be performed. For example, in some embodiments, the markings on the reference element may be one or more measurement scales (e.g., centimeters). In some embodiments, the markings may include numbers. In some embodiments, the markings may or may not include different patterns, colors, or other distinctions of structured electromagnetic radiation.

[0062] In other embodiments, the reference element may be a separate physical element that can be positioned on the patient's neck by the patient, a caregiver, or a physician prior to imaging the patient's neck with the imaging assembly 112. In operation, the sensing device 110 can be positioned on the patient's body such that the imager assembly 112 is positioned in a desired orientation relative to the patient's neck to enable video capture of an area in which venous distension is visible on the patient's neck. In the correct position, the reference element is positioned relative to the patient's neck such that (i) the reference element is also within the electronic imager frame, (ii) it can be captured on the video recorded by the imaging assembly 112, and (iii) mathematical calculations can be made from the captured video to calculate the patient's JVP.

[0063] In some embodiments, the imaging assembly 112 may include an illumination mechanism implemented as an electromagnetic radiation source providing electromagnetic radiation at least in the near infrared (NIR) spectrum, and a filter that selectively passes electromagnetic radiation in the NIR spectrum to the imaging device included in the imaging assembly 112. In some such embodiments, such a structured device helps reduce problems associated with ambient lighting. For example, artificial ambient lighting can introduce noise into the signal due to flicker. Having a dedicated light source in the NIR spectrum and a filter that passes only electromagnetic radiation in the NIR spectrum can substantially reduce noise due to flicker or other optical illumination noise. NIR imaging can also reduce the impact of skin tones on image processing.

[0064] In some embodiments, the imaging assembly 112 may include multiple imaging devices. For example, the imaging assembly 112 may include a first electronic imaging device and a second electromagnetic imaging device fixed in a predetermined position relative to the first electronic imaging device. Having two imaging devices fixed and separated by a known distance may allow for stereoscopic vision or depth sensing by computing a disparity or difference map. This may allow for the generation of a 3D model of the patient's structure (e.g., the neck) being imaged. In some embodiments, the first electronic imaging device may be a NIR spectrum imaging device and the second electronic imaging device may be a visible spectrum imaging device. In some such embodiments, the NIR spectrum imaging device captures images in grayscale while the visible spectrum imaging device captures images in color. Thus, the two imaging devices provide different information that may be useful for image processing, segmentation and feature identification. The color information combined with the NIR information may aid in feature identification and / or segmenting different objects from each other (e.g., clothing from skin, or body contours from background).

[0065] In some embodiments in which the patient's JVP is monitored, the reference element, which may be generated by an illumination mechanism (e.g., a visible or NIR electromagnetic radiation source) included in the imaging assembly 112 or in another part of the sensing device (e.g., in a positioning element or position indicator), may have a predetermined dimension that provides the height of the column of blood in the patient's veins relative to at least one of the patient's sternal angle and / or another macroscopically immovable anatomical feature of the patient's torso, for example, determinable by the processor 124 from a captured image or video of the patient's neck or part of the neck and the position indicator (e.g., positioning element 118). In some such embodiments, the other macroscopically immovable anatomical feature of the patient's torso is one of the patient's clavicle head, cervical notch, and sternum.

[0066] In some embodiments, the height of the blood column in the patient's veins relative to the patient's sternal angle and / or another grossly immovable anatomical feature of the patient's upper body can be determined by the processor 124 from the captured electronic video without reference to a different image of the patient's neck and / or without requiring that the imaging device be fixed in a precise position relative to the patient's neck at the time the electronic video was captured. For example, a known size of the fiducial can facilitate measurement of the JVP. For example, the known size of the fiducial can enable conversion between pixels (e.g., of the video captured by the imaging device) and physical distance. In some embodiments, the clinician may be able to examine the video and determine the location of the apex of the beat in the IJV. Alternatively or additionally, the processor 124 can be configured to identify the location of the apex of the beat in the IJV by processing the video data. The number of pixels and the angle of the patient (e.g., measured by the accelerometer or gyroscope 114) can be used to calculate a distance (e.g., vertical distance).

[0067] The accelerometer or gyroscope 114 may include, for example, a microelectromechanical (MEMS) accelerometer, a piezoelectric accelerometer, a piezoresistive accelerometer, a capacitive accelerometer, a rotational gyroscope, a vibration gyroscope, an optical gyroscope, any other suitable accelerometer or acceleration sensing device, or a combination thereof. In some embodiments, the accelerometer or gyroscope 114 may be used to determine whether the imaging assembly 112 is moving, for example, due to the sensing device 110 (e.g., the positioning element 118 of the sensing device 110) not being stably positioned on the patient's body as described herein. In some embodiments, the processor 124 included in the base 120 may be configured to receive a signal from the accelerometer or gyroscope 112 and activate the imaging assembly 112 based on a determination based on the accelerometer or gyroscope signal that the sensing device 110 is sufficiently stably positioned on the patient's body (e.g., stationary or moving less than a predetermined amount or rate) such that the imaging assembly 112 captures a clear image or video of the portion of the patient's body.

[0068] In another example, the accelerometer or gyroscope 114 may also be used to determine the patient's angle relative to a horizontal axis. For example, when measuring the patient's JVP, the patient's torso and neck may be tilted to the horizontal at an angle between about 30 degrees and about 60 degrees. Depending on the particular angle of the patient's tilt, the vertical height or distance between the sternal angle and the apex of the IJV beat point may vary, for example, as described above with reference to FIG. 1 . Thus, the accelerometer or gyroscope 114 may be configured to measure the angle of tilt and communicate it to the processor 124 of the base 120. In some embodiments, the processor 124 may be configured to activate the imaging assembly 112 when the patient is tilted at an angle between about 30 and about 60 degrees and the sensing device 110 is stably positioned on the patient's body. In some embodiments, the processor 124 may use the angle data acquired by the accelerometer or gyroscope 114, for example, in determining the vertical distance between the sternal angle and the apex of the IJV beat point to determine the JVP.

[0069] The sensing device 110 may also include one or more sensors 116 that may be configured to sense at least one physiological parameter of the patient. In some embodiments, at least a portion of the sensor 116 may protrude outwardly from or be entirely accessible through the housing of the sensing device 110 such that the sensor 116 may contact a portion of the patient's body (e.g., the patient's sternum or chest, or the patient's hand) to measure the patient's one or more physiological parameters. In some embodiments, the sensor 116 may include a contact sensor, an ECG electrode, a PPG sensor, any other suitable sensor, or a combination thereof. In some embodiments, the sensor 116 may be configured to contact the patient's skin, for example the skin of the patient's sternum or torso, or may be provided on a grip defined on the housing of the sensing device 110 such that the sensor 116 contacts the skin of the patient's hand or one or more fingers when the patient grips the sensing device to measure the patient's JVP (or any other physiological parameter described herein). In some embodiments, the sensor 116 may include at least two electrodes for contacting the patient's skin to capture an ECG signal. In some embodiments, one or more of the electrodes may contact the patient's skin when the sensing device 110 is properly positioned on the patient for image capture (e.g., by the imaging assembly 112). For example, in some embodiments, one of the electrodes may be on a location indicator (e.g., the positioning element 118) and positioned on the location indicator such that the electrode contacts the patient's skin when the location indicator is properly positioned on the patient's body.

[0070] In some embodiments, the sensor 116 may be used to send a signal that the sensing device 110 is positioned on the patient's body. In some embodiments, the signal from the sensor 116 is combined with a signal from the accelerometer 112, which may be used to determine whether the sensing device 110 is moving at a velocity above a predetermined threshold (e.g., at a velocity greater than 0.01 mm / sec or about 1 mm / sec, including all subranges and values ​​in between) and is therefore not yet stably positioned on the patient's body. In some embodiments, the processor 124 may be configured to automatically initiate video capture based on receiving appropriate signals from the sensor 116 and / or the accelerometer or gyroscope 114, for example, indicating that the sensing device 110 is stably positioned and that the tilt of the patient's torso and neck is within range for determining the patient's JVP.

[0071] In some embodiments, the sensor 116 can be synchronized with imaging data from the imaging assembly 112, for example by the processor 124 included in the base 120 (via the communication interface 126) or some other processor operatively coupled to the system 100. Thus, in some embodiments, the captured video and the data from the sensor 116 are coordinated or synchronized. In one non-limiting example, if the sensor 116 includes an ECG electrode or a pulse oximeter, the imaging assembly 112 may collect data in synchronization with the signal from the sensor 116. For example, the time when the sensor 116 data is recorded and the time when the image (video) data from the imaging device is recorded can be known or determinable in absolute and / or relative time by the processor 124. For example, in some embodiments, the clock of the sensor 116 and / or the accelerometer 114 can be used to gate the imaging device (or vice versa). In some embodiments, the processor 124 generates a clock signal that gates both the imaging assembly 112 and the sensor 116. In some embodiments, both the image data and the sensor data are time-stamped using the same clock signal, and the data is time-aligned in a post-processing step, for example by processor 124 or a remote processor (e.g., a user device such as a mobile phone, tablet, laptop computer or desktop computer, or a remote server).

[0072] In some embodiments, the sampling rate of the sensor 116 may be a multiple of the sampling rate of the imaging assembly 112. For example, in some embodiments, the ratio of the sensor 116 data sampling rate to the imaging assembly 112 data sampling rate may be from about 0.5:1 to about 10:1, including all values ​​and subranges therebetween, including about 2:1. If the ratio is 2:1, the sensor 116 data will be sampled at T1, T2, T3, T4, T5, etc., while the imaging assembly 112 data will only be sampled at T1, T3, T5, etc. (each T n and Tn+1(The interval between is constant.) In such an embodiment, the sensor 116 data can be used to assist in interpreting the imaging assembly 112 data.

[0073] In some embodiments, the sensor 116 may include a microphone or other sound capture device. The sound capture device may be used, for example, to capture the sound of the patient's voice when the patient is speaking, or to capture other sounds made by the patient (e.g., breathing, heart sounds, etc.). For example, the sound capture device may be contactable with the patient's skin and used to capture sounds made by the patient's body, such as heart sounds (e.g., from the opening and closing of heart valves), breathing sounds (e.g., from air moving in and out of the lungs), and / or blood flow sounds from blood flowing in blood vessels and / or through valves.

[0074] The positioning element 118 may be configured or structured to facilitate correct or desired positioning of the sensing device 110 on the patient's body (e.g., the torso or sternum), for example, to position the imaging assembly 112 in a correct or desired position relative to a portion of the patient's body (e.g., the patient's neck) for measuring or monitoring a condition of the patient. For example, in some embodiments, the positioning element 118 may be configured to facilitate positioning of the sensing device 110 such that a portion of the patient's body (e.g., the patient's neck) is within the field of view of the imaging device of the imaging assembly 112 when the sensing device 110 is positioned on the patient as guided by the positioning element 118. This may be desirable to enable the imaging assembly to perform proper monitoring of the JVP or any other condition or physiological parameter of the patient as described herein.

[0075] In some embodiments, the positioning element 118 may include or be implemented as a position indicator. For example, the positioning element 118 implemented as a position indicator may be a structure positionable on the patient's body relative to an anatomical location of the patient. In some implementations, this may be achieved by making at least a portion of the positioning element 118 sized and shaped to match the size and shape of a particular anatomical location of the patient's body. Examples of such anatomical locations are the patient's sternum, sternal angle, manubrium, clavicular head, and cervical notch. For example, in an implementation where the anatomical location is the patient's cervical notch, the positioning element 118 may have a spherical portion (e.g., a hemispherical protrusion coupled to or integrally formed with a base of a housing of the sensing device 110) that is sized to fit snugly within the cervical notch. In some embodiments, the positioning element 118 may include interchangeable or adjustable patient contact elements, which aid in positioning the positioning element 118 on the patient's torso, thereby allowing the positioning element to be customized to the patient (e.g., to accommodate size variations between patients, anatomical location variations, etc.) in order to properly position the imaging assembly 112 relative to a part of the patient's body (e.g., the neck). The positioning element 118 implemented as a position indicator can aid the imaging assembly (or an imaging device of the imaging assembly) in determining a fixed reference point (e.g., the sternal angle) by positioning and analysis (e.g., mathematical calculations). This can be achieved by image processing or mechanical measurement if there is a mechanical link between the imaging device and the position indicator. Thus, the position indicator also aids in positioning the device by enabling the determination of anatomical landmarks.

[0076] Additionally or alternatively, in some embodiments, the positioning element 118 includes at least one adjustable patient contacting element. If present, an adjustable patient contacting element may also aid in positioning the positioning element 118 on the patient's torso. In other embodiments, the positioning element 118 may additionally or alternatively be a replaceable element, for example, serving a similar purpose. In some embodiments, the sensing device 110 may include a first positioning element configured to be positioned on a first portion of the patient's body (e.g., a spherical element or portion configured to be positioned at the cervical notch) and a second positioning element spaced apart from the first positioning element and configured to be positioned on a separate portion of the patient's body (e.g., on the pectoral muscle or chest). Providing multiple positioning elements 118 may allow for a more substantially stable and correct positioning of the sensing device 110 on the patient's torso.

[0077] Sensing device 110 is operably coupled to base 120. In some embodiments, base 120 may include a base housing (not shown) that includes a groove, notch, cavity, pedestal, or the like, or that otherwise allows a portion of the housing of sensing device 110 to be placed on in a first configuration (e.g., a stored configuration or a charging configuration in which sensing device 110 is not in use). In some embodiments, the base housing of base 120 may include a pedestal that protrudes, protrudes, couples, or otherwise formed within the base housing, on which sensing device 110 may be placed in the first configuration.

[0078] In some embodiments, the base housing may include or define one or more grooves or cavities in which the positioning element 118 can be placed in the first configuration. For example, the base housing may define a first groove or cavity configured to receive the first positioning element 118 of the sensing device (e.g., a spherical portion included in the sternum alignment means) and a second groove or cavity configured to receive the second positioning element (e.g., a second protrusion or arm coupled to or integrally formed with the sensing device housing) in the first configuration. In some embodiments, the base housing may define one or more grooves and may also include an arm that may be configured to receive and / or support a portion of the sensing device housing in the first configuration. In use, the sensing device 110 may be removed from the base 120 and placed on the patient, for example, in the second configuration. In the second configuration, the sensing device 110 may be configured to perform a desired measurement of one or more physiological parameters of the patient.

[0079] In some embodiments, the sensing device 110 may be physically coupled to the base 120 via a linkage assembly (not shown). For example, the linkage assembly may include one or more arms (e.g., articulated arms) that physically couple the sensing device 110 to the base 120. In some embodiments, the linkage assembly may include a first arm hinged, pivoted, or otherwise rotatably coupled to the base housing and a second arm hinged, pivoted, or otherwise rotatably coupled to the first arm at a distal end and also hinged, pivoted, or otherwise rotatably coupled to a sensing device body of the sensing device 110 at a proximal end. Such a linkage assembly may provide a wide range of motion (e.g., 360 degrees of freedom of movement) to the sensing device 110 to facilitate correct or desired positioning of the sensing device 110 on the patient's body, as well as assist the patient in maintaining the sensing device 110 in a stable position on the patient's torso. Additionally, communication conductors (e.g., electrical conductors) may be routed through one or more arms to communicatively couple the sensing device 110 to the base 120 (or the processor 124 via the communications interface 126) and / or to enable the sensing device 110 to receive power from the base 120.

[0080] In some embodiments, the coupling assembly may include one or more conductors, such as electrical leads, electrical wires, flat cords, coil cords, or any other suitable electrical leads, that physically and communicatively couple the sensing device 110 to the base 120 (or to the processor 124 of the base 120 via the communication interface 126 of the base 120). The electrical leads may be permanently or removably connected to the sensing device 110 and / or the base 120. Such electrical leads allow full freedom of movement of the sensing device 120 by the patient, thereby facilitating correct positioning of the sensing device 110 on the patient's body (e.g., torso), as well as improving portability by reducing the weight and mobility of the system 100.

[0081] In some embodiments, the sensing device 110 may only be communicatively coupled to the base 120 and not physically coupled to the base 120. For example, the sensing device 110 may include a wireless transceiver (e.g., a half-duplex transceiver, a full-duplex transceiver, an RF transceiver, an optical transceiver, a BLUETOOTH transceiver, a WI-FI transceiver, a Near Field Communication (NFC) transceiver, any other suitable wireless transceiver, or a combination thereof) for transmitting and / or receiving signals (e.g., activation signals, stop signals, image or video data signals, accelerometer 114 data signals, sensor 116 data signals, or any other signals related to the operation of the system 100) to and from the base 120. In some embodiments, the sensing device 110 may include a power source (not shown) and a wireless charging mechanism (e.g., a wireless charging coil) configured to receive an electromagnetic charging signal from a corresponding wireless charging mechanism (e.g., a corresponding wireless charging coil) that may be included in the communication interface 126 of the base 120.

[0082] As previously mentioned, base 120 includes memory 122, processor 124, communication interface 126, I / O devices 128, and may include additional components to facilitate operation of sensing device 110. Memory 122 may be any suitable memory device configured to store data, information, computer code or instructions (such as those described herein), and / or the like. In some embodiments, memory 122 may be and / or include one or more of random access memory (RAM), static RAM (SRAM), dynamic RAM (DRAM), memory buffer, erasable programmable read only memory (EPROM), electrically erasable read only memory (EEPROM), read only memory (ROM), flash memory, volatile memory, non-volatile memory, combinations thereof, and the like. In some embodiments, memory 122 can store instructions that cause processor 124 to execute modules, processes, and / or functions associated with system 100, such as models, calculations, or other algorithms for analyzing images or video captured by imaging assembly 112, accelerometer 114 data, sensor 116 data, etc. In some embodiments, memory 122 may be configured to at least temporarily store image and / or video data, accelerometer 114 data, and / or sensor 116 data, for example, until the data is transmitted to a user device or a remote server.

[0083] The processor 124 may be any suitable processing device configured to run and / or execute a set of instructions or code. For example, the processor 124 may be and / or include one or more data processors, image processors, graphics processing units (GPUs), physical processing units, digital signal processors (DSPs), analog signal processors, mixed signal processors, machine learning processors, deep learning processors, finite state machines (FSMs), compression processors (e.g., data compression to reduce data rates and / or memory requirements), encryption processors (e.g., to secure wireless data and / or power transmissions), and / or the like. The processor 124 may be, for example, a general purpose processor, a central processing unit (CPU), a microprocessor, a microcontroller, a field programmable gate array (FPGA), an application specific integrated circuit (ASIC), a processor board, a virtual processor, and / or the like. The processor 124 may be configured to run and / or execute application processes and / or other modules, processes and / or functions associated with the system 100. The underlying device technology may be provided with a variety of component types, e.g., metal oxide semiconductor field effect transistor (MOSFET) technologies such as complementary metal oxide semiconductor (CMOS), bipolar technologies such as generative adversarial networks (GAN), polymer technologies (e.g., silicon-conjugated polymers and metal-conjugated polymer-metal structures), mixed analog and digital, and / or the like. In some embodiments, the processor 124 can be configured to receive data from one or more sensors, imaging assemblies, or other components of the sensing device 110 and process the data, e.g., to determine the patient's JVP height or other physiological parameters. Alternatively or additionally, the processor 124 can be configured to transmit data from one or more sensors, imaging assemblies, or other components of the sensing device 110 to one or more remote devices (e.g., via a network or cloud) for further processing and / or analysis.

[0084] The communication interface 126 may be any suitable device and / or interface capable of communicating with the sensing device 110 (e.g., any of the devices, sensors and / or data sources described above with respect to the sensing device 110, and / or any combination or portion thereof), a network (e.g., a local area network (LAN), a wide area network (WAN) or the cloud), or an external device (e.g., a user device such as a mobile phone, tablet, laptop or desktop computer). Additionally, the communication interface 126 may include one or more wired and / or wireless interfaces, such as, for example, an Ethernet interface, an optical carrier (OC) interface, and / or an asynchronous transfer mode (ATM) interface. In some embodiments, the communication interface 126 may be a network interface card and / or the like, which may include, for example, at least an Ethernet port and / or wireless (e.g., WI-FI® wireless, BLUETOOTH® wireless, cellular such as 3G, 4G, 5G, 802.11X Zigbee, etc.). In some embodiments, the communication interface 126 may include one or more satellite, WI-FI, BLUETOOTH, or cellular antennas. In some embodiments, the communication interface 126 may be communicatively coupled to an external device (e.g., an external processor), including one or more satellite, WI-FI, BLUETOOTH, or cellular antennas, or a power source, such as a battery or solar panel. In some embodiments, the communication interface 126 may be configured to receive imaging or video signals from the imaging assembly 112, movement or positioning signals from the accelerometer or gyroscope 114, and / or sensor data from the sensor 116. In some embodiments, the communication interface 126 may also be configured to communicate signals to the sensing device 110, such as activation signals for activating the imaging assembly 112 (e.g., one or more imaging devices and / or electromagnetic radiation sources included in the imaging assembly 112), the accelerometer or gyroscope 114, and / or the sensor 116.

[0085] The I / O device 128 may include any suitable device for receiving input from a user or communicating output to a patient or user. In some embodiments, the I / O device 128 may include an actuation mechanism or other user actuation element (e.g., touch button, push button, switch, touch pad, etc.) for turning on or otherwise activating the sensing device 110 or for allowing a user to input information, request information, or set various parameters of the sensor device 110 (e.g., image capture rate, video bit rate, light intensity, etc.). In some embodiments, the I / O device 128 may include visual indicators (e.g., LED lights, displays, etc.) for displaying information to the patient or user. Such information may include, but is not limited to, the patient's JVP, other patient physiological parameters such as the patient's blood oxygen, heart rate, blood pressure, temperature, time of day, communication interface status (e.g., WI-FI connection status), or any other suitable information or combinations thereof.

[0086] In some embodiments, the I / O device 128 may include a microphone. The microphone may be used, for example, to capture the audio of the patient's voice when the patient is speaking. This may be the case, for example, when the base 120 may include suitable hardware and software to enable a call to another person (e.g., a clinician) at a distance. Additionally or alternatively, the base 120 may include suitable hardware and software for providing computer-controlled voice instructions to the patient and for recording or otherwise processing the speech information returned by the patient. Additionally or alternatively, the microphone (or one of the microphones, if the I / O device 128 has multiple microphones) may be contactable with the patient's skin and may be used to capture sounds made by the patient's body, such as heart sounds (e.g., from the opening and closing of heart valves), breathing sounds (e.g., from air moving in and out of the lungs), and / or blood flow sounds from blood flowing in and / or through blood vessels. In such an embodiment, the microphone may be provided in the sensing device 110 (e.g., may be included in the sensor 116 of the sensing device 110). The microphone may be in electronic communication with the processor 126, for example, for storage of captured sounds and / or transmission of such sounds over a communications link.

[0087] In some embodiments, the I / O device 128 may include a speaker. In some embodiments, this may be the case, for example, when the base 120 includes hardware and software to enable telephony with another person (e.g., a clinician) at a distance. Additionally or alternatively, the base 120 or the sensing device 110 may include appropriate hardware and software to provide audible instructions to the patient, by computer-controlled voice and / or otherwise. Additionally or alternatively, the speaker (or multiple speakers, if there are multiple) may be used to enable the patient to hear their body sounds being captured by the microphone. In some embodiments, the speaker may be used to provide instructions to the user, for example, to position the sensing device 110 on the patient to measure JVP. In some embodiments, in response to signals received from the accelerometer or gyroscope 114, the sensor 116, and / or the imaging assembly 112, the processor 124 of the base 120 may be configured to generate instructions for the user (e.g., the patient) to help the user correct incorrect positioning or use of the sensing device 110. For example, if the accelerometer or gyroscope 114 provides data to the processor 124 such that the processor 124 detects that the patient is not at a proper angle for measuring JVP, the processor 124 can notify the user of such incorrect positioning via the speaker or other I / O device 124 (e.g., make a sound, turn on or flash a light, etc.) and / or instruct the user how to correct their positioning.

[0088] The processor 124 may be configured to perform any suitable operation to measure one or more physiological parameters of the patient and / or communicate such parameters to another remote device, as described in detail above with respect to the sensing device 110. In some embodiments, the processor 124 may be configured to communicate an activation signal to the sensing device 110 in response to an actuation mechanism being grasped by a user to activate the sensing device 110, such as to provide power to various components included in the sensing device 110. In some embodiments, the processor 124 may be configured to receive signals from an accelerometer to determine the tilt or recline angle of the patient's torso, the position of the imaging assembly 112 relative to a target portion of the patient's body (e.g., the patient's neck), and / or the speed or otherwise of the movement of the sensing device 110.

[0089] In response to determining that the angle of tilt of the patient's torso is within a predetermined range (e.g., within a range of about 30 degrees to about 60 degrees, inclusive), that a target portion of the patient's body (e.g., the patient's neck) is within a field of view of an imaging device of the imaging assembly 112, and / or that the sensing device is not moving or is moving at a threshold speed (e.g., less than 0.5 mm / sec), the processor 124 can be configured to instruct the imaging assembly to initiate imaging or video capture of the target portion of the patient's body. In some embodiments, the processor 124 can also be configured to activate an electromagnetic radiation source that may be included in the imaging assembly 112 as described herein above to illuminate the target portion of the patient's body and / or to project a reference element onto the target portion as described above.

[0090] In some embodiments, the system for measuring one or more physiological parameters of a patient can be a portable unit without a base. For example, FIG. 2B is a schematic block diagram illustrating another system 100' for measuring JVP and / or other physiological parameters of a patient according to one embodiment. The system 100' includes an imaging assembly 112', a positioning element 118', and a sensing device 110', which may optionally include an accelerometer or gyroscope 114', and / or one or more sensors 116'. The imaging assembly 112', the accelerometer or gyroscope 114', the sensor 116', and the positioning element 118' may be substantially similar to the imaging assembly 112, the accelerometer or gyroscope 114, the sensor 116, and the positioning element 118, respectively, described with respect to FIG. 2A, and therefore will not be described in detail herein.

[0091] Unlike system 100, system 100' does not include a base. Instead, sensing device 110' includes a memory 122', a processor 124', a communication interface 126, an I / O device 128', and a battery 129' that are positionable within a housing of sensing device 110' and communicatively coupleable to imaging assembly 112', accelerometer 114', and / or sensor 116'. Memory 122', processor 124', communication interface 126', and I / O device 128' may be substantially similar to memory 122, processor 124, communication interface 126, and I / O device 128 described in FIG. 2A. The battery 129' may include a rechargeable battery (e.g., Li-ion, NiCad, etc.) or a disposable battery and can be configured to power the imaging assembly 112', the accelerometer 114', the sensors 116', the memory 122', the processor 124', the communications interface 126', and / or the I / O devices 128'. In some embodiments in which the battery 129' is a rechargeable battery, the system 100' may include an electrical socket or jack configured to be plugged into an external power source, such as a wall outlet, via an electrical lead to charge the battery 129'. Incorporating memory 122', processor 124', communication interface 126', and I / O devices 128' into sensing device 110' increases the portability of system 100', for example, allowing system 100' to fit into a small package for a patient to carry while traveling, allowing the patient the flexibility to use system 100' in a location of the patient's choosing, and making it easier for the patient to position sensing device 110' on the patient's body.

[0092] 3A, 3B, and 3C are schematic diagrams illustrating various configurations for operably coupling a sensing device to a base of a system for measuring a patient's JVP or other physiological parameters, according to various embodiments. For example, FIG. 3A is a schematic block diagram of a coupling mechanism 230 configured to couple a sensing device 210 to a base 220. The sensing device 210 and the base 220 may be substantially similar to the sensing device 110 and the base 120 described above, and therefore will not be described in detail here. In some embodiments, the coupling mechanism 230 may include a linking arm that is articulatable and can provide a degree of movement or rotational freedom greater than about 180 degrees (e.g., up to about 360 degrees) about the X-axis, the Y-axis, and / or the Z-axis. For example, the coupling mechanism 230 may include a first arm 232 coupled to the sensing device 210 at a proximal end. In some embodiments, the proximal end of the first arm 232 may be pivotally, hingedly and / or rotatably coupled to the sensing device 210 (e.g., via a ball and socket joint, hinge, rotary joint, etc.) to enable rotation of the sensing device 220 relative to the first arm 232 about at least one axis (e.g., the X-axis).

[0093] A distal end of the first arm 232 is coupled to a proximal end of a second arm 234 included in the coupling mechanism 230 via a joint 236. The joint 236 may include any suitable joint (e.g., a rotary joint, a ball and socket joint, etc.) that allows the first arm to rotate about at least two axes (e.g., an X-axis and a Y-axis), for example, to allow at least 180 degrees of freedom of movement about at least two axes. The proximal end of the second arm 234 is coupled to the base 220. In some embodiments, the distal end of the first arm 234 may be rotatably coupled to the base (e.g., via a ball and socket joint, a rotary joint, etc.) such that the second arm 234 can rotate about at least one axis (e.g., the Y-axis). The coupling mechanism can thus provide various degrees or directions of movement of the sensing device 210 by allowing the sensing device to rotate about at least one axis relative to the first arm 232, rotation of the first arm 232 about the second arm 234 about at least two axes, and rotation of the second arm 234 about the base 230 about at least one axis (e.g., rotation through an angle of at least 180 degrees about the X-axis, Y-axis and / or Z-axis, and movement of the sensing device 210 proximal and distal to the base 220 so that the sensing device can be positioned on a patient to measure the patient's JVP and returned to the base 220 after the measurement is completed).

[0094] 3B is a schematic block diagram of a coupling mechanism 230' configured to communicatively couple the sensing device 210 to the base 220, according to one embodiment. The coupling mechanism 230' may include electrical conductors, electrical wiring, flat cords, coil cords, or any other suitable wiring configured to physically and communicatively couple the sensing device 210 to the base 220. Thus, the coupling mechanism 230' may be highly flexible to allow the patient to freely move the sensing device 210 relative to the base 220 (e.g., similar to moving a landline telephone handset from its base). Such a configuration may reduce the weight of the system including the sensing device 210 and the base 220, thereby improving portability and ease of use by the patient.

[0095] FIG. 3C is a schematic block diagram of a coupling mechanism 230''" configured to communicatively couple the sensing device 210 to the base 220, according to one embodiment. Unlike coupling mechanisms 230 and 230', this coupling mechanism includes a wireless coupling that communicatively couples, but is not physically coupled to, the sensing device 210 to the base 220 (e.g., similar to a landline wireless handset communicatively coupled to a telephone base). In some embodiments, the coupling mechanism 230'' may include a wireless transceiver (e.g., a half-duplex transceiver, a full-duplex transceiver, an RF transceiver, an optical transceiver, an Ethernet transceiver, a WI-FI transceiver, an NFC transceiver, any other suitable wireless transceiver, or a combination thereof) for transmitting and / or receiving signals (e.g., activation signals, stop signals, image data, accelerometer 114 data, sensor data, or any other data) to and from the base 220. In some embodiments, sensing device 220 may include a power source (not shown) and a wireless charging mechanism (e.g., a wireless charging coil) configured to receive an electromagnetic charging signal from a corresponding wireless charging mechanism (e.g., a corresponding charging coil) that may be included in base 220. Wireless coupling may further enhance portability, for example, by allowing a patient to carry sensing device 210 with them while traveling without having to carry base 220 with them.

[0096] 4 is a schematic block diagram of a sensing device 310 for measuring a patient's JVP positioned on the patient's supine notch SN, according to one embodiment. In some embodiments, the sensing device 310 can be physically and / or communicatively coupled to a base (e.g., any base described herein) using a coupling mechanism (e.g., any coupling mechanism described herein). As shown in FIG. 4, the sensing device 310 includes a body, an imaging assembly 311, a sternum alignment means 318a, and optionally a body support 318b.

[0097] More specifically, the body 311 may be ergonomically shaped to facilitate grasping of the body by the patient to operate the sensing device 310. For example, the body 311 may include an elongated member defining one or more curvatures, grooves, notches, recesses, etc., to provide an ergonomic grip for the patient to grasp or otherwise grasp the body 311, and thus the sensing device 310. The body 311 may define an interior volume within which at least some components of the sensing device 310 may be disposed. For example, as shown in FIG. 4, the sensing device may include an accelerometer or gyroscope 314, a sensor 316, and a communication interface 315 disposed within the interior volume. In some embodiments, the body 311 may optionally include, define, or be coupled to an arm joint 313.

[0098] The accelerometer or gyroscope 314 and the sensor 316 are substantially similar to the accelerometer or gyroscope 114 and the sensor 116, respectively, described with respect to the sensing device 110, and therefore will not be described in detail here. The communication interface 315 can be any suitable device and / or interface capable of communicating with a base (e.g., any of the bases described herein), a network (e.g., a LAN, a WAN, or the cloud), or an external device (e.g., a user device such as a mobile phone, tablet, laptop, or desktop computer). Additionally, the communication interface 315 can include one or more wired and / or wireless interfaces, such as, for example, an Ethernet interface, an Optical Carrier (OC) interface, and / or an Asynchronous Transfer Mode (ATM) interface.

[0099] In some embodiments, the communication interface 315 may be a network interface card and / or the like, which may include, for example, at least an Ethernet port and / or radio (e.g., WI-FI radio, BLUETOOTH radio, cellular such as 3G, 4G, 5G, 802.11X Zigbee, etc.). In some embodiments, the communication interface 315 may include one or more satellite, WI-FI, BLUETOOTH, or cellular antennas. In some embodiments, the communication interface 315 may be communicatively coupled to an external device, including one or more satellite, WI-FI, BLUETOOTH, or cellular antennas, or a power source such as a battery or solar panel. In some embodiments, the communication interface 315 may be configured to receive imaging or video signals from the imaging assembly 312, movement or positioning signals from the accelerometer 314, and / or sensor data from the sensor 316. In some embodiments, the communications interface 315 may also be configured to transmit signals, e.g., activation signals, to the imaging assembly 312, such as for activating the imaging assembly 112 (e.g., activating one or more light sources 312a or cameras 312b included in the imaging assembly 312), the accelerometer 314, and / or the sensor 316.

[0100] The imaging assembly 312 is coupled to, mounted to, or otherwise disposed at a distal end of the body 311 (e.g., an end for positioning at the suprarenal notch SN of the patient). The imaging assembly 312 includes a camera 312b, one or more lenses 312c, and optionally a light source 312a and / or a filter 312(d). The light source 312a may include any light source that projects electromagnetic radiation, such as visible light, infrared light, NIR light, ultraviolet (UV) light, or any suitable combination thereof, onto a target portion of the patient's body (e.g., the patient's neck), for example. The light source 312a may be configured to illuminate the target portion of the patient's body and / or project a reference image onto the target portion, as previously described herein.

[0101] The camera 312b may include any suitable image capture device, such as a CCD camera, configured to capture an image and / or video of the patient's body part. In some embodiments, the lens 312c may include one or more concave and / or convex lenses configured to enable optical focusing of the target part of the user's body by the camera 312b to capture a clearer image of the target part. The filter 312d may include one or more physical filters, such as optical filters (e.g., absorption or interference filters) that cover the surface of the lens 312c and / or software filters, such as high pass filters, low pass filters, band pass filters, etc., that enable capture of a clear image or video of the patient's body part and filter out noise.

[0102] In some embodiments, the sensing device 310 may optionally include a body support 318b. In some embodiments, the body support 318b may optionally be coupled to the imaging assembly 312. Alternatively, one or more body supports 318b may be coupled to one or more locations along the length of the body 311 of the sensing device 310. In some embodiments, the body support 318b may include a support structure that may be placed in contact with a patient's body, for example, to facilitate supporting and / or positioning the sensing device 310 on the patient's body. For example, the body support 318b may include a patient chest rest, which may be sized and / or shaped to rest on the patient's chest when the sensing device 310 (and thus also the imaging assembly and other components of the sensing device 310) is properly positioned on the patient, for example, for surgery. In some embodiments, the body support 318b may include one or more sensors (e.g., a sensor 316 for measuring one or more physiological parameters or other conditions of the patient). In some embodiments, body support portion 318b may include a ring-like structure coupled (e.g., screwed, snap-fitted, or friction-fitted) to the distal end of body 311. Body support portion 318b may be made of any suitable strong, rigid material, such as metal, plastic, polymer, etc.

[0103] The sternal alignment means 318a is coupled or formed at a proximal end of the body 311 and is configured to facilitate positioning of the sensing device 318 on the patient's tibial notch SN. In some embodiments, the sternal alignment means 318a may include, have, or define a bulbous portion (e.g., a hemispherical protrusion coupled to or integrally formed with the body 311) that is sized to fit within the tibial notch. In some embodiments, the sternal alignment means 318a may include a replaceable or adjustable patient contacting element that is customizable to the patient (e.g., to accommodate size variations between patients, anatomical site variations, etc.) to, for example, aid in positioning the sternal alignment means 318a on the patient's jugular notch SN. Once the sensing device 310 is properly positioned on the patient with the sternal alignment means 318a positioned within the jugular notch SN, the imaging assembly 312 may be properly positioned relative to a portion of the patient's body (e.g., neck) to capture video that can be used to, for example, determine the patient's JVP.

[0104] Additionally or alternatively, in some embodiments, the sternum alignment means 318a includes at least one adjustable patient contact element. If present, the adjustable patient contact element may also assist in positioning the position indicator on the patient's torso. In other embodiments, the entire sternum alignment means 318a may additionally or alternatively be a replaceable element, e.g., serving a similar purpose.

[0105] Positioning the sternal alignment means 318a over the patient's suprarenal notch SN positions the imaging assembly 312 in a desired position or orientation relative to a target portion of the patient (e.g., the neck) to enable the imaging assembly 312 to capture images and / or video of the patient, for example, to capture engorgement of the patient's IJV and thereby the patient's JVP. The imaging assembly 312 can capture images and communicate the images to a base (e.g., base 120) via the communications interface 315, for example.

[0106] In some embodiments, the body 311, the body support 318b and / or the sternum alignment means 318a may also include a reference element (e.g., any of the reference elements described herein above) coupled thereto. For example, the body 311, the body support 318b and / or the sternum alignment means 318a may include a portion that is positioned (or positionable) within the field of view of the imaging assembly 312 when the imaging assembly 312 is positioned for image capture of the patient's IVJ. In some embodiments, the sternum alignment means 318a may function as a reference element. In some embodiments, at least one of the body 311, the body support 318b and / or the sternum alignment means 318a may include an extendable or adjustable element (e.g., an arm). The adjustable element may be adjustable such that a length of the adjustable element may be adjusted to position at least a portion of the adjustable element adjacent the patient's neck and within the field of view of the imaging assembly 312 when the sensing device 310 is placed on the patient's torso.

[0107] 5 is a schematic flow chart of a method 400 for measuring a patient's JVP using a monitoring system (e.g., system 100, 100' or any other system described herein) including a sensing device (e.g., sensing device 110, 110', 210, 310 or any other sensing device described herein) and / or a base (e.g., base 120, 220 or any other base described herein), according to one embodiment. Although method 400 is described with respect to a particular configuration of system 100 including sensing device 110 and base 120, it is equally applicable to any other system including any sensing device or base described herein. All such embodiments are contemplated and should be understood to be within the scope of the present disclosure.

[0108] In some embodiments, monitoring can be performed using the monitoring systems described herein based on a pre-set schedule. For example, monitoring can occur once a day, twice a day, three times a day, hourly, etc. Depending on the particular application, a clinician or other medical professional can define the schedule on which a patient is monitored (e.g., for JVP).

[0109] At 402, a patient may be seated in a reclined position near the monitoring system 100. For example, the patient's torso may be reclined to an angle ranging from about 10 degrees to about 90 degrees, including all subranges or values ​​therebetween, such as between about 30 degrees and about 60 degrees. At 404, the monitoring system 100 is powered on. For example, the patient or a monitoring system operator may hold an activation button or switch to turn on the system 100. In some embodiments, powering on the system also optionally turns on an indicator (e.g., an audio and / or visual indicator such as an LED light or display) that indicates to the patient that the system 100 is powered on and ready.

[0110] Optionally, in some embodiments where the sensing device 110 is coupled to the base via a linkage assembly including an adjustable arm, the method 400 includes unlocking the adjustable arm at 406. The adjustable arm may include the articulated arm 230 or any other articulated arm as described with respect to the monitoring system 100. The adjustable arm may be unlocked and manipulated, for example, by a patient, a user, or an operator of the monitoring system, to move the sensing device 110 into proximity with the patient's torso. In some embodiments, the adjustable arm may be a robotic arm that may be remotely operated by an operator, for example a physician, and / or may be operated by a processor (e.g., autonomously based on preprogrammed instructions). At 408, the sternal alignment means (e.g., sternal alignment means 318a) of the sensing device 110 is positioned by the patient or operator over the patient's jugular notch, as described herein above. This also aligns the imaging assembly of the system 100 to the patient's neck such that the patient's IJV is within the field of view of the imaging assembly 112, as described herein above. In some embodiments, when sensing device 110 is held by a patient for placement of sensing device 110, the patient's hand holding sensing device 110 may contact one or more sensors (e.g., ECG, PPG, etc.) The patient's hand may maintain sensing device 110 in place while contacting such sensors.

[0111] At 410, the sensing device 110 is activated to capture video data of the patient's neck. For example, the processor 124 of the sensing device 110 may be configured to detect that the sensing device 110 is properly positioned (e.g., stably positioned and / or positioned at a proper angle) on the patient's torso based on data received from the accelerometer 114 and / or the sensor 116, and thus initiate image and / or video capture. In some embodiments, a patient-activated (or user-activated) switch may be activated by a user to activate the sensing device to capture data. At 412, the sensing device 110 captures data using the imaging assembly 112, the sensor 116, and / or the accelerometer or gyroscope 114. Such data may include, but is not limited to, ECG data, accelerometer or gyroscope data, imaging data, etc., as previously described herein.

[0112] As described above with reference to FIGS. 2-5, in some embodiments, the imaging assembly 112, the sensor 116, and / or the accelerometer or gyroscope 114 can be configured to transmit data (e.g., imaging data, ECG data, accelerometer or gyroscope data) to a processor, such as an on-board processor (e.g., a processor mounted on the sensing device, such as processor 124′) or a remote processor (e.g., a processor in a base or other remote computing device). The processor can be configured to use the data to determine various physiological parameters of the patient. In some embodiments, the processor can be configured to determine the patient's JVP height, as described above. Specifically, the processor in one embodiment can be configured to identify a longitudinal or major axis of the patient's neck, e.g., based on the imaging data, and determine (e.g., estimate) an angle of the major axis of the neck. The angle of the major axis of the neck can be determined relative to an angle of the sensing device (e.g., sensing device 110, 110′, etc.) or an angle of a portion of the sensing device (e.g., a reference element or a positioning element). The angle of the sensing device relative to vertical may be known or may be determined, for example, based on imaging data and / or accelerometer or gyroscope data. Thus, the angle of the long axis of the neck relative to vertical may be determined. The processor may also be configured to determine the location of the patient's sternal angle and the location of the maximal point of the IJV pulsation, for example, based on the imaging data and knowing that the sensing device is correctly positioned. The vertical height of the JVP may then be calculated, for example, using trigonometric calculations. Details of determining the angle of the long axis of the neck and the vertical height of the JVP are described with reference to FIG. 23.

[0113] In some embodiments, the method 400 may optionally include alerting the user or patient of the monitoring status of the system 100 at 414. The alert may include any suitable alert, such as a visual alert using a light source (e.g., an LED lamp) or an audio alert (e.g., using a speaker). The alert may indicate to the user that the monitoring or measurement session is complete. In some embodiments, the alert may also indicate to the user that there is an error in the monitoring or measurement session, for example, thereby prompting the user to adjust the positioning of the sensing device and / or other components of the system to resume data capture at 410-412. At 416, the sensing device 110 is returned to the base 120. For example, after the processor 124 determines that sufficient data has been captured to reliably measure the patient's JVP, the processor 124 may be configured to generate an alert to inform the patient or user that the data has been captured and the measurement session is complete so that the user can return the sensing device 110 to the base 120. In some embodiments, the sensing device may not operate with a base, such as sensing device 110' shown in FIG. 2B, and thus the sensing device is not returned to the base by the user, and the user can place the sensing device on a safe surface (e.g., a table).

[0114] 6-12, a device 500 for capturing video of a human patient's neck, suitable for monitoring the patient's JVP, according to one embodiment, is shown. Device 500 may be an example of a monitoring system, such as any of the monitoring systems described herein (e.g., monitoring systems 100, 100', etc.). Thus, device 500 may include components or elements that are structurally and / or functionally similar to those of other systems described herein, including, for example, systems 100, 100', etc.

[0115] Device 500 has three general components: a base 502, a positioning arm 520, and a camera and light unit 534. Each of these components is described in more detail in turn below.

[0116] As shown, the base 502 is generally cuboid, and thus has a front surface 502, a back surface 510, a right surface 506, a left surface 508, a top surface 512, and a bottom surface 514. The base 502 is designed to rest on a flat horizontal surface on legs 516 that extend downwardly from the bottom surface 514 of the base 502. Although not shown in the figures, one of ordinary skill in the art will appreciate that the base 502 is heavy enough to remain in place during normal operation of the device 500 (as described herein). That is, the base 502 is heavy enough so that the base 502 does not move, become unstable, or tip when the camera and light unit 534 (or imaging assembly) is (i) being moved from a stowed position to an appropriate operating position on the patient's torso for monitoring the patient's JVP, (ii) when in that appropriate operating position, and (iii) when being moved from that position back to the stowed position.

[0117] The base 502 has an internal cavity therein that may be accessible from the back surface 510, for example, for maintenance and / or repair. During normal operation of the device 500, the internal cavity of the base 502 does not need to be accessed. The following components are housed inside the cavity: a power source, a computer processor and associated elements (e.g., similar to the processor 124), computer memory (e.g., similar to the memory 122), wiring, wireless communication devices (e.g., similar to the communication interface 126), including cellular, WI-FI, BLUETOOTH, NFC, etc., sensors, and any other necessary or desirable conventional components currently used in electronic devices (e.g., cellular and / or WI-FI antennas). This list is illustrative and not limiting, as those skilled in the art will appreciate the details of conventional medical device design. In some embodiments, the back surface 510 of the base 502 may have recesses in which standard connectors for power and communication may be placed, such as, for example, USB / Thunderbolt™ ports, sockets for receiving the ends of power cords, etc. In some embodiments, base 502 has a plastic exterior with an internal metal frame. Alternatively, base 502 can include an exterior made of any suitable structure that provides sufficient rigidity to house the components therein.

[0118] The front surface 504 of the base 502 includes a power button and power indicator 518. The power indicator is an illuminated circle that surrounds the power button 518. The illuminated circle is illuminated when the device 500 is powered on. The front surface 504 of the base 502 also includes a shelf 536 that extends from the front surface 504. The shelf 536 provides a location for properly positioning and supporting the camera and light unit 534 when the camera and light unit 534 is in the stored configuration (the camera and light unit 534 is shown in the stored configuration in Figures 6-12).

[0119] The right side 506 and the left side 508 of the base 502 of the device 500 are flat and smooth (although this is not the case in all embodiments of the present technology).

[0120] A movable pivot arm 520 is attached to and extends from an upper surface 512 of the base 502 of the device 500. The movable pivot arm 520 has two main members, a lower arm member 522 and an upper arm member 524. Each of the arm members 522, 524 is elongated with a generally rectangular cross-section. The lower arm member 522 has a forward end 522a and a rearward end 522b. The upper arm member 524 also has a forward end 524a and a rearward end 524b. (The forward ends 522a, 524a and rearward ends 522b, 524b (respectively) of the arm members 522, 524 are consistently defined when the pivot arm 520 is in the stored configuration shown in Figures 6-12.)

[0121] 6-12, a forward end 522a of the lower arm member 522 is pivotally mounted to the upper surface 512 of the base 502. This pivotal mounting allows the lower arm member 522 to pivot in both a clockwise and counterclockwise direction when the pivot arm 522 is in the stored configuration and when the base 502 is viewed from above.

[0122] A rear end 522b of the lower arm member 522 is pivotally mounted to the pivot member 528. This pivotal mounting allows the pivot member 528 to pivot in both a clockwise and counterclockwise direction about a position 520 when viewed from above with the pivot arm 520 in the stored configuration.

[0123] The rear end 524b of the upper arm member 524 is also pivotally attached to a pivot member 528. This pivotal attachment allows the upper arm member 524 to pivot clockwise and counterclockwise when the base 502 is viewed from the left side 508 or the right side 506 with the pivot arm 502 in the stored configuration. Thus, due to the presence and structure of this pivot member 528, the rear end 524b of the upper arm member 522 can simultaneously pivot about two different pivot axes relative to the rear end 522b of the lower arm member 522.

[0124] The front end 524a of the upper arm member 524 is pivotally mounted in a predetermined position on a connecting member 566 that is part of the camera and light unit 534. This pivotable mounting allows the camera and light unit 534 to pivot clockwise and counterclockwise relative to the front end 524a of the upper arm member 524 when the base 502 is viewed from the left side 508 or the right side 506 with the pivot arm 520 in the stored configuration.

[0125] The camera and light unit 534 has an elongated main horizontal member 542 having two ends, a patient-contacting end 538 and a camera end 540. The patient-contacting end 538 is on a right side 542a of the main horizontal member 542. The camera end 540 is on a left side 542b of the main horizontal member 542. As can be seen in Figures 6-12, when the pivot arm 520 and camera and light unit 534 are in the stored configuration, the main horizontal member 542 of the camera and light unit 534 rests on a shelf 536 that extends from the front face 504 of the base 502.

[0126] The patient contacting end 538 of the main horizontal member 542 has a sternum alignment means 546. The sternum alignment means 546 is connected to the main horizontal member 542 via an attachment arm 544 that extends outwardly and downwardly from the right side 542a of the main horizontal member 542 (see, e.g., FIG. 10). The sternum alignment means 546 extends perpendicular to the attachment arm 544 and the main horizontal member 542. Thus, the sternum alignment means 546 extends from the front side 504 of the base 502 toward the rear side 506 of the base (see, e.g., FIG. 3). When the camera and light unit 534 is moved into an operational configuration, the sternum alignment means 546 is used to properly position the camera and light unit 534 using the sternum alignment means 546. In this regard, the underside of the sternum alignment means 547 has an interchangeable curvilinear patient contacting element 547 selected such that the contour of the element follows the particular patient who will be using the device 500. The forward end 550 of element 547 has a bulbous portion 548 sized to fit snugly into the patient's cervical notch 594 (FIG. 12). Thus, in this embodiment of the technology, the bulbous portion 548 of the forward end 550 of the curved patient contacting element 547 acts as a location indicator or locating element as described above. The portion of the curved element 547 rearward of the forward end 550 is also curved to fit the patient's, e.g., sternum below the cervical notch, when the alignment means 546 is properly aligned parallel to the patient's sagittal (longitudinal) plane (with bulbous portion 548 resting within the patient's cervical notch SN).

[0127] As seen in FIG. 10, the underside of the bulb 548 at the forward end 550 of the curved patient contacting element 547 carries a sensor unit 580. The sensor unit 580 has two sensors, an inner circular PPG sensor and an outer ring-shaped ECG electrode surrounding the PPG sensor. When the bulb 548 fits snugly within the patient's suprarenal notch SN, the sensors of the sensor unit 580 contact the patient's skin and can measure one or more physiological parameters or conditions of the patient. The sensor unit 580 is in electronic communication with a computer processor in the base 502 of the device 500.

[0128] As can be seen in Fig. 11, a second ECG electrode 582 can be located on the top surface of the alignment means 546. It is expected that when the camera and light unit 534 is properly positioned on the patient's torso in the operative position (Fig. 12), the hand H of the patient P will be placed on the sternum alignment means with the patient's skin in contact with the ECG electrode 582. Thus, when the device 500 is operational, both the ECG electrode of the sensor unit 580 and the ECG electrode 582 on the top surface of the alignment means 546 will be in contact with the patient's skin, allowing ECG readings to be taken by the device 500. The ECG electrode 582 is in electronic communication with a computer processor in the base 502 of the device 500 (wiring not shown).

[0129] The camera end 540 of the main horizontal member 542 includes a patient chest rest and a camera 560. The patient chest rest 554 is attached to a mounting member 552 that extends downwardly from the left side 542b of the main horizontal member 542 of the camera and light unit 534. The patient chest rest 554 is sized and shaped to rest on the patient's chest when the camera and light unit 534 is properly positioned on the patient's torso when in the operating position (e.g., FIG. 12) to help position and maintain stability of the camera and light unit 534. The patient chest rest 554 can thus act as a second positioning element.

[0130] The camera 560 is connected to the main horizontal member 542 via a mounting arm 558 that extends outwardly and upwardly from the left face 542b of the main horizontal member 542 of the camera and light unit 560. The camera 560 is pivotally mounted to the end of the mounting arm 558. The camera 560 has an aperture 562 through which an image is taken. The camera 560 may include a light or NIR emitter in the form of a ring surrounding the aperture 562. In some embodiments where a NIR emitter is used, a visible light emitter (e.g. in the form of a ring) may be incorporated to provide an indication to the user that the NIR is on or operational when not visible to the user. The camera 160 (and light / NIR emitter, if present) is in electronic communication with a computer processor in the base 502 of the device 500.

[0131] Extending rearwardly from the main horizontal member 542 is the above-mentioned connecting member 566. The connecting member 566 is pivotable relative to the main horizontal member 542, thereby allowing the camera and light unit 534 to pivot clockwise and counterclockwise when viewed from above.

[0132] An accelerometer and / or gyroscope (not shown) is disposed within the camera and light unit 534 and is in electronic communication with a computer processor in the base 502 of the device 500. Signals from the accelerometer and / or gyroscope are used to determine the angle of the camera and light unit 534 (and therefore the angle of the patient) relative to a horizontal reference axis or plane.

[0133] The device 500 can be set up by a clinician or other skilled medical personnel before first use. As part of the set up process, the clinician can select a suitable interchangeable curvilinear patient contact element 547 that is appropriately sized and shaped for the particular anatomy of the patient P (e.g., the bulb 548 is appropriately sized to fit snugly within the patient's suprarenal notch SN (see FIG. 12 )). The clinician also pivots the camera 560 (e.g., about a pivot position) as necessary to ensure that both the patient's neck N and the anterior end 650 (including the bulb 548) of the sternum alignment means 546 are within the camera's frame (e.g., so that images / videos taken by the camera 560 show both). The clinician then locks the camera's position in place to prevent it from being inadvertently altered by the patient P.

[0134] In device 500, bulb 548 at anterior end 550 of sternum alignment means 546 is of known size and shape. Thus, in addition to serving as a position indicator as described above, bulb 548 also serves as a reference element as described above. Although not shown, in some embodiments bulb 548 may have measurement scales thereon to facilitate its use as a reference element (e.g., to facilitate calculation of the relative positioning of the patient's anatomical features (e.g., suprajudicial notches SN and IJV)).

[0135] At home (or any other location where JVP monitoring using device 500 will occur), device 500 is placed on a flat surface (e.g., FIG. 12) and plugged into a power outlet. The patient then sits in an inclined position next to the flat surface on which device 500 is placed. The patient then presses the power button 518, and an indicator lights up to indicate that device 500 is powered on and ready for use.

[0136] 12, the patient P may then grasp the camera and light unit 534. Typically, the patient P will grasp the sternum alignment means 546 when moving the camera and light unit 534, although other portions of the main horizontal member 542 may also be grasped. This allows the patient P to move the camera and light unit 534 from the stored configuration (FIGS. 6-8) by pivoting and repositioning the pivot arm 520 and various other pivotable and / or movable components described above.

[0137] 9 and 12, the pivot arm 520 is pivoted and repositioned into its proper operating position / configuration. The patient P does this by moving the camera and light unit 534 through the air until the bulb 548 of the forward end 550 of the sternum alignment unit 546 fits snugly within the patient's supine notch SN and the sternum alignment unit 546 is aligned with the patient's sternum 598 (as described above). Due to the correct positioning of the camera and light unit 534 by the clinician during device set-up, the camera 560 is properly positioned in the correct position to take an image / video of the patient's neck N and bulb 548 when the patient P correctly positions the camera and light unit 534 in the proper operating position. The patient P does not adjust the camera 560.

[0138] After the patient P has properly positioned the camera and light unit 534, the patient P then places his / her hand H on the ECG electrodes 582 in the position shown in FIG. 12. The powered device 500 monitors input from the sensor unit 580, the ECG electrodes 582, and the accelerometer in the camera and light unit 534. Once the device 500 receives input from the accelerometer that the camera and light unit 534 is not moving and appropriate input from the sensor unit 580 and the ECG electrodes 582 that it is capable of monitoring the PPG and ECG of the patient P, the device 500 begins a monitoring session, captures video from the camera 560, and stores the video in the device's computer memory. Alternatively, once the sensing device is properly positioned, a user (e.g., the patient) can activate a patient or user-activated switch, and the device can wait a predetermined period of time (e.g., between about 1 second and about 10 seconds) before activating the imaging device to begin recording or measuring using the sensor and / or imaging device. The device 500 may be configured to emit an audible signal through a speaker when a monitoring session (and recording) begins and when a monitoring session (and recording) ends to inform the patient that the monitoring session has been successfully initiated and completed. After the monitoring session ends, the patient P grasps the camera and light unit 534, returns it to the stored configuration, and presses the power button 518 to turn off the device 500.

[0139] The stored video can then be sent to a clinician for analysis by any conventional means, such as via a communications interface (e.g., communications interface 126), via the internet if device 500 is so configured and connected to the internet, by retrieval of the video from device 500, by transmission to the clinician via a smart phone (or other device) and then the internet, by retrieval of the video from USB keyed device 500 which is physically given or sent to the clinician for analysis, etc. Alternatively or additionally, the stored video can be processed and the JVP signals extracted and displayed (e.g., as images, videos, etc.) to the clinician for viewing.

[0140] The monitoring process is then repeated by the patient, e.g., P, according to a schedule defined by the clinician.

[0141] 13-14B are various views of another sensing device 610 according to an embodiment. In some embodiments, the sensing device 610 can be used to capture video of a human patient's neck for the purpose of monitoring the patient's JVP. In some embodiments, the sensing device 610 can be communicatively coupled to at least a base (e.g., any of the bases described herein). The sensing device 610 can be structurally and / or functionally similar to other sensing devices described herein, including, for example, the sensing devices 110, 210, etc. For example, the sensing device 610 includes a sternum alignment means 618a disposed at a first end (e.g., a proximal end) of the body 611 of the sensing device 610 and an imaging assembly 612 disposed at a second end 610b (e.g., a distal end) of the body 611 of the sensing device 110.

[0142] The imaging assembly 612 includes a camera 612b configured to capture one or more images or videos of the patient's neck when the sensing device 610 is properly positioned on the patient's torso, as described herein. The camera 612b may be substantially similar to the camera 312b or any other camera, imager, or imaging device described herein. The imaging assembly 612 also includes a light source 612a disposed at a proximal end of the optical imaging assembly 612b and configured to project electromagnetic radiation (e.g., visible light, infrared light, NIR light, any suitable electromagnetic radiation, or combinations thereof) onto the patient's neck, which may include an LED light source or any other light source. As shown in FIGS. 13-14B, the light source 612a may be ring-shaped, although in other embodiments the light source 612a may have any suitable shape or size. In some embodiments, the light source 612a may be configured to project a reference element (e.g., a reference image) onto the user's neck, as described herein. The light source 612a may be substantially similar to the light source 312a or any other light source previously described herein.

[0143] In some embodiments, an aperture 617 may be defined in a proximal end of the imaging assembly 612b (e.g., the portion of the body 611 in which the camera 612a is disposed). The aperture 617 allows light to be transmitted therethrough to a sensing surface of the camera 612a. In some embodiments, one or more lenses and / or filters (e.g., lens 312c or filter 312d, respectively, or any other lenses and / or filters described herein) may be disposed upstream of the camera 612b and configured to focus electromagnetic radiation onto the camera 612b and / or filter noise as previously described herein. In some embodiments, a filter, such as a NIR filter, may be molded into the camera housing of the imaging assembly 612, for example, to allow NIR light to pass and be captured by the camera, while filtering out other light. This allows only NIR light to pass through to the camera, while reducing the effects of ambient lighting (from flickering artificial lighting).

[0144] In some embodiments, the imaging assembly 612 may be coupled to the body 611 at a joint 615. The joint 615 may include a hinge, a slip joint, a rotary joint, a ball and socket joint, or any other suitable joint configured to allow the imaging assembly 612 to rotate about at least one axis (e.g., an X-axis, a Y-axis, and / or a Z-axis) and / or move linearly relative to the body 611. In some embodiments, the joint 615 may be used to calibrate the sensing device 610 for a particular patient, for example, by a physician setting an angle between the imaging assembly 612 and the remainder of the sensing device 610 to facilitate capture of the neck and reference elements during use. After the physician sets the angle of the imaging assembly 612, the physician may lock that angle, for example, to prevent the patient from altering the calibrated sensing device 610.

[0145] The body 611 is configured to be grasped by a user's hand. The body 611 may define a ridge 613 shaped and sized to receive a patient's thumb, index finger, and / or web between the thumb and index finger around at least a portion thereof. The body 611 (e.g., a top surface of the body 611 to which the imaging assembly 612 is coupled or an elongated portion of the body 611) may also include one or more curved portions configured to conform to or be grasped by the patient's hand. Thus, the ridge and / or the one or more curved portions may act as an ergonomic handling mechanism to enable the patient to grasp the body 611 or position the patient's hand on the body 611 in a desired position or orientation.

[0146] The sternal alignment means 618a is configured to enable correct positioning of the sensing device 610 on the patient's torso. For example, the sternal alignment means 618a may include a bulbous or semi-bulbous portion extending from, coupled to, or otherwise integrally formed with, a bottom surface at the proximal end 618a of the body 611, configured to be placed at the patient's cervical notch, as previously described herein. In some embodiments, the sternal alignment means 618a may also include a position sensor 619 (e.g., an electrode) disposed on a bottom surface of the body 611 proximal to the bulbous portion. The position sensor 619 may be configured to contact the user's skin when the bulbous portion is placed at the cervical notch and generate a signal to the sensing device 610 or the patient indicating that the sensing device 610 is correctly positioned. In some embodiments, the sternal alignment means 618a may function as a reference element as described above.

[0147] In some embodiments, the sensing device 610 may also include a second positioning means 618b extending from, coupled to, or otherwise integrally formed with a bottom surface of the body 611. The second positioning means 618b is spaced apart from the sternum alignment means 618a such that the second positioning means 618b is disposed proximally relative to the imaging assembly 612. The second positioning means 618b may be configured to be positioned on the patient's chest (e.g., right pectoral muscle) to facilitate correct positioning of the sensing device 610 on the patient's torso.

[0148] Although not shown, in some embodiments, multiple light sources and multiple cameras can be used, for example, to capture image data in different regions (e.g., visible, NIR, and / or other frequencies). Thus, in some embodiments, two or more light sources may be used to project light onto a target region (e.g., the patient's neck), and two or more cameras can be positioned within the imaging assembly to capture reflected light from the target region. In such embodiments, the different light sources and cameras can facilitate the capture of different types of image data, which can be useful for capturing 3D and / or more informative data of anatomical features.

[0149] 15A and 15B show another example of a sensing device 710, for example for measuring JVP, according to an embodiment. Fig. 15A is a front isometric view of sensing device 710 according to one embodiment, and Fig. 15B is a top view of sensing device 710 of Fig. 15A being held by a patient's hand H. Sensing device 710 can be structurally and / or functionally similar to other sensing devices described herein, including, for example, sensing devices 110, 210, 610, etc.

[0150] The sensing device 710 includes an imaging assembly 712 disposed at a distal end of a body 711 of the sensing device 710. The imaging assembly 712 may also include a light source 712a, a camera 712b, and an opening 717 defined at a proximal end of the imaging assembly 712. The sensing device 712 also includes a sternum alignment means 718a disposed at a proximal end of the body 711, and a second positioning element 718b spaced apart from the sternum alignment means 718a. The body 711 also defines a ridge 713 substantially similar to the ridge 613 defined for the sensing device 610. The body 711, the imaging assembly 712, the sternum alignment means 718a, and the second positioning element 718b may be substantially similar to the body 611, the imaging assembly 612, the sternum alignment means 618a, and the second positioning means 618b described with respect to the sensing device 610, and therefore will not be described in detail here. In some embodiments, the sensing device 710 may also include a communication conductor 729 (e.g., a coil cord) configured to at least communicatively couple the sensing device 710 to a base (e.g., any of the bases described herein).

[0151] Unlike the sensing device 610, the sensing device 710 also includes a first sensor 716a and a pair of second sensors 716b disposed or located on the top surface of the body 711 located proximal to the ridge 713. In some embodiments, the first sensor 716a may include a PPG sensor configured to measure PPG data of the patient. The pair of second sensors 716b (hereinafter "second sensor 716b") may be located adjacent to the first sensor 716a. The second sensors 716b may include parallel electrodes spaced apart from each other and configured to measure the patient's ECG. In some embodiments, additional sensors may also be included, including, for example, a blood oxygen sensor configured to measure the patient's blood oxygen level, a temperature sensor configured to measure the patient's skin temperature, a skin electrodermal sensor configured to measure the patient's skin electrodermal data, etc.

[0152] 15B shows a patient's hand H positioned on the top surface of the body 711 such that the patient's thumb is positioned around at least a portion of the bump 713 and a portion of the palm of the patient's hand H is positioned over and in contact with the first sensor 716a and the second sensor 716b. The bump 713 can be sized and shaped to facilitate positioning of the patient's hand H on the sensing device 710 while gripping the sensing device 710 for proper positioning to take a JVP measurement. Specifically, the patient can grip the sensing device 710 as shown in FIG. 15B and position the sensing device 710 in the correct location on the patient's torso, thereby allowing the sensing device 710 to measure the patient's JVP and simultaneously measure the patient's pulse, ECG, blood oxygen, etc.

[0153] 16-17B are various views of a base 820, and FIG. 18 is an isometric view of a system 800 including a base 820 and a sensing device 810 communicatively coupled to the base 820, according to one embodiment. The sensing device 810 may be substantially similar to the sensing devices 610 or 710 (or other sensing devices described herein) and thus will not be described in detail here. The base 820 includes a housing 821 structured to receive the sensing device 810 thereon (e.g., for storage, charging, etc.). In some embodiments, the housing 821 may include an upper portion matable to a lower portion to define an interior volume within which various components of the base 820 may be disposed.

[0154] The upper surface of the housing 821 defines a first cavity 823 sized and shaped to receive the second positioning means of the sensing device 810 (e.g., second positioning means 618b, 718b or any other second positioning means described herein) and a second cavity 825 sized and shaped to receive the sternal alignment means of the sensing device 810 (e.g., sternal alignment means 618a, 718a or any other sternal alignment means described herein) when the sensing device 810 is placed on the base 820. The base 820 also includes a support arm 827 extending upwardly from the housing 821 configured to support at least a portion of the body of the sensing device 810, such as a portion of the body of the sensing device 810 to which the imaging assembly of the sensing device 810 is coupled (e.g., an elongated neck portion of the body of the sensing device 810). The support arm 827 may define a groove shaped and sized to receive at least a portion of the body of the sensing device 810. The elongated portion of the body of the sensing device 810 may offset the center of gravity of the sensing device 810, thereby making the sensing device 810 more likely to tip over. Thus, the support arm 827 provides support to the body of the sensing device 810, thereby allowing the sensing device 810 to rest stably on the base 820 when the sensing device 810 is placed on the base 820.

[0155] The base 820 may include an indicator light 828a disposed or provided on a first side wall of the housing 821 (e.g., a front side wall of the housing 821). The indicator light 828a may include a light source (e.g., an LED light) that can be configured to activate (e.g., turn on or illuminate) to indicate to a patient that the base 820 is coupled to a power source or is activated and / or that an imaging assembly of the sensing device 820 is capturing image or video data. The base 820 may include a power socket 828b disposed on or through a second side wall of the housing 821 opposite the first side wall. The power socket 828b is configured to accept a power cord to receive power from the power cord and can be configured to use the power to power various components included in the base 820 and / or the sensing device 810 and / or to charge a power source (e.g., a rechargeable battery) included in the base 820 and / or the sensing device 810.

[0156] The base 820 may include a first communication interface or port 828b and a second communication interface or port 828c. The communication interfaces 828b, 828c may include or be coupled to any suitable device and / or interface capable of communicating with the sensing device 810 (e.g., any of the devices, sensors and / or data sources described above with respect to the sensing device 810, and / or any combination or portion thereof), a network (e.g., a LAN, (WAN or cloud), or an external device (e.g., a user device such as a mobile phone, tablet, laptop or desktop computer). The communication interfaces 828b, 828c may also include or be coupled to one or more wired and / or wireless interfaces, such as, for example, an Ethernet interface, an optical carrier (OC) interface, and / or an asynchronous transfer mode (ATM) interface. In some embodiments, the communication interfaces 828b, 828c may include, for example, at least an Ethernet port and / or a wireless (e.g., WI-FI® wireless, BLUETOOTH® wireless, cellular, 802.11X, etc.) port. In some embodiments, the base 820 may include one or more communication devices, such as a satellite, WI-FI, BLUETOOTH, or cellular antenna, or a network interface card and / or the like. In some embodiments, the base 820 may include one or more communication devices, such as a satellite, WI-FI, BLUETOOTH, or cellular antenna, or a power source, such as a battery or solar panel (e.g., via communication interfaces 828b, 828c).

[0157] As shown in FIG. 18, unlike the embodiment of device 500 described with reference to FIG. 12, in which the sensing device and base are coupled to each other via an adjustable arm, the sensing system 810 and base 820 are coupled to each other via a wire connection. Such a connection allows for greater adjustability in the positioning of the sensing device 810 relative to the base 820 as described with reference to FIG. 3B above. This flexible wire connection can also reduce the weight and / or force on the base 820, for example, when positioning and / or adjusting the sensing device 810, thereby reducing the risk of undesired movement (e.g., tilting, slipping, etc.) of the base 820. Thus, the weight and / or form factor of the base 820 can also be reduced. In some embodiments, the sensing device 810 can also be removed from the wire connection, for example, by unplugging the wire connection from the sensing device 810. In such a configuration, sensing device 810 may include an on-board power source (e.g., a battery), a communication interface for transmitting and / or receiving signals and data from base 820, and / or a charging connection (e.g., contact electrodes, wireless, port, plug, etc.), for example, similar to that described above with reference to FIG. 3C. This flexible wire connection may facilitate greater portability of system 800, as compared to device 500, for example.

[0158] 19A and 19B are front and rear isometric views, respectively, of a system 900 for measuring a patient's JVP, including a sensing device 910 operably coupled to and resting on a base 920, according to one embodiment. The system 900 can be similar to other monitoring systems described herein, including, for example, the monitoring system 800 described above. The sensing device 910 includes a body 911 configured to rest on the base 920. The sensing device 910 includes an imaging assembly 910 disposed at a first end (e.g., distal end) of the body 911 and a sternum alignment means 918a disposed at a second end (e.g., proximal end) of the body. The sensing device 910 also includes a second positioning means 918b spaced apart from the sternum alignment means 918a. The sternum alignment means 918a and the second positioning means 918b may be disposed on a lower or bottom surface of the sensing device 910. The body 911, the imaging assembly 912, the sternum alignment means 918a and the second positioning means 918b may be substantially similar to the body 611 / 711, the imaging assembly 612 / 712, the sternum alignment means 618a / 718a and the second positioning means 618b / 718b and therefore will not be described in detail here. The sensing device 910 is communicatively coupled to the base 920 via a communication lead 929 (e.g., a coil cord). For example, as shown in FIG. 19A, a first end 929a of the communication lead 929 is coupled to the base 920 and a second end 929b of the communication lead 929 is coupled to the sensing device 910.

[0159] 20, which illustrates an exploded view of the base 920, the base 920 includes a housing 921 that is structured to receive the sensing device 910 thereon while the sensing device 910 is not in use or is otherwise stowed away for later use. As shown in FIG. 20, the housing 921 includes an upper housing portion 921a that is configured to be removably coupled (e.g., by a friction fit, by a snap fit, or by coupling members such as screws, nuts, bolts, rivets, etc.) or fixedly coupled (e.g., by adhesive or fusion) to a lower housing portion 921b to define an interior volume within which the various components of the base 920 are disposed.

[0160] The upper surface of the housing 921 defines a first cavity 923 sized and shaped to receive the second positioning member 918b of the sensing device 910 and a second cavity 925 sized and shaped to receive the sternum alignment member 918a of the sensing device 910 when the sensing device 910 is positioned on the base 920. The base 920 also includes a support arm 927 extending upwardly from the housing 921 configured to support at least a portion of the body 911 of the sensing device 910, as previously described herein. The support arm 927 may define a groove shaped and sized to receive at least a portion of the body 911 of the sensing device 910 to provide support to the body 911 of the sensing device 910.

[0161] The first cavity 923 and the support arm 927 may be shaped and configured differently than the cavity 823 and the support arm 827 of the base 820. In particular, the first cavity 923 may be larger (e.g., wider and / or deeper) than the first cavity 823. This may allow the sensing device 910 to be more securely positioned within the cavity 923. The support arm 927 may be smaller (e.g., narrower and shorter) than the support arm 927. In some embodiments, the support arm 927 may be smaller given the larger structure of the cavity 923, e.g., the support arm 927 may be smaller because the cavity 923 provides more support to the sensing device 910. In some embodiments, the larger sized first cavity 923 may provide a larger insertion area within which the second positioning means 918b may be positioned, which may facilitate positioning the sensing device 910 on the base 920 in a desired orientation.

[0162] The base 920 may also include an indicator light 928a disposed or provided on a first side wall of the housing 921a. The indicator light 928a may include a light source (e.g., an LED light) that can be configured to activate (e.g., turn on or illuminate) to indicate to a patient that the base 920 is coupled to a power source or activated and / or that an imaging assembly of the sensing device 820 is capturing image or video data. The base 920 may also include a power socket 828b disposed on or through a second side wall of the housing 921 opposite the first side wall. The power socket 928b is configured to accept a power cord to receive power from the power cord and can provide power to various components included in the base 920 and / or the sensing device 910.

[0163] The base 920 may include a memory 922 and a processor 924, which may be substantially similar to the memory 122 and the processor 124 as previously described herein, disposed within the housing 921. Additionally, the base 920 may also include a communication interface 928c provided or disposed on a second side wall included in the second portion 921b of the housing. The communications interface 928c may include any suitable device and / or interface capable of communicating with the sensing device 910 (e.g., any of the devices, sensors, and / or data sources described above with respect to the sensing device 910, or a combination or portion thereof), a network (e.g., a LAN, (WAN, or cloud), or an external device (e.g., a user device such as a mobile phone, tablet, laptop, or desktop computer). The communications interface 928c may also include one or more wired and / or wireless interfaces, such as, for example, an Ethernet interface, an optical carrier (OC) interface, and / or an asynchronous transfer mode (ATM) interface. In some embodiments, the communications interface 928c may include, for example, at least an Ethernet port and / or wireless (e.g., WI-FI® wireless, BLUETOOTH® wireless, cellular, 802.11X, etc.) interfaces. The base 920 may be a network interface card and / or the like, which may include a wireless LAN (e.g., Zigbee), etc. In some embodiments, the base 920 may include one or more communication devices, such as a satellite, WI-FI, BLUETOOTH, or cellular antenna. For example, as shown in FIG. 20, the base 920 may include a first antenna 929a (e.g., a horizontal antenna) and a second antenna 929b (e.g., a vertical antenna) to provide communication between the base 920 and an external device (e.g., a user device, a local server, a remote server, the cloud, etc.). In some embodiments, the base 820 may be communicatively coupled (e.g., via communication interface 928c) to an external device including one or more satellite, WI-FI, BLUETOOTH, or cellular antennas, or a power source, such as a battery or solar panel.

[0164] Different configurations of elements within the sensing device and base of the monitoring system described herein are possible. For example, FIG. 21 shows a schematic of one configuration of a system including a sensing device 1010 communicatively coupled to a base 1020, according to one embodiment. The sensing device 1010 and base 1020 can be structurally and / or functionally similar to other sensing devices and bases described herein, including, for example, sensing devices 110, 210, 310, 610, 710, etc., and bases 120, 220, 720, etc. The sensing device 1010 can be configured to measure the user's JVP as previously described herein. The sensing device 1010 includes a PCB 1019, which may include memory and / or a processor (and other associated circuitry). The sensing device includes a light source implemented as an LED 1012a and a camera 1012b, which may be substantially similar to light sources 312a and 312b, respectively, or any other light source or camera described herein. For example, the LED 1012a may include one or more illumination LEDs and may be implemented as a light ring or other structure in the sensing device 1010. The LED 1012a and the camera 1012b are communicatively coupled to a PCB 1019 and configured to receive an enable / disable signal from the base 1020 via the PCB 1019 to turn the LED 1012a on / off and / or to start or stop image and / or video capture by the camera 1012b.

[0165] The sensing device 1010 may also include one or more sensors. In some embodiments, the sensing device 1010 includes an ECG sensor 1016a, a PPG sensor 1016b, and at least one of a gyroscope 1014a or an accelerometer 1014b. The ECG sensor 1016a may include two or more electrodes spaced apart from one another and configured to capture the patient's ECG when the sensor contacts the patient's skin. The PPG sensor 1016b may be configured to measure the patient's PPG data (e.g., pulse, heart rate, oxygen saturation, blood pressure or blood pressure trend, respiratory rate, SpO2, respiratory effort, etc.). The gyroscope 1014a and accelerometer 1014b may generate data usable to detect the position or movement of the sensing device 110 and determine whether the patient is reclined in an appropriate orientation, whether the sensing device 1010 is positioned on the correct portion of the patient's torso, and / or whether the sensing device 1010 is relatively stationary after being placed on the patient's torso. Data from the gyroscope 1014a and accelerometer 1014b can be sent to a processor in, for example, the PCB 1019 and / or the base 1020, which can then start and / or stop the operation of the light source 1012a and / or the camera 1012b. The ECG sensor 1016a, the pulse oximetry sensor 1016b, the gyroscope 1014a and the accelerometer 1014b may be communicatively coupled to the base 1020 via the PCB 1019. In some embodiments, the PCB 1019 can pre-process the data from the sensors, for example to time align the data and / or clean the data, before passing the data from the sensors to the base 1020.

[0166] The base 1020 includes a disk storage 1022, a sensor actuation module 1024a, a data analysis module 1024b, and a network module 1026. The disk storage 1022 may include a memory (e.g., memory 122 described with respect to the base 120 or any other memory described herein) and is configured to receive and at least temporarily store raw or partially processed data from the camera 1012b, the gyroscope 1014a, the accelerometer 1014b, the ECG sensor 1016a, and the PPG sensor 1016b. The disk storage 1022 is configured to communicate the raw data to a data analysis module 1024b (e.g., a processor such as the processor 124 described with respect to the base 120 or any other processor described herein), which may be configured to process the data and communicate the processed data to the data storage 1022 for at least temporary storage.

[0167] In some embodiments, the data analysis module 1024b may be configured to receive data (e.g., patient data, historical data, or other data) from the network module 1026 and may use the data to process data received from the sensing device 1010 via the PCB 1019. The network module 1026 may include a WI-FI card 1026a and / or an Ethernet port 1026b configured to communicate with external devices (e.g., user devices, remote servers, health databases, clouds, etc.). In some embodiments, the base 1020 may be configured to receive patient data (populated from a worklist, such as a health database) via the network module 1026. The patient data may come from a remote computing device, such as a database, server, or other computing device, connected to the base 1020 via a network. In some embodiments, the connection for receiving the patient data may be a wired connection, while in other embodiments, the connection for receiving the patient data may be a wireless connection. The network module 1026 may transmit the patient data to a data analysis module 1024b, which may be configured to generate matching data based on the patient data or use the patient data for processing and / or analysis of data received from the sensing device 1010. In some embodiments, the network module 1026 may also be configured to receive transmissions from the disk storage module 1022. The transmissions may include processed data, raw data, and / or any other data, and the network module 1026 may be configured to generate an output (e.g., an output signal) indicative of the transmission and communicated by the network module 1026 to an external device (e.g., a computing device external to the base 1020). For example, the network module 1026 may include an antenna or other communication element for transmitting the output to an external server or database.

[0168] In some embodiments, the base 1020 may also include an activation button 1028b (e.g., similar to a patient-activated switch as described above). The activation button 1028b may be configured to be grasped (e.g., pressed) by a patient, user, or caregiver to activate / deactivate the base 1020 and thereby the sensing device 1010. In response to the activation button 1028b being grasped, a trigger collection signal or otherwise activate / deactivate signal is sent to the sensor activation module 1024a. In some embodiments, the sensor activation module 1024a may include a processor or controller configured to send activate / deactivate signals to the LED 1012a to turn on / off and to the camera 1012b to start / stop image or video capture.

[0169] 22 illustrates, in accordance with one embodiment, another configuration of a sensing system including a sensing device 1110 communicatively coupled to a base 1120. The sensing device 1110 and base 1120 may be structurally and / or functionally similar to other sensing devices and bases described herein. For example, the sensing device 1110 and base 1120 may be similar to the sensing device 1010 and base 1020, except that instead of a PCB in the sensing device (as shown in FIG. 21), there is a USB interface 1115 and / or input / output or GPIOs 1119 coupling various elements of the sensing device 1110 to associated processing modules and elements in the base 1120. In particular, one or more of the sensors (e.g., camera 1112b, ECG sensor 1116a, PPG sensor 1116b, gyroscope 1114a, accelerometer 1114a) may be coupled to the base 1120 via the USB interface 1115 and / or GPIOs 1119. The LED 1112a may also be coupled to the base 1120 via a USB interface 1115 and / or a GPIO 1119. Other aspects of the system configuration shown in Figure 22 are similar to those described with respect to the system configuration shown in Figure 21 and therefore will not be repeated here.

[0170] In some embodiments, one or more still images of the patient's neck with a sensing device (or at least a portion of a sensing device) positioned thereon can be captured using any of the imaging devices described herein (e.g., camera, imager, etc.). FIG. 23 shows an example of such a still image according to an embodiment. As shown in FIG. 23, a portion of the sensing device 1210 can be captured, including a positioning element 1218. The positioning element 1218 can be implemented as a position indicator having a portion positioned at the patient's cervical notch. In this still image, the end of the positioning element 1218 positioned at the cervical notch is known, i.e., at a fixed point (X,Y). The long axis of the patient's neck can rotate about this fixed position (X,Y). Thus, the long axis of the patient's neck can be determined, and its relationship to the fixed point (X,Y) can then be used to determine the angle of the neck relative to the angle of the sensing device 1210. Since the angle of the sensing device 1210 is known relative to vertical, the angle of the long axis of the neck relative to vertical can be determined, and trigonometric calculations can be used to determine the vertical height of the JVP. The still image can be segmented as shown diagrammatically in FIG. 23 using lines 1202-1208. The long axis of the neck can be best approximated using one of these lines 1202-1208. Although four lines are shown, it is understood that any number of lines can be used to segment the image and the line that best approximates the long axis of the neck can be determined. It is also understood that other methods of segmenting the image can be used, for example, by standard image processing techniques, to identify the long axis of the neck and / or other anatomical features in the image. The long axis of the neck can be aligned with the line that is closest to it, and the angle associated with that line can be used to approximate the angle of the long axis of the neck, which can then be used to determine the vertical height of the JVP as described above.

[0171] The present technology is not limited in its application to the details of construction and arrangement of components set forth in the above description or illustrated in the drawings. The present technology is capable of other embodiments and of being practiced or carried out in various ways. Also, the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting.

[0172] Certain systems, devices and / or methods described herein may be implemented in software (executed on hardware), hardware, or a combination thereof. Hardware modules may include, for example, general-purpose processors (or microprocessors or microcontrollers), field programmable arrays (FPGAs), and / or application-specific integrated circuits (ASICs). Software modules (executed on hardware) may be expressed in a variety of software languages ​​(e.g., computer code), including C, C++, Java, Python, Ruby, Visual Basic, and / or other object-oriented, procedural, or other programming languages ​​and development tools. Examples of computer code include, but are not limited to, microcode or microinstructions, machine instructions such as those produced by a compiler, code used to create web services, and files containing high-level instructions executed by a computer using an interpreter. Other examples of computer code include, but are not limited to, control signals, encryption code, and compression code.

[0173] The use of "including," "comprising," "having," "containing," "involving," and variations thereof herein is intended to encompass the items listed before it and optionally additional items. In the description, like reference numbers refer to similar elements.

[0174] Please note that as used in this specification and the appended claims, the singular forms "a," "an," and "the" include plural referents unless the context clearly dictates otherwise.

[0175] As used herein, the terms "about" or "approximately" in the context of a given value or range (whether directly or indirectly, e.g., "generally in line," "generally aligned," "generally parallel," etc.) refer to within 20%, preferably within 10%, and more preferably within 5% of the given value or range.

[0176] As used herein, the term "and / or" should be considered a specific disclosure of each of the two ten specified features or components with or without the other. For example, "A and / or B" should be considered a specific disclosure of (i) A, (ii) B, and (iii) each of A and B as if each were individually set forth in this specification.

[0177] Modifications and improvements to the above implementations of the technology may become apparent to those skilled in the art. The above description is intended to be illustrative and not limiting. Accordingly, the scope of the technology is intended to be limited only by the appended claims.

[0178] In the context of this specification, the words "first," "second," "third," etc. are used as adjectives solely to enable the nouns they modify to be distinguished from one another, and are not intended to describe any particular relationship between those nouns. Thus, for example, it should be understood that the use of the terms "first unit" and "third unit" is not intended to imply any particular kind, hierarchy, or order of / between those units (for example). Nor are these uses (alone) intended to imply that any "second unit" necessarily needs to be present in a given situation.

[0179] In the context of this specification, the term "embodiment" is generally used to refer to a physical realization of the technology, and the term "implementation" is generally used to refer to a method encompassed by the technology (which generally also involves a physical realization of the technology). The use of these different terms is not intended to be limiting or restrictive of the scope of the technology. These different terms are used simply to allow the reader to better assess the context when reading the lengthy specification.

[0180] The term "substantially" and similar terms used herein are intended to have a broad meaning consistent with common and accepted usage by those skilled in the art to which the subject matter of the present disclosure pertains. For example, the term "substantially flat" would mean that there may be a small amount of surface variation or undulation due to manufacturing variations present on an otherwise flat surface. Those skilled in the art reviewing this disclosure will understand that these terms are intended to enable the description of the particular features described and claimed without limiting the scope of those features to the precise configurations and / or numerical ranges shown. Thus, these terms should be interpreted to indicate that insubstantial or insignificant modifications or variations of the subject matter described and claimed are considered to be within the scope of the invention as set forth in the appended claims.

[0181] As used herein, terms such as "coupled" mean that two members are directly or indirectly joined to one another. Such joining may be fixed (e.g., permanent) or movable (e.g., removable or releasable). Such joining may be achieved by the two members or the two members and any additional intermediate members being integrally formed with one another as a single unitary body, or by the two members or the two members and any additional intermediate members being attached to one another.

[0182] It should be noted that the structure and configuration of the various exemplary embodiments are merely illustrative. Although only a few embodiments are described in detail in this disclosure, those skilled in the art reviewing this disclosure will readily appreciate that numerous modifications (e.g., changes in the size, dimensions, configuration, shape and proportions of the various elements, parameter values, mounting configurations, use of materials, colors, orientations, etc.) are possible without substantially departing from the novel teachings and advantages of the subject matter described herein. Other substitutions, modifications, changes and omissions may also be made in the design, operating conditions and configurations of the various exemplary embodiments without departing from the scope of the present invention.

[0183] Although the present specification contains many specific implementation details, these should not be construed as limitations on the scope of any invention or what may be claimed, but rather should be considered as descriptions of features specific to particular implementations of a particular invention. Certain features described in the present specification in the context of separate implementations may also be implemented in combination in a single implementation. Conversely, various features described in the context of a single implementation may also be implemented in multiple implementations separately or in any suitable subcombination. Also, although features may be described above as acting in a particular combination and may even initially be claimed as such, one or more features of a claimed combination may, in some cases, be excluded from the combination, and the claimed combination may be directed to a subcombination or variations of the subcombination.

[0184] The above describes specific implementations of the present invention. Other implementations are within the scope of the following claims. In some cases, the actions recited in the claims can be performed in a different order and still achieve desirable results. Moreover, the processes depicted in the accompanying figures do not necessarily require their particular order or sequential order to achieve desirable results. In certain implementations, multitasking and parallel processing may be advantageous.

Claims

1. a locator element sized and shaped to conform to the size and shape of a particular anatomical site on a patient's chest, the locator element being repeatably and stably positionable on the patient's body relative to the anatomical site; a reference structure connected to or integral with the positioning element, the reference structure having known spatial characteristics and positionable relative to the patient's neck by positioning the positioning element; an imaging assembly coupled to the positioning element and spaced apart from the positioning element, the imaging assembly configured to capture imaging data of at least a portion of the patient's neck and at least a portion of the reference structure; a processor operably coupled to the imaging assembly, the processor configured to determine a jugular venous pressure (JVP) level relative to an anatomical feature of the patient based on the imaging data and the known spatial characteristics of the reference structure.

2. The apparatus of claim 1 , wherein the positioning element includes the reference structure.

3. The device of claim 1 , wherein the positioning element includes a bulb configured to fit within the patient's cervical notch.

4. the positioning element includes a first positioning element; The device of claim 1 , further comprising a second positioning element configured to rest against a portion of the patient's chest.

5. the positioning element, the reference structure, and the imaging assembly are disposed on a sensing device, and the processor is disposed in a base; 5. The apparatus of claim 1, wherein the base includes a surface including a set of structures configured to receive a portion of the sensing device and stably support the sensing device on the surface of the base.

6. 5. The device of claim 1, wherein the imaging assembly is coupled to the positioning element such that when the positioning element is positioned within the cervical notch, the imaging assembly can be positioned to capture the imaging data of at least the portion of the patient's neck and the portion of the reference structure.

7. 5. The apparatus of claim 1, wherein the imaging assembly includes a near-infrared (NIR) light source configured to emit NIR light toward the neck of the patient, and an NIR camera configured to capture NIR light reflected from the neck of the patient.

8. 5. The apparatus of claim 1, wherein the imaging assembly includes first and second cameras, each configured to capture light in a different wavelength range.

9. 9. The apparatus of claim 8, wherein the first camera is configured to capture visible light and the second camera is configured to capture NIR light.

10. 5. The apparatus of claim 1, wherein the imaging assembly includes first and second cameras configured to capture light in the same wavelength range to provide stereoscopic viewing.

11. the processor: determining a transformation between a pixel of the imaging data and a difference in a physical measure of distance based on the portion of the reference structure captured in the image data; 5. The apparatus of claim 1, configured to determine the height of the JVP relative to the anatomical features of the patient.

12. the processor: determining a transformation between pixels of the imaging data and a difference in physical measurements of distance based on the portion of the reference structure captured in the image data; determining a pulsation peak of the patient's internal jugular vein (IJV) from the imaging data; determining a vertical height between the patient's sternal angle and the highest point of the beat of the IJV based at least on a transformation between the pixels of the imaging data and the physical measurement of distance, thereby 5. The apparatus of claim 1, configured to determine the height of the JVP relative to the anatomical features of the patient.

13. further comprising at least one of an accelerometer or a gyroscope configured to measure an orientation of the patient's neck relative to a horizontal plane; 13. The apparatus of claim 12, wherein the determination of the vertical height is further based on an angle of tilt of the patient's neck determined based on the measured orientation of the neck.

14. The method of claim 1, further comprising at least one of an accelerometer or a gyroscope configured to measure the orientation of the patient's neck relative to a horizontal plane; 13. The apparatus of claim 12, wherein the determination of the vertical height is further based on an angle of tilt of the patient's neck determined based on the measured orientation of the neck.

15. the processor: determining an angle of a longitudinal axis of the neck relative to an angle of the device based on a still image of the portion of the patient's neck and a portion of the device; determining a pulsation peak of the patient's internal jugular vein (IJV) from the captured image; determining a vertical height between the patient's sternal angle and the highest point of the pulse of the IJV based on the angle of the longitudinal axis of the neck and the highest point of the pulse of the IJV, thereby 5. The device according to claim 1, configured to determine the JVP of the patient.

16. 5. The apparatus of claim 1, further comprising an actuator configured to be actuated by the patient to cause the processor to actuate the imaging assembly to capture the imaging data.

17. 5. The device of claim 1, further comprising one or more sensors including at least one of an electrocardiogram sensor, a photoplethysmogram sensor, a skin potential sensor, or a temperature sensor.

18. 18. The device of claim 17, wherein the one or more sensors are disposed on the body coupled to the imaging assembly and the positioning element such that when the patient grasps the body to position the positioning element relative to the cervical notch, a portion of the patient's hand contacts the one or more sensors to facilitate measurements by the one or more sensors.

19. 18. The device of claim 17, wherein the one or more sensors are disposed on a body coupled to the imaging assembly and the positioning element such that when the positioning element is positioned relative to the supine notch, the one or more sensors contact the patient's skin to facilitate measurements by the one or more sensors.

20. An apparatus described in any one of claims 1 to 4, further comprising a second reference element physically separated from the positioning element and positioned so that the imaging data captured by the imaging assembly includes at least a portion of the second reference element.

21. The device of claim 20, wherein the second reference element is positionable on the neck of the patient.

Images