# US 2019/0167161 A1 · Total hemoglobin screening sensor > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2019/0167161 A1 - Document ID: US20190167161A1 - Status: Published application - Kind: A1 - Application number: 16/268,345 - Filed: 2019-02-05 - Published: 2019-06-06 - Earliest claimed: 2014-09-04 - Assignees: Masimo Corporation - Applicants: Masimo Corporation - Inventors: Ammar Al-Ali; Keith Ward Indorf - Web page: https://patentgrep.com/patent/US20190167161A1 ## CPC - A61B 5/1455: using optical sensors, e.g. spectral photometrical oximeters - A61B 5/14552: {Details of sensors specially adapted therefor} - A61B 5/6826: {Finger} - A61B 5/7221: {Determining signal validity, reliability or quality (preventing, reducing or removing noise induced by motion artefacts A61B5/7207; noise originating from a therapeutic or surgical apparatus A61B5/7217)} - A61B 5/7275: {Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor} - G16H 40/63: for local operation - G16H 50/30: for calculating health indices; for individual health risk assessment - A61B 5/02055: {Simultaneously evaluating both cardiovascular condition and temperature} - A61B 5/742: {using visual displays (displays for heart-related electrical signals, e.g. ECG, A61B5/339)} - A61B 5/746: {Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms} - A61B 2560/0443: Modular apparatus - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA ## Abstract A total hemoglobin index system derives total hemoglobin (tHb) index value utilizing a depopulated emitter with an index set of LEDs. A patient fails a tHb index test if tHb measurements are trending down and/or tHb values fall below a predefined index threshold. If a patient fails the tHb index test, a high resolution sensor derives a specific tHb measurement utilizing a high resolution set of LEDs. The number of high resolution set LEDs is greater than the number of index set LEDs. ## Claims ### Claim at position 1 1-17. (canceled) ### Claim 18 A physiological monitoring system for measuring total hemoglobin in a patient comprising: a first optical sensor configured to measure a first total hemoglobin estimate, the first optical sensor including: a first plurality of emitters configured to emit optical radiation comprising one or more wavelengths towards tissue at a tissue measurement site when the first optical sensor is in use, wherein pulsatile blood flows through the tissue of the patient at the tissue measurement site; a first detector configured to detect the optical radiation emitted from the first plurality of emitters after attenuation by the pulsatile blood flowing through the tissue at the tissue measurement site when the first optical sensor is in use, the first detector further configured to output a first signal responsive to the detected, attenuated light after being emitted by the first plurality of emitters; a second optical sensor configured to measure a second total hemoglobin estimate, the second optical sensor including: a second plurality of emitters configured to emit optical radiation comprising one or more wavelengths towards the tissue at the tissue measurement site when the second optical sensor is in use; and a second detector configured to detect the optical radiation emitted from the second plurality of emitters after attenuation by the pulsatile blood flowing through the tissue at the tissue measurement site when the second optical sensor is in use, the second detector further configured to output a second signal responsive to the detected, attenuated light after being emitted by the second plurality of emitters; wherein the second plurality of emitters of the second optical sensor comprises more emitters than the first plurality of emitters in the first optical sensor; a physiological monitor configured to communicate with the first optical sensor and the second optical sensor and receive at least one of the first signal responsive from the first optical sensor and the second signal from the second optical sensor, the physiological monitor further configured to provide an indication to measure the second total hemoglobin estimate with the second optical sensor if the first total hemoglobin estimate is below a predetermined threshold. ### Claim 19 (depends on 18) The system according to claim 18, wherein the first plurality of emitters of the first optical sensor comprise four LEDs and the second plurality of emitters of the second optical sensor comprise eight LEDs. ### Claim 20 (depends on 19) The system according to claim 19, wherein each of the four LEDs of the first optical sensor comprises a different wavelength selected from the group consisting of 660 nm, 905 nm, 1170 nm, and 1300 nm. ### Claim 21 (depends on 18) The system according to claim 18, wherein at least one of the first optical sensor and the second optical sensor comprise a sensor connector in electrical communications with the physiological monitor. ### Claim 22 (depends on 18) The system according to claim 18, wherein the tissue measurement site is located on a finger of the patient. ### Claim 23 (depends on 22) The system according to claim 22, wherein at least one of the first optical sensor and the second optical sensor comprise an adhesive butterfly wrap configured to secure to the finger of the patient when in use. ### Claim 24 (depends on 18) The system of claim 18, wherein the physiological monitor is further configured to generate a total hemoglobin index display comprising the first total hemoglobin estimate. ### Claim 25 (depends on 24) The system of claim 24, wherein the total hemoglobin index display of the physiological monitor has no time axis and comprises a vertical bar graph for indicating a range of relative total hemoglobin values. ### Claim 26 (depends on 25) The system of claim 25, wherein the total hemoglobin index display further comprises a pointer configured to move vertically so as to indicate a present total hemoglobin index value. ### Claim 27 (depends on 26) The system of claim 26, wherein the total hemoglobin index display further comprises a trend indicator. ### Claim 28 A method for measuring total hemoglobin in a patient, the method comprising: attaching a first optical sensor to the patient, the first optical sensor configured to measure a constituent of the patient's blood, the first optical sensor comprising: a first plurality of emitters configured to emit optical radiation comprising one or more wavelengths towards tissue at a tissue measurement site, wherein pulsatile blood flows through the tissue of the patient at the tissue measurement site; and a first detector configured to detect the optical radiation emitted from the first plurality of emitters after attenuation by the pulsatile blood flowing through the tissue at the tissue measurement site, the first detector further configured to output a first signal responsive to the detected, attenuated light after being emitted by the first plurality of emitters; measuring a first total hemoglobin estimate using the first optical sensor; and if the first total hemoglobin estimate is below a predetermined threshold, replacing the first optical sensor with a second optical sensor and measuring a second total hemoglobin estimate with the second optical sensor, wherein the second optical sensor comprises: a second plurality of emitters configured to emit optical radiation comprising one or more wavelengths towards the tissue at the tissue measurement site; and a second detector configured to detect the optical radiation emitted from the second plurality of emitters after attenuation by the pulsatile blood flowing through the tissue at the tissue measurement site, the second detector further configured to output a second signal responsive to the detected, attenuated light after being emitted by the second plurality of emitters, the second plurality of emitters comprising more emitters than the first plurality of emitters in the first optical sensor. ### Claim 29 (depends on 28) The method according to claim 28, wherein measuring the first total hemoglobin estimate further comprises transmitting the first signal of the first optical sensor to a physiological monitor. ### Claim 30 (depends on 29) The method of claim 29, wherein at least one of the first optical sensor and the second optical sensor comprise a sensor connector in electrical communications with the physiological monitor. ### Claim 31 (depends on 29) The method according to claim 29, further comprising: analyzing the first signal to determine a total hemoglobin trend; and graphically showing the total hemoglobin trend on a display of the physiological monitor. ### Claim 32 (depends on 31) The method of claim 31, wherein the display of the physiological monitor has no time axis and comprises a vertical bar graph for indicating a range of relative total hemoglobin values. ### Claim 33 (depends on 32) The method of claim 32, wherein the display further comprises a pointer configured to move vertically so as to indicate a present total hemoglobin index value. ### Claim 34 (depends on 28) The method of claim 28, wherein the first plurality of emitters of the first optical sensor comprise four LEDs and the second plurality of emitters of the second optical sensor comprise eight LEDs. ### Claim 35 (depends on 28) The method of claim 28, wherein the tissue measurement site is located on a finger of the patient. ### Claim 36 (depends on 35) The method of claim 35, wherein at least one of the first optical sensor and the second optical sensor comprise an adhesive butterfly wrap configured to secure to the finger of the patient when in use. ### Claim 37 (depends on 28) The method of claim 28, wherein measuring the first total hemoglobin estimate comprises sequentially transmitting 660 nm, 905 nm, 1170 nm, and 1300 nm wavelengths from the first optical sensor into a fingernail portion of the tissue measurement site.