The report generated by the brain4care system has five sections that organizes all information acquired and processed for a monitoring sesion.
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Report Header
The first report section is a summary of the monitoring session information including patient identification, monitoring session identification, sensor and patient information, observations, and patient clinical context.
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Patient Identification:
this sub-section contains all information to uniquely identify a patient.
Patient name: field used to identify the patient with his/her full name
Social name: field used to identify the patient with his preferred name.
Birthday - patient date of birth and current age;
Gender - patient gender;
Document - patient document ID (optional field)
Appointment (ID): field to identify the appointment ID.
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ATTENTION - Appointment (ID) field title and meaning can be customized according to the organization you are working with. Please consult your clinical engineering team if you have any questions. |
Monitoring observations:
indicates how many observations were included in the monitoring session.
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Monitoring session information:
this sub-section contains information that identifies the monitoring session The report generated by the brain4care system has five sections that organizes all information acquired and processed for a monitoring sesion. The report generated by the brain4care system has five sections that organizes all information acquired and processed for a monitoring session.
UMI: monitoring session unique ID;
Beginning: date and time of session start;
Duration: how long the monitoring session took.
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Sensor sensor unique identifier (UDI);
Sensor initial position: sensor’s position on patient head at start of monitoring session’.
Patient initial position: patient’s position on patient head at start of monitoring session.
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The available options for sensor position are
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The available options for patient position are
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Patient clinical context:
information entered by the health professional at the beginning of the monitoring session.
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Security watermark:
this is a safety feature printed throughout the report that indicates who, when and from which system the report was generated from. This inhibits any unauthorized report replication.
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Report Footer
This report section is included in every report page with relevant disclaimer plus
support email contact
support telefone
support web address
hospital name
UMI: report unique identifier
report page number
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ICP Pulse Morphology Report
The second report section is a summary of the monitoring session pulse morphology and relevant disclaimers.
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P2/P1 ratio variation in time:
This graph is a summary of the waveform P2/P1 peaks ratio estimation for each minute of the monitoring period. Each blue line represents a minute of the monitoring session and the position of each in the graph scale is the calculated ratio for that minute. Each blue rectangle behind each blue line indicates the confidence interval for that P2/P1 ratio estimation.
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ATTENTION - These P2/P1 peaks identified in this report are the most likely P1 and P2 derived from a statistical model based on the cardiac cycle of patients. The P2 / P1 ratio shows the value of the division between the amplitude of peak P2 and the amplitude of peak P1. Values above 1.0 indicate that P2 is greater than P1 when monitored with the brain4care sensor. |
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PRECAUTION - The derived P2/P1 ratio is a predicted value and therefore carries some uncertainty. The clinician is reminded to use their professional judgment when interpreting this and all waveform information in the report. |
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WARNING - The B4C System does not replace a comprehensive clinical evaluation. The waveform output should always be evaluated by the clinician in conjunction with other clinical parameters or analyses |
Minutes with observations
The purple box in the summary graph is a visual representation for the minutes that have observations in them. The purple balloon indicates the minute in which the observations were included.
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Duration of monitoring session
The total time of a monitoring session is divided into four segments, Each time stamp is represented in an hour, minute and second format. In addition to this, in parentheses on the right side of the time stamp indicates of the day that the timestamp is for. D0 represents the same day the monitoring session started. D1, and so on for the next days after the monitoring session began. This is useful for multi-day monitoring sessions or sessions that start on one day and end on another day.
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P2/P1 ranges
On the right side of the graph there is a visual aid that identifies minutes of the monitoring session for which the calculated P2/P1 ratio was above 1.2, between 1.2 and 0.8, and below 0.8.
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Disclaimers
This section contains important information and disclaimers that should be read by the clinician.
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Monitoring observations
The third report section, which appears only for monitoring sessions that have had an observation included, will show the observation details for each minute that has an observation. It can be one to several pages depending on how many observations were made.
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b4c signal through time:
Shows the overall minute pulses and the moments an observation was included.
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ATTENTION - A minute can have a maximum of six observations. |
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Observation minute pulse morphology
Shows the calculated average waveform of the minute with observation presenting respective parameters such as:
P2/P1 ratio: the estimated P2/P1 ratio for that minute with confidence interval
morphology (A, B, or C) = visual aid for the pulses’ P2/P1 ratio range
useful pulses = how many pulses from that minute were useful pulses for all calculations
heart rate = the calculated heart rate derived from ICP pulses with confidence interval
time to peak = the normalized time to maximum peak of pulses with confidence interval
T1 = normalized time to P1 pulse peak
T2 = normalized time to P2 pulse peak
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Minute’s observations: this box contains the actual observations included for a minute. There can be a maximum of 6 observations. Each observation is numbered and includes the sensor and patient position informed by the operator at the moment of observation.
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Monitoring results
The fourth report section will show minute by minute average waveform calculation for the whole monitoring session. Each subsection will have two swimlanes for each 4 minutes of monitorization. It could be one to many pages depending on how many minutes the monitoring session lasted.
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b4c signal timeline
This swimlane will show the actual pulse by pulse visual representation in a four minute timeline. The minutes with a purple box are the ones that have an observation and the grey circle depict the exact moment the observation happened. You will also have a view of any relevant trends as well as the timestamp for each minute.
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Pulse morphology - average per minute:
This swimlane will show, for each minute, the calculated average pulse morphology with additional parameters, which from top to bottom are:
a visual aid for the P2/P1 ratio range (a, b, or, c)
minute count with P1 and P2 markings
T1 = normalized time to P1 pulse peak
T2 = normalized time to P2 pulse peak
P2/P1 ratio: the calculated P2/P1 ratio for that minute with confidence interval
useful pulses = how many pulses from that minute were useful pulses for all calculations
heart rate = the calculated heart rate derived from ICP pulses with confidence interval
time to peak = the normalized time to maximum peak of pulse with confidence interval
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ATTENTION - A message of “insufficient sample size” will appear if the number and quality of pulses in the calculated minute do not result in a statistically significant calculation. |
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Additional information
The fifth report section, which appears in the last page contains more technical information for the entire monitoring session. It contains five graphs as explained below. This is typically used in research and support context.
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b4c signal timeline graph
Visually shows the sensor’s pin deflexion, in micrometers, for each waveform pulse during the overall monitoring session.
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Heart Rate graph
Shows for each minute (blue horizontal line) the calculated heart derived from the sensor waveform. The histogram on the right side shows the distribution of minutes count for each heartbeat range.
A blue rectangle behind each blue line indicates the confidence interval for that minute. The grey dotted in the middle is the average for the whole monitoring session and the top and bottom red dotted lines represent two standard deviations from the average.
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Normalized time to peak graph
Shows for each minute (blue horizontal line) the calculated average normalized time to peak. The histogram on the right side shows the distribution of minutes count for each time to peak range.
A blue rectangle behind each blue line indicates the confidence interval for that minute. The grey dotted in the middle is the average for the whole monitoring session and the top and bottom red dotted lines represent two standard deviations from the average.
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Monitoring useful minutes graph
shows for each minute (blue horizontal line) the useful amount of pulses. The histogram on the right side shows the distribution of minutes count for each useful minutes count range. A red line represents a minute with insufficient useful pulses for any statistically representative calculation.
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Pulse amplitude graph
Shows for each minute (blue horizontal line) the calculated average pulse amplitude. The histogram on the right side shows the distribution of minutes count for each amplitude range.
A blue rectangle behind each blue line indicates the confidence interval for that minute. The grey dotted in the middle is the average for the whole monitoring session and the top and bottom red dotted lines represent two standard deviations from the average.
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