COLLEGE OF ENGINEERING AND

TECHNOLOGY
DEPARTMENT OF COMPUTER SCIENCE
Courses Code: CoSc4181
Course Name: Selected topics in computer science
Assignment Number: 16
Assignment Title: How To effect embedded system application in medical field
Section: C1
No Group Id Number Contribution
Members Name
1 Fentalem Mule 0900607 What is embedded system
2 Miftah Mufti 0900608 Devices used in embedded system
3 Firdews Fentaw 0900612 Types of embedded system
4 Yohannes Busho 0900786 Application of embedded system in medical field
5 Fikade Tilahun 0900610 Other applications of embedded system in medical field
Contents
1. What is an Embedded System? ................................................................................................... 1
1.2. Devices used in embedded system .................................................................................... 1
1.2.1. Microprocessor ............................................................................................................. 1
1.2.2Microcontroller ............................................................................................................... 2
1.3. Type of Embedded System ................................................................................................ 2
1.3.1 Embedded systems are classified into four categories based on their performance and
functional requirements: ......................................................................................................... 2
1.3.2 Embedded Systems are classified into three types based on the performance of the
microcontroller ........................................................................................................................ 2
1.4 Application of Embedded System in Medical field .......................................................... 3
1.4.1 New age embedded Medical Devices ............................................................................ 3
1.4.2 Existing Embedded Medical Devices ............................................................................ 5
1.5 Other applications of embedded system in medical system ............................................ 8
1.5.1Diagnosis......................................................................................................................... 8
1.5.2 Prognosis ........................................................................................................................ 8
1.5.3Patient management ........................................................................................................ 8
1.5.4 Telemedicine .................................................................................................................. 9
1.6 Conclusion ........................................................................................................................... 9
1. What is an Embedded System?
An Embedded system is a combination of computer hardware and software. As with any electronic
system, this system requires a hardware platform and that is built with a microprocessor or
microcontroller. The Embedded system hardware includes elements like user interface,
Input/output interfaces, display and memory, etc. Generally, an embedded system comprises
power supply, processor, memory, timers, serial communication ports and system application
specific circuits.

Figure 1: Embedded System Flow Diagram

Embedded system software is written in a high-level language, and then compiled to achieve a
specific function within a non-volatile memory in the hardware. Embedded system software is
designed to keep in view of three limits. These are availability of system memory and processor
speed. When the system runs endlessly, there is a need to limit the power dissipation for events
like run, stop and wake up.

1.2. Devices used in embedded system

In general, embedded system is a combination of both hardware and software used to achieve a
unified single task/performance. Importantly it monitors, responds to/or control an external
environment that is well connected to a system through sensors, actuators and other interfaces and
it meets timing and other constraints imposed on it by the environment. However, embedded
systems require a processor that is an important unit and mostly like a heart. The processing core
in the embedded system is either a micro-controller or digital signal processors (DSP).

1.2.1. Microprocessor
Microprocessor integrates the functions of central processing units (CPU) on single or some
integrated circuits. It is a programmable device that accepts digital data as input, processes it
according to instructions stored in its memory, and gives as output and it is an example of
sequential digital logic as it has internal memory and operates on numbers and symbols represented
in the form of binary digits. It mostly uses integrated circuits (IC) for memory and peripherals.
Generally, microprocessors are used in embedded systems however, it require more support
circuitry than microcontrollers. Therefore, it is mostly used in personal computers and other
general purpose applications.

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1.2.2Microcontroller
Microcontroller constitutes a single integrated circuit (IC) containing a processor core,
memory, and programmable input/output (I/O) peripherals. The program memory is often in the
form of NOR flash or OTP ROM which is included on chip and often microcontrollers are
considered as small computers it uses mostly peripherals on chip and it reduces the power
consumption, reduce the size of the device and minimizes the cost. Various types of
microcontrollers have been developed based on the need and use. Embedded system communicates
to the environment with the peripheral devices such as serial communication interfaces (SCI),
synchronous serial communication (SSC), etc.

1.3. Type of Embedded System

1.3.1 Embedded systems are classified into four categories based on their performance and
functional requirements:

a Real time embedded systems

A real time embedded system is defined as, a system which gives a required o/p in a particular
time. These types of embedded systems follow the time deadlines for completion of a task. Real
time embedded systems are classified into two types such as soft and hard real time systems.
b Standalone embedded systems
Standalone embedded systems do not require a host system like a computer, it works by itself. It
takes the input from the input ports either analog or digital and processes, calculates and converts
the data and gives the resulting data through the connected device-Which both controls, drives and
displays the connected devices. Examples for the stand alone embedded systems are mp3 players,
digital cameras, video game consoles, microwave ovens and temperature measurement systems.
c Networked embedded systems
These types of embedded systems are related to a network to access the resources. The connected
network can be LAN, WAN or the internet. The connection can be any wired or wireless. This
type of embedded system is the fastest growing area in embedded system applications. The
embedded web server is a type of system wherein all embedded devices are connected to a web
server and accessed and controlled by a web browser. Example for the LAN networked embedded
system is a home security system wherein all sensors are connected and run on the protocol
TCP/IP.
d Mobile embedded systems
Mobile embedded systems are used in portable embedded devices like cell phones, mobiles, digital
cameras, mp3 players and personal digital assistants, etc. The basic limitation of these devices is
the other resources and limitation of memory.

1.3.2 Embedded Systems are classified into three types based on the
performance of the microcontroller
a Small Scale embedded systems
These types of embedded systems are designed with a single 8 or 16-bit microcontroller that may
even be activated by a battery. For developing embedded software for small scale embedded
systems, the main programming tools are an editor, assembler, cross assembler and integrated
development environment (IDE).

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b Medium Scale embedded systems
These types of embedded systems design with a single or 16 or 32 bit microcontroller, RISCs or
DSPs. These types of embedded systems have both hardware and software complexities. For
developing embedded software for medium scale embedded systems, the main programming tools
are C, C++, JAVA, Visual C++, RTOS, debugger, source code engineering tool, simulator and
IDE.
c Sophisticated embedded systems
These types of embedded systems have enormous hardware and software complexities that may
need ASIPs, IPs, PLAs, scalable or configurable processors. They are used for cutting-edge
applications that need hardware and software Co-design and components which have to assemble
in the final system.
1.4 Application of Embedded System in Medical field
Embedded technology in medical devices in one of its applications. There are so many benefits of
“Embedded technology” as well as use of graphical user interface in medical devices.
In today’s world heart problems are one of the most common problems occurs in every second
person in the world.
So to do continue monitoring we need something which can monitor the patient for 24 hours. S0
yes cardiology is the only medical department that takes maximum advantage of embedded
technology.

1.4.1 New age embedded Medical Devices

a Defibrillators
It is used to monitor a patient’s heart for in consistence rhythms and gently shock the heart back
into its normal rhythm when necessary, using embedded technology. Doctors program the
defibrillator to fit the patient using an external device. A defibrillator can be implanted in the
patient and replaces the need for the external paddle (manual) defibrillators. Patients might not
feel any difference until the machine starts to work
And except that cardiology, we have some more in medical industries, like in blood analyzer,
diagnostic imaging devices, and monitoring devices for cholesterol or diabetic patients. They
enable patients to respond well to treatment based on the embedded devices and their condition
may be monitored remotely by their doctor using the technology.

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Figure 2: Defibrillators

b Digital Flow Sensor

Digital Flow Sensor are used to measure respiratory flow in patients. It also have some additional
features in this we need to set such as offset monitoring, self-test functionality etc. These devices
can measure liquid flow, so such devices can monitor the drug delivery functionality.
c Fetal Monitor Electronic
Fetal heart monitoring is done during pregnancy, labor, and delivery to keep track of the heart rate
of your baby (fetus) and the strength and duration of the contractions of your uterus. Your baby's
heart rate is a good way to tell whether your baby is doing well or may have some problems.

Figure 3: Fetal Monitor

Two types of monitoring—external and internal—can be done.

d External monitoring
You may have external monitoring at different times during your pregnancy, or it may be done
during labor.
External monitoring can be done by listening to your baby's heartbeat with a special stethoscope.
More often, external monitoring is done using two flat devices (sensors) held in place with elastic
belts on your belly. One sensor uses reflected sound waves (ultrasound) to keep track of your
baby's heart rate. The other sensor measures the duration of your contractions. The sensors are
connected to a machine that records the information. Your baby's heartbeat may be heard as a
beeping sound or printed out on a chart. The frequency and duration of your uterine contractions
are usually printed out on a chart.

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External monitoring is used for a no stress test, which records your baby's heart rate while your
baby is moving and not moving. A no stress test may be combined with a fetal ultrasound to
evaluate the amount of your amniotic fluid.
External monitoring is also done for a contraction stress test, which records changes in your baby's
heart rate when you have uterine contractions. It may be done to check on your baby's health if
your baby does not move enough during a no stress test. It may help predict whether your baby
can handle the stress of labor and vaginal delivery.
Sometimes external monitoring is done remotely (called telemetry), without your needing to be
connected by wires to a machine. At some hospitals, the sensors can send the information about
your baby's heart rate and your uterine contractions to a remote monitor, usually at a nurse's station.
Remote monitoring allows you to walk around freely.

e Internal monitoring
Internal monitoring can be done only after your cervix has dilated to at least 2 centimeters (cm)
and your amniotic sac has ruptured. Once started, internal monitoring is done continuously.
For internal monitoring, a sensor is attached to your thigh with a strap. A thin wire (electrode)
from the sensor is inserted through your vagina and cervix into your uterus. The electrode is then
attached to your baby's scalp. Your baby's heartbeat may be heard as a beeping sound or printed
out on a chart. Internal monitoring does not use reflected sound waves (ultrasound) for monitoring.
A small tube that measures uterine contractions may be placed in your uterus next to your baby.
The strength and timing of your uterine contractions is usually printed out on a chart.
Internal monitoring is more accurate than external monitoring for keeping track of your baby's
heart rate and your contractions.

1.4.2 Existing Embedded Medical Devices

a Pacemaker
Pacemaker is yet another application of embedded systems. A pacemaker is a small device that's
placed in the chest or abdomen to help control abnormal heart rhythms. This device uses low-
energy electrical pulses to prompt the heart to beat at a normal rate.
Pacemakers are used to treat arrhythmias. Arrhythmias are problems with the rate or rhythm of the
heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm.
Pacemakers can relieve some arrhythmia symptoms, such as fatigue (tiredness) and fainting. A
pacemaker also can help a person who has abnormal heart rhythms resume a more active lifestyle.
Doctors also treat arrhythmias with implantable cardioverter defibrillators (ICDs). ICDs are
similar to pacemakers. However, besides using low-energy electrical pulses to control abnormal
heart rhythms, ICDs also can use high-energy electrical pulses to treat certain dangerous
arrhythmias.
Doctors recommend pacemakers for a number of reasons. The most common reasons are
Bradycardia and heart block. Bradycardia is a slower than normal heartbeat. Heart block is a
problem that occurs with the heart's electrical system. The disorder occurs when an electrical signal
is slowed or disrupted as it moves through the heart.
Before recommending a pacemaker, your doctor will consider any arrhythmia symptoms you have,
such as dizziness, unexplained fainting, or shortness of breath. He or she also will consider whether
you have a history of heart disease, what medicines you're currently taking, and the results of heart
tests.

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A pacemaker consists of a battery, a computerized generator, and wires with sensors called
electrodes on one end. The electrodes detect your heart's electrical activity and send data through
the wires to the computer in the generator.
If your heart rhythm is abnormal, the computer will direct the generator to send electrical pulses
to your heart. The pulses then travel through the wires to reach your heart.
Newer pacemakers also can monitor your blood temperature, breathing, and other factors and
adjust your heart rate to changes in your activity.
Placing a pacemaker requires minor surgery. The surgery usually is done in a hospital or special
heart treatment laboratory. You'll be given medicine just before the surgery that will help you relax
and may make you sleepy.
The surgery takes just a few hours, but you'll stay in the hospital overnight so your health care
team can check your heartbeat and make sure your pacemaker is working properly.
Complications from pacemaker surgery are rare. Most people can return to their normal activities
within a few days.
Your doctor may ask you to avoid vigorous exercise or heavy lifting for about a month after your
surgery. After you have fully recovered from surgery, discuss with your doctor how much and
what kinds of physical activity are safe for you.
Once you have a pacemaker, you have to avoid close or prolonged contact with electrical devices
or devices that have strong magnetic fields. You also need to avoid certain medical procedures that
can disrupt your pacemaker.
Let all of your doctors, dentists, and medical technicians know that you have a pacemaker. Your
doctor can give you a card that states what kind of pacemaker you have. Carry this card in your
wallet. You may want to consider wearing a medical ID bracelet or necklace that explains that you
have a pacemaker.
Your doctor will want to check your pacemaker regularly. Some pacemaker functions can be
checked remotely through a telephone call or a computer connection to the Internet. Your doctor
may ask you to come to his or her office to check your pacemaker.

Figure 4: Pacemaker
Pacemaker batteries last between 5 and 15 years (average 6 to 7 years), depending on how active
your pacemaker is. The wires of your pacemaker also may need to be replaced eventually. Your
doctor can tell you whether your pacemaker or its wires need to be replaced.

b Pulse oximeter
Pulse oximetry is a simple, relatively cheap and non-invasive technique to monitor oxygenation.
It monitors the percentage of hemoglobin that is oxygen-saturated. Oxygen saturation should
always be above 95%, although in those with long-standing respiratory disease or cyanotic
congenital heart disease, it may be lower, corresponding to disease severity. The oxy-hemoglobin
dissociation curve becomes sharply steep below about 90%, reflecting the more rapid desaturation
that occurs with diminishing oxygen partial pressure (PaO2). On most machines the default low
oxygen saturation alarm setting is 90%.

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Pulse oximetry does not provide information on the oxygen content of the blood nor ventilation
and thus care is needed in the presence of anemia and in patients developing respiratory failure
due to carbon dioxide retention, for example.

Principles of pulse oximetry

Oximeters work by the principles of spectrophotometry the relative absorption of red (absorbed
by deoxygenated blood) and infrared (absorbed by oxygenated blood) light of the systolic
component of the absorption waveform correlates to arterial blood oxygen saturations.
Measurements of relative light absorption are made multiple times every second and these are
processed by the machine to give a new reading every 0.5-1 second that averages out the readings
over the last three seconds.
Two light-emitting diodes, red and infrared, are positioned so that they are opposite their respective
detectors through 5-10 mm of tissue. Probes are usually positioned on the fingertip, although
earlobes and forehead are sometimes used as alternatives. One study has suggested that the ear
lobe is not a reliable site to measure oxygen saturations. Probes tend to use 'wrap' or 'clip' style
sensors.

Uses
Central cyanosis, the traditional clinical sign of hypoxemia, is an insensitive marker occurring only
at 75-80% saturation. Consequently, pulse oximetry has a wide range of applications including
Individual pulse oximetry readings - can be invaluable in clinical situations where hypoxemia may
be a factor - for example, in a confused elderly person.
Continuous recording - can be used during anesthesia or sedation, or to assess hypoxemia during
sleep studies to diagnose obstructive sleep apnea. Peri-operative monitoring has not, however,
been shown to improve surgical outcomes.
Pulse oximetry can replace blood gas analysis in many clinical situations unless PaCO 2 or acid-
base state is needed. It is cheaper, easier to perform, less painful and can be more accurate where
the patient is conscious (hyperventilation at the prospect of pain raises PaO2).
Pulse oximetry allows accurate use of O2 and avoids wastage. For example, in patients with
respiratory failure, rather than limit the use of O2 to maintain hypoxic ventilator drive, it can be
adjusted to a saturation of ~90% which is clinically acceptable.
Neonatal care - the safety limits for oxygen saturations are higher and narrower (95-97%)
compared to those for adults] Pulse oximetry is not yet a standard of care in the screening of
neonates for asymptomatic congenital heart disease but may become so. It appears to be
significantly more reliable than clinical methods alone, as shown by recent studies.
Intrapartum fetal monitoring - there has been some interest in the use of fetal pulse oximetry in
combination with routine cardiograph (CTG) monitoring, although its use does not reduce the
operative delivery rate.
Pulse oximeter are now used routinely in critical care, anesthesiology, and A&E departments, and
are often found in ambulances. They are an increasingly common part of a GP's kit. Pulse
oximetry's role in primary care may include
Diagnosing and managing a severe exacerbation of chronic obstructive pulmonary disease (COPD)
in the community.
Grading the severity of an asthma attack. Where oxygen saturations are less than 92% in air,
consider the attack potentially life-threatening.
Assessing severity and oxygen requirements for patients with community-acquired pneumonia.

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Assessing severity and determining management in infants with bronchiolitis.

Using an oximeter
Resting readings should be taken for at least five minutes.
Poor perfusion (due to cold or hypotension) is the main cause of an inadequate pulse wave. A sharp
waveform with a dichotic notch indicates good perfusion whilst a sine wave-like waveform
suggests poor perfusion.
If a finger probe is used, the hand should be rested on the chest at the level of the heart rather than
the affixed digit held in the air (as patients commonly do) in order to minimize motion artefact.
Checking that the displayed heart rate correlates to a manually checked heart rate (within 5 beats
per minute) generally rules out significant motion artefact.
Emitters and detectors must oppose one another and light should not reach the detector except
through the tissue. Ensure the digit is inserted fully into the probe and that flexible probes are
attached correctly. Appropriately sized probes should be used for children and infants.
Oximeter accuracy should be checked by obtaining at least one simultaneous blood gas, although
this rarely happens. Oximeters may correct average oximeter bias based on pooled data but this
does not eliminate the possibility of larger individual biases.

1.5 Other applications of embedded system in medical system

In the modern society, there is a consistent increase in the number of people who suffer from
various illness that includes metabolic and life style related diseases, though most of the infectious
diseases are under control and cured. This condition always looks for better diagnostic tools,
expedited information transfer technologies, accurate prognostic devices, importantly patient
management system and other alternative medicine strategies. Recently, embedded system
technologies have occupied an important area in the medical application in diagnosis, prognosis,
patient management and telemedicine that broadly includes the diseases of various kinds such as
infectious, metabolic and lifestyle related disease in human beings.

1.5.1Diagnosis
Embedded systems are used in wide range of diagnostic devices in medical applications that
ranges from various hand held devices to big medical instruments. For example, blood glucose
monitors, blood pressure monitors, patch detection of various disease like dengue, malaria, and
portable ECG (electrocardiogram), CT (computed tomography), defibrillators, CRT-D device,
digital thermometers, and digital flow sensors.

1.5.2 Prognosis
Prognostication is done using various medical devices, for example, PET (positron emission
tomography), digital X-ray, MRI (magnetic resonance imaging), etc.

1.5.3Patient management
Wireless technology incorporated with embedded systems helps for self-management by self-
testing various clinical parameters such as the blood pressures, blood glucose, body temperature,
heart rhythms, etc. Embedded systems with the use of wireless technology is more beneficial to
the patients and the doctors especially, the elderly and impaired. Majority of the patients with
chronic illness such as diabetes and heart disease benefit from wireless technology.

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1.5.4 Telemedicine
This employs both wired and wireless technology with embedded system to diagnose, prognoses
and manage the patients. It gives both patients and physicians immediate access to important
information in real time.

1.6 Conclusion
The benefits of implementing the technology of embedded (hardware and software) into medical
Diagnostics and treatment are clear. That the treatment which could only be provided manually by
practitioners now can be done by machines too that is with the patients 24 hours. These types of
devices are also able to monitor critical health parameters continuously helping in accurate
diagnosis.
Embedded technology reduces the cost of freight to send medical records. Instead of sending mail
carrier we can use fast telecom network. Also, using embedded technology allows the physician
to obtain medical information about a patient. Physicians can view the medical reports on an
embedded software-driven PDA which means the doctor-patient consultation can happen much
sooner than ever before.
The application of embedded technology in the medical field appears to have endless possibilities.
The benefits mentioned above are just some examples of how the embedded systems make a
difference to both the patient as well as the medical staff.
Future of embedded system technology in the medical sector is bright. The fact is real that the
medical field will always be looking for new treatment and diagnostic tools. And as technology
increases medical industry need that technology, there will be numerous opportunities to dive into
the market with new software designed to fit specific medical device needs