BIOTELEMETRY

ABSTRACT Biotelemetry is a vital constituent in the field of medical sciences. It entails remote measurement of biological parameters. Transmission of physiological data from point of generation to the point of reception can take many forms. Biotelemetry, using wireless diagnosis, can monitor electronically the symptoms and movements of patients. This development has opened up avenues for medical diagnosis and treatment. It enables monitoring of activity levels in patients suffering from heart troubles, asthma, pain, Alzheimer’s disease, mood disorders, cardiovascular problems, accidents, etc. A patient’s response and reaction to drugs can also be investigated for treatment. Radio telemetry transmits biological data using various radio transmission techniques. No wires are required to be attached to the patient’s body. The patient just carries a bracelet-sized transmitter that enables monitoring of the patients symptoms. Carrier modulation, physiological data encoding, frequency and time division multiplexing blocking oscillator or Endoradiosonde, receivers and antennas for Biotelemetry, power sources, and transcutaneous power transfer are discussed in this paper.

INTRODUCTION Biotelemetry is a vital constituent in the field of medical sciences. It entails remote measurement of biological parameters. Transmission of physiological data from point of generation to the point of reception can take many forms. Biotelemetry, using wireless diagnosis, can monitor electronically the symptoms and movements of patients. This development has opened up avenues for medical diagnosis and treatment. It enables monitoring of activity levels in patients suffering from heart troubles, asthma, pain, Alzheimer’s disease, mood disorders, cardiovascular problems, accidents, etc. A patient’s response and reaction to drugs can also be investigated for treatment. Radio telemetry transmits biological data using various radio transmission techniques. No wires are required to be attached to the patient’s body. The patient just carries a bracelet-sized transmitter that enables monitoring of the patients symptoms. Carrier modulation, physiological data encoding, frequency and time division multiplexing blocking oscillator or Endoradiosonde, receivers and antennas for Biotelemetry, power sources, and transcutaneous power transfer are discussed in this paper. EVOLUTION OF BIOTELEMETRY

Technology By wire

Who S.R.Winters

When 1921

How Electrode wires to a Galvanometer

EndroradiosondeStuart Mackay Multiplexed Physiologic signals Multiplexed Physiologic Signals. Magnetically Coupled Transcutaneous Data Transfer. Next technologies

1950’s

Many 1970’s Investigators Many 1970’s Investigators to Present Many 1980's to InvestigationsPresent

TransistorBlocking Readily oscillator Available FDM FM encoding TDM TDM PIM, PCM Encoding. PDM and PCM Encoding.

?

Present and Portably PCM, future TDM Spread Spectrum

HISTORY OF BIOTELEMETRY THE FIRST WILDLIFE TRANSMITTER Above ground range: 25 yards Below ground range: 8 yards Transmitter breaking through the skin Batteries last 161 days FURTHER DEVELOPMENT NEEDED Can’t be used in any critters smaller than a woodchuck Range of 18-25 yards not adequate for some species, or inaccessible locations Transmitter could not be recovered after it died EXTERNAL TRANSMITTER Studied porcupines in Minnesota Used miniature transmitters Home made harnesses Modified dog harnesses for immature Allowed them to make general statements about porcupines TRANSMITTER One-transistor, crystal-controlled oscillator

Copper or aluminum 10 grams (without battery) RECEIVER Portable, battery-operated 10 lbs, including batteries Battery 9” x 6” x 5” Commercial receivers equal or better, but not portable FIELD USE Portable receiver Using the “null” Tracking a moving animal Tracking a stationary animal Accuracy IMPROVEMENTS Efficiency improves Encapsulation for effective, weatherproof Less prone to damage from the animals Lighter weight batteries Transmitter, collars, etc. become commercially available NEW VARIATIONS Activity indicator Death indicator Urination indicator Automatic tracking system DEATH INDICATOR “Dead animals are hard to find” Penned vs. free-roaming animals Grizzly bear transmitter AUTOMATIC TRACKING SYSTEMS Outputs of receivers linked to “visual indicator tubes” Records of signals made on 16 mm film Film developed, data read and tabulated

Tune receivers every 2 hours Power line problems, electrical storms PHYSIOLOGICAL DATA Respiration Temperature Heart rate Blood pressure SATELLITE TRACKING: IMPETUS Whales Sea turtles Polar bears Polar bears Elephants Avian orientation and navigation ADVANTAGES OF SATELLITE TRACKING Impervious to weather Latitude and longitude Good for isolated areas Migrating animals Long, automatic tracking Lots of animals tracked at once, in real time OPERATION AND COMPONENTS 4.1 OPERATION Current radio monitoring systems keep thousands of patients under surveillance, with limited scope. Biotelemetry systems consist of transmitter, simple telephone modem, and central receiving station. Central receiving station tunes into a transmitter, whose size may range from a bracelet to a small pocket transistor. This tracking system can be used within the hospital premises. Each patient is equipped with a pager sized personal monitoring as well as alarm system. When the patient wearing the transmitter device attached to his wrist, chest, waist etc- leaves a specified range, periodic RF signals are sent to the modem. The modem sends out an alert signal to both the patient and to the central monitoring station. When the patient’s health condition becomes worse, emergency signals are transmitted. The mobile unit attached to the patient has an output of nearly 1W. Location of the patient is derived from time- of-arrival calculations. The system uses spread spectrum techniques operating in the RF band of 902- 928 MHz to transmit signals of the patient’s condition alone with whereabouts. A network of receivers scattered through out the

specified area picks up the signals with health condition of patient. Location is display on a map at central facility in the hospital/ treatment center. Tracking is done by a spread spectrum, using triangulation technique based on time of arrival at various receivers, to locate the patient. This triangulation technology is applied to locate the origins of all emergency signals send and users with personal two – way digital wireless communication devices. 4.2 COMPONENTS A basic biotelemetry system consists of – besides a transmitter, simple modem, and a central receiving station- the basic circuits like oscillators, amplifiers, power supply, etc, usually present in a communication system. The earliest (1952) biotelemetry transmitter was the “ Endo radio- sonde”. The pressure-sensing device was a “radio pill”, which had a volume less than 1cm and could be swallowed by the patient. As it passed through the gastro- intestinal tract, it measured the pressure at various points it encountered. Such radio pills are available to measure temperature, pH, and enzyme activity also. PHYSIOLOGICAL PARAMETERS Any quantity that can be measured in the biomedical field is adaptable to biotelemetry. The measurements are divided in to two categories: bioelectrical and physiological variables. Bioelectrical variables include measurements like ECG, EMG, and EEG. Signals are obtained directly in the electric form. Physiological variables such as temperature, blood pressure, blood flow etc require some excitation or external electrical parameters. Transducers are used for the conversion of physiological parameters into an electrical signal. Parameters are measured as the variation of resistance, capacitance, or inductance. Variations can be calibrated to represent pressure, temperature, or blood flow. Base signal is modulated for transmission. And finally, this signal is detected (demodulated) and converted back to its original form. 5.1 BIOTELEMETRY FOR BIOELECTRIC POTENTIALS: 5.1.1 ECG TELEMETRY One example of ECG telemetry is the transmission of electrocardiograms from an ambulance or site of an emergency to a hospital, where a cardiologist can immediately interpret the ECG, instruct the trained rescue team in their emergency procedures, and arrange for any special treatment that may be necessary upon arrival of the patient at the hospital. Other applications include monitoring of athletes running a race in an effort to improve their performance. The actual equipments worn by the subject is quite comfortable and usually does not impede movement. In addition to the electrodes that are taped into place, the patient or subject wears a belt around the waist with a pocket for the transmitter. Power for the transmitter is from a battery, usually a mercury cell, with a useful life of about 30 hours. 5.1.2 EEG TELEMETRY Most of the applications of this telemetry have been involved with experimental animals for research purposes. One example is in the space biology program, where chimpanzees have had the necessary EEG electrodes implanted in the brain. The leads from the electrodes are brought to a small transmitter installed on the animals’ head, and the EEG is transmitted. Telemetry of EEG signals has also been used in the studies of mentally distributed children. The child wears a

specifically designed “football helmet” with built- in electrodes so that EEG can be continuously monitored without traumatic difficulties during play. One advantage of monitoring by telemetry is to circumvent a problem that often hampers medical diagnosis. Patients frequently experience pains; aches or other symptoms that give trouble for days, only to have them disappear just before or during medical examination. With telemetry and long term monitoring, the cause of these symptoms may be detected when they occur or, if recorded on magnetic tape, can be analyzed later. 5.1.3 EMG TELEMETRY The EMG particularly useful for studies of muscle damage and partial paralysis problems and also in human performance studies. The telemetry also can be used in transmitting stimulus signals to a patient. For example, it well known that an electrical impulse can trigger the firing of nerves. If an electrode is surgically implanted and connected to the dead nerve endings, an electrical impulse can sometimes cause the nerve to function as they once did. If a miniature receiver is implanted subcutaneous, the electrical signal can be generated remotely. One example is the use of telemetry in the treatment of “droop foot” which is one of the most common disabilities resulting from stroke. 5.2 BIOTELEMETRY USING TRANSDUCERS: By using suitable transducers, telemetry can be employed for the measurement of a wide variety of physiological variables. In some cases, the transducer circuit is designed as a separate “plug-in” module to fit into the transmitter, allowing one transmitter design to be used for different types of measurements. Also, as many variables can be measured and transmitted simultaneously by multiplexing techniques. One important application of telemetry is in the field of blood pressure and heart rate research in anaesthetized animals. The transducers are surgically implanted with leads brought out through the animal’s skin. A male plug is attached postoperatively and later connected to the female socket contained in the transmitter unit. Blood flow also has been studied extensively by telemetry. Both Doppler-type and electromagnetic-type transducers can be employed. The use of thermistors to measure temperature is also easily adaptable to telemetry. In addition to constant monitoring of skin temperature or systemic body temperature, the thermistors system has applications in obstetrics and gynecology. Long-term study of natural birth control by monitoring vaginal temperature has incorporate telemetry units. A final application is the use of “radio-pills” to monitor stomach pressure or pH. In this application, a pill that contains a sensor plus a miniature transmitter is allowed and the data are picked up by a receiver and recorded. UNIVERSAL BIOTELEMETRY SYSTEM

FIGURE 1. BLOCK DIAGRAM FOR UNIVERSAL BIOTELEMETRY SYSTEM

Any signals (Physiological) are fed into the signal conditioner and then to an encoder, where the encoded is transmitted across transmission media with the help of a transmitter. The modulated carrier or the transmission medium takes the signals to the remote monitoring station where the signals are first detected and then passed through a demultiplexer and decoder. Signals, which are decoded, are then taken as output.

6.1 THE TRANSMITTER Mobile units attached to the patient consist of a transmitter. Bioelectrical signals are obtained directly from the patient while physiological variables like temperature, pressure, or other parameters from the patient are converted into electrical form using appropriate transducers. Signal conditioning is used to amplify, modify and process the input received. It combines or relates the output of two or more transducers. Even though the input it receives is an electrical signal, signal-conditioning circuit produces an output to satisfy the function and makes signals suitable for transmission. Transmission and receiving circuits act upon the physiological signal from the signal conditioning equipment. The physiological signal modulates a lowfrequency carrier, called a sub carrier, often in the audio frequency range. The sub carrier in turn modulates the RF signal to be propagated and sent to the antenna. If several physiological signals are to be transmitted simultaneously, each signal is placed on a carrier of a different frequency and all sub carriers are combined to simultaneously modulate the RF carrier. This process of transmitting many channels of data on a single carrier, called frequency multiplexing, is more efficient. The sub-carrier is modulated either by AM (amplitude modulation) or FM (frequency modulation).

FIGURE 2. TRANSMITTER BLOCK DIAGRAM

TRANSMITTER COMPONENTS: 1. ANTENNA 2. POWER SOURCE (BATTERY) 3. TRANSMITTER UNIT 6.1.1. ANTENNA The two most common types of transmitting antenna are external whip antenna and the internal coil antenna. The external whip is most frequently used and preferred because it has a better signal than internal coil antenna. 6.1.2. POWER SOURCE (BATTERY) Lithium and silver oxide batteries are most commonly used for wildlife transmitters, and battery life is proportional to pulse period and inversely proportional to pulse width and signal strength. Lithium batteries have a flat discharge curve, meaning they maintain a relatively constant terminal voltage until the last 15% of their life for significant discharge rates. At lower discharge rates the terminal voltage will stay almost constant until the last 5% of the battery’s life. Lithium batteries can be stored at room temperature for 10years and still retain 70% of their rated capacity. The shelf is reduced to 5 years at significantly elevated temperatures. The silver oxide battery is also noted for its extremely stable discharge voltage and good shelf life. Charge retention is over 84% after two years of storage at 70’F(21’C). Batteries are sealed and may be encased with the transmitter. Smaller transmitters and batteries are encased in a waterproof epoxy resin, and larger models are enclosed in an aluminum or nylon case filled with waterproof resin. Other batteries, used especially in larger transmitters, may use 3-volt or 6-8 volt battery circuits. Batteries may also be rechargeable and changeable in the field. The larger the battery, the longer the life and range of the unit. Transmitters may also have solar power, having a renewable energy source and requiring no battery. 6.1.3. TRANSMITTER UNIT Transmitters are available as complete units or as components assembled by the researcher. They are packaged in a metal can or covered with an epoxy or acrylic resin coating. There are one-stage and two-stage circuits. One-stage transmitters have a design and low weight, with less range for a given weight of tag and longer life. Two

stage transmitters consist of a basic oscillator and an amplifier, needing a minimum of 2.4 volts for power. They weigh more and have a shorter life, but have a greater range for a given weight of tag. 6.2 THE RECEIVER

FIGURE 3. RECEIVER BLOCK DIAGRAM

It is the receiving station, situated at the hospital/treatment center. The receiver consists of tuner, demodulator, and displaying system. It receives the multiplexed RF carrier emitted by the patient’s transmitter, as shown in fig. The tuner has a tuning circuit. When the circuit is tuned to receive signals, the appropriate signal is selected and the unwanted signals are rejected. The multiplexed RF carrier is demodulated to recover the individual sub carriers. Sub carriers are then demodulated to reproduce original physiological signals emitted by the patient. A recorder records physiological signals for future reference. Signals can be stored on any secondary storage media like tape, magnetic disks, etc. Display system used can be a CRO, CRT or computer monitor, chart recorder etc. 6.3 MODULATION TECHNIQUES The two basic systems of system modulation are amplitude modulation (AM) and frequency modulation (FM). The methods mentioned are discussed below. In amplitude-modulated system, the amplitude of the carrier is caused to vary with the information being transmitted. Standard radio broadcast stations utilize this method of modulation. Amplitude modulated systems are susceptible to natural and man-made electrical inference. In frequency-modulated system, the frequency of the carrier is caused to vary with the modulated signal. An FM system is much less susceptible to interference, because in variations in the amplitude of the received signal caused by interference can be removed at the receiver before demodulation takes place. Because of this reduced interference, FM transmission is often used for telemetry. In biotelemetry systems, the physiological signal is sometimes used to modulate a low frequency carrier, sub carrier, often in the audio frequency range. The sub carrier then modulates the RF carrier of the transmitters. If several physiological signals are to be transmitted simultaneously, each signal is placed on a sub carrier of a different frequency and all of the sub carriers are combined to simultaneously modulate the RF carrier. This process of transmitting many channels of data on a single RF carrier is called frequency multiplexing. At the receiver, a multiplexed RF carrier is first demodulated to recover each of the separate sub carriers; it must then the demodulated to retrieve

the original physiological signals. Either frequency or amplitude modulation can be used for interesting data on the sub carriers. A system in which the sub carriers are frequency modulated and the RF carriers are amplitude modulated is designated as FM / AM. An FM/ AM designation means that both the sub carriers and the RF carrier are frequency modulated. Both FM/AM and FM/ FM, systems have been used in biotelemetry. The common denominator for most of other approaches is a technique known as pulse modulation, in which the transmission carrier is generated in a series of short pulses. If the amplitude of pulses is used to represent the transmitted information, the method is called pulse modulation (PAM), where as, the width of each pulse is varied according to the information, a pulse modulation (PWM), system results. 6.4. IMPLANTABLE UNITS Some it is desirable to implant the telemetry or receiver subcutaneous. The implanted transmitter is especially useful in animal’s studies, where the equipment must be protected from the animals. Once a unit is implanted, it is no longer available for serving and the life of the unit depends on how long the battery can supply the necessary current. The use of implanted unit also restricts the distance of transmission of the signal. Since the body fluids and skin greatly attenuate the signal , the range of signal is quite restricted, often to just a few feet. This disadvantages has been overcome by picking up the signal with a near by antenna and transmitting it. Another problem has been the encapsulation of the unit. The outer case and any writing must be impervious to body fluids and moisture. Silicon encapsulation is commonly used. The power source is of great importance. Mercury and silver oxide primary batteries have been used extensively. Implantable telemetry batteries vary in physical size and electrical capacity, depending on the application. Also, if power is not needed continuously, radio frequency switches can be used to turn the system on and off on command. In simple terms, the complete implantable telemetry transmitter system consists of the transducer, the leads from transducer to the transmitter, the transmitter unit itself and power supplies. The transducers are implanted surgically in the position required for a particular measurement, such as in aorta or other arteries for blood pressure. APPLICATIONS OF TELEMETRY 1. Applications of telemetry in patient care a. Telemetry of ECG’s from extended coronary care patients b. Telemetry for ECG measurements during exercise. c. Telemetry for elementary patient monitoring. In many areas ambulances and emergency rescue teams are equipped with telemetry equipment to allow electrocardiograms and other physiological data to be transmitted to a near by hospital for interpretation. Two-way voice transmission is used in conjunction with telemetry to facilitate identification of the telemetered information and to provide instructions for treatment. Through the use of such equipment, ECG’s can be interpreted and treatment begun before the patient arrives at the hospital. Telemetry of this requires mush powerful transmitters than ordinary systems. 2. Collection of medical data from a home or office.

3. Research on unrestrained, unanesthized animals in their natural habitat. 4. Isolation of an electrically susceptible patient from power line operated ECG equipment to protect him from accident or shock. 5. Measurement of the temperature and position of the egg in a nest by telemetry system. This works describes a biotelemetry system for continuous monitoring of temperature and position of an artificial radio transmitter egg in a mall bird nest. 6 Biotelemetry for space life sciences research ADVANTAGES Reduction of the impediment of the information source (patient, subject or animal). Reduction of the psychological effects on the information source. Reduction of measuring artifacts, Reduction of the risk for electroshock, Reduction of the complexity of monitoring of physiological variables, as well as a potential reduction of the total cost of patient care. LIMITATIONS & ALTERNATIVES 9.1 LIMITATIONS The system has inherent limitations. Movement of the patient is restricted. If the patient goes beyond the range of the system, his ECG cannot be monitored. Research is in progress for upgrades. Practical systems are being developed to build on existing technology and public infrastructure. 9.2 ALTERNATIVES A consortium of private companies, national laboratories, universities and end users such as hospitals, health care centers, nonprofit organizations, etc would be the best to explore the alternatives. The consortium could study the feasibility of such systems, communication and interface standards, methods improving the communication infrastructure in the locale, and human aspects such as which types of patients would be candidates for these systems. Legal changes, ethics, social impacts and safeguards etc are the other issues to be considered. Economic consideration such as cost of the society in comparison with outlay for the existing system, size of the market, number of patients qualified as system users, etc need to be examined. A demonstration system could be developed and tried out on patients. FUTURE SCOPES • BiotransceiversCollect data from/ send commends to an implanted biotelemeter • Smart sensors- incorporate signal conditioning (and potentially even more function) into sensors • Reduced volume implantable biotelemeters- continuing advances in integrated circuit fabrications will reduced physical size • Reduced power requirements- Lower operating voltage, lower power consumption, integrated circuits. • Increased functional sophistication- Integrated circuit advances will offer more functionality to biotelemeters.

• Biotelemeter on a chip • Human implantable Biotelemeter- Small, reliable, packaged for lead wire-free, unrestrained monitoring. CONCLUSION Use of biotelemetry techniques in medical science will bring out a seachange with improvements in patient care treatment. Since the technology uses the existing communication infrastructure, it is easy to realize and implement biotelemetry without much effort and cost. Biotelemetry will enable patients to move and perform their daily chores without any worry or mental stress of the unpredictable attack due to their body disorders. Patients who need continuous monitoring can wear a biotelemetry device, which automatically sends the vital signals to the hospitals. There is need to create interest in this field and initiate research activities. BIBLIOGRAPHY • Biomedical Instrumentation and Measurements by Leslie Cromwell & Fred J. Weibell • www.habitresearch.com • www.electronicsforu.com • www.ieee.com • www.edufive.com/seminartopics.html

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