Index: firmware/App/Controllers/PresOccl.c =================================================================== diff -u -r0a61f7fa5ff6945ebc2e507d8ecb71a652c38eaa -r709def41bcde8e2e59d83c5e9c5a06ab0ee74ec8 --- firmware/App/Controllers/PresOccl.c (.../PresOccl.c) (revision 0a61f7fa5ff6945ebc2e507d8ecb71a652c38eaa) +++ firmware/App/Controllers/PresOccl.c (.../PresOccl.c) (revision 709def41bcde8e2e59d83c5e9c5a06ab0ee74ec8) @@ -63,14 +63,13 @@ #define ARTERIAL_PRESSURE_SELF_TEST_MAX ( 100.0F ) ///< Maximum self-test value for arterial pressure sensor reading (in mmHg). #define ARTERIAL_PRESSURE_MAX_MMHG ( 2000.0F ) ///< Maximum arterial pressure reading (in mmHg) for range check. #define ARTERIAL_PRESSURE_MIN_MMHG ( -1500.0F ) ///< Minimum arterial pressure reading (in mmHg) for range check. -#define ARTERIAL_PRESSURE_ND_MIN_MMHG ( -250.0F ) ///< Minimum arterial pressure reading (in mmHg) when not dialyzing. #define VENOUS_PRESSURE_SELF_TEST_MIN ( -100.0F ) ///< Minimum self-test value for venous pressure sensor reading (in mmHg). #define VENOUS_PRESSURE_SELF_TEST_MAX ( 100.0F ) ///< Maximum self-test value for venous pressure sensor reading (in mmHg). #define VENOUS_PRESSURE_MAX_MMHG ( 2000.0F ) ///< Maximum venous pressure reading (in mmHg) for range check. #define VENOUS_PRESSURE_MIN_MMHG ( -1500.0F ) ///< Minimum venous pressure reading (in mmHg) for range check. -#define VENOUS_PRESSURE_ND_MAX_MMHG ( 300.0F ) ///< Maximum venous pressure reading (in mmHg) when not dialyzing. #define VENOUS_PRESSURE_OCCL_OFFSET_MMHG ( 50.0F ) ///< Venous pressure occlusion threshold offset from max alarm limit (in mmHg). +#define VENOUS_PRESSURE_LIMIT_DELAY_MS ( SEC_PER_MIN * MS_PER_SECOND ) ///< Venous pressure limit delay period following dialysis start/resume (use wider limits during this period). #define PSI_TO_MMHG ( 51.7149F ) ///< Conversion factor for converting PSI to mmHg. @@ -165,6 +164,7 @@ static U32 venPressureReadingsShortIdx = 0; ///< Index for next sample in rolling average array. static F32 venPressureReadingsShortTotal = 0.0; ///< Rolling total - used to calc average. static U32 venPressureReadingsShortCount = 0; ///< Number of samples in flow rolling average buffer. +static U32 venPressureLimitDelayStart; ///< Time stamp for last time dialysis started/resumed. static PRESSURE_SELF_TEST_STATE_T presOcclPostState; ///< Pressure self test post state. static HD_PRESSURE_SENSORS_CAL_RECORD_T pressureSensorsCalRecord; ///< Pressure sensors calibration record. static HD_OCCLUSION_SENSORS_CAL_RECORD_T occlusionSensorsCalRecord; ///< Occlusion sensors calibration record. @@ -208,13 +208,14 @@ initFPGAPersistentAlarm( FPGA_PERS_ERROR_VENOUS_PRESSURE_SESNOR, ALARM_ID_HD_VENOUS_SENSOR_FPGA_FAULT, PRES_SENSORS_FPGA_ERROR_TIMEOUT_MS, PRES_SENSORS_FPGA_ERROR_TIMEOUT_MS ); - longFilteredArterialPressure = 0.0F; - shortFilteredArterialPressure = 0.0F; - shortFilteredVenousPressure = 0.0F; - presOcclDataPublicationTimerCounter = DATA_PUBLISH_COUNTER_START_COUNT; - presOcclState = PRESSURE_WAIT_FOR_POST_STATE; - presOcclPostState = PRESSURE_SELF_TEST_STATE_START; + longFilteredArterialPressure = 0.0F; + shortFilteredArterialPressure = 0.0F; + shortFilteredVenousPressure = 0.0F; + presOcclDataPublicationTimerCounter = DATA_PUBLISH_COUNTER_START_COUNT; + presOcclState = PRESSURE_WAIT_FOR_POST_STATE; + presOcclPostState = PRESSURE_SELF_TEST_STATE_START; bloodPumpOcclusionAfterCartridgeInstall = 0; + venPressureLimitDelayStart = 0; } /*********************************************************************//** @@ -302,6 +303,20 @@ } } +/*********************************************************************//** + * @brief + * The signalStartDialysisStartOrResume function signals that dialysis has + * just been started or resumed which begins a brief time window where + * venous pressure limits are relaxed while treatment reaches stability. + * @details Inputs: none + * @details Outputs: venPressureLimitDelayStart + * @return none + *************************************************************************/ +void signalStartDialysisStartOrResume( void ) +{ + venPressureLimitDelayStart = getMSTimerCount(); +} + /*********************************************************************//** * @brief * The execPresOccl function executes the pressure and occlusion monitor. @@ -470,12 +485,12 @@ // Check arterial pressure during treatment mode against either user set limits or fixed max limits depending on treatment state if ( ( MODE_TREA == getCurrentOperationMode() ) && - ( ( ( TREATMENT_DIALYSIS_STATE == txState ) && ( getDialysisState() != DIALYSIS_SALINE_BOLUS_STATE ) ) || - ( ( TREATMENT_STOP_STATE == txState ) && ( TRUE == isBloodPumpRunning() ) ) || - ( TREATMENT_BLOOD_PRIME_STATE == txState ) ) ) + ( ( ( TREATMENT_DIALYSIS_STATE == txState ) && ( DIALYSIS_UF_STATE == getDialysisState() ) ) || + ( ( TREATMENT_STOP_STATE == txState ) && ( TRUE == isBloodPumpRunning() ) ) ) ) { F32 artLowLimit = (F32)getTreatmentParameterS32( TREATMENT_PARAM_ART_PRESSURE_LOW_LIMIT ); F32 artHighLimit = (F32)getTreatmentParameterS32( TREATMENT_PARAM_ART_PRESSURE_HIGH_LIMIT ); + BOOL artPresLow, artPresHigh; // If BP is ramping up, extend range to outer limits as pressure may not yet have reached expected range. if ( isBloodPumpRampComplete() != TRUE ) @@ -484,24 +499,36 @@ artHighLimit = (F32)getS32TreatmentParamUpperRangeLimit( TREATMENT_PARAM_ART_PRESSURE_HIGH_LIMIT ); } + artPresLow = ( artPres < artLowLimit ? TRUE : FALSE ); + artPresHigh = ( artPres > artHighLimit ? TRUE : FALSE ); + // Check arterial pressure is within user set alarm limits - if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_ARTERIAL_PRESSURE_LOW, artPres < artLowLimit ) ) + if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_ARTERIAL_PRESSURE_LOW, artPresLow ) ) { SET_ALARM_WITH_2_F32_DATA( ALARM_ID_ARTERIAL_PRESSURE_LOW, artPres, artLowLimit ); } - if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_ARTERIAL_PRESSURE_HIGH, artPres > artHighLimit ) ) + if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_ARTERIAL_PRESSURE_HIGH, artPresHigh ) ) { SET_ALARM_WITH_2_F32_DATA( ALARM_ID_ARTERIAL_PRESSURE_HIGH, artPres, artHighLimit ); } } else if ( MODE_TREA == getCurrentOperationMode() ) // All treatment states not covered by the if above { - // Check arterial pressure is within non-treatment alarm limits - if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_ARTERIAL_PRESSURE_LOW, artPres < ARTERIAL_PRESSURE_ND_MIN_MMHG ) ) + F32 artLowLimit = (F32)getS32TreatmentParamLowerRangeLimit( TREATMENT_PARAM_ART_PRESSURE_LOW_LIMIT ); + F32 artHighLimit = (F32)getS32TreatmentParamUpperRangeLimit( TREATMENT_PARAM_ART_PRESSURE_HIGH_LIMIT ); + BOOL artPresLow = ( artPres < artLowLimit ? TRUE : FALSE ); + BOOL artPresHigh = ( artPres > artHighLimit ? TRUE : FALSE ); + + // Check arterial pressure is within max selectable range + if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_ARTERIAL_PRESSURE_LOW, artPresLow ) ) { - SET_ALARM_WITH_2_F32_DATA( ALARM_ID_ARTERIAL_PRESSURE_LOW, artPres, ARTERIAL_PRESSURE_ND_MIN_MMHG ); + SET_ALARM_WITH_2_F32_DATA( ALARM_ID_ARTERIAL_PRESSURE_LOW, artPres, artLowLimit ); } + if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_ARTERIAL_PRESSURE_HIGH, artPresHigh ) ) + { + SET_ALARM_WITH_2_F32_DATA( ALARM_ID_ARTERIAL_PRESSURE_HIGH, artPres, artHighLimit ); + } } else { // Reset persistence if alarm is out of scope @@ -537,12 +564,12 @@ // Check venous pressure during treatment mode against either user set limits or fixed max limits depending on treatment state if ( ( MODE_TREA == getCurrentOperationMode() ) && - ( ( ( TREATMENT_DIALYSIS_STATE == txState ) && ( getDialysisState() != DIALYSIS_SALINE_BOLUS_STATE ) ) || - ( ( TREATMENT_STOP_STATE == txState ) && ( TRUE == isBloodPumpRunning() ) ) || - ( TREATMENT_BLOOD_PRIME_STATE == txState ) ) ) + ( ( ( TREATMENT_DIALYSIS_STATE == txState ) && ( DIALYSIS_UF_STATE == getDialysisState() ) && ( TRUE == didTimeout( venPressureLimitDelayStart, VENOUS_PRESSURE_LIMIT_DELAY_MS ) ) ) || + ( ( TREATMENT_STOP_STATE == txState ) && ( TRUE == isBloodPumpRunning() ) ) ) ) { F32 venLowLimit = (F32)getTreatmentParameterS32( TREATMENT_PARAM_VEN_PRESSURE_LOW_LIMIT ); F32 venHighLimit = (F32)getTreatmentParameterS32( TREATMENT_PARAM_VEN_PRESSURE_HIGH_LIMIT ); + BOOL venPresLow, venPresHigh; // If BP is ramping up, extend range to outer limits as pressure may not yet have reached expected range. if ( isBloodPumpRampComplete() != TRUE ) @@ -551,10 +578,13 @@ venHighLimit = (F32)getS32TreatmentParamUpperRangeLimit( TREATMENT_PARAM_VEN_PRESSURE_HIGH_LIMIT ); } + venPresLow = ( venPres < venLowLimit ? TRUE : FALSE ); + venPresHigh = ( venPres > venHighLimit ? TRUE : FALSE ); + // Cannot monitor for low venous pressure while venting air trap if ( getValveAirTrapStatus() != STATE_OPEN ) { - if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_VENOUS_PRESSURE_LOW, venPres < venLowLimit ) ) + if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_VENOUS_PRESSURE_LOW, venPresLow ) ) { SET_ALARM_WITH_2_F32_DATA( ALARM_ID_VENOUS_PRESSURE_LOW, venPres, venLowLimit ); } @@ -564,19 +594,27 @@ isPersistentAlarmTriggered( ALARM_ID_VENOUS_PRESSURE_LOW, FALSE ); } - if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_VENOUS_PRESSURE_HIGH, venPres > venHighLimit ) ) + if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_VENOUS_PRESSURE_HIGH, venPresHigh ) ) { SET_ALARM_WITH_2_F32_DATA( ALARM_ID_VENOUS_PRESSURE_HIGH, venPres, venHighLimit ); } } else if ( MODE_TREA == getCurrentOperationMode() ) // All treatment states not covered by the if statement above { - // Check venous pressure is less than non-treatment alarm limit - if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_VENOUS_PRESSURE_HIGH, venPres > VENOUS_PRESSURE_ND_MAX_MMHG ) ) + F32 venLowLimit = (F32)getS32TreatmentParamLowerRangeLimit( TREATMENT_PARAM_VEN_PRESSURE_LOW_LIMIT ); + F32 venHighLimit = (F32)getS32TreatmentParamUpperRangeLimit( TREATMENT_PARAM_VEN_PRESSURE_HIGH_LIMIT ); + BOOL venPresLow = ( venPres < venLowLimit ? TRUE : FALSE ); + BOOL venPresHigh = ( venPres > venHighLimit ? TRUE : FALSE ); + + // Check venous pressure is within max selectable range + if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_VENOUS_PRESSURE_HIGH, venPresHigh ) ) { - SET_ALARM_WITH_2_F32_DATA( ALARM_ID_VENOUS_PRESSURE_HIGH, venPres, VENOUS_PRESSURE_ND_MAX_MMHG ); + SET_ALARM_WITH_2_F32_DATA( ALARM_ID_VENOUS_PRESSURE_HIGH, venPres, venHighLimit ); } - isPersistentAlarmTriggered( ALARM_ID_VENOUS_PRESSURE_LOW, FALSE ); + if ( TRUE == isPersistentAlarmTriggered( ALARM_ID_VENOUS_PRESSURE_LOW, venPresLow ) ) + { + SET_ALARM_WITH_2_F32_DATA( ALARM_ID_VENOUS_PRESSURE_LOW, venPres, venLowLimit ); + } } else { // Reset persistence if alarm is out of scope