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1. (WO2017040700) WIRELESS PATIENT MONITORING SYSTEMS AND METHODS
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WHAT IS CLAIMED IS:

1 . A method to reduce a risk that a monitored patient will develop one or more pressure ulcers by pairing a wireless physiological sensor with a patient monitoring device in a caregiver environment where other wireless sensors may be paired with and communicating with other patient monitoring devices,

the physiological sensor including a movement sensor, a first processor, and a first wireless transceiver, the physiological sensor configured to eventually be positioned with respect to a surface of said monitored patient to transmit information responsive to one or more of the patient's movement, lack of movement, or both,

the patient monitoring device including a second processor, a memory device, a storage device, a display, and a second wireless transceiver, the patient monitoring device responsive to the transmitted information from the physiological sensor to present to a caregiver patient information indicative of said risk of said pressure ulcers,

the method comprising:

in said physiological sensor, initiating a pairing mode of operation;

wirelessly transmitting from said physiological sensor a pairing signal configured to be effective for a pairing signal transmission range, said pairing signal including information identifying said physiological sensor;

in said physiological sensor, receiving a confirmation signal from said patient monitoring device confirming that said physiological sensor has been paired with said patient monitoring device;

in said physiological sensor, initiating a patient parameter sensing mode of operation; and

wirelessly transmitting to said patient monitoring device, a patient parameter sensing signal configured to be effective for a patient parameter sensing signal transmission range, said patient

parameter sensing signal including information indicative of said risk of said pressure ulcers,

wherein said pairing signal transmission range is configured to be substantially less than said patient parameter sensing transmission range.

2. The method of Claim 1 , wherein said wirelessly transmitting said pairing signal comprises wirelessly transmitting said pairing signal configured to be effective approximately zero (0) to approximately (36) thirty six inches.

3. The method of any one of Claims 1 or 2, wherein said wirelessly transmitting said pairing signal comprises wirelessly transmitting said pairing signal configured to be effective approximately zero (0) to approximately twelve (12) inches.

4. The method of any one of Claims 1 to 3, wherein said wirelessly transmitting said pairing signal comprises wirelessly transmitting said pairing signal configured to be effective approximately zero (0) to approximately six (6) inches.

5. The method of any one of Claims 1 to 4, wherein said wirelessly transmitting said pairing signal comprises wirelessly transmitting said pairing signal configured to be effective approximately zero (0) to approximately three (3) inches.

6. The method of any one of Claims 1 to 5, wherein said wirelessly transmitting said patient parameter sensing signal comprises wirelessly transmitting said patient parameter sensing signal configured to be effective approximately ten (10) feet to approximately thirty (30) feet.

7. The method of Claim 6, wherein said wirelessly transmitting said patient parameter sensing signal comprises wirelessly transmitting said patient parameter sensing signal configured to be effective approximately ten (10) feet.

8. The method of any one of Claims 1 to 7, wherein said wirelessly transmitting said patient parameter sensing signal comprises wirelessly transmitting said patient parameter sensing signal configured to be effective approximately three (3) meters.

9. The method of any one of Claims 1 to 8, wherein said wirelessly transmitting said pairing signal and said patient parameter sensing signal comprises wirelessly transmitting said patient parameter sensing signal configured to be effective an order of magnitude greater than said wirelessly transmitting said pairing signal.

10. The method of any one of Claims 1 to 9,

wherein said transmitting said pairing signal and said patient parameter sensing signal further comprises transmitting to an extender/repeater, and

wherein said receiving said confirmation signal further comprises receiving from said extender/repeater.

1 1 . The method of any one of Claims 1 to 10, comprising:

sensing acceleration using an accelerometer of said patient movement sensor and angular velocity using a gyroscope of said patient movement sensor;

with said first processor, processing signals responsive to said sensed acceleration and angular velocity; and

with said first wireless transceiver, transmitting said patient parameter sensing signal responsive to said processing.

12. The method of any one of Claims 1 to 1 1 , wherein said transmitting said pairing signal further comprises transmitting a message indicating that said wireless physiological sensor has been previously activated.

13. The method of any one of Claims 1 to 12, wherein said transmitting said pairing signal further comprises transmitting a notification indicating that a quality standard associated with said physiological sensor is compromised.

14. The method of any one of Claims 1 to 13, wherein said transmitting said patient parameter sensing signal further comprises transmitting a message indicating that said physiological sensor is nearing an end of service life.

15. The method of any one of Claims 1 to 14, wherein said initiating said pairing mode of operation further comprises activating said wireless physiological sensor.

16. The method of Claim 15, wherein activating said wireless physiological sensor comprises removing a battery isolator from said wireless physiological sensor.

17. The method of Claim 15, wherein activating said wireless physiological sensor comprises depressing for a predetermined duration a button on said wireless physiological sensor.

18. A method to reduce a risk that a monitored patient will develop one or more pressure ulcers by pairing a wireless physiological sensor with a patient monitoring device in a caregiver environment where other wireless sensors may be paired with and communicating with other patient monitoring devices,

the physiological sensor including a movement sensor, a first processor, and a first wireless transceiver, the physiological sensor configured to eventually be positioned with respect to a surface of said monitored patient to transmit information responsive to one or more of the patient's movement, lack of movement, or both,

the patient monitoring device including a second processor, a memory device, a storage device, a display, and a second wireless transceiver, the patient monitoring device responsive to the transmitted information from the physiological sensor to present to a caregiver patient information indicative of said risk of said pressure ulcers,

the method comprising:

in said patient monitoring device, receiving a pairing signal transmitted from said wireless physiological sensor, wherein said transmitted pairing signal is configured to be effective for a pairing signal transmission range, said pairing signal including information identifying said physiological sensor;

in said patient monitoring device, associating said wireless physiological sensor with said patient monitoring device;

wirelessly transmitting to said wireless physiological sensor, a confirmation signal confirming that said wireless physiological sensor is associated with said patient monitoring device; and

in said patient monitoring device, receiving a patient parameter sensing signal transmitted from said physiological sensor, wherein said transmitted patient parameter sensing signal is configured to be effective for a patient parameter sensing signal transmission range, said patient parameter sensing signal including information indicative of said risk of said pressure ulcers,

wherein said pairing signal transmission range is substantially less than said patient parameter sensing transmission range.

19. The method of Claim 18, wherein said patient parameter sensing signal is responsive to an orientation of said patient at a first time period and at a second time period; the method comprising processing said patient parameter sensing signal to determine whether there is a sufficient difference in said patient parameter sensing signal between said first time period and said second time period to indicate a patient turn.

20. The method of any one of Claims 18 or 19, wherein said patient parameter sensing signal is responsive to a sensor data vector comprising data elements; the method comprising electronically:

processing said data elements to determine a plurality of features indicative of a patient fall to form a feature vector;

applying a weight vector to said feature vector to derive an activation value;

analyzing said activation value to determine whether the patient has fallen; and

reporting a patient fall in response to a determination that a patient fall has occurred.

21 . A system for reducing a risk that a monitored patient will develop one or more pressure ulcers by pairing a wireless sensor with a portable computing device in a caregiver environment where other wireless sensors may be paired with and communicating with other computing devices, the system comprising:

a wireless sensor comprising an accelerometer, a gyroscope, a first processor, and a first wireless transceiver, said wireless sensor configured to operate in an association mode to transmit an association signal a desired association transmission range, the wireless sensor also configured to operate in a patient parameter measurement mode to transmit a measurement signal a desired measurement transmission range, wherein said association transmission range is substantially less than said measurement signal transmission range; and

a portable computing device comprising a second processor, a memory device, a storage device, a display, and a second wireless transceiver, said computing device configured to receive said association signal, said patient monitor also configured to transmit an association confirmation signal, and said patient monitor also configured to receive said measurement signal;

wherein said computing device, in response to receiving said association signal, associates said wireless sensor with said computing device and transmits said association confirmation signal; and

wherein said wireless sensor, in response to receiving said association confirmation signal, discontinues operating in said association mode and begins to operate in said patient parameter measurement mode and to transmit said measurement signal.

22. A system for monitoring an orientation of a patient to reduce a risk of the patient developing a pressure ulcer, the system comprising:

a sensor including an accelerometer, a processor, and a first wireless transceiver, said sensor configured to output a signal responsive to acceleration, said acceleration indicative of a possible change in an orientation of said patient when said sensor is worn by said patient; and

a patient monitor comprising a signal processor, a memory device, a storage device, and a second wireless transceiver, said second wireless transceiver is configured to receive said signal, and said signal processor is configured to process said signal to determine whether said possible change corresponds to an actual change in said orientation, when said actual change has occurred, configured to record a patient turn event, to compare said patient turn event with a patient turn protocol, and when said possible change is not said actual change and no patient turn event occurs according to the patient turn protocol, said patient monitor is configured to notify a caregiver of a patient turn protocol violation,

wherein said signal processor configured to determine whether said possible change corresponds to said actual change includes being configured to determine a difference between said orientation at a previous time and at a current time based at least on said signal, and when said difference is above a threshold, recording said patient turn event.

23. The system of Claim 22, wherein said signal processor of said patient monitor is further configured to reset a patient orientation duration timer when said processor records said patient turn event.

24. The system of any one of Claims 22 or 23, comprising a third wireless transceiver, said third wireless transceiver configured to receive said signal from said sensor and to transmit said signal to said patient monitor.

25. The system of Claim 24 comprising a power supply for said third wireless transceiver different from a power supply for said sensor or said patient monitor.

26. The system of any one of Claims 22 to 25, wherein said sensor comprises a gyroscope.

27. The system of any one of Claims 22 to 26, wherein said sensor comprises an acoustic sensor.

28. The system of any one of Claims 22 to 27, wherein said sensor comprises a temperature sensor.

29. The system of any one of Claims 22 to 28, wherein said sensor comprises an ECG sensor.

30. The system of any one of Claims 22 to 29, wherein said sensor comprises one or more of an acoustic sensor, a temperature sensor and an ECG sensor.

31 . The system of any one of Claims 22 to 30, wherein said patient monitor is configured to determine measurements of one or more of the following

parameters: an acceleration, an angular velocity, a magnetic field, a respiration rate, a temperature, an impedance value, a moisture value, an oximetry value and an electrocardiogram.

32. A method to determine a patient's change in orientation by monitoring patient movement with a patient-worn sensor, communicating a signal indicative of said monitoring to a processing device, receiving said signal at said processing device, and processing using a signal processor said signal to determine whether said change in orientation has occurred, said patient-worn sensor including an accelerometer, a processor, and a first wireless transceiver, said processing device including said signal processor, a memory device, a storage device, and a second wireless transceiver, said method comprising:

receiving, from said patient-worn sensor, information indicative of a patient's orientation at a first time period;

receiving, from said patient-worn sensor, information indicative of the patient's orientation at a second time period, wherein said first time period is prior to, and in close temporal proximity to said second time period; and

with said signal processor, processing said information including:

combining said received information to form a time window of patient orientation information, wherein said time window spans said first and second time periods;

dividing said time window into segments, wherein each segment has a segment value indicative of said patient's orientation;

determining a difference between said segment values;

when said determined difference exceeds a predetermined threshold, determining a patient turn event has occurred;

classifying said patient turn event;

reporting said classified patient turn event to a caregiver; and resetting a timer associated with a patient turn protocol.

33. The method of Claim 32, comprising determining whether the patient has remained in an orientation for a period of time that exceeds a predetermined maximum duration and transmitting an alert in response to said determination.

34. The method of any one of Claims 32 or 33, wherein said receiving information indicative of said patient's orientation at said first and second time periods comprises receiving acceleration data at said first and second time periods.

35. The method of Claim 34, wherein said acceleration data includes a roll axis value and a pitch axis value.

36. The method of Claim 35, comprising determining a change in a longitudinal axis of said patient responsive to said roll axis value and determining a change relative to an axis aligned with hips of the patient responsive to said pitch axis value.

37. The method of any one of Claims 32 to 36, wherein said classifying said patient turn event comprises comparing said segment values with a table of profiles of patient orientation change actions.

38. The method of any one of Claims 32 to 37, wherein each of said segment values comprises a roll axis median and a pitch axis median, and wherein said roll axis median and said pitch axis median are in units of degrees ranging from -180 degrees to +180 degrees.

39. The method of any one of Claims 32 to 38, wherein said predetermined threshold of said difference between said segment values is 45 degrees.

40. A method to determine a patient's change in orientation by monitoring patient movement with a patient-worn sensor, communicating a signal indicative of said monitoring to a processing device, receiving said signal at said processing device, and processing using a signal processor said signal to determine whether said change in orientation has occurred, said patient-worn sensor including an accelerometer, a processor, and a first wireless transceiver, said processing device including said signal processor, a memory device, a storage device, and a second wireless transceiver, said method comprising:

receiving, from said patient-worn sensor, information indicative of a patient's orientation at a current time period, said information including acceleration data having a roll axis value and a pitch axis value;

with said signal processor, electronically processing said information including:

extracting, from said storage device, information indicative of the patient's orientation at a previous time period, said previous time period is prior to, and in close temporal proximity to said current time period;

combining said current and previous orientation information to form a time window of patient orientation information, said time window spanning said previous and current time periods;

segmenting said time window into at least two segments;

determining, for each segment, a segment value, each segment value comprising a roll component and a pitch component;

comparing, pairwise, said determined segment values;

determining, for each pairwise comparison whether a patient turn event has occurred;

in response to a determined patient turn event occurrence classifying said determined turn event;

identifying a most frequently classified turn event;

reporting, as said patient's new orientation, said most frequently classified turn event; and

resetting an orientation duration timer.

41 . The method of Claim 40, wherein said received information comprises a plurality of samples, sampled at a sampling rate.

42. The method of Claim 41 , wherein said sampling rate is configured to be between approximately 10 Hz and approximately 100Hz.

43. The method of Claim 41 , wherein said sampling rate is configured to be between approximately 5 Hz and approximately 40Hz.

44. The method of any one of Claims 40 to 43, wherein processing said information further comprises:

determining a roll axis orientation indicative of said patient's orientation relative to a longitudinal axis of the patient; and

determining a pitch axis orientation indicative of said patient's orientation relative to an axis aligned with hips of the patient.

45. The method of any one of Claims 40 to 44, wherein said received information comprises a plurality of samples, sampled at a sampling rate, and wherein processing said information further comprises determining, for each of said plurality of samples, a roll axis value indicative of said patient's orientation relative to a longitudinal axis of the patient and a pitch axis value indicative of said patient's orientation relative to an axis aligned with hips of the patient.

46. The method of Claim 45, wherein determining said roll and pitch axis values includes determining said values in units of degrees ranging from -180 degrees to +180 degrees.

47. The method of any one of Claims 40 to 46, wherein determining said segment values comprises determining a roll axis median and a pitch axis median said roll and pitch axis medians in units of degrees ranging from -180 degrees to +180 degrees.

48. The method of Claim 47, wherein comparing said segment values comprises determining a difference between roll axis medians and a difference between pitch axis medians.

49. The method of Claim 48, wherein determining whether a patient turn event is indicated comprises determining whether said difference between roll axis medians or said difference between pitch axis medians exceeds a predetermined threshold, when said predetermined threshold is exceeded, a patient turn event is determined to have occurred.

50. The method of any one of Claims 40 to 49, further comprising:

determining that said patient has remained in an orientation for a period of time that exceeds a predetermined duration; and

transmitting an alert that said patient has remained in the orientation for a period of time that exceeds said predetermined duration.

51 . A method of detecting at least one of whether a monitored patient has fallen or is about to fall by processing signals indicative of movement by the patient, the signals output from a wireless sensor and communicated to a processing device,

the sensor including an accelerometer, a gyroscope, a first processor, and a first wireless transceiver, the sensor being configured to be worn by the patient, the processing device having a signal processor, a memory device, a storage device, a display, and a second wireless transceiver, the processing device configured to process the signals to determine at least one of whether the patient has fallen or is about to fall, the method comprising:

receiving, by said processing device from said wireless sensor, signals responsive to a linear acceleration and an angular velocity of said patient; and

processing said signals with said signal processor of said processing device, including electronically:

forming a sensor data vector comprising data elements responsive to said linear acceleration and said angular velocity;

normalizing said data elements to form a normalized sensor data vector;

determining from said normalized sensor data vector, a plurality of features indicative of a patient fall, to form a feature vector;

applying an a priori weight vector to said feature vector to derive an activation value;

analyzing said derived activation value to determine at least one of whether a patient fall has occurred or is about to occur; and

when said determination is that the at least one of said patient fall has occurred or is about to occur, alerting a caregiver.

52. The method of Claim 51 , wherein said receiving said signals includes receiving said signals indicative of said linear acceleration responsive to an output of an accelerometer and receiving said signals indicative of said angular velocity responsive to an output of a gyroscope.

53. The method of Claim 52,

wherein said receiving said signals indicative of said linear acceleration includes receiving said signals indicative of said linear acceleration in three dimensions,

wherein said receiving said signals indicative of said angular velocity includes receiving said signals indicative of said angular velocity in three dimensions, and

wherein said sensor vector comprises six data elements.

54. The method of any one of Claims 51 to 53, wherein said normalizing said data elements comprises:

normalizing each of said data elements to have zero-mean and unit- variance; and

forming said normalized sensor data vector comprising normalized data elements, wherein certain of said normalized data elements correspond to said linear acceleration and certain of said normalized data elements correspond to said angular velocity.

55. The method of any one of Claims 51 to 54, wherein determining said plurality of features to form a feature vector further comprises:

determining an acceleration magnitude;

determining an angular velocity magnitude;

determining a jerk magnitude;

determining a fall duration;

determining a pitch change; and

determining vertical velocities.

56. The method of any one of Claims 51 to 55, wherein said applying said weight vector to said feature vector to derive said activation value comprises computing an inner product of said feature vector with said weight vector.

57. The method of any one of Claims 51 to 56, wherein said applying said weight vector to said feature vector to derive said activation value comprises:

presenting, to a supervised learning algorithm, training data that include example inputs and known outputs; and

mapping, by said supervised learning algorithm, said example inputs to said known outputs to derive said weight vector.

58. The method of Claim 57, wherein said mapping said example inputs to said known outputs to derive said weight vector is performed by Fishers' linear discriminant.

59. The method of any one of Claims 51 to 58, wherein said analyzing said derived activation value to determine at least one of whether a patient fall has occurred or is about to occur comprises identifying a sign attribute of said derived activation value, wherein a positive sign attribute of said derived activation value indicates that said patient has fallen or is about to fall.

60. A system configured to determine at least one of whether a patient has fallen or is about to fall, the system comprising:

a wireless physiological sensor including an accelerometer, a gyroscope, a processor, and a first wireless transceiver, said sensor configured to sense a linear acceleration and an angular velocity of said patient, said sensor also configured to transmit information indicative of said sensed linear acceleration and angular velocity of said patient;

a patient monitor comprising a signal processor, a memory device, a storage device, a communications interface, a display, and a second wireless transceiver, said patient monitor configured to receive said transmitted information, to analyze said received information, and to determine at least one of whether said patient has fallen or is about to fall, said patient monitor further configured to transmit, in response to determining said patient has fallen or is about to fall, a notification that said patient has fallen or is about to fall.

61 . The system of Claim 60, wherein said patient monitor is further configured to determine from said received information one or more of an acceleration magnitude, an angular velocity magnitude, a jerk magnitude, a fall duration, and a pitch change, and to form a feature vector comprising said determined acceleration magnitude, angular velocity magnitude, jerk magnitude, fall duration, and pitch change.

62. The system of Claim 61 , wherein said patient monitor is further configured to apply a weight vector to said feature vector.

63. The system of Claim 62, wherein said patient monitor is further configured to determine an inner product of said weight vector and said feature vector.

64. The system of any one of Claims 60 to 63, wherein said accelerometer comprises a three-axis accelerometer and said gyroscope comprises a three-axis gyroscope.

65. The system of Claim 62, wherein said weight vector is derived using a supervised learning algorithm comprising executable instructions stored on a computer-readable medium.

66. The system of Claim 65, wherein said supervised learning algorithm is configured to execute on a processing device, to receive a set of training data having example inputs and known outputs, and to map said example inputs to said known outputs to derive said weight vector.

67. The system of Claim 65, wherein said supervised learning algorithm is Fisher's linear discriminant.

68. A wireless physiological sensor for measuring acceleration of a patient, the physiological sensor comprising:

a base including a bottom surface and a top surface, said base also including a first aperture, a second aperture, and a third aperture, wherein each of said first, second, and third apertures extends between said bottom surface and said top surface of said base;

a substrate layer including conductive tracks and connection pads, a top side, and a bottom side, said bottom side of said substrate layer being disposed above said top surface of said base, said substrate layer also including a first through-hole via and a second through-hole via, wherein each of said first and second through-hole vias extends through said substrate layer between said top and bottom sides of said substrate layer;

a temperature sensor responsive to thermal energy of said patient, said temperature sensor mounted on said top side of said substrate layer, said temperature sensor including a thermal contact in thermal communication with said top side of said substrate layer, wherein said first through-hole via is aligned with said thermal contact of said temperature sensor on said top side of said substrate layer and with said first aperture of said base on said bottom side of said substrate layer, and wherein said first aperture of said base and said first through-hole via of said substrate layer are filled with at least a thermally conductive material to cause said temperature sensor to be in thermal communication with a portion of said bottom surface of said base corresponding to said first aperture;

an ECG sensor mounted on said top side of said substrate layer, said ECG sensor responsive to electrical signals generated by said patient's heart, said ECG sensor including an extendible lead with an electrode responsive to said electrical signals, said ECG sensor also including an electrical contact in electrical communication with said top side of said substrate layer, wherein said second through-hole via is aligned with said electrical contact of said ECG sensor on said top side of said substrate layer and with said second aperture of said base on said bottom side of said substrate layer, and wherein said second aperture of said base and said second through-hole via of said substrate layer are filled with at least an electrically conductive material to cause said ECG sensor to be in electrical communication with a portion of said bottom surface of said base corresponding to said second aperture;

an accelerometer, mounted on said substrate layer, said accelerometer responsive to a linear acceleration of said patient; and

an acoustic respiration sensor responsive to vibrational motion generated by said patient, said acoustic respiration sensor being disposed on said bottom side of said substrate layer and extending through said third aperture in said base and beyond said bottom surface of said base, said acoustic respiration sensor being in structural communication with said substrate layer so as to mechanically transmit vibrational motion to said accelerometer.

69. The physiological sensor of Claim 68, further comprising an information element configured to store information indicative of whether said physiological sensor has been previously activated.

70. The physiological sensor of any one of Claims 68 or 69, further comprising a gyroscope, mounted on said substrate layer, said gyroscope responsive to an angular velocity of said patient.

71 . The physiological sensor of any one of Claims 68 to 70, wherein said base insulates a portion of said patient's body surrounding said portion of said bottom surface of said base corresponding to said first aperture.

72. The physiological sensor of any one of Claims 68 to 72, further comprising a wireless transceiver configured to wirelessly transmit information representative of said thermal energy, said electrical signals, said linear acceleration, and said vibrational motion.

73. The physiological sensor of Claim 72, wherein said wireless transceiver is configured to transmit a pairing signal.

74. The physiological sensor of Claim 72, wherein said wireless transceiver is configured to transmit a message indicating that said physiological sensor has been previously activated.

75. The physiological sensor of Claim 72, wherein said wireless transceiver is configured to transmit a notification that a quality standard associated with said physiological sensor is compromised.

76. The physiological sensor of Claim 72, wherein said wireless transceiver is configured to transmit a message indicating that said physiological sensor is nearing an end of service life.

77. The physiological sensor of any one of Claims 68 to 76, further comprising:

a battery, mounted on said bottom side of said substrate layer and between said bottom side of said substrate layer and said top surface of said base, said battery being in electrical contact with said substrate layer, wherein said battery forms a recess between a portion of said bottom side of said substrate layer and said top surface of said base; and

a mounting frame, disposed to fill said formed recess, said mounting frame configured to provide rigid structural support between said base and said substrate layer.

78. The physiological sensor of Claim 77, wherein said mounting frame further comprises:

a first mounting frame aperture aligned with said first through-hole via and with said first aperture of said base, wherein said first mounting aperture is at least filled with said thermally conductive material to cause said temperature sensor to be in thermal communication with said portion of said bottom surface of said base corresponding to said first aperture; and

a second mounting frame aperture aligned with said second through- hole via and with said second aperture of said base, wherein said second mounting aperture is at least filled with said electrically conductive material to cause said ECG sensor to be in electrical communication with said portion of said bottom surface of said base corresponding to said second aperture.

79. The physiological sensor of any one of Claims 68 to 78, further comprising:

a gyroscope, mounted on said substrate layer, said gyroscope responsive to an angular velocity of said patient;

a magnetometer, mounted on said substrate layer, said magnetometer responsive to a magnetic field;

a processor, mounted on said substrate layer and in communication with said temperature sensor, ECG sensor, accelerometer, gyroscope, and magnetometer, said processor configured to generate signals representative of said thermal energy, electrical signals, linear acceleration, vibratory motion, angular velocity, and magnetic field; and

a wireless transceiver, mounted on said substrate layer and in communication with said processor, said wireless transceiver configured to transmit said generated signals representative of said thermal energy, electrical signals, linear acceleration, vibrational motion, angular velocity and magnetic field.

80. The physiological sensor of Claim 79, further comprising:

an impedance sensor, mounted on said substrate layer and in electrical communication with said portion of said bottom surface of said base corresponding to said second aperture.

81 . The physiological sensor of Claim 79, wherein said accelerometer is a three-dimensional accelerometer and said gyroscope is a three-dimensional gyroscope.

82. A wearable wireless sensor for monitoring at least one of pressure ulcer risk, fall detection, or fall risk, said physiological sensor comprising:

a base including a first aperture;

a circuit layer including a first through-hole via extending through said circuit layer; and

a temperature sensor responsive to a thermal energy of a patient, said temperature sensor mounted on said circuit layer, said temperature sensor including a thermal contact in thermal communication with said circuit layer, wherein said first through-hole via is aligned with said thermal contact of said temperature sensor and with said first aperture of said base, and

wherein said first aperture and said first through-hole via include a thermally conductive material to cause said temperature sensor to be in thermal communication with a portion of said base corresponding to said first aperture.

83. The sensor of Claim 82, wherein said base insulates a portion of said patient's body surrounding said portion of said base corresponding to said first aperture.

84. The sensor of any one of Claims 82 or 83, further comprising:

a second aperture in said base;

a second through-hole via extending through said circuit layer between said top side and bottom side of said circuit layer;

an ECG sensor mounted on said circuit layer, said ECG sensor responsive to electrical signals, said ECG sensor including an extendible lead with an electrode responsive to said electrical signals, said ECG lead also including an electrical contact in electrical communication with said circuit layer,

wherein said second through-hole via is aligned with said electrical contact of said ECG sensor on said circuit layer and with said second aperture of said base, and

wherein said second aperture of said base and said second through-hole via of said circuit layer include an electrically conductive material, said ECG sensor in electrical communication with a portion of said base corresponding to said second aperture through said conductive material.

85. The sensor of any one of Claims 82 to 84, further comprising:

an accelerometer, mounted on said circuit layer, said accelerometer responsive to a linear acceleration of said patient;

a third aperture in said base; and

an acoustic respiration sensor responsive to vibrational motion of said patient, said acoustic respiration sensor being disposed on said circuit layer and extending through said third aperture in said base, wherein said acoustic respiration sensor is in rigid structural communication with said circuit layer so as to mechanically transmit sensed vibrational motion to said accelerometer.

86. The sensor of any one of Claims 82 to 85, further comprising a gyroscope mounted on said circuit layer, said gyroscope responsive to an angular velocity of said patient.

87. The sensor of Claim 86, wherein said accelerometer comprises a three-dimensional accelerometer and said gyroscope comprises a three-dimensional gyroscope.

88. The sensor of any one of Claims 82 to 87, further comprising an information element configured to store information indicative of whether said physiological sensor has been previously activated.