Interactive education system for teaching patient care

An embodiment of the present invention relates to an interactive education system for patient nursing professors, and more particularly to a system having a virtual device to be used in combination with a maternal simulator in carrying out patient nursing activities.

Although it is desirable to train students on patient nursing protocols before allowing them to interact with real patients, textbooks and flashcards lack the significant benefits of "practical" practice. Therefore, patient nursing education was often taught using medical equipment for performing patient nursing on a simulator such as a human body model. However, one of the drawbacks of such systems is that medical devices are often extremely expensive, and many users, at the expense of narrowing the scope of their educational experience, are of the type of device. There is no choice but to reduce. One solution to the above problem is a set of inexpensive simulation medical devices, as taught in US Pat. No. 5,853,292, which is incorporated herein by reference in its entirety. To use (virtual equipment). Another solution is to make the simulator compatible with real medical devices.

[0003] Another challenge in patient nursing education is that the patient simulator used to teach the user is passive. For example, in a birth simulation, the user places the simulated foetation in the simulated maternal pelvis, lowers it through the birth canal, delivers the fetal head, rotates the foetation about 90 ° and shoulders. It is necessary to deliver and finally withdraw the foetation (at this point it will be referred to as the "newborn"). While imitating a series of events in actual delivery, the user's physical manipulation of the foetation lacks authenticity, making it difficult to perceive the difficulty of patient care. In actual delivery, the foetation is inaccessible and most movements are hidden and invisible, and prior art systems address the most difficult situation of providing patient care during childbirth. Absent. In addition, the prior art system does not simulate cervical dilatation as the foetation descends through the birth canal, thus allowing students to assess the stage of labor and assess the progression of labor. Unable to create time extension chart (delivery record). Yet another challenge in patient nursing education is that the system is often too bulky and the number of required wiring connections to other components is often too high, making it difficult to move the simulator to other positions. Even in a system called "portable", it is often necessary to move a large number of connecting parts such as compressors and power supplies in order for the simulator to function fully. The solution to this problem is to create a fully functional, independent simulator that communicates wirelessly with external devices. Therefore, there is a need for a system for interactive education systems used to conduct patient nursing training sessions, including more realistic simulation patients. [Prior Art Document] [Patent Document]

<patcit num="1"><text>U.S. Patent Application Publication No. 2003/073060</text></patcit><patcit num="2"><text>International Publication No. 2002/29765</text></patcit><patcit num="3"><text>U.S. Pat. No. 3,822,486</text></patcit>

<p num="0005"> Embodiments of the present invention provide an interactive education system for patient nursing professors for users. The system is designed for both maternal and fetal simulators (used with and separate from maternal simulators), and neonatal simulators (for fetal simulators in postpartum simulations). (Designed to replace) includes. In some embodiments, the system has a simulator that is completely tetherless. That is, the simulator functions without the need for wiring connections to other external appliances, devices or power supplies. In such an embodiment, the simulator can communicate wirelessly with other devices and instruments.</p>

<figref num="1a">FIG. 1a is a schematic diagram of an embodiment illustrating an interactive education system.</figref><figref num="1b">FIG. 1b is a schematic diagram of an interactive education system according to another embodiment.</figref><figref num="2">FIG. 2 is a schematic diagram of the interaction between the virtual instrument and the patient simulator.</figref><figref num="3a">FIG. 3a is a cross-sectional perspective view of the virtual instrument.</figref><figref num="3b">FIG. 3b is a cross-sectional perspective view of the sensor.</figref><figref num="4">FIG. 4 is a perspective view of an embodiment illustrating a patient simulator.</figref><figref num="5a">FIG. 5a is a perspective view of the patient simulator of FIG. 4 with the cover attached.</figref><figref num="5b">FIG. 5b is a top view of the control box.</figref><figref num="6">FIG. 6 is a perspective view of the body of the patient simulator of FIG.</figref><figref num="7">FIG. 7 is a perspective view of the patient simulator of FIG. 6 with the fetal part removed.</figref><figref num="8">FIG. 8 is a perspective view of the expandable cervix of the patient simulator.</figref><figref num="9">FIG. 9 is a perspective view of the outside of the patient simulator.</figref><figref num="10">FIG. 10 is a perspective view of an embodiment of the patient simulator as a newborn baby.</figref><figref num="11">FIG. 11 is a schematic diagram of usage illustrating the system of the present invention.</figref><figref num="12">12 to 16 are screen display diagrams generated by a program according to an embodiment of the system of the present invention.</figref><figref num="13">12 to 16 are screen display diagrams generated by a program according to an embodiment of the system of the present invention.</figref><figref num="14">12 to 16 are screen display diagrams generated by a program according to an embodiment of the system of the present invention.</figref><figref num="15">12 to 16 are screen display diagrams generated by a program according to an embodiment of the system of the present invention.</figref><figref num="16">12 to 16 are screen display diagrams generated by a program according to an embodiment of the system of the present invention.</figref><figref num="17">FIG. 17 is a perspective view of an embodiment as a newborn of a patient simulator according to an embodiment of the disclosed contents of the present invention.</figref><figref num="18">FIG. 18 is a perspective view of various modules used in combination with the neonatal simulator of FIG.</figref><figref num="19">19 is a perspective view of a cross section of the neonatal simulator of FIG.</figref><figref num="20">FIG. 20 is a schematic diagram of the air supply system of the neonatal simulator of FIG.</figref><figref num="21">FIG. 21 is a perspective view of a cross section of the muffler used in combination with the air supply system of FIG.</figref><figref num="22">FIG. 22 is a screen display diagram generated by a program according to an embodiment of the disclosed contents of the present invention.</figref><figref num="23">FIG. 23 is an output display diagram of simulated life signs of the neonatal simulator of FIG. 17 according to an embodiment of the disclosed content of the present invention.</figref><figref num="24">FIG. 24 is a front view of a mechanism for fixing a fetal / neonatal simulator to a maternal simulator according to an embodiment of the disclosed content of the present invention.</figref><figref num="25">FIG. 25 is an exploded perspective view of the mechanism of FIG. 24.</figref><figref num="26">FIG. 26 is a perspective view of a part of the mechanism of FIG. 24.</figref><figref num="27">FIG. 27 is a perspective view of another part of the mechanism of FIG. 24.</figref><figref num="28">FIG. 28 is a side view of a system that selectively rotates a fetal / neonatal simulator during a birth simulation.</figref>

With reference to FIG. 1a, reference numeral 10 generally represents an interactive education system for teaching a patient nursing protocol to a user. The system 10 has a set of virtual instruments 12 used to simulate a medical device and a simulator 14 used to simulate at least one patient receiving patient nursing activity from a user. The virtual instrument 12 is a tangible object that looks, feels, and operates like a real medical device in relation to the simulator 14. Simulator 14 comes in a variety of forms, including fully articulated adult-sized mannequins and parts of the mannequin such as the fetal, newborn, pediatric, adolescent, or arm, torso, head, or pelvis. It should be understood that it contains.

The patient nursing activity received by the simulator 14 from the user is detected by the method described later, and the system 10 provides feedback to the user in response to the activity. Feedback should be understood to include auditory, visual, or tactile responses. The computer 15 having the program 15a is selectively connected to the system 10 for the reason described below.

Referring to FIG. 1b, system 10'has a computer 15 and a program 15a, provided which a set of software-generated virtual instruments 12'and a software-generated simulator 14' are provided. Thus, the patient nursing activity performed by the user involves manipulating the icon associated with the software-generated selected virtual instrument 12'to provide patient care to the software-generated simulator 14'. In the present embodiment, as will be described later, the program 15 monitors the activity of the user by using means by prior art such as mouse click and voice operation software, and provides feedback in response to the activity.

Returning to Figure 1a, system 10 also has a communications interface module (CIM) 16, which receives operational power from the prior art power supply 18 and is a microcontroller (PIC). Including 20. Microcontrollers are available from various vendors such as Microchip Technology, Inc. (Chandler, Arizona, USA) and are customized. As described below, the PIC 20 is programmed to receive an input signal from a user's activity and react in a specific way to provide feedback to the user. For example, to provide auditory feedback, the CIM16 further acts on the speaker 24 in response to the PIC20 to produce authentic patient sounds such as heart, lungs, blood pressure (Korotkoff sounds), intestines, and fetal sounds. It has a chip 22. The CIM16 includes a controller 26 for adjusting the volume of the speaker 24.

Alternatively, the CIM 16 may be connected to the computer 15 and the program 15a, depending on the desired feedback complexity. In one example of feedback, program 15a can be used to provide, for example, a large library of ultrasound cross-sections and fetal asphyxia monitor traces. The feedback can also be the body sound generated by program 15a and played from the computer speakers.

The CIM 16 has a plurality of ports (collectively referred to as 28) that receive an input signal generated by the interaction between the virtual device 12 and the sensor 30 on the simulator 14 due to the user's patient nursing activity. It should be understood that there may be one or more PIC20s and one or more CIM16s to control the input signal generated in this way.

The virtual device 12 is a patient care device, eg, at least one intravenous drip (IV) needle, an endotracheal (ET) tube, an electrocardiogram (ECG or EKG) monitor, a blood pressure ( blood pressure: BP) Pressure band for measurement, pulse oxygen concentration meter band, temporary external pacer, automatic external defibrillator (AED), manual defibrillator, ultrasonic light pen, virtual hearing It has a vessel, a thermometer, and a fetal asphyxia monitor (12 a to l each). Such virtual instruments look and operate like real medical devices. Of course, the use of relatively inexpensive medical devices such as conventional stethoscopes, vacuum extractors, catheters, trays, and intravenous drip (IV) stands, and other virtual instruments are also expected.

With reference to FIG. 2, the drip needle 12a has a selectable group of specific drugs and drug formulations, and in one embodiment, the drug with the administered effect controlled by the program 15a is distributed to the simulator 14. It is part of a tray of medicine with a set of labeled syringes for. The ET tube 12b is used for airway management in a simulated patient and is placed in the trachea of simulator 14. The EKG monitor 12c has a 3, 5, or 12 guidance system with a real-time trace monitor and R-wave sound wave markers, and multiple color-coded patches for connecting to the fuselage of the simulator 14. Blood pressure pressure: BP) The measuring band 12d is attached to the simulator 14, for example, around the arm. The fingertip band 12e for the pulse densitometer is attached to the simulator 14, for example, around the finger. The temporary external pacer 12f has a plurality of front and rear pacer pads for attachment to the fuselage of the simulator 14. The pacer 12f has a controller for pacer speed and current and displays rhythm pacing, cap time, and loss of cap time, all of which are controlled by program 15a. Automatic external defibrillator (automatic external) The defibrillator (AED) 12g has multiple AED pads for the apex such as the heart and the sternum for attachment to the fuselage of the simulator 14. When a shock button generated by software controlled by program 15a is selected, system 10 simulates defibrillation shock under the resulting conditions controlled by program 15a. The manual defibrillator 12h has multiple defibrillator rods (paddles) for the apex of the heart and sternum for contact with the body of the simulator 14. By selecting a software-generated shock button or by using a dual shock button combined with a manual defibrillator 12h, the system 10 is removed according to the resulting conditions controlled by program 15a. Simulate a fibrillation shock.

Continuing with reference to FIG. 2, the ultrasonic light pen (ultrasonic wand) 12i interacts with the simulator 14, and when the wand 30i is brought within a predetermined neighborhood of a given anatomical structural region of the simulator, the CIM 16 interacts with this mutual. Detecting action, program 15a provides ultrasound images and / or ultrasound cross-sections taken from a library of ultrasound. Program 15a can choose between a normal section and an abnormal section to allow the user to interpret the section and respond accordingly. The virtual stethoscope 12j interacts with the simulator 14, and when the stethoscope 12j is brought within a predetermined vicinity of a predetermined anatomical structure region of the simulator, the CIM 16 interacts with this interaction, as described later in FIGS. Detect and provide feedback to the user. The thermometer 12k interacts with the simulator 14, and when the thermometer 12k is brought within a predetermined neighborhood of a given anatomical structure region of the simulator, the CIM 16 detects this interaction and program 15a provides a temperature reading. .. The fetal asphyxia monitor 12l (labor meter) is mounted on a portion of the simulator 14, by which the program 15a provides a simulated fetal heart rate.

Each instrument has corresponding sensors 30a-l, as shown by line 36 as a whole. Unless otherwise stated, line 36 is schematic, in which the virtual instrument 12 and the sensor 30 are functionally interconnected to provide the interaction created by the user's patient nursing activities, said interaction. , Only exemplifies that it is reported as an input signal to CIM16. It should be understood that it is also intended to share such physical lines between the instrument 12 and the sensor 30.

The interaction between the virtual instrument 12 and the sensor 30 is electrical, optical, pressure difference, tactile, temperature controlled, or wireless. Generally speaking, electrical interactions (which also provide the input signal) can be created via a virtual instrument 12 having a sensor 30 with one node and another node, both of which Physically connected to CIM16. Alternatively, it is connected to a virtual instrument having two nodes formed from conductive material and a sensor or vice versa, and only one of them is physically connected to the CIM16. For example, the IV needle 12a corresponds to a portion of the simulator 14 that can accept the drug, such as the anterior elbow region of the arm, which region has the appropriate thickness and a small sharp angle (eg, 20 °) for the IV needle 12a. You may have a sensor 30a with an insulator sandwiched between two layers of conductive material having a weave density that allows it to penetrate the cloth. The conductive layer of the sensor 30a is electrically connected to the CIM 16 via the line 36a', and if the drip needle 12a correctly passes through the two conductive layers that simulate intubation of the simulator 14 into a blood vessel, a circuit. Is completed between the layers and is detected by CIM16.

As another example of how to detect interactions, ET tube 12b is used for simulated patient airway management, and simulator 14 accepts head, eyes, nose, mouth, and normal airway appendages. It has a near-realistic airway that allows it, the placement of the airway is adjustable, and displays a large tongue, blocked pharynx, or closed vocal cords, increasing the difficulty of the patient's nursing activities. To ensure correct placement of the simulator 14 in the trachea, an optical sensor 30b is provided on the tracheal wall of the simulator 14 and is connected to the CIM 16 through a line 36b'. The correct placement of the ET tube 12b in the trachea is confirmed when the tip of the ET tube blocks the light beam of the optical sensor 30b. Sensor 30b can also be used to determine if a fluid has passed.

The virtual stethoscope 12j provides an example of a wireless method that senses interactions. At least one sensor 30j is provided at the anatomical site of the simulator 14, where specific heart sounds, lung (including airway) sounds, Korotkoff sounds, fetal sounds, or other sounds are usually I can hear you. The sensor 30j provides the integrated acoustic circuit with at least one signal identified by the stethoscope 12j, thereby producing a sound suitable for the anatomical position of the sensor on the simulator 14 to the user. Instruct. It should be understood that the acoustic circuit has a library that stores body sounds corresponding to the position of the selected sensor 30j, which exemplifies any number of similar sensors.

Referring to FIG. 3a, in some embodiments, the stethoscope 12j looks like a normal stethoscope, has earpieces 50a-b for listening to sound, and is an extension connected to the bifurcated Eustachian tube 52. It is connected to 51a ~ b. Similarly, the stethoscope further has a bell tube 54 and a bell 56, preferably made of a non-ferrous material. However, unlike conventional stethoscopes, an electronic control box 58 is placed between the eustachian tube 52 and the bell tube 54. It should be understood that the control box 58 is a well-crafted CIM 16 and is physically incorporated into the virtual stethoscope 12j to simplify the system 10. A jack 64 is provided in the control box 58 for output to an external speaker (not shown) so that other users can hear the sound heard by the earpieces 50a-b. This not only increases the number of users who benefit from patient nursing activities, but also allows leaders to test their abilities and modify their skills if necessary. The control box 58 is a small speaker 72, for example ADDAX Sound, to produce a given sound. Small power supplies 66, such as batteries, capture circuits 68, and acoustic circuits 70 (for schematics, co-pending U.S. Patent Application 09 / (See No. 640,700, filed August 17, 2000). The speaker 72 is arranged in the earpiece 50a and connected to the control box 58 via the wire 72a so that the user can hear the sound produced by the acoustic circuit 70. It will be appreciated that a second, substantially identical speaker may be provided on the opposite earpiece 50b and also connected to the control box 58. In an alternative embodiment, the speaker 72 may be placed within the control box 58 so that sound is transmitted to the earpiece via the conventional eustachian tube. The acoustic circuit 70 is also connected to the jack 64 so that it can be connected to an external speaker for the reasons described above.

A switch 74 with a large number of configuration states is arranged for switching between a set of sounds, eg, a set of typical normal and abnormal sounds heard in adults, newborns, and foets. Radio frequency (RF) signal acquisition coils 76, such as those available from MC Davis Co. (Arizona City, Arizona), are available from Bell 56 to transmit and capture RF signals, as described below. It is located inside. The capture coil 76 has a copper wire coil and a circuit element having a related wire 76a attached to the electronic control device 58. A resin disc 78 is placed between the capture coil 76 and the bell and 56 to reduce noise from the bell 56.

In another embodiment, the sound is reproduced by a speaker (not shown) placed within the mannequin so that the sound can be heard without the use of a real or virtual stethoscope. In yet another embodiment, the sound is reproduced by speakers (not shown) arranged within the mannequin so that the sound can be heard with a real stethoscope.

Referring to FIG. 3b, the sensor 30j is placed under the skin 14b of the simulator 14 to avoid visual exposure by the user. Also, anatomical sites, such as intercostal spacing, should be palpated to confirm location, so the sensor 30j can avoid intentional or accidental exposure by providing a minimum thickness. convenient. In an alternative embodiment, the sensor 30j is better attached to a lid (not shown) that is substantially similar to the skin 14b, and this lid can be placed on top of other simulators or models of the patient. Change the device so that it can be used with the stethoscope 12j.

The sensor 30j has a radio frequency ID tag 80, which is available, for example, from Microchip Technology, Inc. (Chandler, Arizona, USA) (part number MCRF200-I / 3C00A), but identifies a particular sensor 30j. This may be programmed using "Developer's Tools", also sold by Microchip Technology, Inc., to generate a unique signal that is useful for this. A coil 82, eg, one available from MC Davis Co. (Arizona City, Arizona), is operably connected to the tag 80. Tags 80 and coil 82 are room temperature vulcanizable, such as those available from MC Davis Co. (Arizona City, Arizona). vulcanizing: RTV) Embedded material 84, ie, embedded in silicone rubber to prevent damage. Once embedded, the tag 80 and coil 82 collectively form a COB module 86 that outputs a signal with a unique frequency sequence when a response command signal is issued.

In operation, the COB module 86 can actively transmit frequencies, but preferably the COB module is passive, i.e., when a response command signal is issued by the capture coil 76 in the stethoscope bell 56. Should only work. In the best embodiment for carrying out the invention, the capture coil 76 transmits a carrier signal, eg, a carrier signal such as an excitation frequency of 125 kHz, which causes the bell 56 to be within a predetermined vicinity of the COB module 86, i.e. capture. Received by COB module 86 if brought within range. The capture distance of the bell 56, therefore the capture coil 76 to the COB module 86, is the signal strength to of the carrier signal. noise: S / N) Determined by the ratio. Therefore, adjusting the signal-to-noise ratio of the carrier signal provides a means for controlling the stethoscope bell 56, and thus the COB module 86, with the precision that the user must place with respect to the anatomical position of the sensor 30j. The precise position of the bell 56 on the simulator 14 by the user is rewarded by feedback in the form of a suitable body sound. Normally, the signal-to-noise ratio is set to require that the bell 56 be brought within approximately 1.5-2 cm of the COB module 86 of the sensor 30j.

Although other keying methods can be used in response to receiving a sufficiently strong carrier signal, the COB module 86 provides frequency shift modulation. It emits a series of two marking frequencies for use in a process traditionally known as keying: FSK). The capture coil 76 in the stethoscope bell 56 receives the transmitted frequency and relays the signal to the capture circuit 68, which checks the identity of the sensor 30j. Since the anatomical position of each sensor 30j is known to the programmer, the appropriate body sound coupled to each sensor is selected and the acoustic circuit 70 is accessible. So, by checking the sensor 30j, the capture circuit 68 directs the acoustic circuit 70 to make a proper body sound for the anatomical position of the COB module 86, which is placed in the earpiece 50a. The user hears through the speaker 72. It is permissible to add more sensors 30j to the simulator 14 or to have each sensor correspond to one or more sounds in order for the user to hear a wider selection of sounds. As described above, the switch 74 has five different setting states and has means for switching the acoustic circuit 70 between five different groups of sounds. Therefore, the number of switch settings corresponds to the number of sounds that can be produced by a single sensor, that is, with 13 sensors and 5 switch settings, the user has normal and abnormal sounds. It will be appreciated that you can hear sounds specific to up to 65 positions, including the example in.

The capture coil and COB module described above include an ECG monitor 12c guide, paddle, or probe (connector), temporary external pacer 12f, automatic external defibrillator (AED) 12g, manual defibrillator 12h, It is recognized that it can be improved for use with ultrasonic wands 12i and fetal asphyxia monitors 12l. If desired, the connectors may be provided glued together to temporarily hold them in place on the patient simulator. The interaction between the instrument connector and the sensor 30 is detected by the CIM16 to confirm the correct placement. The arrangement of the sensor 30 hidden under the skin of the patient simulator further resembles a real patient and will test the user's patient's nursing skills.

The simulator 14 is designed to represent and receive treatment for a patient, so that the simulator 14 takes various shapes, the shapes of which are in parts of the simulated patient, such as the torso and pelvis. It should be understood that along with the area, it includes a fully articulated adult-sized obstetric simulator, a curled foetation, an articulated foetation, a multiple birth, or a newborn.

With reference to FIGS. 4 and 5a, in an exemplary embodiment, the simulator 14 has a maternal simulator 300 that gives birth to a child and a removable linked fetal simulator 302. The maternal simulator 300 has a head 304 with hair 306, eyes 308a-b, nose 310, and mouth 312. The head assembly has a near-realistic airway (not shown) that can accept conventional airway appendages. The sensor, represented by 30 as a whole (Figure 1a), is located above the skin of the maternal simulator (represented by spots) and / or below the skin (represented as in the model). You may. It should be understood that in one embodiment of the maternal simulator (not shown), the sensor is not connected to the simulator. A line 36 projects from the fuselage 316 to provide an electrical, pneumatic, or fluid connection and, if necessary, to connect the sensor 30 to the CIM 16.

In another embodiment, the maternal simulator 300 is tetherless. That is, the parent simulator functions without the need to connect to devices other than the simulator with wires or tubes, and therefore does not have lines 36, 325a, and 326b extending from the fuselage 316. Rather, the maternal simulator is independent. Thus, the parent simulator 300 can include a built-in power source such as a rechargeable battery, and all pneumatic and fluid connections are connected to the compressor or other device within the corresponding master simulator 300. Since the maternal simulator is stand-alone, it is not only portable, but can also be used during transfers between different locations. Further, in such an embodiment, the mother simulator 300 may communicate with another device such as CIM16 by wireless communication. Therefore, the entire simulator system 14 can function to the limit of wireless communication. Further, in some embodiments, the maternal simulator 300 wirelessly connects to a computer or network system, which in turn connects to the CIM 16 via a wired or wireless network, effectively extending the functional distance of the maternal simulator. Make it infinite. Although only the maternal simulator has been described here, the fetal and neonatal simulators described in more detail below are also tetherless in some embodiments. In some embodiments, the simulator is configured to be used in both tetherless and tethered states. In some embodiments, the simulator works perfectly with tetherless use (ie, the simulator has the same functionality in both tethered and tetherless states).

A pair of arms 318a to bb are connected to the body portion 316. At least one arm has an infusion receptacle (not shown) capable of receiving the drug, and the sensor 30a may be placed in the receptacle to see if the infusion has been initiated. Similarly, the arm may have a sensor 30d for auscultation of Korotkoff sounds, as well as a means for measuring blood pressure. The pelvic region 320 of the torso 316 receives a pair of legs 322a ~ b.

With reference to FIG. 5a, the cover 324 can be attached to the fuselage 316 via a plurality of snaps 324a, although removable coupling means such as hooks and annular fasteners can also be used. To work with the ultrasonic wand 12i, the fetal asphyxia monitor 12l, and the stethoscope 12j or at least one small speaker instead, the cover 324 holds the sensor 30, respectively by the stethoscope 12j or a conventional stethoscope. It enables simulation of detected fetal heart sounds. In one embodiment, the cover 324 surrounds an open cell foam (not shown) connected to the vacuum generating means. The generation of vacuum shrinks the bubbles, making them feel stiffer, which simulates the contraction of the uterus by the maternal simulator 300. Alternatively, the cover 324 may hold an air sac and a connecting line (not shown) for pressurizing the cover, which makes it feel stiffer. In yet another embodiment, the cover has a plurality of flexible tubes (not shown) extending across the fuselage. Hardness is determined by the air pressure inside the tube. Adjusting the air pressure changes the hardness. It should be appreciated that different levels of hardness can be produced to simulate different levels of shrinkage strength, such as mild, moderate, and strong shrinkage. If connected to CIM16 and program 15a, contractions are regularly spaced and maternal intrauterine pressure can be displayed programmatically, as described with reference to FIG.

Returning to FIG. 4, the fetal simulator 302 is depicted as having an umbilical cord 302a and a placenta 302b and occupying a position on a removable stage 325 located inside the maternal simulator. The removable stage 325 has a sac (not shown), a line 325a, and a sphere 325b. Using the sphere 325b to pump air into the sac, stage 325, and thus fetal simulator 302, rises slightly upwards. When covered with cover 324 (FIG. 5a), as stage 325 rises, the user can palpate the fetal simulator 302 through the cover to evaluate its position and perform Leopold operations. In another embodiment, the sphere 325b is replaced with an alternative pump, for example an electric pneumatic pump. The electric pump may be remotely controlled by a computer or other device.

The delivery device 326 is located inside the body 316, as described below. The cover 324 hides the fetal simulator 302 and the birthing device 326 of the simulator from view. Therefore, it more accurately simulates the childbirth process and tests the user's therapeutic ability. When the stage 325 is removed, the maternity device 326 is small, connected via a manual crank (not shown) or with control means to turn the motor on and off and determine operating speed via line 326b. It can be operated by the motor 326a.

In the first embodiment, the software of program 15a controls the birthing device 326 as described below with respect to FIG. In another embodiment, the control means is a line 330 connecting the control box 328 and the control box 328 to the CIM 16. Referring to FIG. 5b, each of the control boxes 328 has controllers 328a-d for turning on and off the simulator 14, stopping and resuming childbirth, determining the rate of delivery, and setting the fetal heart rate. doing.

With reference to FIGS. 6 and 7, the body portion 316 of the maternal simulator 300 is illustrated with the cover 324 removed to expose the fetal simulator 302. The fetal simulator 302 is provided in the body cavity 333 of the maternal simulator 300, and has a head 334 and an attached body portion 336 together with arms 338a to b and legs 340a to b attached to the body portion. The head 334 is soft so that suction delivery is possible and has a mouth and nose that the user can aspirate.

In that regard, in some embodiments, the fetal simulator 302 is a force sensor (shown) placed on the neck, shoulders, and hips to monitor the amount of force applied to the fetal simulator 302 during labor. Do not have). Pulling on the head 334 produces a signal from the neck sensor. The amount of force is relayed to the user and / or leader by the user interface. The user interface includes graphic display and audible signals. For example, the user interface may generate a bar graph showing the amount of force applied, and the user interface may beep or otherwise when the force exceeds a predetermined threshold. The alarm sound may be generated to urge the user to reduce the force applied or to use a different delivery method. In one embodiment, the maximum force threshold is about 40 pounds force. In one embodiment, the desired force range is about 17-20 pounds force. Abnormal shoulder delivery is a potentially fatal condition in which the fetal shoulder is caught behind the maternal pubis. Excessive force causes the fetal cranial nerve plexus and also Elb's It can even cause palsy). To simulate this potentially lethal condition, the force applied to the shoulders is monitored by including shoulder sensors on the left and right shoulders of the fetal simulator 302. Finally, due to various situations such as breech vaginal delivery, it is possible to grab the legs 340a-b and remove them from the vagina. The hip sensor serves to monitor the force applied to the fetal simulator 302 in such a state. In some embodiments, the sensor 30 communicates with an operable output device to provide an output signal indicating a measurement that a particular sensor is designed to monitor. The output device can output an electrical signal, a wireless signal, or any other suitable output signal.

The umbilical cord and placenta 302a-b (Fig. 4) have been removed for simplification of the figure, while placenta 302b (Fig. 4) has any number of common orientations, eg, normal bottom position, low. It should be understood that it is located in the position or placenta previa and can be attached to the body cavity 333 by a conventional removable fastener. Similarly, the umbilical cord 302a (FIG. 4) can be presented to mimic a variety of complex situations, accommodating a connection line to the fetal simulator 302, allowing the umbilical cord pulse to be felt by the user. Alternatively, current can be transmitted to the fetal simulator 302 if desired.

A receiving portion 342 is provided in the fetal simulator 302 so that the delivery device 326 can hold the fetal simulator. Similar to the receiving portion 342, other receiving portions are intended for various parts of the fetal simulator 302 for breech birth simulation and the like, and since the fetal simulator 302 is articulated, various breech births are performed. Breech deliveries, such as complete, overt, and breech births, can be simulated.

The delivery device 326 has a protrusion 344 of the piston portion 346 that cooperates with the receiving portion 342 of the fetal simulator 302 to hold the fetal simulator 302. In some embodiments, the receiving portion 342 and the protrusion 344 allow the fetal simulator 302 to selectively engage with and release from the maternal simulator 300. There is. In the illustrated embodiment, the piston section 346 is driven by a drive system, which drive system includes a small electric motor, gears, resettable electrical logic circuits, means for determining the position of the piston section, and forward / reverse function. have. The piston portion 346 travels downward along a set of trajectories 347a-b, thereby moving the fetal simulator 302 out of the maternal simulator 300.

The protrusion 344 of the piston section 346 is rotatable, which causes the birthing device 326 to generate both rotational and translational movements of the fetal simulator 302, simulating a realistic childbirth scenario. The foetation then rotates to a normal crowning position with the nose down. After advent, the foetation can rotate further and the foetation's shoulders can successfully pass through the birth canal. In some embodiments, the receiver 342 is located in another part of the fetal simulator, eg, in the head, neck, shoulders, arms, hips, and / or legs. Another embodiment of the receiving portion 342 and the protrusion 344 will be described later with reference to FIGS. 24 to 27.

In one embodiment, the levers 346a-b of the piston portion 346 are operably connected to the protrusions 344 and engage with the cams 348a-b, respectively, to create rotation. When the piston portion 346 descends from the orbit 347a to b, the levers 346a to b of the piston portion engage with the fixed cams 348a to b in order to move each lever. The movement of the lever rotates the protrusion 344. Eventually, each lever is moved to the point where the lever leaves each cam. It can be seen that the cams 348a ~ b are placed where they want to rotate along the orbits 347a ~ b that simulate the birth canal. Thus, the internal rotation of the foetation is caused by the lever 346a that engages the cam 348a, and the external rotation of the foetation is caused by the lever 346b that engages the cam 348b. As will be described later with respect to FIG. 28, in some embodiments, the cams 348a-b can move between a position where the fetal simulator is rotated and a position where the fetal simulator is not rotated. Further, in some embodiments, cams 348a-b include an intermediate position for giving the fetal simulator some rotation. Alternatively, program 15a allows the rotation of the protrusion 344 to be adjusted from 0 degrees to 180 degrees, as described below in connection with FIG. In both embodiments, the fetal 302 passes through the expandable cervix 350, as described below.

With reference to FIGS. 8 and 9, the expandable cervical 350 has a ring 352 with flaps 353a-b attached to hold the position of the cervix in body cavity 333. Thus, flaps 353a-b may have attached snaps, hooks, and annular fasteners, or other releaseable binding means. The wall portion 354 is connected to the ring 352 and is preferably formed of an elastic member such as Lycra® or a thermoplastic elastomer. Gathers 356, made of wall members, define holes 358. The gather 356 may be provided with an attached elastomer element inside to increase the elasticity of the hole 358. Alternatively, the wall portion 354 itself may have sufficient elasticity.

When the fetal simulator 302 is pushed through the hole, the hole 358 expands to about 2-10 cm in diameter, and due to the shape of the fetal simulator head 334 and the elasticity of the wall 354, the expansion is automatic. Is simulated to coincide with the descent of the fetal. The user then performs a measurement of cervical dilatation and plots the progress of labor as a partograph. The elasticity of the wall 354 can be adjusted, for example, by using thicker or thinner wall members, thus creating a cervix that expands faster or slower than usual. The cervix 350 is coaxially provided in the pelvic region 320 with the pubic bone 360, along with a plurality of snaps 324a for the cover.

The fetal simulator 302 is ejected from the body cavity 333 through the cervix 350 and through the vulva 362. The vulva 362 is made of a flexible material and allows the user to perform an episiotomy to manipulate the vulva or deliver the head 334. The vulva 362 may have a portion (not shown) of an insert having features such as the ureter or rectum, which inserts other genitals to indicate the condition of various patients. It should be understood that it can be replaced with an insert of. After delivery, the user may perform postpartum exercises, such as a massage to return the uterine insert (not shown) to the desired size, removal of the retained placental part (not shown), or the cervix. Repair of part 350 or vulva 362 may be performed.

In one embodiment, the torso 316 has a simulated heart, lungs, and ribs. The heart (not shown) pulsates by the action of pulsatile flow controlled by program 15a, depending on the patient's condition and in response to therapeutic intervention. Palpable veins can be found in the carotid artery, upper arm, radial side, thigh, and foot and dorsal positions. The location of a particular pulse cannot be palpated when systolic blood pressure drops, and the presence or absence of a pulse depends on the simulated blood pressure. Heart sounds can be heard in place through the stethoscope 12j. Heartbeats are synchronized with virtual electrocardiograms (EKGs) determined by program 15a. When the stethoscope 12j is applied to a point below the blood pressure measuring band 12d (Fig. 2), a reasonable Korotkoff sound can be heard.

The maternal simulator 300 displays a combination of ventilation means and the sounds of the lungs and airways can be heard in the proper position using the stethoscope 12j. Simulator 300 breathes spontaneously to achieve the targeted arterial blood gas in a given situation, including responses to interventions such as gas exchange in the lungs and administration of drugs, and tidal volume. And display the amount of thoracic elevation associated with physiological conditions. The dynamics of a normal gas exchange lung are hypothetical, with tidal volume (TV), functional residual capacity (FRC) and exhaled carbon dioxide (CO2). It is controlled by program 15a which can be determined. Airway resistance, lung, and chest wall compliance are also controlled by Program 15a.

The heart and lungs are connected to a pressure converter that establishes airway ventilation and compression of the heart. For example, if an air line is attached to the wall of the trachea or to the lungs of the simulator 300, connected to a sensor circuit connected to the CIM16, and ventilation by cardiopulmonary resuscitation (CPR) is performed in the simulator, the CIM16 Monitors the timing and magnitude of ventilatory pressure and volume via air lines and sensors. Similarly, when a compression sac is implanted in the heart or chest cavity of Simulator 300 and an air line connects to a compression sensor circuit attached to the CIM16, it detects the correct timing and size of the CPR chest compression procedure. Check. It will be acknowledged that compression and ventilation data are obtained from the pressure waves detected by CIM16 via line 36. Blood pressure, heart rate, and oxygen saturation are virtually measured in the blood pressure (BP) measurement pressure band 30d (Figure 2) and the pulsed oxygen meter band, but the data displayed is shown by Program 15a. appear.

With reference to FIG. 10, the neonatal simulator 302'is used to replace the fetal simulator 302 (FIG. 8), allowing program 15a to perform resuscitation of the newborn. In another embodiment, the fetal simulator 302 itself is used for postnatal simulation. In that respect, the fetal simulator 302 can have all of the functions and features of the neonatal simulator 302' described herein. The neonatal simulator 302'has a head 370 with hair 372, eyes 374a-b, nose 376, and mouth 378. The head assembly determines whether a near-realistic airway (not shown) that can accept conventional airway appendages and whether conventional airway appendages are placed or fluid has passed. It has a sensor for checking. The head 370 is connected to the body portion 382 via the neck 380.

The sensors, represented by 30 (Figure 1a) as a whole, are located above the skin (represented by spots) and / or below the skin (represented as in the model) of the neonatal simulator. Is also good. Line 36 "protrudes from fuselage 382 to the above to connect a sensor (not shown) to CIM16 and to make electrical, pneumatic, or fluid connections. Has a umbilicus position 384 for catheterization and simulated heart, lungs, and ribs to perform CPR. The heart and lungs are airway ventilation and heart, as described above for the maternal simulator 300. Connected to a pressure converter to check for compression. The neonatal simulator 302'can detect heart rate, pulse, oxygen supply, and using a hearing device 12j (Figure 2) or a conventional hearing device. It represents a number of features similar to the maternal simulator 300 (Fig. 6), which includes various body sounds. A pair of arms 386a-b and a pair of legs 388a-b are also connected to the torso 3382.

In one embodiment, the hands and feet, along with the face and upper torso, change color due to oxygen delivery to the appropriate blood or lack of oxygen. When oxygen delivery to the blood is reduced, both hands and feet first change color (peripheral cyanosis), followed by the face and upper torso (central cyanosis). Such changes are reversible as oxygen delivery into the blood progresses.

In the best embodiment, the coloring is transparent by dissolving about 3 grams of blue heat-sensitive coloring dye (such as Reversatherm Blue Type F available from Keystone, Chicago, Illinois) in 10 grams of clear vinyl resin paint thinner. This is achieved by using a vinyl resin paint dispersed in 300 grams. The mixture is applied to the hands, feet, chest and face. At room temperature, the newborn is blue. Resistor heaters (such as those available from Minco Products in Minneapolis, Minnesota) are connected in parallel and placed under the skin to raise the surface temperature of the skin to about 115 ° C or 5-15 watts / square inch. Apply enough heat energy to erase the blue color. The power of the heater is supplied via CIM16. Peripheral and central heaters are controlled separately to allow the development of peripheral cyanosis that does not cause central cyanosis. A heat sink can also be provided with a heater to allow for faster cooling and thus faster color change.

In one embodiment, the thermal coloring system is logically connected to program 15a, for example, the instructor clearly defines the conditions for the newborn. Coloring then corresponds to the quality of CPR performed by the user and can be either improved, worsened or maintained as is. Program 15a also provides an override if you do not want the color change. Alternatively, coloring is simulated by applying a conventional phototautomer to the simulator, making the simulator appear to turn blue when exposed to the relevant adjustable UV light. Alternatively, coloring may be simulated by colored light. For example, according to one aspect, a blue light emitting diode (LED) can be used.

As mentioned above with respect to the maternal simulator, in some embodiments the neonatal simulator does not have line 36 ". Rather, such neonatal simulator is tetherless, wiring to external devices, tubes, or other physics. It works independently without the need for a physical connection.

With reference to FIG. 11, the birth system 500 illustrates the use of the previous embodiment. In the simulator 14, for example, the maternal simulator 300 and the fetal simulator 302 are placed on the table 502. Students W, X, Y, and Z occupy positions around the table, for example, W oversees drug treatment, Y oversees virtual device 12, X oversees anesthesia, and Z oversees obstetrics. Supervise. The maternity device 326 is driven via a manual crank or by a small motor 326a connected to the control box 328, as described above, or program 15a of the computer 15 selectively controls the maternity device 326. Can be (shown in the model). Regardless of which control means is used, the dilated cervix accurately reflects the progression of the fetal simulator's birth canal descent. Finally, as mentioned above, the fetal simulator is delivered.

Once the fetal simulator has given birth, Teams W', X', and Y'(these are the same students as W, X, Y, or others depending on the size of the class) are at Table 502'. Travel along Route 1 to perform neonatal nursing on. At least one team lacking Z remains behind with the maternal simulator for the possibility of monitoring and stabilizing. The fetal simulator is switched to a neonatal simulator 14', for example, a neonatal simulator 302' (Fig. 10). If connected to a computer, Program 15a can be used to simulate what is needed for neonatal resuscitation, and CPR and other urgent nursing protocols may be performed. Program 15a monitors the nursing received by the simulator through CIM 16 and virtual instrument 12 and compares this nursing with the recognized standards.

On the other hand, program 15a of computer 15 may be used to simulate what is needed for maternal resuscitation. If so, one team moves along path 2 and performs maternal nursing at table 502 ". Students W", X ", Y" and Z are maternal simulator 14 ", eg fetal. The simulator can work on the removed maternal simulator 300. CPR and other emergency nursing may be given, program 15a monitors the nursing received by the simulator via CIM 16 and virtual instrument 12.

Referring to FIG. 12, the screen display 400 of the introductory part of program 15a is shown on the computer 15 to teach the user the patient's nursing protocol. The display 400 has some decorative features. That is, the title box 402, the fetal heart rate box 404, the maternal intrauterine pressure box 405, the life sign box 406, and the ultrasound video box 407. The display 400 also has a professor box 408, a test box 410, and a virtual instrument textbook box 412. In some modules, program 15a compares information about user activity with predetermined standards, as described below.

The screen display 400 displays a collection of selectable patient nursing modules 414a-p provided by program 15a, which modules provide information about medical subjects and related concepts. Each module has a single subject and displays an interactive patient nursing training session for the user. Modules 414a-g are provided in Professor Box 408 and provide an overview of related physiology, pregnancy, complications, labor and delivery, and resuscitation protocols for childbirth, postpartum, and maternal and neonatal. Modules 414h ~ j are placed in test box 410, giving the user the opportunity to test the maternal and neonatal resuscitation protocols, along with the instructor-defined protocol (Codemaker). An Exit button 415 that terminates program 15a is also located inside the test box 410. Modules 414k ~ p are located within the Virtual Instrument Textbook Box 412 and provide the user with guidance on using the system, including automatic delivery, fetal ultrasound, fetal asphyxia monitoring, life signs, delivery records, and cardiopulmonary sounds.

Referring to FIG. 13, if one of the modules (FIG. 12) is selected by the user, for example by voice recognition or mouse selection of computer 15, program 15a displays display screen 416. The display screen 416 has an information box 418, which contains subject-specific information. The display screen 416 also has a menu bar 420 containing information items (denoted by A to D for convenience) that list information categories specific to the subject of the selected module. One item can be selected from screen 416 via the menu bar 420, and each module 414a-p has its own display screen, along with its own menu for specific information items A-D. It should be understood that each item can be extended to contain a large number of items, or can be compressed, for example, by placing selectable subitems under the item.

When you select an item from a menu that is different from the containment item, the text and / or figure for the selected menu item is displayed in information box 418. During the exercise, the program can generate a new display screen (not shown). Therefore, it should be understood that the information screen 416 is used as an example of any number of screens, and that such screens can be displayed in a series of orders or in pairs for each item. A set of screens, such as the display screen 416, constitutes guidance on the patient treatment protocol for the selected menu item. Thus, the user can review information from the subject library by selecting the appropriate modules and items and then navigating through a set of screens. Navigation on a set of screens allows the user to have three boxes 422, 424 and 426, "Back", "Next", and "Exit", respectively. Achieved by selecting between said boxes having corresponding on-screen features such as reverse or forward travel within the set. If the "back" or "next" function is not possible, then the box 422 or 424 is not selectable, as it is the case for a set of first and last screens, respectively.

For example, modules 414f and 414g each generate a pair to teach the user about maternal and neonatal resuscitation, respectively. The user can also perform CPR on a simulator 14 (Fig. 1a) such as the maternal simulator 300 or neonatal simulator 302' described above, with program 15a running CIM 16 (Fig. 1a) and sensor 30 (Fig. 1a). Through, the pressure and ventilation of the user are detected. The cardiopulmonary of the simulator 14 is connected to a pressure converter that establishes airway ventilation and compression of the heart, for example, an air line is provided within the tracheal wall of the simulator 14 and is connected to a sensor 30 connected to the CIM 16. When ventilation by CPR is performed in the simulator, CIM16 monitors the timing, magnitude and volume of pressure for ventilation activity via air lines and sensors. Similarly, when the compression sac is implanted in the chest cavity of the simulator 14 and connected to the compression sensor 30 attached to the CIM 16 by an air line, the correct timing and strength of the CPR chest compression procedure. Detect and confirm. Program 15a compares information about user activity with pre-determined standards and provides interactive training sessions.

Pre-determined standards are selectable and include basic life support (BLS) and advanced life support (ACLS) guidelines set by the American Heart Association and others. Reflects the medical protocols used around the world. At least seven major protocols for cardiopulmonary resuscitation (CPR) are stored and selectable by the user. In addition, the user can update or enter protocols and store "new protocols" that reflect local protocols for cardiac compression and airway ventilation depth, duration, and frequency. The program uses a set of tolerances to generate a new CPR waveform for testing CPR.

Returning to Figure 12, selecting test modules 414h-j from test box 410 directs the execution of program 15a and users in patient nursing protocols such as maternal and neonatal resuscitation, and other responses to emergency scenarios. Provides a useful test sequence for testing. Program 15a proceeds slowly through the procedure of the patient's distress scenario, giving the user a predetermined amount of time to respond or complete the required work, thereby causing the user to experience difficulties in an emergency. To enable. For example, program 15a can test a user by providing the choices that the user must make to treat the patient, where the user is correct before the sequence proceeds to the next event. You have to make a selection. Program 15a allows the user to enable, disable, or check the connections between the virtual appliance 12 and the sensor 30 to supply input to the CIM 16.

If virtual instrument 12 (Fig. 2) is available, virtual instrument 12 can be used by the user to perform patient nursing activities on simulator 14, but the results and quality of the response are in program 15a. Monitored by. Alternatively, the user may use the software-simulated instrument 12'(Figure 1b) generated by program 15a. Program 15a follows the scenario until the patient is resuscitated (recovered) and provides a current critique of the user's response, along with a description of each incorrect choice and each action. A feature of test modules 414h ~ j is that the user can specify that the preset motion sequence in the scenario has a predetermined number of compression / ventilation cycles in the simulator 14, or the compression performed by the user in the simulator 14. And the time and intensity of ventilation can be recorded, or can be selected between a set of choices to hear realistic sounds.

The test can be defined by program 15a or by the user, as described above. For example, selecting the codemaker test module 414j (FIG. 12) allows a first user, eg, an instructor, to generate a scenario to test a second user, eg, a student. The first user is one regarding information such as gender, weight, age, patient indication, life signs and heart rhythm, which is realistically reflected in life sign box 406 (FIG. 12). By entering a set of preliminary patient parameters, a patient simulator with test scenarios can be defined. An instructor-defined testing system allows instructors to test students through regional, national, or international patient nursing protocols. A number of algorithms can be selected by opening the file, which has BLS, ACLS, pediatric, and obstetric (OB) emergencies. Other algorithms can also be generated and stored, and the algorithms may be linked to each other. Advantages of this module include flexibility in teaching and the ability to detect subject understanding. The algorithm defined by the instructor is probably different from the algorithm with a well-known structure, but by doing so, the problem of rote memorization of the response by the student can be avoided.

The action is made in response to, for example, the student's condition that the student chooses from virtual instruments and uses them to perform patient nursing activities. Students can then virtually perform patient nursing activities or use tangible simulators.

Modules 414k ~ p of the Virtual Instrument Textbook Box 412 provide information about instruments commonly used in childbirth scenarios. In some examples, the patient nursing protocol provides the opportunity to use some of the virtual instruments 12 in the simulator 14.

Proceed to FIGS. 14 and 15. The entire delivery process can be automated through program 15a by the user simply defining the initial conditions, such as delivery time 430, delivery overview 432 and compression intensity 434. The warp function allows a complete reduction in labor from 16 hours to 5 minutes. Birth consists of placing the fetal simulator 302 on the protrusion 344 and the cover 324 on the maternal simulator 300. Program 15a also allows the speed of travel of piston section 346 to be changed. That is, the first 2-3 centimeters progress more slowly than the last 2-3 centimeters, better simulating childbirth.

Referring to FIG. 16, if module 414m (FIG. 12) is selected, a set of screens for the fetal asphyxia monitor is shown with instructional information. The illustrated fetal asphyxia monitor box 436 is depicted with a selectable ON button 436a to turn on the monitor. The fetal asphyxia monitor 12l, in collaboration with the simulator 14, has the fetal heart monitor placed on cover 324 of the maternal simulator 300 (FIG. 5a) and interacts with at least one sensor 30, while the compression monitor is on the cover. Interacts with another sensor 30 provided in.

With reference to FIG. 17, the neonatal simulator 600 is used to replace the fetal simulator 302 and allows the resuscitation of the newborn to be performed by program 15a. In one embodiment, the neonatal simulator 600 is substantially the size of an average size newborn with a gestational age of 28 weeks. In another embodiment, the neonatal simulator 600 is substantially the size of an average size newborn with a gestational age of 40 weeks. The neonatal simulator 600 represents many of the features similar to the maternal simulator 300, including heart rate, pulse, oxygen supply, and various body sounds that can be detected using a stethoscope 12j or a conventional stethoscope. Further, as will be described later, the neonatal simulator 600 is independent in that it does not require wiring or tube connection to external devices such as bulky external compressors and power supplies to properly operate various functions. The newborn simulator 600 is portable. In some embodiments, the neonatal simulator is tetherless and works without the need for wiring, tubes, or other physical connections to other external devices.

The neonatal simulator 600 has a head 602 with hair 604, eyes 606 and 608, nose 610, and mouth 612. The head 602 is connected to the body 616 via the neck 614. The torso 616 has a umbilicus position 618 for catheterization. The torso 616 also has a compatible genital position 620 that allows it to receive both male and female genital pieces (not shown). Two arms 622 and 624 are connected above the fuselage 616 and extend from it. Two legs 626 and 628 are connected below the fuselage 616 and extend from there.

The sensors, represented by 30 as a whole, are above the skin (represented by spots) and / or below the skin (in the model) of the neonatal simulator to simulate various features, as described above. It may be arranged in (represented as). Torso 616 has a simulated heart, lungs, and ribs to perform CPR. In one embodiment, the heart and lungs, it described above for the simulator 300 maternal urchin, and is connected to the pressure transducer in order to verify the airway ventilation and cardiac compression. The fuselage portion 616 also includes other components such as a power supply and a wireless communication device. In one embodiment, the power source is a rechargeable pack of 5 cells of lithium-ion batteries. In one aspect, the power source is usually placed in an area reserved for the liver.

To fit all of the features of the Neonatal Simulator 600 into a neonatal-sized mannequin with a gestational age of 28 or 40 weeks, many electronic components must be properly sized and placed exactly where they are needed. Must be. In one embodiment, the electronic components of the neonatal simulator 600 are grouped into smaller modules, depending on their function, rather than being placed on a typical motherboard, eg FIG. 18 is used in the neonatal simulator 600. A set of possible modules 630 is shown. This set of modules 630 includes a master module 632 that connects the newborn simulator 600 to a computer, a module 634 that generates ECG signals, and a module 636 that generates sounds such as heart sounds, lung sounds, voices, and Korotkov sounds. Module 638 to detect pressure such as chest compressions, airway ventilation, blood pressure, and compressor, module 640 to monitor intubation, module 642 to drive valves and LEDs, wireless interface and USB? RF, etc. It has a module 644 that provides connectivity, a module 646 that creates sounds for voice, and a module 648 that creates sounds other than voice. Any number of features of the neonatal simulator 600 can be simulated by combining one or more of these modules 632 to 648.

With reference to FIG. 19, the neonatal simulator 600 has a near-realistic airway 650 accessible via mouth 612 and nose 610. The airway 650 can accept conventional airway appendages, such as whether a sensor such as module 640 has a conventional airway appendage placed or fluid has passed through the airway. Is arranged to look up. In one embodiment, module 640 is an optical sensor that monitors the position of airway appendages, such as an endotracheal tube, and finds that the position of this appendage is too high, too low, or just right. The neonatal simulator 600 also has a simulated esophagus 652 extending into the torso 616 towards the simulated stomach.

With reference to FIG. 20, the neonatal simulator 600 also has an air supply system 654 for simulating respiration, pulse, and associated neonatal physiology. The air supply system 654 includes a muffler 656, a compressor 658 (which may be a single diaphragm compressor such as the T2? 03? E available from T? Squared Pumps, NJ), and a check valve 660 (appropriate). Valves are available from Gulf Controls, NJ), include a compressor controller 662, a primary accumulator 664, and a secondary accumulator 666. Alternatively, the compressor may be a rotary compressor or other suitable compressor.

In operation, the air supply system 654 supplies pressurized air to the neonatal simulator 600 as follows. Air 668 or air from the tank enters the compressor through the input muffler 656. The compressor controller 662 is used to maintain the pressure in the primary accumulator 664. Check valve 660 ensures that the air flow is in the correct orientation. A pressure regulator (not shown) can also be used to maintain a predetermined pressure within the secondary accumulator. The primary and secondary accumulators are connected to the actuators of the neonatal simulator 600 to control the air supply. In one embodiment, the primary accumulator is connected to an actuator to control the air supply to the airway 650. In one embodiment, the secondary accumulator is connected to an actuator to control the air supply to the lungs. The compressor controller 662 selectively powers the compressor 658 to maintain the desired pressure within the primary accumulator. In one embodiment, the approximate value of the desired primary accumulator pressure is 4.5-5.5 psi and the approximate value of the desired secondary accumulator pressure is 1.5 psi. In some embodiments, the air supply system 654 further facilitates a simulated circulatory system, such as being connected to a simulated circulatory system to provide a simulated pulse.

The components of the air supply system 654 are arranged, insulated, and muted to minimize the noise generated by the system. Since the user uses a stethoscope to evaluate the heart and respiration of the neonatal simulator 600, excessive noise from the air supply system 654 can be annoying and distracting to the user. Therefore, a part of the air supply system 654 may be housed in the head 602 and both hands and feet (arms 622, 624 and legs 626, 628) of the neonatal simulator 600.

For example, according to one embodiment, the compressor 658, check valve 660, and compressor controller 662 are located within the head 602 and within the muffler and accumulator legs 626, 628. The noise generated by the head components is blocked by the sound buffer enclosure 672 outlined in FIG. According to one embodiment, the sound buffer enclosure 672 is a two-layer system having a first layer acting as a sound insulator and a second layer acting as a mass barrier. In one aspect, the sound insulator and mass barrier are formed of noise inhibitor from EAR Specialty Composites. In addition, the exhaust generated by the compressor 658 is sent into the legs 626, 628 of the neonatal simulator 600. Each leg 626, 628 includes a muffler system and an air tank. The muffler system buffers the "noisy" exhaust and supplies the tank with the "quiet" air used in the neonatal simulator 600 to simulate breathing and pulse. In one aspect, the legs 626, 628 themselves function as air tanks and are sealed to prevent leaks.

FIG. 21 shows an embodiment of the muffler system 674. The muffler system 674 has three separate parts 676, 678, and 680 that buffer the sound of noisy air. Each portion 676, 678, and 680 has first layers 682, 684, and 686 that act as sound insulators and second layers 688, 690, and 692 that act as mass barriers, respectively. In one aspect, the sound insulator and mass barrier are formed as a sound buffer enclosure 672, similar to the noise inhibitor from EAR Specialty Composites described above. Noisy air is sent into the muffler system via tube 694. Quiet, or buffered air, then exits the muffler system via tube 696. In one embodiment, each leg 626, 628 is lined with a noise-preventing material, as well as a muffler system, to further reduce and buffer noise.

In one embodiment, the hands and feet, along with the face and upper torso, change color due to oxygen delivery to the appropriate blood or lack of oxygen. When oxygen delivery to the blood is reduced, both hands and feet first change color (peripheral cyanosis), followed by the face and upper torso (central cyanosis). Such changes are reversible as oxygen delivery into the blood progresses. In one embodiment, the length of time the newborn is deprived of oxygen determines where the color change and the corresponding change in life signs begin, and the work required to successfully return the newborn to a healthy state. .. In some embodiments, the simulator has a mechanism for changing the color of the central and peripheral parts separately. This mechanism, in some embodiments, simulates cyanosis with a blue LED or other light.

In one embodiment, the thermal coloring system is logically connected to program 15a, for example, the instructor clearly defines the conditions for the newborn. Coloring then corresponds to the quality of CPR performed by the user and can be either improved, worsened or maintained as is. By comparison, adults can tolerate 5-10 minutes without oxygen. The maternal or maternal simulator 300 is affected faster because it uses oxygen faster than normal adults. On the other hand, newborns can tolerate about 15 minutes without oxygen, but die in about 30 minutes. Therefore, if the hypoxic event is 5-7 minutes, the neonatal simulator 600 "returns to pink" fairly easily. If the hypoxic event is 12 to 15 minutes, recovery is slower and requires more work on the part of the user. In addition, if the hypoxic event exceeds 20 minutes, it is very difficult for the user to "return to pink" the neonatal simulator 600, even with epinephrine, and the neonatal simulator 600 will die or be like cerebral palsy. You can end up with a lifelong illness.

In one embodiment, the instructor can select the degree of cyanosis of the neonatal simulator 600, as shown in the screen display 700 of FIG. Although not shown on the screen display 700, the instructor also said that the muscle tone of the arms 622, 624 and legs 626, 628 of the neonatal simulator 600 (eg, fluffy, moderately flexible, movement, etc.) and "speech". (For example, crying, moaning, wheezing, etc.), other attributes of the neonatal simulator 600 can be selected or defined. Life signs and recovery of the neonatal simulator 600 can be monitored using display 702, as shown in FIG. The program also provides an override if you do not want the color change.

An engagement system 740 is shown in FIGS. 24-27, which is an alternative embodiment of a system of receivers 342 and protrusions 344 that selectively engage fetal or neonatal simulators 302, 600 with the maternal simulator 300. is there,. The engagement system 740 has a mechanism 742 that engages with the mechanism 744. In some embodiments, the mechanism 742 is located within the fetal or neonatal simulator 302, 600 and the mechanism 744 is located within the maternal simulator 300. In one embodiment, the mechanism 742 replaces the receiving portion 342, and the mechanism 744 replaces the protrusion 344. In another embodiment, the mechanism 742 is located within the maternal simulator 300 and the mechanism 744 is located within the fetal or neonatal simulators 302, 600.

Particularly with reference to FIG. 25, the mechanism 742 has a housing 745 that extends through the opening 746. In this embodiment, the opening 746 is centrally located and is substantially cylindrical. In another embodiment, the opening 746 can have various other cross-sectional shapes, including polygonal, irregular shapes, other shapes and the like. The mechanism 742 also has a locking portion 748. The lock portion 748 and the housing 745 may be permanently fixed together (eg, glued) or temporarily together (eg, screwed together). Further, the locking portion 748 and / or the housing 745 may have additional features (not shown) to facilitate fitting between the two pieces. In another embodiment, the housing 745 and the locking portion 748 are integral pieces.

As shown in FIG. 26, the lock portion 748 has a main body 749. The main body 749 is designed to be joined to the opening 746 of the mechanism 742. Thus, in this embodiment, the body 749 is substantially cylindrical, but in another embodiment it can have other cross-sectional shapes that fit the opening 746. The lock portion 748 further includes an actuator 750 that moves the lock pin 752 from the extension position shown in FIG. 26 to the degenerate position. In one embodiment, the degenerate position of the lock pin 752 is substantially within the main body 749 of the lock portion. As will be described later, the mechanism 742 is selectively fitted with the mechanism 744 by selectively extending and retracting the lock pin 752. In this way, the fetal and neonatal simulator 302 selectively engages with the maternal simulator 300. In some embodiments, the actuator 750 is selectively actuated by a solenoid. In some embodiments, the solenoid is placed in a fetal or neonatal simulator in close proximity to the actuator 150, or in a maternal simulator 300. In some embodiments, the solenoid is located within mechanism 742. In some embodiments, the solenoid is actuated by a wireless device or computer system that allows the instructor to selectively release the fetal or neonatal simulator.

In particular, referring to FIG. 27, the mechanism 744 has a body 754. In this embodiment, the body 753 is substantially cylindrical, but in another embodiment it has other cross-sectional shapes. The mechanism 744 also has an engaging portion 754. The engaging portion 754 has a substantially square cross-sectional shape, but in another embodiment, it has another cross-sectional shape. The engaging portion 754 further has an opening 755 extending through it. The opening 755 receives the locking portion 748 of the mechanism 742. The engaging portion 754 also has a locking hole 756. The lock pin 752 of the lock portion 748 is fitted with the lock hole 756 at the time of extension. When retracted, the lock pin 752 retracts from the lock hole 756 to release the locking mechanism 748 from the engaging portion 754.

With reference to FIG. 28, a system for selectively rotating the fetal or neonatal simulators 302, 600 is shown. The system moves the cam 348a between a first position that rotates the fetal simulator and a second position that does not rotate the fetal simulator. Thus, the system can be used to selectively rotate or not rotate the fetal simulator during birth simulation. In some embodiments, degenerating the cam 348a to a position close to the trajectories 347a-b prevents the fetal simulator from rotating. In some embodiments, the cam 348a can move further to an intermediate position to give the fetal simulator some rotation, which is less rotation than the first position. In some embodiments, the cam 348a can move between multiple intermediate positions, allowing different rotational momentums at each position. In some embodiments, the plurality of intermediate positions and the rotational momentum are continuous. In some embodiments, the plurality of intermediate positions and the rotational momentum are discrete.

The system has a solenoid 760 that is designed to selectively degenerate the cam 348a. The solenoid 760 is connected to the cam 348a via an extension 761 and a fixing member 762. In one embodiment, the fixing member 762 is a mechanism that connects a bolt, screw, other threaded member, or other cam 348a to the extension 761. Cam 348a is connected to track 347a via fixing members 764 and 766. Fixing members 764 and 766 are bolts and nuts in some embodiments. The fixing members 764 and 766 also serve to prevent the cam 348a from making unwanted translational and rotational movements with respect to the orbit 347a. In another embodiment, the cam 348a and the solenoid 760 may be adapted to translate along the orbit 347a. Further, in some embodiments, the cam 348a may be adapted to rotate with respect to the orbit 347a. In some embodiments, the position of the cam 348a is remotely controlled by a leader or computer program, and in some embodiments wirelessly. Although the system has been described for orbits 347a and cam 348a, the system also applies to orbits 347b and 348b.

Although exemplary embodiments have been shown and described, extensive modifications, modifications, and alternatives are intended in the disclosures described above, and in some examples, some features of this embodiment are other features. It can be adopted without using it. It should be understood that in the above description, various modifications can be implemented without departing from the scope of the embodiment. For example, system 10 can be modified by simply modifying program 15a and / or virtual appliance 12 and sensor 30. Therefore, it is appropriate that the appended claims be interpreted broadly and consistently with the scope of the embodiments.