EA037417B1 - Method for developing practical skills of auscultation with the help of medical simulator - Google Patents

Abstract

The invention relates to the field of medicine. A dummy man including a simulated cardiopulmonary resuscitation system, a defibrillator simulation system, a chest decompression simulation system, a pleural cavity drainage procedure simulation system, a tracheal intubation and conicotomy simulation system, a drug injection simulation system, a bleeding simulation system, and bladder catheterization simulation system is used. Voice coils are built into the dummy, which interact with a permanent magnet mounted on the membrane of the acoustic head of the stethoscope. Depending on the training scenario used, sound signals of functioning the internal organs are simulated, physical effects on a human dummy are carried out for resuscitation or medical procedures. The physical effects exerted on the mentioned imitation systems or their absence is recorded. The data on the impacts are transmitted to a computer for processing, and sound signals are simulated, and transmitted to the voice coil system for playback them through the acoustic head of the stethoscope. The technical result is to provide comprehensive training for doctors.

Description

Technology area

The invention relates to medicine and can be used in patient simulators, as well as in medical simulators for practicing practical skills in diagnosing disorders of internal organs by listening to sound phenomena of the lungs, heart, stomach, intestines and blood vessels (blood flow in arteries and veins).

Prior art

An analogue is a surgical operating room simulator, which includes a patient simulator module, which allows simulating the response (state) of the operated patient depending on the selected scenario, medical history, actions taken by a team of doctors. The patient simulator module is made in the form of a human dummy equipped with systems for simulating human vital signs, systems for resuscitation, for example, a system of cardiopulmonary resuscitation (CPR), intubation, artificial lung ventilation (ALV), a system for administering medications, defibrillation, and systems simulating urination, hemorrhage, tears, sweat, hyperemia, convulsions (patent RU No. 2546404, IPC G09B 23/28 (2006.01)). However, this simulator does not provide a training process for practicing practical auscultation skills. There is no technical implementation of the method of operation of the module for imitation of the system by auscultation.

The prototype is an auscultation training device and related techniques, which is an auscultation system that includes a dummy having at least one built-in speaker, a non-contact device built into the dummy and capable of detecting the proximity of the auscultation device, a controller capable of interacting with a non-contact device and receive a signal, a second controller for redefining the first controller and a database storing a plurality of sound files (US patent 9064428 (B2), CPC G09B 23/28 (2013.01)). However, this device does not allow simulating the response (state) of the dummy (patient simulator) depending on the actions taken by the doctor, i.e. the feedback is not implemented the action of the doctor - the response of the simulator of the patient - the modeling of sound signals of the functioning of internal organs into the auscultation device.

Disclosure of invention

The objective of the claimed invention is to develop a method for the operation of the module for simulating the auscultation system as part of a medical simulator for comprehensive training of doctors in diagnosing disorders of human internal organs and providing first aid in various clinical situations. In addition, an important task posed in the development of the claimed method of work is to increase the realism of training doctors in diagnosing disorders of human internal organs on a medical simulator using a standard stethoscope without equipping it with additional bulky transmitting devices.

The technical result is the creation of a medical simulator that simulates the sound signals of the functioning of the internal organs of a human dummy, depending on the physical effects exerted on this dummy during resuscitation measures or medical procedures.

The technical result is achieved by the fact that a method of practicing practical skills of auscultation using a medical simulator, including a patient simulator module in the form of a human dummy, consists in the fact that an auscultation simulation module is used, including a standard stethoscope, a permanent magnet and voice coils, and sound signals of functioning are simulated internal organs, according to the present invention, a human dummy is used, including a system for simulating cardiopulmonary resuscitation, a system for simulating the effects of a defibrillator, a system for simulating chest decompression, a system for simulating a pleural drainage procedure, a system for simulating tracheal intubation and conicotomy, a system for simulating drug administration, a system for simulating bleeding and a system for simulating bladder catheterization, voice coils are previously built into the dummy, interacting with a permanent magnet installed on the membrane of the acoustic head of the stethoscope PA, depending on the training scenario used, they simulate sound signals of the functioning of internal organs, carry out physical effects on a human dummy for resuscitation or medical procedures by influencing the mentioned systems, fix the physical effects exerted on the said systems of imitation or their absence, transmit data on the effects in a computer for processing, and simulate sound signals and transmit them to a system of voice coils for reproduction through the acoustic head of the stethoscope, depending on the physical effects exerted on said dummy.

Thus, the technical result is achieved due to the complete implementation of feedback in real time, the action of the subject (doctor) - the response of the patient simulator module - modeling of the sound signal into the voice coil system.

Brief Description of Drawings

The essence of the invention is illustrated by drawings (Fig. 1 and 2), which shows a medical

- 1 037417 a simulator for practicing practical auscultation skills, with a patient simulator module (front and back view, respectively) and an auscultation simulation module.

FIG. 3 is a general view of the patient simulator module with specifically defined areas of physical impact above the human dummy.

FIG. 4 shows a block diagram of the auscultation imitation module.

FIG. 1-4 numbers are designated

- medical simulator,

- patient simulator module,

- module for imitation of auscultation,

- computer (server),

- stethoscope (standard),

- voice coil (electromagnet),

- human dummy of the patient simulator module,

- the subject (doctor) of interaction,

- a system for simulating cardiopulmonary resuscitation,

- a system for simulating the impact of a defibrillator,

- a system for simulating chest decompression,

- a system for imitation of the pleural cavity drainage procedure,

- a system for simulating tracheal intubation and conicotomy,

- a system for simulating the introduction of drugs (intravenous, intramuscular, intraosseous), 15 - a system for simulating bleeding,

- a system for imitation of bladder catheterization,

- acoustic head of a stethoscope,

- the body of the acoustic head of the stethoscope,

- membrane of the acoustic head of the stethoscope,

- permanent magnet (neodymium magnet),

- cover of the acoustic head of the stethoscope,

- silicone skin of a human mannequin,

- contact terminals of the winding of the voice coil (electromagnet).

Implementation of the invention

Medical simulator 1 contains a patient simulator 2, connected to a computer 4, and a simulation of auscultation 3. The auscultation simulation 3 includes a standard stethoscope 5, a permanent magnet 20 mounted on the membrane 19 of the acoustic head 17 of the stethoscope 5, and voice coils 6, mounted on the torso of the manikin 7 of the patient simulator 2, with which the subject 8 interacts. The voice coils 6 are located on the front and back of the body of the dummy 7 of the patient simulator 2.

The patient simulator module 2 contains a system for simulating cardiopulmonary resuscitation 9, a system for simulating the effects of a defibrillator 10, a system for simulating chest decompression 11, a system for simulating a pleural drainage procedure 12, a system for simulating tracheal intubation and conicotomy 13, a system for simulating drug administration (intravenously, intramuscularly, intraosseously) 14, a bleeding simulation system 15 and a bladder catheterization simulation system 16.

A standard stethoscope 5 contains an acoustic head 17 made of a housing 18, a membrane 19 and a fixing cap 21.

Practical training of auscultation skills using a medical simulator is carried out as follows. A method of practicing practical auscultation skills using a medical simulator 1, which includes a patient simulator 2 in the form of a human dummy 7, which consists in using the auscultation simulation module 3, including a standard stethoscope 5, a permanent magnet 20 and voice coils 6, and simulating sound signals the functioning of internal organs.

The difference between the proposed method of practicing practical skills of auscultation is that a person's dummy 7 is used, which includes a system for simulating cardiopulmonary resuscitation 9, a system for simulating the effects of a defibrillator 10, a system for simulating chest decompression 11, a system for simulating a pleural cavity drainage procedure 12, a system for simulating tracheal intubation and conicotomy 13, a system for simulating the administration of drugs 14, a system for simulating bleeding 15 and a system for simulating bladder catheterization 16, voice coils 6 are preliminarily built into said dummy 7, interacting with a permanent magnet 20 mounted on the membrane 19 of the acoustic head 17 of the stethoscope 5, in depending on the training scenario used, sound signals of the functioning of internal organs are simulated, physical effects on the human dummy 7 are carried out to carry out resuscitation measures or medical procedures by influencing the above systems, physical influences applied to the mentioned systems of imitation or their absence, the data on the effects are transmitted to the computer 4 for processing and

- 2 037417 simulate sound signals and transmit them to the system of voice coils 6 for playback through the acoustic head 17 of the stethoscope 5, depending on the physical effects exerted on the said dummy 7.

An example of a specific implementation

Practical training of auscultation skills is carried out on the patient simulator module 2, which is made in the form of a human dummy 7 with anatomically correct musculoskeletal structure (height 183 cm, weight 70 kg, age 40-50 years). Patient Simulator Module 2 is primarily designed to simulate the widest possible range of clinical situations and practice the skills of performing cardiopulmonary resuscitation, intensive therapy and a set of measures aimed at maintaining vital functions.

Thus, this allows you to gain practical skills in performing auscultation in various clinical situations, which in real life situations will allow you to correctly diagnose a person's condition and correctly provide first aid.

The operation of the patient simulator module 2 is carried out using the computer software algorithm 4, which ensures the operation of all vital signs simulation systems on the dummy 7, depending on the scenario used. For example, when simulating cardiac complications on the dummy 7, an imitation of the corresponding clinical picture occurs - a change in blood pressure, heart rate, and the magnitude of the pulsation power. When simulating respiratory complications, there is a change in the frequency of respiratory movements, the appearance of cyanosis, loss of consciousness, voice, and various wheezing. And also when simulating injuries to the head, torso and extremities, various physiological reactions occur: no reaction of the pupils, auscultatory picture on the left or right, a drop in pressure during blood loss, convulsions.

In this case, the module for simulating auscultation 3 is carried out as follows.

Depending on the scenarios for practicing practical skills on the patient simulator module 2 on the computer (server) 4, certain sound signals are modeled for each individual voice coil 6, which performs the function of an electromagnet. Voice coils (38 mm in diameter) are rigidly (motionless) mounted on the body of the mannequin 7 under a layer of silicone 22 (4 mm thick), a material that imitates human skin. The audio signal applied to the contact terminals 23 of the winding of the voice coil 6 is an alternating electric current, where, depending on the change in the strength and direction of the current in the coil 6, the magnetic flux changes in magnitude and direction. To reproduce sound signals through the acoustic head 17 of a standard stethoscope 5, a permanent magnet 20 of the neodymium magnet type is used, which is rigidly (stationary) mounted centrally on the membrane 19 of the acoustic head 17 from the outer or inner side. In this case, the overall dimensions of the neodymium magnet (diameter 6 mm, height 3 mm) are several times smaller than the dimensions of the membrane 19 itself (diameter 42 mm), which is made of flexible material. Thus, when the electromagnetic field of the voice coil 6 interacts with the magnetic field of the neodymium magnet 20, the magnet 20 mechanically vibrates in time with the frequency of the alternating current, which is transmitted to the flexible membrane 19, while creating acoustic waves (sounds) that will be heard by the doctor 8 through the stethoscope 5. A similar principle of sound signal reproduction is used in traditional sound speakers (loudspeakers), except for the fact that the voice coil itself, rigidly connected to a flexible cone, is subjected to mechanical vibration. The main difference of the proposed solution is that the voice coil 6 and the permanent magnet 20 are spaced apart from each other at a certain distance and their magnetic fields can interact with each other at a distance of up to 100 mm (experimental data), which allows the voice coils 6 to be installed on the body of the dummy 7 at a certain depth.

Further modeling (change) of sound signals occurs depending on the actions or inactions of the subject (doctor) 8 over the dummy 7, i.e. whether or not any medical procedures are performed on the dummy 7 by the subject (doctor) 8.

The performed actions or inactions of the subject (doctor) 8 are as follows. Any manipulations on the dummy 7: carrying out cardiopulmonary resuscitation on the imitation system 9, using a defibrillator on the sham system 10, administering drugs using special syringes on the sham system 14, intubation, mechanical ventilation and conicotomy using endotracheal tubes, LMA, Combitube and other devices on the imitation system 13, performing chest decompression with a tension pneumothorax on the imitation system 11, carrying out the procedure for draining the pleural cavity on the imitation system 12, applying a tourniquet for bleeding on the imitation system 15 and carrying out bladder catheterization on the imitation system 16 are fixed with special devices tracking the module of the patient simulator 2, the data of which is transmitted and processed by the software algorithm on the computer 4 and is reflected in the state of the patient simulator 2, while the sound signals about the state of the patient 2 are simulated, which are transmitted to the system of voice coils 6. For example p, the result of feedback with the correct execution of cardiopulmonary resuscitation on the simulation system 9 is the stabilization of the state of the patient simulator 2 module, namely the restoration of respiration (respiratory rate) and cardiac

- 3 037417 rhythms (heart rate), pulse probing, automatic blinking and pupil response to light. However, incorrect actions or inaction of the subject (doctor) 8 can lead to an abnormal situation and simulate different sound signals for the voice coil system 6, depending on the scenario used.

The wrong actions of the subject (doctor) 8 may be as follows. When a drug is injected on the imitation system 14 that causes an allergic reaction, an anaphylactic shock simulation algorithm is started. Signs of anaphylaxis: tachycardia, tachypnea, low blood pressure. Breaks in cardiac massage on the imitation system 9 or the complete absence of resuscitation measures between defibrillator shocks, applying a low or too high voltage discharge on the imitation system 10, applying a shock against the background of small-wave fibrillation without taking measures that increase the energy resources of the myocardium can lead to imitation of death on the simulator module patient 2.

Thus, the reproduction of sound signals in the auscultation simulation module 3 directly depends on the physical effects on the human dummy 7 carried out by the subject (doctor) 8 during resuscitation measures or medical procedures.

Standard limit switches and non-contact position sensors of the following types can be used as position sensors of mechanisms in the patient simulator module 2: capacitive, inductive, generator, magnetoherkon and photoelectronic.

The use of the proposed medical simulator 1 allows, in comparison with the prototype, to carry out joint work of doctors both in providing first aid and in conducting auscultation, as well as to improve the practical skills of doctors in diagnosing a person's condition in various clinical situations by practicing practical skills of auscultation during resuscitation. measures or medical procedures on the module of the patient simulator 2. At the same time, the realistic training of doctors in diagnosing a person's condition is ensured through the use of a standard stethoscope 5 with a permanent magnet 20 installed on its membrane 19 (on the inside), which does not cause any aesthetic or functional inconvenience in using a stethoscope 5.

Claims (1)

CLAIM 1. A method of practicing practical auscultation skills using a medical simulator, which includes a patient simulator module in the form of a human dummy, which consists in using an auscultation simulation module, including a stethoscope, a permanent magnet and voice coils, and simulating sound signals of the functioning of internal organs, which is characterized by that a human dummy is used, including a system for simulating cardiopulmonary resuscitation, a system for simulating the effects of a defibrillator, a system for simulating chest decompression, a system for simulating a pleural drainage procedure, a system for simulating tracheal intubation and conicotomy, a system for simulating drug administration, a system for simulating bleeding and a system to simulate bladder catheterization, voice coils are previously built into the dummy, interacting with a permanent magnet installed on the membrane of the acoustic head of the stethoscope, depending on the training scenario used, simulate sound signals of the functioning of internal organs, carry out physical effects on a human dummy for carrying out resuscitation measures or medical procedures by influencing the mentioned systems, fixing physical effects exerted on the said systems of imitation or their absence, data on the effects are transmitted to a computer for processing and modeling of sound signals and transferring them to the system of voice coils for reproduction through the acoustic head of the stethoscope, depending on the physical influences exerted on the said dummy.