EA043493B1 - METHOD OF TRAINING PRACTICAL SKILLS IN PROVIDING FIRST MEDICAL AID AND DIAGNOSIS OF VARIOUS TYPES OF HEART PATHOLOGIES USING A MEDICAL SIMULATOR - Google Patents

Description

Field of technology

The invention relates to the field of medicine and can be used in patient simulators, as well as in medical simulators for practicing practical skills in providing first aid and diagnosing various types of heart pathologies by conducting electrocardiography using a standard defibrillator-monitor.

Prior Art

An analogue is a surgical operating room simulator, which includes a patient simulator module, which allows you to simulate the reaction (state) of the patient being operated on depending on the selected scenario, medical history, and actions taken by the team of doctors. The patient simulator module is made in the form of a human mannequin equipped with systems for simulating human vital signs, systems for performing resuscitation measures, for example, a cardiopulmonary resuscitation (CPR) system, intubation, artificial pulmonary ventilation (ALV), a system for administering medications, defibrillation, as well as systems that simulate urination, hemorrhage, tears, sweat, hyperemia, convulsions (RU patent No. 2546404, IPC G09B 23/28 (2006.01)). However, this simulator does not contain a technical implementation of the method of operation of the system simulation module for conducting electrocardiography and defibrillation using a standard defibrillator-monitor. Therefore, this simulator does not allow modeling the reaction (state) of a mannequin (patient simulator) depending on the actions taken by the doctor, that is, the feedback of the doctor’s action - the reaction of the patient simulator module - modeling of video signals of the functioning of the cardiovascular system of the body into the device of a standard defibrillator monitor is not implemented.

The prototype is a simulator for teaching emergency trauma and resuscitation techniques. The simulator contains a human dummy, including: a head block with a device to protect students from cross-contamination, a torso block made hollow, inside of which a simulator of respiratory movements of the chest is installed, a shock sensor in the heart area, a video simulator of external bleeding during pneumothorax and position sensors of the dummy on sideways and vertically, simulators of the upper extremities with pulse simulators and with pressure sensors and an external bleeding simulator, simulators of the lower extremities with pulse simulators, with a simulator of external bleeding, with pressure sensors and magnetically controlled contacts; anatomical display, video simulators of external bleeding and bone fractures and a simulator control system, a simulator control panel, training remote electrodes and an electrical defibrillation circuit (RU patent No. 2124762, IPC G09B 23/28 (1995.01)). However, this simulator does not contain simulation systems for medical procedures (for example, a drug administration system). There is also no possibility of connecting (adapting) the simulator to a standard (non-training) defibrillator-monitor with an automatic defibrillation function, which leads to low information content of the actions performed by students on this simulator, which is implemented on the simulator in a primitive way, by highlighting the desired image on the anatomical display, performed in the form of relief panels on which images of the human skeleton and the outline of a person are applied. Thus, this simulator does not allow modeling the reaction (state) of a mannequin (patient simulator) depending on the actions taken by the doctor, that is, the feedback of the doctor’s action - the reaction of the patient simulator module - modeling of video signals of the functioning of the body’s cardiovascular system in device of a standard defibrillator-monitor.

Disclosure of the Invention

The objective of the claimed invention is to develop methods for operating modules for simulating defibrillation and electrocardiography systems as part of a medical simulator for training doctors in providing first aid and diagnosing various types of heart pathologies in various clinical situations. In addition, an important task posed in the development of the claimed method of operation is to combine the methods of operation of modules for simulating defibrillation and electrocardiography systems with a standard medical device.

The technical result is the creation of a medical simulator that provides modeling of video signals of the functioning of the cardiovascular system of the body (heart function) 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 the method of practicing practical skills in providing first aid and diagnosing various types of heart pathologies using a medical simulator, including a patient simulator module in the form of a human mannequin, which consists in using a standard defibrillator-monitor, including at least two output to standard metal defibrillator electrodes and one input for electrical electrocardiography signals, according to the present invention, a human manikin is used, including a system for simulating cardiopulmonary resuscitation, a system for simulating defibrillation, a system for simulating electrocardiography, a system for simulating chest decompression, a system for simulating a chest drainage procedure , tracheal intubation and conicotomy simulation system, simulation system

- 1 043493 injection of medications, a system for simulating bleeding and a system for simulating catheterization of the bladder, non-contact devices are first built into the mentioned manikin, providing identification of the location of two metal defibrillator electrodes with installed pads and four modules for simulating electrocardiography electrodes, depending on the training scenario used, a video is simulated signals of the functioning of the cardiovascular system of the body, carry out physical influences on a human mannequin for carrying out resuscitation measures or medical procedures by influencing the mentioned systems, record the physical influences exerted on the mentioned simulation systems or their absence, measure the pulse energy of the action of an electric discharge on the electrodes of the defibrillator through load adapter unit, data on impacts is transferred to a computer for processing, and video signals are simulated and transferred to the control unit of the electrocardiography simulation system for playback through a standard defibrillator-monitor, depending on the physical impacts on said mannequin.

Thus, the technical result is achieved through the full implementation of real-time feedback: the action of the subject (doctor) - the reaction of the patient simulator module - modeling of video signals into the electrocardiography simulation system, to which a standard defibrillator-monitor is connected.

Brief description of drawings

The essence of the invention is illustrated by the drawing (Fig. 1), which shows a medical simulator for practicing practical skills in providing first aid and diagnosing various types of heart pathologies, having a patient simulator module, defibrillation and electrocardiography simulation systems.

In fig. Figure 2 shows a general view of the patient simulator module with specifically defined areas of physical influence on the human mannequin.

In fig. Figure 3 shows a general diagram of the implementation of a system for simulating defibrillation and electrocardiography on a patient simulator module.

In fig. 1-3 numbers indicate:

- medical simulator,

- patient simulator module,

- defibrillation simulation system,

- electrocardiography simulation system,

- Computer (server),

- human mannequin of the patient simulator module,

- subject (doctor) of interaction,

- system for simulating cardiopulmonary resuscitation,

- system for simulating chest decompression,

- system for simulating the procedure of drainage of the pleural cavity,

- system for simulating tracheal intubation and conicotomy,

- system for simulating drug administration (intravenous, intramuscular, intraosseous), 13 - system for simulating bleeding,

- system for simulating bladder catheterization,

- non-contact device for simulating defibrillation system,

- non-contact device for electrocardiography simulation system,

- standard defibrillator monitor,

- standard metal defibrillator electrodes,

- pads (contact pads) on the metal electrodes of the defibrillator,

- load adapter unit for the defibrillation simulation system,

- module for simulating electrocardiography electrodes,

- splitter,

- control unit for the electrocardiography simulation system,

- pulse oximetry simulation module.

Carrying out the invention

Medical simulator 1 contains: a patient simulator module 2, defibrillation simulation systems 3 and electrocardiography 4, connected via a wireless channel to a computer 5, and a standard defibrillator-monitor 17, connected via a wired channel to simulation systems 3 and 4.

The patient simulator module 2 contains: a system for simulating cardiopulmonary resuscitation 8, a system for simulating chest decompression 9, a system for simulating the procedure for drainage of the pleural cavity 10, a system for simulating tracheal intubation and conicotomy 11, a system for simulating drug administration (intravenous, intramuscular, intraosseous) 12 , a bleeding simulation system 13, a bladder catheterization simulation system 14 and non-contact device positioning systems 15 and 16, respectively, for interaction with the defibrillation simulation systems 3 and electrocardiography 4.

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The systems for simulating defibrillation 3 and electrocardiography 4 are connected to a standard defibrillator-monitor 17, which is characterized by the presence of at least two outputs for standard metal electrodes 18 of the defibrillator and one input for electrical electrocardiography signals. The defibrillation simulation system 3 is characterized by the presence of two pads (contact pads) 19, which are connected (attached) to standard electrodes 18 to discharge electrical discharges into the load adapter unit 20. The electrocardiography simulation system 4 is characterized by the presence of four electrode simulation modules 21, which, using a splitter 22 are connected to the control unit 23, and one pulse oximetry simulation module 24, which is also connected to the control unit 23.

Practicing practical skills in providing first aid and diagnosing various types of heart pathologies using a medical simulator is carried out as follows.

A method for practicing practical skills in providing first aid and diagnosing various types of heart pathologies using a medical simulator 1, including a patient simulator module 2 in the form of a human mannequin 6, which consists in using a standard defibrillator-monitor 17, including at least two outputs on 18 standard metal defibrillator electrodes and one input for electrocardiography electrical signals.

The difference between the proposed method of practicing practical skills in providing first aid and diagnosing various types of heart pathologies is that a mannequin 6 is used, including a system for simulating cardiopulmonary resuscitation 8, a system for simulating defibrillation 3, a system for simulating electrocardiography 4, a system for simulating chest decompression 9, a system for simulating the procedure of drainage of the pleural cavity 10, a system for simulating tracheal intubation and conicotomy 11, a system for simulating drug administration 12, a system for simulating bleeding 13 and a system for simulating catheterization of the bladder 14, non-contact devices 15 and 16 are first built into the mentioned manikin 6, providing identification of the location of two metal electrodes 18 of the defibrillator with installed pads 19 and four modules for simulating electrodes 21 of electrocardiography 4, depending on the training scenario used, video signals of the functioning of the cardiovascular system of the body are simulated, physical influences are exerted on the mannequin 6 of a person for resuscitation measures or medical procedures by influencing the mentioned systems, record the physical impacts exerted on the mentioned simulation systems or their absence, measure the pulse energy of the electric discharge on the electrodes 18 of the defibrillator 17 through the load adapter unit 20, the data on the impacts are transferred to the computer 5 for processing, and perform video simulation signals and transmitting them to the control unit 23 of the electrocardiography simulation system 4 for reproduction through a standard defibrillator-monitor 17, depending on the physical effects exerted on the mentioned mannequin.

Example of concrete implementation

Practicing practical skills in first aid and auscultation is carried out on the patient simulator module 2, which is made in the form of a human mannequin 6 with an 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 skills in performing cardiopulmonary resuscitation, intensive care, and a set of measures aimed at maintaining life.

The operation of the patient simulator module 2 is carried out using a computer software algorithm 5, which ensures the operation of all systems for simulating vital signs on the mannequin 6, depending on the scenario used. For example, when simulating cardiac complications on mannequin 6, the corresponding clinical picture is simulated - changes in blood pressure, heart rate, and pulsation power. When simulating respiratory complications, there is a change in the frequency of respiratory movements, the appearance of cyanosis, loss of consciousness, voices, and various wheezing. And also when simulating injuries to the head, torso and limbs, various physiological reactions occur: lack of reaction of the pupils, auscultation pattern on the left or right, drop in pressure due to blood loss, convulsions.

Infrared LEDs 15 and 16 are installed on the patient simulator module 2 to carry out wireless interaction and determine the correct positioning, respectively, of two metal electrodes 18 of the defibrillator with installed pads 19 and four modules for simulating electrodes 21 of electrocardiography 4. At the same time, on the pads themselves 19 and the electrode simulators 21 36 kHz infrared receivers (the frequency of infrared pulses that the internal demodulator filters) type TSOP 2136 are installed to receive infrared signals. Moreover, contactless devices such as infrared LEDs 15 and 16 are located at a certain depth in the body of the mannequin 6, which is covered with a layer of silicone (4 mm thick), a material that imitates human skin.

The systems for simulating defibrillation 3 and electrocardiography 4 consist of two separate units, 20 and 23, respectively, connected to a standard type 17 defibrillator-monitor

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DKI-N-11 AXION with automatic defibrillation function, intended for resuscitation and electrical pulse therapy of acute and chronic cardiac arrhythmias, determination of oxygen saturation of blood hemoglobin and blood pressure, as well as for external, transesophageal, endocardial pacing. Defibrillator-monitor type DKI-N-11 AXION is used in medical hospitals, cardiology clinics, to equip ambulance and emergency medical care teams.

Blocks 20 and 23 are equipped with Wi-Fi modules of the ESP8266 type to receive and transmit information through server 5. For example, load adapter block 20 measures the pulse energy of the discharge in J and transmits this information to server 5. At the same time, electrical discharges are removed from metal electrodes 18 of the defibrillator and measurement of the pulse energy of the discharge is carried out using an electronic board (not shown in Fig.) block 20, where the electrical discharge flows through a block of resistors with a rated heat dissipation power from 0.25 W to 50 W and is measured using an integrated circuit of the current collector with Hall effect type ACS711 (measures bidirectional current up to 25A) controlled by a microcontroller type STM32F405RGT6 (ARM Cortex-M4 core, 32-bit, FLASH 1 MB, RAM 192 KB). For example, the control unit 23 receives information from the server 5 about the simulated video signal, which is converted into several electrical signals with a constantly changing voltage value, which are subsequently reproduced on the screens of a standard defibrillator-monitor 17 type DKI-N-11 AXION in the form of curved lines , which represent the current value of heart rate, respiratory rate, systolic and diastolic blood pressure, and saturation (SpO2). Moreover, to receive an electrical signal with a constantly changing voltage value, several blocks of resistors are installed on the electronic board (not shown in Fig.) of the control unit 23 through which electrical signals flow under the control of a microcontroller type STM32F405RGT6 (ARM Cortex-M4 core, 32-bit, FLASH 1 MB, RAM 192 KB). In this case, the pulse oximetry simulation module 24 performs the function of recognizing (identifying) the presence or absence of fixation on one of the fingers of the human dummy 6. In the absence of fixation of the pulse oximetry simulation module 24 on one of the fingers of the human dummy 6, the saturation line curve (degree of saturation) is not reproduced blood oxygen) on the screens of a standard defibrillator-monitor 17.

Further modeling (change) of video signals occurs depending on the actions or inactions of the subject (doctor) 7 on the mannequin 6, that is, any medical procedures are carried out or not performed on the mannequin 6 by the subject (doctor) 7.

The actions or inactions of the subject (doctor) 7 are as follows. Any manipulations on the mannequin 6: performing cardiopulmonary resuscitation on the simulation system 8, applying an electric discharge using a real defibrillator 18 on the simulation system 3, administering drugs using special syringes on the simulation system 12, intubation, artificial ventilation and conicotomy with using endotracheal tubes, LMA, Combitube and other devices on the simulation system 11, performing chest decompression for tension pneumothorax on the simulation system 9, performing a pleural cavity drainage procedure on the simulation system 10, applying a tourniquet for bleeding on the simulation system 13 and performing bladder catheterization on the simulation system 14 are recorded by position sensors of the mechanisms of the patient simulator module 2, the data of which is transmitted and processed by a software algorithm on the computer 5 and reflected on the state of the patient simulator 2, while video signals of the functioning of the cardiovascular system of the body (heart function) of patient 2 are simulated, which are sent to the control unit 23 of the electrocardiography simulation system 4. For example, the result of feedback when cardiopulmonary resuscitation is performed correctly on the simulation system 8 is the stabilization of the state of the patient simulator module 2, namely the restoration of breathing (respiratory rate) and heart rhythm (heart rate ), palpation of the pulse, automatic blinking and reaction of the pupils to light, which can be visually observed on the module of the patient simulator 2 and on the standard defibrillator-monitor 17. However, incorrect actions or inactions of the subject (doctor) 7 can lead to an emergency situation and the simulation of various video signals for the electrocardiography simulation system 4 depending on the scenario used.

Incorrect actions of the subject (doctor) 7 may be as follows. When a drug is introduced into the simulation system 12 that causes an allergic reaction, an algorithm for simulating anaphylactic shock is launched. Signs of anaphylaxis: tachycardia, tachypnea, low blood pressure. Interruptions in cardiac massage on the simulation system 8 or the complete absence of resuscitation measures between defibrillator discharges 18, application of a low or too high voltage discharge on the simulation system 3, application of a shock against the background of small-wave fibrillation without measures that increase the energy resources of the myocardium can lead to simulated death on the module patient simulator 2.

In this way, complete immersion of the subject (doctor) 7 in the learning process is achieved through visual and tactile perception, where changes in video signals occur in real time and directly depend on the physical influences exerted on the mannequin 6 by the subject (doctor) 7 during resuscitation or medical procedures.

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

The use of the proposed medical simulator 1 allows, in comparison with the prototype, to improve the practical skills of doctors in providing first aid and diagnosing a person’s condition in various clinical situations. At the same time, the realistic training of doctors in providing first aid and diagnosing a person’s condition is ensured by combining the methods of operation of the modules for simulating systems for defibrillation 3 and electrocardiography 4 with a standard medical device such as a standard defibrillator-monitor 17.

Claims (1)

CLAIM A method for practicing practical skills in providing first aid and diagnosing various types of heart pathologies using a medical simulator, including a patient simulator module in the form of a human mannequin, which consists in using a defibrillator-monitor, including at least two outputs to the metal electrodes of the defibrillator and one input for electrical signals of electrocardiography, characterized in that a human mannequin is used, including a system for simulating cardiopulmonary resuscitation, a system for simulating defibrillation, a system for simulating electrocardiography, a system for simulating chest decompression, a system for simulating the procedure of drainage of the pleural cavity, a system for simulating tracheal intubation and conicotomy, a simulation system injection of drugs, a system for simulating bleeding and a system for simulating bladder catheterization, contactless devices are first built into the mentioned manikin, providing identification of the location of two metal defibrillator electrodes with installed pads and four modules for simulating electrocardiography electrodes; depending on the training scenario used, video signals of the functioning of the cardiovascular system are simulated. the vascular system of the body, carry out physical impacts on a human mannequin for resuscitation or medical procedures by influencing the mentioned systems, record the physical impacts exerted on the mentioned simulation systems or their absence, measure the pulse energy of the electric discharge on the defibrillator electrodes through the load adapter unit, data on impacts is transferred to a computer for processing and video signals are simulated and transferred to the control unit of the electrocardiography simulation system for playback through a defibrillator-monitor, depending on the physical impacts on said mannequin.