ES2684418A1 - SIMULATION EQUIPMENT FOR CONTROL OF HEMORRHAGE (Machine-translation by Google Translate, not legally binding) - Google Patents

Abstract

Hemorrhage control simulation equipment. It allows training of the tourniquet technique and comprises at least one first wearable device (1) configured to be arranged around part of the patient's arm or leg and comprising at least one resistant inner layer, intended to be in contact with the patient. patient's body, and at least one outer layer that simulates the patient's skin. Between both layers it comprises at least one pressure sensor (2), an inner passage (5) simulating a blood vessel; and the equipment comprises at least one battery (4) that feeds an electrical circuit in which the sensors are, and a warning means and/or a control unit. (Machine-translation by Google Translate, not legally binding)

Description

OBJECT OF THE INVENTION

The present invention is part of the technical field of health training. More specifically, a health simulation team is proposed that allows training in hemorrhage control.

BACKGROUND OF THE INVENTION

The accumulated experience in the management of traumatic injuries in recent military conflicts, and incidents with multiple intentional victims, together with the need to seek a solution in the control of external mass hemorrhages in non-intentional extrahospital traumatic incidents, makes adaptation necessary of the teaching methodology in the training of military personnel, members of the police units, health personnel and civilian personnel. Today, the debate is still going on about the best way to approach training to the levels of stress and realism that these people will face when dealing with traumatic firearm and / or explosive injuries or unintended trauma with massive external hemorrhages.

Although the debate persists, one of the accepted conclusions is that it is necessary to train with devices that approximate in the most realistic way possible in terms of texture, anatomy and movement to those corresponding to a real patient. This field is where wearable devices are framed, which allow interaction between the person who acts as an injured or patient and the person who is training and who acts as an assistant. This facilitates the realization, by the assistant, of the techniques on said device with total security both for himself and for the person acting as a patient.

Armed conflict situations and terrorist acts have contributed to increasing the sense of a growing and global threat that is associated with a change in the care paradigm. These programs have been adapted for the civil environment to train the first intervener in cases of intentional and unintended incidents as reflected in the recommendations of the European Resuscitation Council.

In this regard, a joint policy on training in control of external hemorrhages has now been created. Likewise, it has established the need to position material necessary for the management of hemorrhages in places of mass influx of people.

With this and other strategies, we try to strengthen the role of the "immediate intervener" (citizen) and the first intervener when it comes to controlling bleeding early in the same place of the incident.

On the other hand, it is intended to train the ordinary citizen to be able to identify the hazards and avoid them and to be able to identify and treat with the available means the causes of preventable death that occur in this type of incident .

The current objective of the authorities is to train the citizen as "first intervener" or "immediate intervener" as part of the first link in the healthcare chain, with a

philosophy similar to that followed with cardiopulmonary resuscitation (CPR) survival chain. Likewise, work is being done to achieve positioning, in strategic places of massive influx, equipment with turnstiles and hemostatic bandages, placed next to the defibrillators, to allow the placement of tourniquets in cases of bleeding.

Thus, these policies are aimed at reducing the mortality rate in all care steps of those patients who present with massive hemorrhage.

DESCRIPTION OF THE INVENTION

The present invention describes a hemorrhage control simulation device comprising at least one first wearable device that, placed on the arm of a person, allows it to simulate a patient on which invasive and non-invasive interventions can be performed. The purpose is training in health care in a realistic environment.

The equipment allows the prehospital training of the typical massive hemorrhage injuries produced in incidents with firearms and explosives as well as in traumatic situations without intentional incidents. Thus, it is aimed at all those personnel who can be faced with such incidents, from police and military, civil assistance personnel and firefighters.

The invention makes it possible to improve the training in health sciences of students, health professionals, residents, civilians and security forces in a sanitary, out-of-hospital, health tactical or major catastrophe environment.

Specifically, the pennite hemorrhage control simulation team simulates a hemorrhage to practice tourniquet placement. The first wearable device is designed to be arranged in the arm (in the part of the arm that goes from the elbow to the shoulder) of a person who will act as a patient. So the assistant can train bleeding control

In this case, the equipment allows practicing the placement of tourniquets without danger to the simulated patient (who is wearing the equipment), which is an advantage over other known solutions of the state of the art in which the training is carried out on the unprotected members of the patients. Performing this type of practice directly on the simulated patient can cause muscle and nerve injuries.

The correct placement of a tourniquet is determined by the pressure applied with the tourniquet, which is the pressure applied to cut the hemorrhage and to cut the arterial pulse.

In order to verify if the tourniquet placement, and therefore the bleeding control training, is being carried out correctly, the first wearable device comprises a plurality of sensors that allow to take data of the pressure applied by the tourniquet. The sensors not only measure the pressure applied but also the position in which the tourniquet has been placed and the pressure exerted when applying the hemostatic bandage on the wound.

Preferably the assistant (the student who is training his skills) receives an immediate response from the team that informs him if he has correctly placed the tourniquet. In an embodiment, the team also immediately informs the patient about the correct application of hemostatic bandage. The equipment may comprise at least one control unit in which at least one routine of running a bleeding simulation is stored.

In another embodiment, the equipment comprises a control unit with transmission and reception means that are configured to send and receive data from an external equipment, controlled by an instructor. In this example, the communication between the first wearable device and the external equipment is carried out wirelessly and in real time so that the training is carried out correctly.

The first wearable device of the hemorrhage control simulation equipment is very thin so that its placement in the arm or leg of the simulated patient is as realistic as possible. Likewise, the pressure measurement sensors (turnstile pressure and direct pressure) exerted on the first wearable device are also fine to be able to maintain, at the points where the measurements are made, the described low thickness requirements.

In a preferred embodiment, the equipment also comprises a second wearable device (intended to be placed in the part of the patient's arm that goes from the elbow to the wrist, or in the part of the patient's leg that goes from the hip to the roll) set to connect to the first wearable device.

In this second wearable device is a simulated wound that the user can use to confirm whether the tourniquet that is being placed on the first wearable device is used to stop bleeding from the simulated wound. In an exemplary embodiment, the bleeding simulation is performed by means of a lighting circuit, which illuminates the simulated wound with more or less intensity to represent greater or lesser intensity of bleeding, and / or by a bleeding circuit comprising the use of a fluid that simulates the patient's blood and is expelled through a hole in the wound.

In cases where the second wearable device comprises a circuit of

5 bleeding and therefore at least one hole in the wound, this can be used for the assistant to train the application of hemostatic bandage application. This training is performed on the simulated wound of the second wearable device in a non-injurious way for the simulated patient. It is possible to detect the pressure that the student makes when applying it and if said pressure is maintained above a given threshold.

10 The first wearable device, and the second wearable device when it is part of the equipment, comprise an inner layer that is in contact with the body of the simulated patient, which is made of a material strong enough to prevent maneuvers performed on the device affect the simulated patient.

15 The first wearable device, and the second wearable device when present, comprise an inner duct that simulates a blood vessel. The pressure sensor is connected to the vessel and has to do with the pressure applied by the tomiquete to stop bleeding or the pulse.

In an exemplary embodiment in which the second wearable device is intended to be disposed on the arm of a patient, it may comprise a flexible lower section, in which there is at least one actuator that simulates the pulse. In this case, the actuator that simulates the pulse is arranged in correspondence with the wrist of the

25 patient to make the training as real as possible. When the pressure exerted on the tourniquet increases, bleeding will be cut first and if we continue to increase it, the pulse will be cut.

One factor that has been taken into consideration during the development of the team has been

30 structural ergonomics since being a team with at least one wearable device that is placed on a person's arm or leg, it must be able to adapt to different sizes of arms or legs. In addition the device has to be resistant and lightweight to give the simulation a realism. It should also be washable when used with realistic bleeding (using colored fluids).

The battery that controls the power of all the components of the equipment is also integrated in it so it must be small and light and have sufficient capacity to power the control unit, sensors, etc.

DESCRIPTION OF THE DRAWINGS

To complement the description that is being made and in order to help a better understanding of the characteristics of the invention, according to a preferred example of practical implementation thereof, a set of drawings is attached as an integral part of said description. where, for illustrative and non-limiting purposes, the following has been represented:

Figure 1.- Shows a schematic view of the first wearable sanitary simulation device.

PREFERRED EMBODIMENT OF THE INVENTION

An example of embodiment of the present invention is described below with the aid of Figure 1.

The proposed hemorrhage control simulation equipment comprises at least a first wearable device (1) that is intended to be placed on the arm or leg of a person acting as a patient so that a user can train the tourniquet placement technique. All the equipment shown in the figure would then be covered by a plastic / silicone skin that would hide all the electronics and give a more realistic look to the whole.

In this way, a user can practice bleeding control using the tourniquet technique in a controlled but very realistic environment. In addition, as the practice is performed with a person acting as a patient, the assistant (student) can train at the same time non-technical skills, such as empathy, dealing with the patient, crisis management, decision making, etc. .

The first wearable device (1) is intended to be placed on the upper arm (above the elbow) or on the upper leg (above the knee) of the patient. Said first wearable device (1) comprises at least one resistant inner layer, intended to be in contact with the patient's body, and at least one outer layer that simulates the patient's skin.

Likewise, the first wearable device (1) comprises at least one pressure sensor (2), and an inner duct (5) that simulates a blood vessel. The equipment comprises at least one battery (4) that feeds an electrical circuit in which the sensors are; and a warning means and / or a control unit. The pressure sensor (2) is configured to compare the pressure exerted by the user with a corresponding first threshold value with a correct application of tourniquet placement pressure (tourniquet pressure) and with a corresponding second threshold value with a correct application of pulse stop pressure (pulse pressure).

As previously described, when performing turnstile maneuvers, it is necessary to consider the pressure applied to determine if a correct tourniquet pressure has been reached and check if sufficient pressure has been applied to stop the patient's pulse. Therefore, the equipment comprises a sensor to measure the pressure applied in the placement of the tourniquet. Said sensor works with two threshold values. The lowest pressure threshold value determines when the correct tourniquet pressure has been reached and where the highest pressure threshold value determines when the correct pressure has been reached for the patient's pulse.

When the equipment is placed on the arm of a patient, the pressure sensor (2) is in an area of the first device you see tibie (1) destined to be arranged in correspondence with the external half circumference of said arm. It would not be appropriate to place these elements in correspondence with the inner part of the patient's arm because the free movement of the arm towards the body would be prevented. This would subtract realism from the simulation and maneuvering ability to the assistant.

In a first embodiment, for measuring the turnstile pressure, the first wearable device (1) comprises a pressure sensor (2) which is a mechanical actuation switch. In this exemplary embodiment, it is only detected if the assistant has reached a first pressure threshold value to cut bleeding and a second pressure threshold value to cut the pulse. In this version you don't need a controller or fluid system. It is a purely mechanical equipment and the response given to the user is made by lighting a different light for each target pressure.

Preferably, the mechanical actuation switch comprises two conductive plates separated from each other, and comprises at least one spring with a threshold pressure resistance. By exerting on the plates a pressure greater than the threshold pressure, they join together allowing the passage of current therethrough two separate plates that are joined together when the appropriate pressure is exerted on them. By allowing the passage of current through the mechanical switch an electrical circuit is closed that connects the battery with the warning means and / or with a control unit.

In an exemplary embodiment, the warning means are LEO lights. Preferably, the warning means are lights configured to be switched on when the pressure sensor (2) detects that the pressure corresponds to the first pressure threshold value (tourniquet pressure) or corresponds to the second pressure threshold value (pressure of pulse).

In this case, the first device you see tibie can comprise, for example, a LEO light of a certain color, which turns on when the pressure sensor (2) detects that a pressure threshold value that matches the correct pressure value has been reached Turnstile placement. It can also comprise a LEO light of another color, which turns on when the pressure sensor (2) detects that a pressure threshold value has been reached that coincides with the correct stopping value of the patient's pulse.

In a preferred embodiment, the bleeding control simulation equipment additionally comprises a second wearable device (6), intended to be arranged around part of a patient's arm or leg, below the first wearable device (1) . It comprises connection means to said first wearable device (1). It comprises at least one resistant inner layer, intended to be in contact with the patient's body, and at least one outer layer that simulates the patient's skin.

The second wearable device (6) comprises at least one simulated wound (7), and at least one lighting circuit or a bleeding circuit linked at least to the pressure sensor (2). The second wearable device (6) also comprises an actuator to simulate the patient's pulse (3).

In this exemplary embodiment, there are already two parts of the wearable (first and second wearable devices (1, 6 »the first to put the tourniquet and see the position and the second to detect the pulse and see the simulated wound (7). This second version of use can be used in two more ways: -a first option with which the pressures are detected by sensors and controller and the bleeding is simulated with lighting; -a second option that only differs from the first in which the blood instead of being simulated by light it is simulated by fluid and that requires pneumatic circuit with a second controller for bleeding that is located in correspondence with the patient's chest

The lighting circuit and / or a bleeding circuit allow to recreate a hemorrhage in the simulated wound (7). In the first case, bleeding is represented by lighting a plurality of lighting means (8) with more or less intensity depending on the volume of bleeding. In the second case, the hemorrhage is represented by expelling a greater or lesser amount of a fluid (which simulates the blood from the hemorrhage) through a hole arranged in the simulated wound (7).

The connection means between wearable devices (1, 6) are arranged in correspondence with the patient's elbow. The connection means comprise at least electrical connections for the sensors and possible actuators of the wearable devices (1, 6).

In an exemplary embodiment, the second wearable device (6) comprises a lighting circuit to simulate bleeding. In this case, the second wearable device

(6) comprises at least one lighting means (8) connected to the turnstile pressure sensors (2) of the first wearable device (1). When the pressure sensor

(2) detects an increase in the pressure on the inner duct (5), the intensity of the light emitted by the at least one lighting means (8) is decreased.

That is, the at least one lighting means (8) illuminates the area of the simulated wound

(7) with greater or lesser intensity. It can comprise a single light emitter arranged at the point of bleeding or several light emitters along the area near the simulated wound (7) in the second upper section that simulates the amount of blood lost (depending on whether light more or less light emitters are considered to be losing more or less blood).

In this case the lighting means (8) are located below the outer layer of the second wearable device (6) that simulates the skin, in correspondence with the simulated wound (7). When they light up, they illuminate the simulated wound (7) pretending that there is blood. The light intensity with which the LED light emitters are switched on depends on the greater or lesser correction of the turnstile maneuver performed.

In an exemplary embodiment in which the second changing device (6) comprises a bleeding circuit, the equipment additionally comprises a third device (9) in which at least one fluid accumulation vessel (10) is located, a Compressor (shown in the figure together with the battery (4 ') and the second wearable device comprises at least one bleeding conduit that connects the container (10) with the simulated wound (7), preferably in the third device (9 ) the battery, a control unit (11) and the corresponding electronic communications are also arranged.The third device (9) can be a backpack, belt, vest, etc.

The bleeding duct must be fully protected to avoid external actions that may affect the result of the training. The simulated wound (7), in this embodiment, comprises at least one orifice through which the fluid that reaches the simulated wound (7) from the container (10) exits.

Preferably, the third device additionally comprises pressure means configured to regulate the delivery of fluid from the container (10) to the simulated wound (7). It can be at least one pneumatic piston that has the possibility of displacement by compressing the container (10) and preferably also a pressure regulator linked to the piston to control the force with which said piston moves and thus control the level of fluid flowing out of the simulated wound hole (7). The control unit (11) manages the piston movement parameters to control the frequency and level of bleeding.

In the exemplary embodiment in which the second wearable device (6) comprises a bleeding circuit and at least one hole, the user can practice the application of hemostatic bandage to control bleeding in the simulated wound (7). To avoid possible harm to the patient, the second wearable device (6) also comprises, as previously described, a sufficiently resistant inner layer, which protects the patient's skin and body from any damage.

The second device you see tibie (6) comprises a lower section configured to be placed in correspondence with the patient's wrist. In said lower section there is a pulse actuator that simulates the patient's pulse. It is a flexible section so that when the equipment is used on a patient's arm, the lower section rotates when the assistant turns the patient's wrist. In this way, the assistant always has to feel the patient's pulse in the correct anatomical area, regardless of wrist rotation.

The actuator is preferably a vibrating motor that allows to simulate the pulse of the person creating short vibrations spaced by times at low level according to simulated heart rate and times at high level according to the intensity of tactile perception that you want to transmit to the user who feels the pulse. The pulse actuator is connected to the control unit (11) such that when a pressure greater than or equal to the second pressure threshold value (pulse pressure) is detected in the pressure sensor (2), the pulse actuator is stopped , thus simulating the patient's pulse stop.

Also, in the embodiments in which the equipment also comprises a second wearable device (6), it may be possible to measure the direct pressure on the simulated wound (7). In an exemplary embodiment, the simulated wound (7) represents the entrance of a projectile. This embodiment allows an additional cure to be trained which comprises performing a hemostatic bandage on the simulated wound (7) with one hand while maintaining constant pressure with the other on the simulated wound itself (7). To measure this pressure, the device comprises an additional pressure sensor (13) arranged in correspondence with the simulated wound (7).

In this exemplary embodiment, the second wearable device (6) comprises an additional pressure sensor for measuring the pressure that is being exerted on the simulated wound itself (7). Using the data obtained, it is possible to know if the hemostatic bandage has been correctly placed.

Preferably in the embodiment in which the second wearable device (6) comprises a bleeding circuit, the equipment also comprises a bleeding simulation actuator that allows an immediate response to the user about the quality of the tourniquet placement technique that has been provided. accomplished. The control unit (11) controls the expulsion of fluid through the simulated wound (7) based on the data obtained by the pressure sensor (2). It allows to show how the bleeding decreases through the simulated wound (7) as the pressure exerted by the tourniquet is increased.

In another embodiment of the invention in which the equipment comprises at least one control unit (11), it comprises means for transmitting and receiving signals. This embodiment allows the equipment to be used by means of an external control device, which can be for example a computer, a smartphone, etc. These means for transmitting and receiving signals are preferably wireless. This embodiment example is designed so that an instructor can visualize the simulation status from the external control equipment at all times. In an exemplary embodiment, at least one routine of executing a bleeding simulation is stored in the control unit (11). In another embodiment, a control routine can be sent to the control unit (11) from the external equipment.

Due to the environment in which the equipment is going to be used, at the electronic level, it must be resistant to splashes and sporadic spills of fluids.

In a preferred embodiment of the invention, the first wearable device (1)

it includes position sensors (12) that allow to evaluate if the turnstile has

placed in a correct position. That is, it allows to determine if the technique of

5 tourniquet has been performed properly and if it has been placed in the correct position.

A correct turnstile application technique comprises the realization of a first turnstile and subsequently, the realization of a second turnstile more towards

10 up or down the arm or leg. Once the second tourniquet is tight and fixed, the first one is loosened. Thus, it is important to have information about how many turnstiles there are at each moment and about their position.

Claims (12)

1.-Simulation equipment for hemorrhage control that allows training of the tourniquet technique characterized in that it comprises at least a first wearable device (1) configured to be arranged around part of the patient's arm or leg and comprising the at least one resistant inner layer, intended to be in contact with the patient's body, and at least one outer layer that simulates the patient's skin, and among them comprises at least: a pressure sensor (2) configured to compare the pressure exercised by the user with a corresponding first threshold value with a correct application of tourniquet pressure and with a corresponding second threshold value with a correct pulse pressure; -a inner duct (5) that simulates a blood vessel; and the equipment comprises at least one battery (4) that feeds an electrical circuit in which the sensors are; and a warning means and / or a control unit. 2. A hemorrhage control simulation device according to claim 1 characterized in that the pressure sensor (2) comprises a mechanical actuation switch. 3. Bleeding control simulation equipment according to claim 2, characterized in that the mechanical actuation switch comprises two conductive plates separated from each other, and comprises at least one spring with a threshold pressure resistance, so that when exerting on the plates, a pressure greater than the threshold pressure, come together, penetrating the flow of current through it. 4. Bleeding control simulation equipment according to claim 1, characterized in that the warning means are LED lights configured to be switched on when the pressure sensor (2) detects that the pulse pressure and / or the tourniquet pressure is they correspond to a predetermined value of pulse pressure and / or corresponding pressure of tomiquete with a correct placement of the tomiquete. 5. A bleeding control simulation device according to claim 1 characterized in that it comprises at least a second wearable device (6), intended to be arranged around part of a patient's arm or leg, below the first wearable device (1) and comprising at least one layer resistant interior, intended to be in contact with the patient's body, and at least an outer layer that simulates the patient's skin, and includes at least: - a simulated wound (7); -at least one lighting circuit or a bleeding circuit linked to at least the pressure sensor (2). 6. Bleeding control simulation equipment according to claim 5 characterized in that the lighting circuit comprises at least one means of lighting (8) connected to the pressure sensors of tomiquete (2) of the first wearable device (1) such that when the pressure sensor (2) detects an increase in the pressure on the inner duct (5), the intensity of the light emitted by the at minus a lighting medium (8). 7.-Bleeding control simulation equipment according to claim 6 characterized in that the lighting means (8) are LEDs that are located below the outer layer of the second wearable device (6) that simulates the skin, in correspondence with the simulated wound (7). 8.-Bleeding control simulation equipment according to claim 5 characterized in that it further comprises a third device (9) in which find at least one container (10) for accumulation of a fluid and the second wearable device comprises at least one bleeding conduit that connects the container (10) with the simulated wound (7). 9.-Bleeding control simulation equipment according to claim 8 characterized in that the third device additionally comprises means of pressure configured to regulate the sending of fluid from the container (10) to the simulated wound (7). 10.-Bleeding control simulation equipment according to claim 3 characterized in that it comprises an additional pressure sensor in the simulated wound (7). 11. A bleeding control simulation device according to claim 1, characterized in that the control unit comprises means for transmitting and receiving signals configured to wirelessly connect to an external device. 12.-Bleeding control simulation equipment according to claim 1 characterized in that the first wearable device (1) additionally comprises position sensors (12). 13. 13. Bleeding control simulation equipment according to claim 5, characterized in that the second wearable device (6) additionally comprises a pulse actuator (3).