GB2610233A - Haemorrhage-simulation training system - Google Patents

Abstract

A haemorrhage-simulation training system 10 is provided and includes a haemorrhaging-liquid reservoir 12 for storing simulated haemorrhaging-liquid. The reservoir 12 has a liquid outlet 22. The training system 10 also includes an imitation wound-site element 16 which is liquidly communicable with the reservoir 12. A liquid flow path is formed between the liquid outlet 22 and the imitation wound-site element 16. The training system 10 further has a control element 18 including a pressure controller 28 for controlling a pressure in 10 the liquid reservoir 12 and/or on the liquid flow path. The control element 18 also has a pressure-monitoring element for monitoring the pressure. A pulsed flow-rate controller for controlling a pulsing flow rate of said simulated haemorrhaging-liquid on said liquid flow path is also provided. The pulsed flow-rate controller is in communication with the pressure-monitoring element and is configurable to alter a pulsed flow rate based on a pressure monitored by the pressure-monitoring element.

Description

Haemorrhage-Simulation Training System The present invention relates to a system which simulates a haemorrhage for training purposes. The present invention also relates to a method of simulating a haemorrhage with greater realism. The invention also relates to a training system for simulating a 5 sucking chest wound.

When presented with a life-threatening haemorrhage, knowing the correct procedures to adopt can save a life. Training, such as through simulations, is therefore vital to ensure medical personnel and first aiders are familiar and comfortable with carrying out these life-saving procedures correctly and rapidly. Realism of simulations is important.

Existing solutions to train medical personnel and first aiders include using artificial body parts or mannequins. Whilst mannequins may enable social distancing and/or more hygienic training, artificial body parts or a mannequin is no substitute for a real, living human body. By having different material properties to a real, living human body, artificial body parts and mannequins may provide incorrect feedback to the trainee, if any.

Furthermore, artificial body parts and mannequins may be bulky, and therefore difficult to store. Cost can be prohibitive and restrict how many mannequins can be sourced, which in turn limits the amount of experience a trainee can have and/or the number of trainees.

A further solution is to train on a real, living actor or actress pretending to have a haemorrhaging wound. Whilst more lifelike than a mannequin, the actor or actress is generally in good health. As such, the actor or actress does not present any of the physiological symptoms associated with a haemorrhage. In a real haemorrhage, blood gushing from the wound instils a sense of urgency, whilst a medical personnel's actions stemming the blood flow provides immediate and effective feedback. In the simulation on the other hand, the trainee may not experience the same sense of urgency and instant feedback compared to dealing with a real situation.

The present invention seeks to provide a solution to these problems.

According to a first aspect of the present invention, there is provided a haemorrhage-simulation training system comprising: a haemorrhaging-liquid reservoir for storing 30 simulated haemorrhaging-liquid, the reservoir having a haemorrhaging-liquid outlet; an imitation wound-site element which is liquidly communicable with the haemorrhaging-liquid reservoir; a liquid flow path between the haemorrhaging-liquid outlet and the imitation wound-site element; and a control element which includes: a pressure controller for controlling a pressure in the haemorrhaging-liquid reservoir and/or on the liquid flow path; a pressure-monitoring element for monitoring said pressure; and a pulsed flow-rate controller for controlling a pulsing flow rate of said simulated haemorrhaging-liquid on said liquid flow path, the pulsed flow-rate controller being in communication with the pressure-monitoring element and the pulsed flow-rate controller being configurable to alter a pulsed flow rate or pulsing flow rate based on a pressure monitored by the pressure-monitoring element.

The pulsed flow-rate controller can maintain the rate of pulses or pulsed flow rate constant or substantially constant. However, the pulsed flow-rate controller can also be reconfigured to vary the rate of pulses of fluid. This may be useful to simulate a variable heart beating pattern. The variable pattern may optionally be erratic or non-erratic, such as predictable. The pulsed flow-rate controller may increase with time and/or as the pressure decreases. A simulated drop in blood pressure accompanied by an increasing heart rate increases the realism of the training system. The provision of a pressure-monitoring element enables the change in pulsed flow-rate to be adjusted dynamically to the pressure. This removes the requirement for a user to pre-program or select a programme which alters the pulsed flow-rate irrespective of the pressure, although this alternative may be envisioned. There is also no requirement for the user to provide an input to generate each pulse of fluid, although once again, this alternative may be possible.

Preferably, the haemorrhaging-liquid reservoir may include a rigid container. A rigid container reduces or removes the risk of any or any combination of the reservoir becoming deformed, bursting due to a higher pressure within, and punctured. Furthermore, a rigid container may also provide a more reliable change in pressure. A rigid container may be self-standing and/or self-righting. A rigid container may provide a support for a manual pump received at least in part inside the reservoir.

Beneficially, the pressure controller may comprise an internal pump received at least in 30 part within the haemorrhaging-liquid reservoir for pressurising the simulated haemorrhaging-liquid. The training system may be more compact and/or easy to carry as the pump may be received and/or stored at least in part within the reservoir.

Optionally, the haemorrhaging-liquid reservoir may further comprise a gas-inlet. The gas-inlet may be useful to prevent or reduce the formation of a vacuum or a low pressure relative to atmospheric pressure by letting gas, such as air, into the reservoir. The gas-inlet may passively permit gas flow therethrough and/or actively move gas through the inlet.

Additionally, the pressure controller may comprise an external pump. The external pump may even be connectable to the gas-inlet for pumping gas thereinto to pressurise the simulated haemorrhaging-liquid. An external pump may be easier to access, such as for servicing, replacing or operating, compared with an internal pump at least.

Beneficially, at least one of the said internal pump and extemal pump may be a nonelectrically-energisable user-operated pump. In other words, the user's actions may operate the internal pump and/or external pump. Beneficially, a user-operated pump may not require electricity to function. An example of a user-operated pump may include a piston with a movable handle for pressurising fluid by movement of the handle. Further examples of user-operated pumps may include a squeezable pump, a bicycle pump, or a foot pump, by way of example only. Any alternative user-operated pump may be envisioned.

Preferably, the pressure controller may further comprise a valve at or downstream of the haemorrhaging-liquid outlet along the liquid flow path. Additionally or alternatively, the pulsed flow-rate controller may further comprise a valve at or downstream of the haemorrhaging-liquid outlet along the liquid flow path. One or both controllers may include a valve, although neither controller may include a valve. A valve easily enables fluid flow to be controlled.

Optionally, the or at least one of the valves may be a solenoid valve. A solenoid valve is 25 typically in either an open condition or in a closed condition. The simplicity of the valve mechanism reduces the risk of malfunction or breakage.

Alternatively, the or at least one of the valves may be a servo valve. A servo valve may have a plurality of open conditions, as well as a closed condition. More preferably, a servo valve may vary the flow through the valve. Even more preferably, the servo valve may vary the flow, preferably continuously, from no flow through the valve when in the closed condition to a maximum flow when in a fully open condition. In other words, a servo valve may regulate or throttle the flow.

Beneficially, the pressure-monitoring element may include a pressure sensor. The pressure sensor may enable a pressure measurement to be directly obtained.

Alternatively, the pressure-monitoring element may include a sonar element and/or a lidar element for detecting a surface of the haemorrhaging-liquid within the 5 haemorrhaging-liquid reservoir via the timing of reflected pulses of sound and/or light respectively, the control element further comprising data relating to a reference haemorrhaging-liquid-surface level and a pressure-calculating element for calculating a pressure of the liquid based on the said data relating to a reference haemorrhagingliquid-surface level and the detected surface of liquid. These alternative pressure-10 monitoring elements enable a pressure to be measured or estimated, preferably indirectly.

Beneficially, the control element may further comprise a user interface. Preferably, the user interface may include an interactive element. Advantageously, the user interface may include a screen for providing an output to the user and/or enabling the user to provide an input via the screen. Optionally, the user interface may include a speaker for providing an auditory output to the user. The user can obtain data from the user interface, such as visually and/or sound. Furthermore, the user can interact with the control element, for example to turn the control element on and off. The user can provide an input through the user interface such as specify a flow rate. The user can input and/or select a pre-set simulation programme.

Additionally, the control element may further comprise a time-measuring element. The time-measuring element may include a clock or clock element. The time-measuring element may be beneficial to measure a time period between pulses of fluid.

Optionally, the control element may further comprise at least one of: a receiver, an emitter, and a transceiver communicable via a wireless communication channel with a further emitter, receiver or transceiver for enabling one-or two-way wireless communication therebetween. A user may be able to provide an input and/or receive an output remotely, such as via a software application.

Preferably, the imitation wound-site element may further comprise a wearable element such that the imitation wound-site element may be wearable by a user and/or a mannequin. The wearable element may provide flexibility in terms of where on the body the imitation wound-site may be simulated. As the imitation wound-site element may be worn by a user, this may further increase the realism of the simulation.

Alternatively, the training system may further comprise a mannequin, and the imitation wound-site element may be integrated into the mannequin. The mannequin may be specifically designed for the purposes of simulating haemorrhages. A mannequin may remove the requirement for close contact with a human actor, which in turn, may be beneficial, for example, for hygiene and/or social distancing purposes.

Optionally, the training system may further comprise simulated haemorrhaging-liquid. The simulation blood may be provided as part of the training system.

According to a second aspect of the invention, there is provided a method of increasing the realism of a simulated haemorrhage, the method comprising the steps of providing a simulated wound-site pulsingly releasing simulated haemorrhaging-liquid at a decreasing fluid pressure to simulate pulse rate and decreasing blood pressure for increasing the realism of the simulated haemorrhage.

A decreasing blood pressure improves the realism of the simulation relative to a method in which the blood pressure remains constant or substantially constant. This alternative 15 may be envisioned however.

Beneficially, the pulse rate may increase as the fluid pressure varies, and more preferably, decreases, for further increasing the realism of the simulated haemorrhage. As the simulated blood pressure decreases, the simulated heart rate increases, which further improves realism.

According to a third aspect of the invention, there is provided a haemorrhage-simulation training system comprising: a haemorrhaging-liquid reservoir for storing simulated haemorrhaging-liquid, the reservoir having a haemorrhaging-liquid outlet; an imitation wound-site element which is liquidly communicable with the haemorrhaging-liquid reservoir; a liquid flow path between the haemorrhaging-liquid outlet and the imitation wound-site element; and a control element which includes: a pressure controller for controlling a pressure in the haemorrhaging-liquid reservoir and/or on the liquid flow path; and a pulsed flow-rate controller for controlling a pulsing flow rate of said simulated haemorrhaging-liquid on said liquid flow path.

The training system simulates a haemorrhage and includes elements which enable 30 pressure and flow-rate to be controlled and/or altered. The realism of the simulated haemorrhage can be increased.

According to a fourth aspect of the invention, there is provided a sucking chest wound simulation training system for simulating a sucking chest wound for training purposes, the system comprising: a fluid reservoir for storing fluid; an imitation wound-site element which is fluidly communicable with the fluid reservoir; a fluid flow path between the fluid 5 reservoir and the imitation wound-site element; and a control element which includes: a pressure controller for controlling a pressure in the fluid reservoir and/or on the fluid flow path, the pressure controller being configurable to generate a low fluid pressure to suck air into the imitation wound-site element from the ambient environment and/or to generate a high fluid pressure to expel fluid out through the imitation wound-site element; 10 and a flow-rate controller for controlling a flow rate of said fluid on said fluid flow path.

The training system can be used for different types of wounds, such as a haemorrhage but also a sucking chest wound. A sucking chest wound occurs when a hole is formed in the chest and is typically characterised by a hissing or sucking noise upon the injured person inhaling and exhaling. The sucking chest wound may additionally bleed. The training system enables a hissing or sucking sound at least, and optionally bleeding, to be emulated, thereby providing a simulation of a sucking chest wound.

According to a fifth aspect of the invention, there is provided a haemorrhage-simulation training system for simulating at least one haemorrhage for training purposes, said system comprising: a haemorrhaging-liquid reservoir for storing and pressurising fluid, the reservoir having a reservoir-outlet; a simulated wound-site element having a wound-site outlet; a fluid conduit connectable to the reservoir-outlet and the wound-site outlet, the fluid conduit defining a fluid-flow path there between such that the reservoir-outlet is fluidly communicable with the wound-site outlet; a fluid-flow regulator along the fluid-flow path for regulating fluid flow along the fluid-flow path, the fluid-flow regulator being actuatable between an open condition and an at least partially closed condition; and a controller communicable with the fluid-flow regulator for actuating the valve from the closed condition into the open condition and vice-versa, the controller being configurable to actuate the fluid-flow regulator to simulate a varying pulse rate drop in pressure due to haemorrhaging-liquid reservoir emptying.

The invention will now be more particularly described, by way of example only, with reference to the accompanying drawings, in which: Figure 1 shows a first embodiment of a training system in accordance with the first aspect of the invention; Figure 2 illustrates a second embodiment of a training system in accordance with the first aspect of the invention; and Figure 3 shows a third embodiment of a training system in accordance with the first aspect of the invention.

Referring firstly to Figure 1, there is shown a training system, indicated generally at 10. The training system 10 emulates a wound or injury for training purposes. More preferably, the wound is a haemorrhage, but any alternative to a haemorrhage may be envisioned. Thus, the training system 10 may be alternatively referred to as a wound-simulation training system, an injury-simulation training system, or, in the case of a haemorrhage, a haemorrhage-simulation training system. The simulated wound may be a wound to any part of the body. For example, the simulated wound may be a wound to a chest, a head, a leg, an arm, a torso, a foot, a hand, a finger, a toe, or any other body part. The training system 10 or any part thereof may comprise metal, plastics, wood, glass, fibreglass, carbon fibre, fabric, felt, magnetic material, ferrous material, silicone, any other suitable material, or any combination thereof. The training system 10 includes a reservoir 12, a conduit 14, an imitation wound-site element 16, a control element 18, and fluid, although any of these features may be omitted and/or a plurality of any of these features may be provided.

The reservoir 12 in-use stores the fluid. More preferably, the reservoir 12 stores fluid under pressure. The reservoir 12 may therefore be referred to as a fluid reservoir, a haemorrhaging-liquid reservoir or container, a chamber, a pressure chamber. The reservoir 12 has a reservoir body 20, a fluid outlet 22, a fluid inlet, not shown, and a volume, although any of these features may be omitted and/or a plurality of any of the features may be provided. For instance, instead of an inlet distinct from an outlet, the inlet and the outlet may be one and the same. The reservoir body 20 is preferably a rigid container, but a non-rigid container or a partly rigid container may be envisioned.

The fluid outlet 22 enables the reservoir 12 to be emptied of the fluid. The fluid outlet 22 may be referred to as a haemorrhaging-fluid outlet or haemorrhaging-liquid outlet.

The fluid inlet enables the reservoir 12 to be at least partly filled with fluid. The fluid inlet 30 may be referred to as a first fluid inlet, a haemorrhaging-fluid inlet or haemorrhaging-liquid inlet. The inlet and/or outlet 22 may enable flow of one or more of: gas, haemorrhaging-liquid or any other fluid. Preferably in the shown embodiment, there is one fluid inlet and one fluid outlet 22, but none, or at least two of either or both features may be envisioned.

The fluid outlet 22 and/or the fluid inlet may be positioned anywhere on the reservoir body 20. The fluid outlet 22 may be positioned away from an in-use lower end of the 5 reservoir 12 if the reservoir 12 maintains the fluid in a pressurised condition and/or if the volume of the reservoir body changes to match the volume of the fluid. In the shown embodiment, the fluid outlet 22 is provided near an in-use upper end or end portion of the reservoir 12. However, the fluid outlet may be positioned at or adjacent an in-use lower end or lower end portion of reservoir body. This may be beneficial to enable fluid 10 exit from the reservoir due at least in part to gravity, particularly if the fluid is not pressurised.

Flow through the or each fluid inlet and the or each fluid outlet is preferably one way, but any inlet and/or any outlet may alternatively enable two-way flow. In other words, the inlet may function as an outlet when required, or vice versa.

The inlet and/or outlet 22 may optionally be selectably closeable. In other words, the or each fluid inlet and/or the or each fluid outlet 22 is preferably sealable, but non-sealable is an option. For instance, the inlet and/or outlet may be permanently open. A cap, top, a screw top, a flap, a valve, a stopper, a gate, a door, or any other sealing portion may optionally be provided. The valve may be a one-way valve, such as a check valve.

Backflow may be prevented or inhibited. The inlet and/or outlet 22 may be actuatable between an open condition and a closed condition.

Optionally, the inlet and/or outlet 22 may be biased by a biasing means or mechanism to remain in a default condition. The default condition may be one of the closed condition and the open condition. If moved away from the default condition, the biasing means or mechanism may provide a biasing force towards the default condition. If the closed condition is the default, this may prevent or inhibit leakages of fluid and/or help maintain a specific pressure within the reservoir 12.

It may even be envisioned that connecting the conduit 14 and/or tubing is necessary to reconfigure or actuate the inlet and/or outlet 22 into the open condition. "Mien received 30 at least in part in the inlet and/or outlet, the conduit 14 and/or tubing may act against the biasing means to open the inlet and/or outlet 22.

The volume, also referred to as a space or cavity, receives and/or at least temporarily retains the fluid. The volume may be defined by at least one internal wall of the reservoir body 20. However, it could be envisioned that the reservoir may comprise a secondary internal body or container at least partly within the reservoir body. The secondary internal body may define the volume instead. Preferably, the volume is fixed or constant, but a non-constant volume may be envisioned.

The conduit 14 defines or provides at least a portion of a fluid flow path from the reservoir 12 to the wound-site element 16 at least. If the fluid is a liquid, the fluid flow path may be referred to as a liquid flow path. More preferably, the conduit 14 is connected or connectable to the fluid outlet 22. The conduit 14 is also connected or connectable to the wound-site element 16. Preferably, the conduit 14 comprises a duct, tube or tubing, but any alternative may be envisioned. Preferably, the conduit 14 has just one tube as this reduces the risk of leaks and/or accidental disconnection, but a plurality of tubes may be an option.

For clarity, the fluid flow path extends at least from within the reservoir 12, and optionally upstream of the reservoir 12 until at least the wound-site element 16 and optionally downstream thereof. The fluid flow path may comprise a plurality of fluid flow path portions.

The conduit 14 is preferably flexible or bendable, but non bendable is an option. This may be enabled, for example, by using deformable plastics to at least partly form the conduit 14. The conduit 14 may be circular or substantially circular in transverse cross-section, but non-circular may be an option. The conduit 14 may optionally be extendable and/or compressible or collapsible radially. In other words, a cross-sectional area of a lumen of the conduit 14 may be adjustable. On the other hand, a conduit which is radially non-collapsible and/or non-extendable, in other words, a rigid conduit, may prevent or inhibit accidental compression of the lumen and thereby, obstruction of the flow path. A rigid conduit may also prevent or inhibit collapse of the lumen due to a low pressure.

The imitation wound-site element 16 provides a simulation injury. The wound-site element 16 includes a wound-site fluid outlet 24, a support 26, and wound-imitation 30 material, not shown, although any of the above features may be omitted and/or a plurality of any of the features may be provided.

The wound-site fluid outlet 24 enables fluid to enter and/or, preferably exit, the flow path in-use. Simulated haemorrhaging-liquid exiting the wound-site fluid outlet 24 emulates a haemorrhage. To enable this, the conduit 14 is connectable to the wound-site element 16 and more preferably to the wound-site fluid outlet 24. In other words, the wound-site element 16 is preferably fluidly communicable, and more preferably liquidly communicable with the reservoir 12. The wound-site fluid outlet 24 is preferably through, in and/or on the support 26. The wound-site fluid outlet 24 may be connected or connectable, optionally releasably connectable, from the support 26 but preferably is integrally formed therewith.

The support 26 provides a base or supporting element for the wound-site fluid outlet 24 and/or wound-imitation material. The support 26 may include a wearable element, but this is optional.

The wearable element, also referred to as a wearable portion, enables the imitation wound-site element 16 to be worn by or placed in, on or around a user and/or a mannequin. The wearable element includes at least one pad as shown, but any alternative or additional element may be envisioned such as fabric, clothing, a cuff or any alternative wearable element. The shown pad is preferably concave as this shape may provide a better fit around a limb such as a leg or an arm, but non-concave may be an option. The wearable element may be deformable, foldable, pliable, but these are optional. For instance, the wearable may be rigid or substantially rigid. The wearable element may be stretchable, such as by being elasticated, or non-stretchable. The wearable element may optionally have an attachment portion, not shown, to help maintain the support 26 in place.

The attachment portion may include any of: an adhesive, tying elements, such as a lace, string, rope, elastic band or any other element which may interact with the user and/or the mannequin. Alternatively or additionally, the attachment portion may enable a portion of the wearable element to be engageable with another portion of the wearable element. For example, the attachment portion may include a hook, a button, a loop, a slit, a lace, complementary hook and loop portions, a popper, a zip, magnets, an adhesive, any other engagement means, a plurality of any of the above, or any combination thereof. The attachment portion may be omitted entirely. For instance, a tubular or substantially tubular wearable element may be receivable around a limb, head or torso. Interference fit may maintain such a tubular wearable element in position.

The wound-imitation material provides a more realistic injury. The realism may be increased for any or any combination of the senses. In other words, the realism may be improved visually. The injury may feel more realistic to the touch. Any material, such as gauze, paint, stuffing material, padding, cottonwool, textures, fabrics, silicone, artificial 5 tissue, live tissue, any other suitable material, or any combination of the above may be used to improve the visual and/or tactile realism. Live tissue may be lab-grown, for example. Optionally, the wound-imitation material may even include a heater or heating element, but this may be omitted. The heater may emit heat to emulate body warmth. The heater may be single use and/or re-usable. The heat may include an exothermic gel 10 pack, a heating patch or pad by way of example only.

The imitation wound-site element 16 may sound like a realistic injury, such as by providing gurgling, sucking noises, blowing noises, high-pressure jet noises, or any other appropriate sound or sounds. These noises may be provided naturally or mechanically by the fluid exiting the imitation wound-site element 16. Alternatively or additionally, the training system 10 may further comprise a speaker for emitting sound data.

The smell of the imitation wound-site element 16 may be more realistic. For example, the imitation wound-site element 16 and/or the fluid may emit a smell or odour, such as the smell of blood, optionally the smell of dry or drying blood, the smell of necrotic tissue, vomit, urine, feces, or any other smell. The smell may be provided by adding a chemical or essence to the fluid. As a smell may be sufficiently strong so as to solicit a gag reflex, nausea and/or vomiting, training to be able to carry out the life-saving procedures despite these inconveniences may be greatly beneficial. Smell may elicit or help recall memories more strongly, such that in an emergency, smelling an odour may help the first aider recall the life-saving procedures more easily and/or faster.

The control element 18 controls the flow of fluid in the training system 10. More preferably, the control element 18 controls characteristics of the fluid, such as pressure and/or flow rate. The control element 18 may comprise one or more controller sub-units. In other words, the control element 18 may comprise a hub or centralised sub-unit and/or devolved or disparate sub-units. Preferably, the control element 18 includes: a pressure controller 28, a pressure-monitoring element; a flow-rate controller, a user interface 30, a processor module, a memory unit, a time-measuring element, a power source, but any of the above features may be omitted and/or a plurality of any of the features may be provided.

The pressure controller 28 in-use controls, regulates and/or is able to alter a pressure of the fluid in the reservoir 12 and/or in or along fluid flow path. More preferably, the pressure controller 28 controls the pressure of the fluid directly but indirect control may be an option. For example, the pressure of any other feature, such as a second fluid may be controlled instead. The second fluid may act upon the notionally first fluid. In the shown embodiment, the pressure controller 28 includes a pump 32 and a flow-regulator, but either may be omitted and/or a plurality of either may be provided.

The pump 32, also referred to as a pump element, may cause, indirectly or directly, fluid movement and/or or may generate the potential for fluid movement. In the preferred embodiment, the pump 32 may enable the pressure of the fluid to be altered. In other words, the pump 32 may be actioned to pressurise any fluid within the reservoir 12. The pump 32 is preferably an internal pump 32 received fully or at least in part within the reservoir 12, but a pump external to the reservoir may be envisioned. An opening in the reservoir 12 may enable the internal pump 32 to be received at least partly within the reservoir and/or extend out of the reservoir 32. Optionally, the pump 32 may be selectably removable from the reservoir. Optionally, the opening for the pump 32 may be the same as the said fluid inlet, although the opening may be distinct from the fluid inlet. Thus, fluid may be inserted into the reservoir 32 via the said opening. The pump 32 may then optionally close or seal the opening.

In the shown embodiment, the pump 32 is a user-operated pump. However, a non-useroperated pump may be an option, such as an automatic and/or electronic pump. Any of a range of alternative embodiments of a user-operated pump 32 may be employed, as required. As shown, the pump 32 comprises a handle 34 and a piston element 36, but either feature may be omitted and/or a plurality of either may be provided. A pump-up pressure sprayer may be used by way of example.. As operated by hand, the user-operated pump may be referred to as a manual pump, manually-operated pump.

If provided, the flow-regulator in-use regulates the flow and/or pressure of the fluid in the reservoir 12 and/or fluidly downstream of the reservoir 12. The flow-regulator may alter the pressure by altering the cross-sectional area of the reservoir fluid outlet 22 and/or the lumen of the conduit 14. The flow-regulator may selectably enable flow in one direction or both directions. Optionally, the flow regulator includes a valve, referred to as a pressure valve for clarity, although a plurality may be provided and/or a pressure valve may be omitted or replaced with any other suitable device. More preferably yet, the valve is electronically actuated or electronically controlled, but a non-electronically controlled valve may be an option. Examples of non-electronically-actuated valves may include manual valves and/or automatic valves.

The flow-regulator and/or the valve thereof is preferably at or downstream of the reservoir 5 fluid outlet 22 along the fluid flow path, but upstream may be an option. The valve is preferably one of: a solenoid valve, a servo valve, and a proportional valve.

The fluid pressure may optionally be the fluid pressure in or at any or any combination of: the reservoir 12, the fluid inlet, the fluid outlet 22, the conduit 14, the control element 18, the pressure controller 28, the flow-rate controller, the wound-site outlet 24 or any 10 other desirable location of the training system 10.

Preferably, the fluid pressure may be constant or substantially or may vary throughout the simulation in the range of 68,948 Pa to 344,738 Pascal (Pa) or thereabouts, which may correspond to a range of 10 to 50 PSI or thereabouts, although any pressure outside of this range may be envisioned. More preferably, the pressure is in the range of 165,474 Pa to 248,211 Pa or thereabouts, corresponding to a range of 24 PSI to 36 PSI or thereabouts.

If the pressure decreases over the duration of the simulation, the pressure may be or be substantially in the range of 70,000 Pa to 350,000 Pa and more preferably in the range of 170,000 Pa to 250,000 Pa at the start of the simulation. During the simulation, the pressure may decrease to end in the range of 0 Pa to 170,000 Pa and more preferably in the range of 34,474 Pa to 96,527 Pa, corresponding to a range of 5 PSI to 14 PSI. Any values outside of these ranges may be envisioned, however.

If provided, the pressure-monitoring element monitors and/or estimates a pressure in the reservoir 12 and/or along the fluid flow path. The pressure monitored is preferably that 25 of the fluid, but this is optional. Preferably, the pressure-monitoring element includes a pressure sensor.

The pressure sensor may be received or receivable in and/or on the training system. More preferably, the pressure sensor may be received or receivable in and/or on the reservoir 12 and/or anywhere along the conduit 14. The pressure sensor may be for measuring the pressure of air and/or fluid, and may be referred to as an air-pressure sensor or a fluid sensor. The pressure sensor may measure pressure via a deviation, deformation or deflection of a part thereof. The pressure sensor may be any of: a gauge sensor, an absolute sensor or a differential sensor. Preferably, the pressure sensor is a piezoelectric sensor. A piezoelectric sensor may measure a change in pressure, strain, force, and output an electric signal accordingly. However, any alternative to a piezoelectric pressure sensor of air and/or fluid, may be envisioned, such as a potenfiometric pressure sensor, an inductive pressure sensor, a capacitive pressure sensor, a strain gauge pressure sensor, a variable reluctance pressure sensor, or any other suitable sensor.

The flow-rate controller controls, sets or defines a flow rate or velocity of the fluid along the flow path. The flow rate is the volume of fluid which passes per unit time. For example, the flow-rate controller may set the flow rate to zero or null such that there would be no fluid flow along the fluid flow path. The flow-rate controller preferably comprises a valve, although a plurality may be provided and/or any alternative to a valve may be envisioned. For clarity, the valve of the flow-rate controller may be referred to as the flow-rate valve. The flow-rate valve is preferably at or downstream of the fluid outlet 22 along the flow path. Similarly to the pressure valve, the flow-rate valve is preferably an electronically-actuated valve, and even more preferably is one of: a solenoid valve, a servo valve, and a proportional valve.

Preferably, the flow-rate controller is a pulsed flow-rate controller for controlling a pulsing flow rate of the fluid. In other words, the flow-rate controller releases pulses or predefined volumes of fluid along the flow path, preferably spaced apart by time intervals. An indication of the volume aspect of the pulsed flow rate can be provided by measuring the volume of fluid which passes per unit time. However, instead of the volume being continuous or substantially continuous over time, a maximum or greater volume of fluid, corresponding to a pulse, may be followed by either a smaller volume, a decreasing volume and/or no volume of fluid. The averaged pulsed flow rate may remain constant or substantially constant. However, the time-resolved pulsed flow rate may be variable. In other words, flow rate may change when measured at a sub-unit of time, the sub-unit being smaller than the unit of time.

Preferably, the averaged flow rate, whether pulsed or not, is in the range of 5 x10-6 m3.s1to 2.5 x10-5 m3.s-1, which corresponds to a range of 0.3 to 1.5 litres per minute [PM or thereabouts, although any average flow rate outside of this range may be envisioned. More preferably, the averaged flow rate is in the range of 7 x10-6 M3.S-1to 1 x10-5 re.S-1, corresponding to a range of 0.42 LPM to 0.6 LPM, and most preferably is 8.33 x10-6 M3.S1,, corresponding to 0.5 LPM. Optionally, the flow rate may vary or fluctuate within the above ranges.

Optionally, the flow rate may increase or, preferably, may decrease over time. The flow rate may be or be substantially in the range of 3 x10-6 m3.s-1 to 5 x105 m3.s-1 and more preferably in the range of 1 X10-5 M3.S-1 to 7 x10' rn3.s-1 at the start of the simulation. The flow rate may during the simulation, decrease to end in the range of 0 m3.s-1 to 7 x10-6 M3.S-1 and more preferably in the range of 0 m3.s-1 to 3.3 x10-6 m3.s-1 corresponding to a range of 0 LPM to 0.2 LPM or thereabouts.

The start or maximum of a pulse is separated from the start or maximum of a consecutive pulse by a time interval. The frequency of the pulses may be referred to as a pulse rate. For example, if the starts of two consecutive pulses is separated by one second, the pulse rate is 60 Hertz (Hz). This simulates a heart rate of 60 beats per minute. Thus, an indication of the pulsed aspect of the flow rate is provided by the pulse rate. Wien referring to a pulsed flow rate, either or both the pulse rate and the flow rate may be referred to.

The time intervals between each pulse of fluid are preferably all the same but the interval may be variable. The length of a notionally first time-interval may be greater or smaller than the length of a notionally second time interval. The length of a notionally third time interval may be greater or smaller than the length of the notionally second time interval. The intervals between consecutive pulses of fluid may increase and/or decrease. In other words, the pulse rate is preferably constant or substantially constant but the flow-rate controller may be configurable or adjustable to have a variable or varying pulse rate. The pulse rate may decrease and/or increase. The pulse rate may fluctuate or vary in the range of 20 Hz to 200 Hz, although any frequency outside of this range may be an option. More preferably, the pulse rate may fluctuate in the range of 70 Hz to 140 Hz.

Optionally, the pulse rate may decrease or increase monotonically or substantially monotonically over the duration of the simulation. An increasing pulse rate may be more physiologically realistic.

In the latter case, the pulse rate may be or be substantially in the range of 70 Hz to 140 Hz and more preferably in the range of 60 Hz to 80 Hz at the start of the simulation. The pulse rate may during the simulation, increase to end in the range of of 100 Hz to 200 Hz and more preferably in the range of 110 Hz to 150 Hz.

Optionally, the training system may even be able to emulate the atrial and ventricular systole of a simulated heartbeat. In other words, Each pulse may have two peaks of fluid 5 volume corresponding to atrial and ventricular contractions.

Optionally, the flow-rate controller may be in communication with the pressure-monitoring element if a pressure-monitoring element is provided. The flow-rate controller may optionally be actuated, configurable, reconfigurable or adjustable to alter the flow rate based on a pressure monitored by the pressure-monitoring element. In other words, the flow rate may change according to the fluid pressure. If the fluid flow is pulsed, more preferably, the pulse rate may change according to the fluid pressure. Even more preferably, the pulse rate may increase with a decreasing pressure.

The user interface 30 enables the user to interact with the training system 10 and/or the control element 18 thereof. The user interface 30 preferably includes an interactive 15 element 38, a screen 40, and a speaker, but any of these features may be omitted and/or a plurality of any of these features may be provided.

The interactive element 38 in-use enables the user to provide an input, such as turn the training system 10 on and/or off, or display and/or select information. The interactive element 38 may be referred to as an interactive portion, an input means, element or part.

In the simplest embodiment, the interactive element 38 may include a button, toggle, knob, switch element or switch, dial, or any similar part enabling an interaction between the user and the training system 10. The button or switch may be analogue, such as a physical button or switch which the user can press, push, move, squeeze or perform an action on. Non-analogue may be an option however, such as a digital button. The user interface may even have one or more analogue interactive elements and/or one or more non-analogue interactive elements. The interactive element 38 may optionally include a microphone or microphone element. This may enable a user to provide a voice input.

The screen 40 enables the training system 10 to provide or display an output to the user. The screen 40 may also enable the user to provide an input. For instance, the screen may display information corresponding to a plurality of options on the screen and the user can provide an input to select and/or modify one or more options. The user may be able to select the one or more option via the interactive element 38. Optionally, the screen 40 itself may be a tactile or interactive screen, such as a touch screen. This may enable the user to provide an input via interacting with the screen directly, such as by touching or positioning a finger on or adjacent the screen.

Any of: the output, the input, and a said option selectable by the user may be a parameter 5 or characteristic. The parameter displayed may be any or any combination of: simulated fluid flow-rate, simulated fluid pulse rate, fluid pressure, ambient pressure, the pressure of air in the reservoir 12, a pressure exerted by the user and/or tourniquet, time, time period since haemorrhage start, time period since haemorrhage end, estimated blood oxygen levels, status of the training system 10, status of any part of the training system 10 10, capacity status of the reservoir 12, status of the pressure controller 28, the status of the flow-rate controller, user profile, user previous session or sessions, a scenario description, such as a description of the injury and/or of the environment in which the injury occurred, any other desirable parameter, or a derivative of any of the above parameters.

Any of: the output, the input, and a said option selectable by the user may be a programme, such as a training programme. A training programme may comprise one or more pre-set parameters and/or instructions to modify those parameters.

Optionally, the user interface 30 may include a speaker for providing an auditory output to the user. The auditory output may be feedback to the user. This may be particularly useful for visually impaired users. The auditory output may be a sound of the wound, such as a sucking sound for a sucking chest wound. The sound may be sounds emitted by a person when experiencing the injury, such as pain, talking, shouting, threatening behaviour or any sound conveying an emotion such as anger, fear, and/or panic. The sound may be an answer or an explanation, such as how the wounded person is feeling, where they are experiencing pain, or what happened in the moments leading up to the injury. The answer or explanation may be in response to a question asked by the user being trained.

The processor module, also referred to as a processor or processor element, a programmable logic controller or PLC, not shown, enables processing of inputs and/or outputs. The processor module preferably also controls all or at least a subset of the parts of the control element 18. The processor module is therefore preferably communicable with all or at least a subset of the parts of the control element 18. The processor module preferably comprises at least one Printed Circuit Board or PCB.

The memory unit may store information or data. The stored data may include one or more values of any or any combination of the above-described parameters. The one or more values may include a reference value and/or a measured or calculated value. The memory unit may store one or more said training programmes.

A time-measuring element enables the training system 10 to track time and/or measure a time period. The time-measuring element, unit or portion may include a clock or clock element and/or a timer or timer element. The time-measuring element may be required to enable the flow-rate controller to set the pulse rate or time the pulses of fluid accurately.

The training system 10 may even include an Al module but this is optional. The Al module may optionally be able to automatically recognise a verbal input from the user and provide an output accordingly.

A power source in-use powers the control element 18 and/or the processor module. The power source may even power any other part of the training system 10, such as the reservoir 12 and/or a pump 32, if the part is electrically energisable. The power source preferably comprises at least one battery. If the power source is omitted, the training system 10 may comprise a power connection or connection means for enabling the training system 10 or part thereof to connect to a power source, such as the electric mains. The power source and power connection may even be omitted altogether. For example, the fluid may be pressurised and/or pumped manually by the user. The controller may mechanical and/or non-electronically operated. The controller may be manually controlled by the user.

The fluid preferably includes a liquid for simulating blood, but a gas may be envisioned. Thus, the fluid may be referred to as simulated haemorrhaging-fluid or simulated haemorrhaging-liquid. The fluid may be formed by suspending additives in a liquid. Preferably, the fluid comprises one or more properties which is or are the same or similar the properties of blood, for increased realism. The properties may include any or any combination of: consistency, viscosity, density, colour, clotting ability, smell, or any other desirable property. The fluid may even be real blood.

In-use, the user may need to assemble the training system 10 prior to use. The training system 10 may be provided as a kit of parts. If not already done, the processor module of the control element 18 is connected to or at least made to be communicable with all or any subset of the parts of the control element 18.

The conduit 14 is connected to the reservoir 12 at or adjacent an end of the conduit 14. If not integrally formed or already connected therewith, the or each imitation wound-site element 16 is connected to or adjacent to the or an opposing end of the conduit 14. The flow path is thereby created between the reservoir 12 and the imitation wound-site element 16. The wearable element can optionally be positioned on or around a body part of the or a further user and/or of a mannequin at any time.

The flow-rate controller and/or the pressure controller 28 are connected with the training system 10. More preferably, the pressure controller 28 is received in or on the reservoir 12 and/or the conduit 14. Similarly, the flow-rate controller may be received in or on the reservoir 12 and/or the conduit 14. The flow-rate controller may be any of: upstream, downstream, or level with the pressure controller 28 along the fluid flow path.

If a pressure-monitoring element is provided, the flow-rate controller may be connected to be communicable with the pressure-monitoring element. Communication between any parts of the training system 10 may be wireless or remote. Additionally or alternatively, communication between any parts of the training system 10 may be by wire, cable, or track, such as a circuit track.

Fluid may be inserted into the reservoir 12. Preferably, this is done via the fluid inlet of the reservoir. The fluid may be pre-pressurised before insertion into the reservoir. In the shown embodiment however, the fluid is not pre-pressurised. Once the reservoir contains at least some of the fluid, which is preferably liquid, the fluid in the reservoir can be pressurised. This may be done via the pump 32.

In the preferred embodiment, the user manually actuates the pump 32 to pressurise the fluid. The user does this via grasping the handle 34 and moving the handle 34 in at least one, and more preferably both directions at least once.

In other words, a movable portion of the piston element 36 of the pump 32 may be moved, such as by moving the handle 34, away and/or towards the fluid within the reservoir volume. This may enable the user to change the pressure of the fluid, at least relative to ambient pressure. In particular, the user may at least partly compress the fluid, directly or indirectly, thereby increasing the pressure of the fluid in the reservoir at least.

The fluid thereby has a higher pressure.

If the fluid is formed by suspending additives in a liquid to provide the simulation blood, an optional advantage of using a piston element 36 is that the piston element 36 may mix the fluid and maintain or substantially maintain the additives suspended and/or increase the homogeneity of the fluid.

The piston element 36 may be temporarily and/or selectably lockable in position. Once the fluid has been pressurised, the user preferably stops actuating the pump 32. Upon the fluid being drained from the reservoir 12, the pressure of the fluid preferably falls. It may easily be envisioned however, that the fluid pressure may be maintained constant, for example, by actuating the pump to compensate for a drop in pressure.

The flow-rate controller and/or the pressure controller 28 is or are in a condition whereby the fluid flow path is obstructed at least in part, at least until the simulation begins. The condition may be an off condition or closed condition. In other words, the fluid does not reach the wound-site fluid outlet 24. The flow-rate controller and/or the pressure controller 28 may be actuated or reconfigured into the closed condition manually and/or by part of the control element 18. Optionally, the user may "bleed" the conduit 14 to remove any air and/or residues from the training system 10 prior to use during the simulation. This may help to check the training system 10 is operational and/or prime the training system 10.

The training system 10 and/or the control element 18 may be turned on at any time.

To dismantle the training system 10, the above steps may be done in reverse. The reservoir 12 may be emptied by the fluid outlet 22, or optionally via the fluid inlet.

Once the training system 10 is ready for use, the user can turn the training system 10 on to provide a simulation injury. Optionally, the memory unit may store one or more programme with pre-set values of fluid pressure, flow rate and/or time periods between pulses. The user may optionally select such a programme, such as via the user interface 30.

The control element 18 actuates or reconfigures the flow-rate controller and/or the pressure controller 28. In particular in the present embodiment, the control element 18 and/or the processor may send an instruction to the pressure-controller 28. The instruction may be to open the pressure valve. If the pressure valve is already open, the instruction may be to alter the pressure. This may be done via a change in the cross-sectional area of the fluid flow path through the pressure valve. In other words, the pressure valve may have at least two different open conditions into which or between which the pressure valve may be actuated. For example, to reduce the pressure downstream of the pressure valve, the cross-sectional area of the pressure valve may be at least partly reduced. This is referred to a throttling the flow. A lower volume of fluid may be permitted into the conduit 14 downstream of the pressure valve.

Similarly, the control element 18 and/or the processor may send an instruction to the 5 flow-rate controller in addition to or instead of the pressure controller 28. The instruction may be to open the flow-rate valve, at least temporarily and/or partly. As simulating pulsing blood is desirable, the flow-rate controller may be instructed by the control element 18 and/or processor to repeatedly open and close sequentially. The flow-rate valve may be actuatable only between an open condition and a closed condition, but this 10 is optional. For example, the flow-rate valve may be actuatable into or between at least two different open conditions. This may provide throttling and pulsing simultaneously.

The user may set any or all of the fluid pressure, the flow rate, and the time periods between consecutive pulses to be constant or substantially constant. However, the user may alternative select any or any combination of: the fluid pressure, the flow rate, and 15 the pulse rate to be variable or varying.

Varying these parameters can be done by the user manually and/or via the control element 18. The control element 18 and/or processor may alter a parameter without any input from the user and/or without any further input following an initial input from the user. The control element 18 and/or the processor may be able to alter a parameter, such as the fluid pressure, flow rate or pulse rate automatically, for example in response to a change in pressure, flow rate or pulse rate.

For example, in one scenario, the control element 18 and/or the processor may maintain the pressure constant or substantially constant but the flow rate and/or the pulse rate may be changing or changeable over time. The flow rate and/or the pulse rate may increase or decrease. This may simulate heart palpitations and/or an increased or decreased heart rate. The changing variables may be changing monotonically or non-monotonically.

In another scenario, the control element 18 and/or processor may maintain the pulse rate and/or the flow rate constant or substantially constant whilst varying the fluid pressure. 30 For example, the fluid pressure may increase or decrease over time. The change may be a monotonic change. A drop in pressure may increase the realism of the simulation.

In a, notionally third, scenario, the control element 18 and/or the processor may vary the fluid pressure as well as the flow rate and/or the pulse rates over time. For example, the fluid pressure may decrease whilst the pulse rate and/or the flow rate may increase. Once again, the changes may optionally be monotonic changes. This simulates an increasing heart rate to compensate for a decreasing blood pressure, which may further improve the realism.

Any alternative scenario may be envisioned and/or programmed. Alternative parameters to pressure, flow rate and time between pulses may be alterable. For example, if multiple conduit sub-portions are provided to simulate arterial flow and venous flow, the control element 18 may alter which sub-conduit fluid flows in and/or the characteristics of the flow within each sub-conduit.

The control element 18 may change any of the parameters according to a pre-set value or series of values. For example, the duration between pulses may be decreased over time, irrespective of any other changes in any other parameter.

Preferably in the present embodiment however, a pressure-monitoring element is provided. The pressure-monitoring element is able, configured or configurable to measure and/or estimate the fluid pressure. The pressure-monitoring element may provide an output to the pressure controller and/or the flow-rate controller, optionally via the processor. The output may include a pressure reading and/or estimate.

As the reservoir 12 empties, the pressure of the fluid may decrease. The pressure control element 18 may or may not correct this decrease in pressure. However, upon receipt of the output from the pressure-monitoring element, the flow-rate controller may alter the flow rate and/or the pulse rate accordingly. Thus, the training system 10 may simulate an increasing heart rate and a simultaneously decreasing blood pressure.

If the reservoir 12 was not completely full of fluid at the start of the simulation, the pressure-monitoring element enables the training system 10 to adjust the simulation according to the state of the reservoir 12. This provides additional flexibility, for instance, compared with a training system in which the reservoir is assumed to be full at the start of every simulation.

Upon the pressure valve and/or the flow-control valve being actuated into an open condition, fluid is able to flow along the flow path. Open reaching the wound-site fluid outlet 24, a haemorrhage is simulated.

The user carries out the life-saving procedures. For example, in the case of a simulated femoral artery haemorrhage, the user being trained applies a tourniquet around the mannequin and/or user fitted with the training system. The tourniquet may compress the conduit 14, thereby at least in part obstructing the conduit 14. In turn, fluid flow along the flow path is restricted or stopped.

Thus, there is provided a method of increasing the realism of a simulated haemorrhage, by providing a simulated wound-site which can pulsingly release simulated haemorrhaging-liquid. The pulsing release simulates a pulse rate. The fluid pressure can optionally decrease with time to simulate decreasing blood pressure for increasing the realism of the simulated haemorrhage. Optionally, the pulse rate may even increase as the fluid pressure decreases for further increasing the realism of the simulated haemorrhage.

Referring now to Figure 2, there is shown a second embodiment of a training system 110. Features of the training system 110 of the second embodiment which are the same 15 or similar to features of the training system 10 of the first embodiment have the same or similar reference numerals with the prefix "1" added.

The second embodiment of the training system 110 is similar to the first embodiment of the training system 10, having a reservoir 112, a conduit 114, an imitation wound-site element 116 and a control element 118. Detailed description of the common features is omitted for brevity. The same caveats of the first embodiment apply to the second embodiment.

In the second embodiment, in addition to a notionally first, fluid inlet 142, the reservoir 112 additionally comprises a second fluid inlet 144 for letting a fluid, and more preferably a second fluid, into the reservoir 112, but this is optional. The second fluid may be the same as or similar to the above-described fluid of the first embodiment, but preferably, differs therefrom. For clarity, the above-described fluid may be referred to as a first fluid or haemorrhage simulation fluid. More preferably, the second fluid is a gas, and even more preferably, the second fluid is air. Thus, the second fluid inlet 144 may be referred to as a gas-inlet. All the same caveats of the first fluid inlet 142 may apply to the second fluid inlet 144.

Furthermore, instead of or in addition to an internal pump, the training system 110 and more preferably the pressure controller may further comprise an external pump, not shown. The external pump may be user-operable, but non-user-operable, such as automatic or electronically-operated may be options. The external pump may include a foot pump or bicycle pump. The external pump may be connectable to the first fluid inlet 142 and/or the second fluid inlet 144. This enables the second fluid to be inserted or injected into the reservoir 112. The second fluid may be used to pressurise the first fluid. The internal pump is preferably omitted in this embodiment but may be additionally provided. A plurality of pump may provided redundancy.

The uses of the second embodiment are similar to the uses of the first embodiment. Detailed description of the common steps is omitted for brevity. To pressurise the first 10 fluid, the user pumps the second fluid into the reservoir before, during or preferably, after the first fluid is received in the reservoir 112.

Referring now to Figure 3, there is shown a third embodiment of a training system 210. Features of the training system 210 of the third embodiment which are the same or similar to features of the training system 10 of the first embodiment have the same or similar reference numerals with the prefix "2" added. Any of the caveats in any of the embodiments may be applied to any of the other embodiments.

The third embodiment of the training system 210 is similar to the first embodiment of the training system 10, having a reservoir 212, a conduit 214, an imitation wound-site element 216 and a control element 218. Detailed description of the common features is omitted for brevity. In the shown embodiment, at least part of the control element 218 is preferably connected to or integrally formed with the reservoir 212. Furthermore, the user interface 230 includes a switch 246. The uses of the third embodiment are similar to the uses of the first embodiment. Detailed description of the common steps is omitted for brevity.

Whilst the reservoir body is preferably rigid, any non-rigid or partly rigid container may be an option. Non-rigid or partially rigid containers include a foldable container, a container with one or more pliable walls or surfaces, a bladder, an inflatable balloon, or any other suitable container. A non-rigid or partially rigid container may be easier to transport as lighter than a rigid container. Pliability or foldability may enable the system or at least the reservoir to be more easily stored. A foldable container may be easier to conceal in or on a mannequin or a person, for improved realism.

While the conduit preferably has only one tube, multiple tubes may be envisioned in an alternative embodiment. The tubes may be connected fluidly in series and/or fluidly in parallel with each other. These tubes may form conduit sub-portions. It may be envisioned that there may be a plurality of wound-site elements which the conduit may be connected or connectable with. The conduit may even connect with a plurality of the wound-site elements simultaneously.

The fluid flow within each conduit sub-portion may be independently controllable. A subset or all conduit sub-portions may have their own controller or parts thereof This may be useful to be able to simulate venous blood flow, arterial blood flow, air flow, by way of example. A dedicated air flow conduit may be useful for simulating a sucking chest wound for example. A dedicated air flow conduit may be useful to remove any air from the reservoir, if this is necessary for the pressurising and/or pumping of the fluid. The conduit may even have a conduit sub-portion for enabling refilling of the reservoir.

VVhilst the support preferably includes a wearable element, this may be omitted. The training system may additionally or alternatively include any of: a mannequin, a part of a mannequin, a body part or limb. The limb may preferably be an artificial limb. The 15 imitation wound-site element may optionally be integrated into the mannequin or limb.

The mannequin may comprise one or more ducts for providing a simulated vascular system or part thereof. The duct may connect or be connectable to the or a said wound-site fluid outlet. Thus, the conduit may be connected or connectable to the one or more ducts.

Optionally, the mannequin may comprise a deformable material, such as a plastic or foam. Upon a user applying a force thereto or therearound, such as with their hands and/or with a tourniquet, the deformable material may deform sufficiently to at least partly compress the conduit. In turn, this may stem the fluid flow. Instantaneous feedback is thereby provided.

Whilst the pressure-controller element and the flow-rate controller are preferably separate, it may even be envisioned that the flow-rate controller or part thereof and the pressure-controller element or part thereof may be one and the same. The pressure-controller element and the flow-rate controller may be a single unit or feature, which can control both pressure and flow simultaneously. For example, the pressure valve and the controller valve may be one and the same.

A valve may be repeatedly actuated between a first open condition and a second open condition. Thus, there may be fluid flowing at all times in the conduit and/or from the wound-site outlet with temporary increases in fluid volume and/or pressure due to the temporary actuation into the second open condition, to simulate pulses of blood.

Whilst the pressure valve and the flow-rate valve are preferably one of: a solenoid valve, a servo valve and a proportional valve, any alternative actuated valve may be envisioned for either or both valves. In a further modification, any alternative valve may be envisioned, such an isolation valve, a regulation valve, a safety relief valve, a non-return valve, or a special purpose valve. Examples of an isolation valve may include a pinch valve, a ball valve, a diaphragm valve, a piston valve, a butterfly valve, a gate valve, a plug valve. Examples of a regulation valve may include a pinch valve, a ball valve, a diaphragm valve, a globe valve, a butterfly valve, a pin valve, a needle or valve, and a plug valve. Safety relief valves may include pressure release and vacuum relief valves. Non-return valves may include check valves, such as swing check and lift check valves. A special purpose valve may include a float valve, a foot valve, a knife gate valve, a multi-port valve, and a line blind valve. If the pressure valve and the flow-rate valve are one and the same, the valve may be any of a solenoid valve, a servo valve and a proportional valve or any of the above-described valves.

Although a pump is preferable used, the pump may be omitted entirely. For example, the fluid may be inserted into the reservoir when the reservoir and/or the fluid may be pre-pressurised such that a pump may be omitted. Alternatively, the reservoir may elastically deform to accommodate fluid. When in a stretched condition, the elastically-deformable reservoir attempts to return to a non-stretched condition. In turn, this applies a force upon the fluid, thereby pressurising the fluid without requiring a pump.

The pump may be positioned anywhere relative to the reservoir and/or along the conduit. The pump may be connected or connectable fluidly upstream of any of: the reservoir, the or a said fluid inlet of the reservoir, the or a said fluid outlet of the reservoir, the conduit, the pressure controller, the flow-rate controller, the pressure-monitoring element, the imitation wound-site element, and the wound-site fluid outlet. Simultaneously, the pump may be connected or connectable fluidly downstream of any of: the reservoir, the or a said fluid inlet of the reservoir, the or a said fluid outlet of the reservoir, the conduit, the pressure controller, the flow-rate controller, the pressure-monitoring element, the imitation wound-site element, and the wound-site fluid outlet. The pump may even be connected or connectable at any of: the reservoir, the or a said fluid inlet of the reservoir, the or a said fluid outlet of the reservoir, the conduit, the pressure controller, the flow-rate controller, the pressure-monitoring element, the imitation wound-site element, and the wound-site fluid outlet.

There is preferably only one pump in all the above embodiment, however, a plurality of pumps may be envisioned.

Whilst preferably user-operated, a non-user operated pump may be used, such as any electronic, electric or powered pump. In other words, an electrically energisable pump may be used. The pressure controller or any part thereof may be controlled by the processor. More preferably, the pump and/or the flow regulator may be controlled by the processor. Thus, the process can alter the fluid pressure.

Any type of pump may be used, such as a peristaltic pump, a diaphragm pump, a centrifugal pump, a submersible pump, a fire hydrant system, a gear pump, a lobe pump, a piston pump, or any other type of pump. For example if a peristaltic pump is used, the peristaltic pump may be provided around the conduit.

Certain types of pump, such as pulsatile pumps may function by moving defined volumes of fluid along the flow path. A diaphragm pump or a peristaltic pump may be an example of a pulsatile pump. This may enable these pumps to control any combination or all of the fluid pressure, the flow rate and the pulse rate simultaneously. The pump may act as a valve. No separate flow regulator or valve may be required. Instead of increasing the fluid pressure of the reservoir, the operation of such a pump may cause a low pressure at or adjacent the fluid outlet. The low pressure sucks or draws fluid from the reservoir into the conduit.

Whilst the pressure-monitoring element preferably includes a pressure sensor, any alternative to a pressure sensor may be envisioned. For example, the pressure-monitoring element may include a sonar element and/or a lidar element. The sonar element and/or a lidar element may enable detection of a height of fluid within the reservoir via pulses of sound and/or light. The pulses may be reflected on a surface of the fluid. The timing or duration between emission and receipt of the reflected pulses of sound and/or light may enable the location or height of the surface of the fluid to be estimated. The control element may further comprise data relating to a reference fluid level. The reference fluid level may be any level of the reservoir, but preferably may correspond to a maximum height of the fluid. In other words, the level of the surface when the reservoir is full may be considered to be the reservoir maximum-capacity reference fluid level. In yet again other words, the control element may include a reference height or location of the surface of the liquid. The control element may optionally further comprise a pressure-calculating element, module, or portion.

The pressure-calculating element may optionally be part of the processor. The pressure-calculating element may enable calculation or estimation of a pressure of the fluid. The 5 pressure-calculating element may comprise data about the density of the fluid and/or the total volume of the fluid when the reservoir contains fluid up to the reference fluid level. Based on these parameters, and the detected height of fluid, the pressure-calculating element can estimate the weight of the fluid. The pressure-calculating element can thereby estimate the fluid pressure at a location or height of the reservoir, such as at the 10 fluid outlet. The pressure may be derived from a ratio of the measured volume over the total volume, by way of example.

Optionally, the control element may further comprise at least one of a receiver, an emitter, and a transceiver for enabling one-or two-way wireless communication with a further emitter, receiver or transceiver. For example, the further emitter, receiver or 15 transceiver may be provided in or on a personal communications device, such as a phone, and more preferably, a smartphone. A software application may be provided on the smartphone. This may enable the user to provide and/or receive an output via the software application. A communication channel may be established between transceiver or emitter and a transceiver or receiver. The communication channel may be wireless. 20 For example, the communication channel may be any of a Bluetooth (RTM) channel, a (RTM) channel, an internet channel, a satellite-communication channel, or any other desirable means of communication.

VVhilst the training system preferably simulates a haemorrhage, it may easily be used to simulate any other injury. A user may even be able to select which injury to simulate. For example, the same or substantially the same training system may be used to emulate a sucking chest wound. The fluid may optionally comprise gas, or even may consist of gas. The gas may be air. In this alternative embodiment, the training system for simulating a sucking chest wound may comprise a fluid reservoir for storing fluid; an imitation wound-site element which is fluidly communicable with the fluid reservoir; a fluid flow path between the fluid reservoir and the imitation wound-site element. The training system may further comprise a control element. The control element may include a pressure controller for controlling a pressure in the fluid reservoir and/or on the fluid flow path. Detailed description of the common features is omitted for brevity.

The control element may be used to generate a fluid pressure in the reservoir and/or on the fluid flow path. If the fluid pressure is low relative to an environmental pressure, the pressure differential may enable air to be sucked or drawn into the imitation wound-site element from the ambient environment. The pressure controller may pump fluid out of the reservoir in order to create a pressure which is lower relative to the environmental pressure. Fluid may be pumped out via an outlet in or on the reservoir, by way of example. Fluid may be pumped out via the imitation wound-site element and/or conduit, by way of example. The fluid pressure in the training system and/or the reservoir may even be negative. The fluid may be air. In other words, the pressure controller may form a vacuum or partial vacuum. The rigid container of the reservoir may be particularly beneficial as a rigid container has a reduced likelihood of collapsing under a vacuum. In-use, fluid, such as air, may be drawn into the reservoir from the ambient environment via the imitation wound-site element and/or conduit.

Alternatively, the control element and/or the reservoir may be used to generate a fluid pressure which is higher than the environmental pressure. The higher pressure may enable the training system to push, vent or expel fluid out through the imitation wound-site element. Optionally, control element may include a flow-rate controller for controlling a flow rate of said fluid on said fluid flow path. The control element may optionally even be able to repeatedly increase and decrease the pressure. This may enable the training system to simulate the effect of breathing on the simulation wound. Beneficially, the training system may emulate sounds, such as hissing and/or sucking, typically associated with sucking chest wounds. This may be enabled by a speaker. Alternatively or additionally, the dimensions of the fluid flow path and/or characteristics of the flow, such as flow velocity and/or pressure, may be chosen so as to create the sounds mechanically. For example, the dimensions of the wound fluid outlet may be selected so as to vibrate due to fluid flow through the fluid outlet, thereby generating a sound. A sucking chest wound may additionally haemorrhage. Thus, the fluid may comprise only liquid, only gas, or both gas and simulation haemorrhage-liquid. The gas and simulation haemorrhage-liquid may flow along the same conduit or conduit sub-portion.

Alternatively, the gas and simulation haemorrhage-liquid may flow along different conduit sub-portions.

VVhilst a preferred shape may have been specified for any of the above-described any alternative shape may be envisioned in any of lateral or cross-section, longitudinal cross-section, in side view, or in plan view. The shape may be any or any combination of: curved, part curved, non-curved, linear, part linear, non-linear, a broken line, any polygon, whether regular or irregular, having one or more chamfered and/or rounded corners, a triangle, a quadrilateral, such as a square, a rectangle, a trapezium, a trapezoid, a pentagon, a hexagon, a heptagon, an octagon, or any other polygon, a cross, an ellipse, a circle, part circular, an oval, or any abstract shape.

It is therefore possible to provide a haemorrhage-simulation training system which has a control element which includes: a pressure controller for controlling a pressure in the haemorrhaging-liquid reservoir and/or on the liquid flow path; a pressure-monitoring element for monitoring said pressure; and a pulsed flow-rate controller for controlling a pulsing flow rate of simulated haemorrhaging-liquid on liquid flow path, the pulsed flow-rate controller being in communication with the pressure-monitoring element and the pulsed flow-rate controller being configurable to alter a pulsed flow rate based on a pressure monitored by the pressure-monitoring element. The ability to alter the pressure and the ability to vary the timing of pulses provides the option to increase the realism of the simulation. Furthermore, if a pressure-monitoring element is provided, the pulsed flow rate may vary automatically in response to the pressure, due to the communication between the pressure-monitoring element and the flow-rate controller.

It is also possible to provide a method of increasing the realism of a simulation by simulating a drop in blood pressure accompanied by a compensatory increase in 20 simulated heart rate.

It is further possible to provide training system to simulate a sucking chest wound, or at least a characteristic sound thereof. This is achieved by expelling or drawing in fluid, such as air, into a reservoir via an imitation wound-site element. The training system includes a control element which has: a pressure controller for controlling a pressure in a fluid reservoir and/or on a fluid flow path, the pressure controller being configurable, configured, adapted, or actuated to generate a low fluid pressure to suck air into the imitation wound-site element from the ambient environment and/or to generate a high fluid pressure to push fluid out through the imitation wound-site element; and a flow-rate controller for controlling a flow rate of said simulated fluid on said fluid flow path. The controller is able to cause and control fluid flow.

The words 'comprises/comprising' and the words 'having/including' when used herein with reference to the present invention are used to specify the presence of stated features, integers, steps or components, but do not preclude the presence or addition of one or more other features, integers, steps, components or groups thereof.

It is appreciated that certain features of the invention, which are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the invention which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable sub-combination.

The embodiments described above are provided by way of examples only, and various other modifications will be apparent to persons skilled in the field without departing from 10 the scope of the invention as defined herein.

Claims (25)

1. Claims 1. A haemorrhage-simulation training system comprising: a haemorrhaging-liquid reservoir for storing simulated haemorrhaging-liquid, the reservoir having a haemorrhaging-liquid outlet; an imitation wound-site element which is liquidly communicable with the haemorrhaging-liquid reservoir; a liquid flow path between the haemorrhaging-liquid outlet and the imitation wound-site element; and a control element which includes: a pressure controller for controlling a pressure in the haemorrhaging-liquid reservoir and/or on the liquid flow path; a pressure-monitoring element for monitoring said pressure; and a pulsed flow-rate controller for controlling a pulsing flow rate of said simulated haemorrhaging-liquid on said liquid flow path, the pulsed flow-rate controller being in communication with the pressure-monitoring element and the pulsed flow-rate controller being configurable to alter a pulsed flow rate based on a pressure monitored by the pressure-monitoring element.
2. 2. A training system as claimed in claim 1, wherein the haemorrhaging-liquid reservoir includes a rigid container.
3. 3 A training system as claimed in claim 1 or claim 2, wherein the pressure controller comprises an internal pump received at least in part within the haemorrhaging-liquid reservoir for pressurising the simulated haemorrhaging-liquid.
4. 4. A training system as claimed in any one of the preceding claims, wherein the haemorrhaging-liquid reservoir further comprises a gas-inlet.
5. A training system as claimed in claim 4, wherein the pressure controller comprises an external pump connectable to the gas-inlet for pumping gas thereinto to pressurise the simulated haemorrhaging-liquid.
6. 6 A training system as claimed in claim 3 or claim 5, wherein at least one of the said internal pump and external pump is a non-electrically-energisable user-operated pump.
7. 7 A training system as claimed in any one of the preceding claims, wherein the pressure controller further comprises a valve at or downstream of the haemorrhaging-liquid outlet along the liquid flow path.
8. 8 A training system as claimed in any one of the preceding claims, wherein the pulsed flow-rate controller further comprises a valve at or downstream of the haemorrhaging-liquid outlet along the liquid flow path.
9. 9. A training system as claimed in claim 7 or claim 8, wherein the or at least one of the valves is a solenoid valve.
10. 10. A training system as claimed in any one of claims 7 to 9, wherein the or at least one of the valves is a servo valve.
11. 11. A training system as claimed in any one of the preceding claims, wherein the pressure-monitoring element includes a pressure sensor.
12. 12 A training system as claimed in any one of the preceding claims, wherein the pressure-monitoring element includes a sonar element and/or a lidar element for detecting a surface of the haemorrhaging-liquid within the haemorrhaging-liquid reservoir via the timing of reflected pulses of sound and/or light respectively, the control element further comprising: data relating to a reference haemorrhaging-liquid-surface level and a pressure-calculating element for calculating a pressure of the liquid based on the said data relating to a reference haemorrhaging-liquid-surface level and the detected surface of liquid.
13. 13. A training system as claimed in any one of the preceding claims, wherein the control element further comprises a user interface.
14. 14. A training system as claimed in claim 13, wherein the user interface includes an interactive element.
15. 15. A training system as claimed in claim 13 or claim 14, wherein the user interface includes a screen for providing an output to the user and/or enabling the user to provide an input via the screen.
16. 16. A training system as claimed in any one of claims 13 to 15, wherein the user interface includes a speaker for providing an auditory output to the user.
17. 17 A training system as claimed in any one of the preceding claims, wherein the control element further comprises at least one of: a receiver, an emitter, and a transceiver communicable via a wireless communication channel with a further emitter, receiver or transceiver for enabling one-or two-way wireless communication therebetween.
18. 18. A training system as claimed in any one of the preceding claims, wherein the control element further comprises a time-measuring element.
19. 19. A training system as claimed in any one of the preceding claims, wherein the imitation wound-site element further comprises a wearable element such that the imitation wound-site element is wearable by a user and/or a mannequin.
20. 20. A training system as claimed in any one of the preceding claims, further comprising a mannequin, the imitation wound-site element being integrated into the mannequin.
21. 21. A training system as claimed in any one of the preceding claims, further comprising simulated haemorrhaging-liquid. 30
22. 22. A method of increasing the realism of a simulated haemorrhage, the method comprising the steps of providing a simulated wound-site pulsingly releasing simulated haemorrhaging-liquid at a decreasing fluid pressure to simulate pulse rate and decreasing blood pressure for increasing the realism of the simulated haemorrhage.
23. 23. A method as claimed in claim 22, wherein the pulse rate increases as the fluid pressure decreases for further increasing the realism of the simulated haemorrhage.
24. 24. A haemorrhage-simulation training system comprising: a haemorrhaging-liquid reservoir for storing simulated haemorrhaging-liquid, the reservoir having a haemorrhaging-liquid outlet; an imitation wound-site element which is liquidly communicable with the haemorrhaging-liquid reservoir; a liquid flow path between the haemorrhaging-liquid outlet and the imitation wound-site element, and a control element which includes: a pressure controller for controlling a pressure in the haemorrhaging-liquid reservoir and/or on the liquid flow path and a pulsed flow-rate controller for controlling a pulsing flow rate of said simulated haemorrhaging-liquid on said liquid flow path.
25. 25. A sucking chest wound simulation training system for simulating a sucking chest wound for training purposes, the system comprising: a fluid reservoir for storing fluid; an imitation wound-site element which is fluidly communicable with the fluid reservoir; a fluid flow path between the fluid reservoir and the imitation wound-site element; and a control element which includes: a pressure controller for controlling a pressure in the fluid reservoir and/or on the fluid flow path, the pressure controller being configurable to generate a low fluid pressure to suck air into the imitation wound-site element from the ambient environment and/or to generate a high fluid pressure to expel fluid out through the imitation wound-site element; and a flow-rate controller for controlling a flow rate of said fluid on said fluid flow path.