JP4993971B2 - Tracheal intubation training device - Google Patents

Description

  The present invention relates to a tracheal intubation training apparatus, and more particularly to a tracheal intubation training apparatus that can objectively evaluate a tracheal intubation technique performed by a doctor, a paramedic, or the like.

  Consciousness disturbances and cardiopulmonary arrest occur due to illness or accident, and when general anesthesia is performed during surgery, the muscles in the lower jaw of those patients relax and the root of the tongue (lingual root) sinks. As a result, the air passage (airway) from the patient's mouth to the lungs is partially blocked, and air is not supplied to the patient's lungs. In such an airway obstruction state, a doctor or a paramedic inserts a tracheal intubation tube into the airway from the patient's mouth and forcibly sends air into the patient's lungs by the tracheal intubation tube. In this procedure, first, a device called a laryngoscope having a substantially L shape in a side view is used, a blade on the tip side is put into the mouth, the sinking tongue root portion is raised, and the occluded portion of the airway is lifted. While confirming the condition of the mouth, insert the tracheal intubation tube from the mouth into the airway. Here, the tracheal intubation tube includes a tube body provided with an air blowing portion on the most distal side thereof, and a cuff provided around the tube body slightly behind the blowing portion. . The cuff is provided in a balloon shape that can be expanded and contracted according to the amount of air injected into the cuff, and when the blowing portion reaches an appropriate intratracheal position in the airway, Air is sent into the cuff and expands to bring the cuff into contact with the tracheal wall. In this state, air from outside the body passes through the tube body and is supplied from the blowout portion into the trachea. At this time, the gap formed between the outer side of the tube body and the tracheal wall is closed by the cuff around the tube body. As a result, it is possible to prevent air supplied in the lung direction from the blowing portion located deeper in the trachea than the cuff from flowing back to the outside of the body, which is the opposite side of the lungs. Foreign substances such as gastric juice from the esophagus can also be prevented from entering the lungs.

In such a tracheal intubation treatment, since it is contending for a moment, the tracheal intubation tube must be inserted instantaneously and appropriately into the airway, and daily training is essential for this purpose. For such training, a training tool such as a mannequin model disclosed in Patent Document 1 is used. The model is equipped with an airway structure that mimics the airway and an esophagus structure that mimics the esophagus, so that tracheal intubation training can be performed while also using an esophageal intubation detector used for secondary confirmation at the emergency site. It has become. In other words, this model is for training so that the tracheal intubation tube is not accidentally inserted into the esophagus during tracheal intubation, and such an erroneous insertion into the esophagus can be detected by an esophageal intubation detector. ing.
JP 2005-227372 A

  By the way, at the time of tracheal intubation, there are various points to be noted in addition to preventing erroneous insertion of the tracheal intubation tube to be trained in the model of Patent Document 1 into the esophagus, and training taking these points into consideration is also possible. Necessary.

  For example, when using the laryngoscope to raise the tongue base, it is necessary to apply the blade on the tip side of the laryngoscope to the appropriate portion of the tongue, and the tongue can be lifted well by rotating the laryngoscope with this as a fulcrum. However, since beginners sometimes rotate the laryngoscope with the wrong part as a fulcrum and do not lift the tongue well, the correct part that becomes the fulcrum of the laryngoscope can be found accurately and the part can be quickly found. Training to hit the blade is required. Also, when lifting the tongue with the laryngoscope, the blade may come into contact with the maxillary anterior teeth and the teeth may be broken.Do not press the maxillary anterior teeth with the blade when the laryngoscope rotates. There is also a need to train.

  Furthermore, when the tracheal intubation tube is taken in and out, the tracheal intubation tube passes through the gap formed at the center of the vocal cord. At this time, the tracheal intubation tube may be damaged by contact with the vocal cord. is there. Therefore, when putting in and out the tracheal intubation tube, it must be performed with careful attention to contact with the vocal cords.

  Moreover, the blowing part which becomes the forefront side of a tracheal intubation tube needs to be arrange | positioned in the intratracheal part before a bronchi. That is, when the blowout part reaches one trachea branched from the bronchi, a one-lung state in which air is supplied only to one lung is caused. Therefore, it is also necessary to train to reliably arrange the blowout part at an appropriate part in the trachea before the bronchus.

  Further, when air is injected into the cuff, if the cuff does not bulge, the backflow of the supply air from the blow-out portion as described above occurs. On the other hand, if the cuff bulges too much, the mucous membrane of the trachea wall may be damaged and cell necrosis may occur. Therefore, training to inflate the cuff with an appropriate pressure is also necessary.

  However, in the model of Patent Document 1, even if tracheal intubation training is performed using the model, it is not possible to obtain an objective evaluation of the entire tracheal intubation training in consideration of the above noted points. You can only figure out if the intubation tube was accidentally inserted into the esophagus. Moreover, in order to grasp the erroneous insertion of the esophagus, an esophageal intubation detector must be used in combination, and the evaluation cannot be performed when tracheal intubation training is performed without using the esophageal intubation detector.

  The present invention has been devised by paying attention to such problems, and its purpose is to consider various points to consider for tracheal intubation treatment when doctors, paramedics, etc. perform tracheal intubation training. An object of the present invention is to provide a tracheal intubation training apparatus that can objectively evaluate a tracheal intubation technique.

(1) In order to achieve the above object, the present invention evaluates a model in which a simulated airway simulating a living airway is formed, and evaluation of a tracheal intubation technique of a trainee who has inserted a tracheal intubation instrument into the simulated airway Means and
The model includes a simulated part of a living body exposed in the simulated airway, and a pressure sensor capable of measuring a pressing force when the tracheal intubation instrument contacts the simulated part,
The evaluation means adopts a configuration in which a tracheal intubation technique is evaluated in accordance with a measurement value of the pressure sensor.

(2) The present invention also includes a model in which a simulated airway simulating a living airway is formed, and evaluation means for evaluating a tracheal intubation technique of a trainee who has inserted a tracheal intubation instrument into the simulated airway,
The model includes an airway position detection sensor capable of detecting whether or not the tracheal intubation device is present in a predetermined region of the simulated airway,
The evaluation means adopts a configuration in which an evaluation of a tracheal intubation technique is performed according to a measurement value of the airway position detection sensor.

(3) The model further includes a simulated esophagus simulating a living esophagus, and an intra-esophageal position detection sensor capable of detecting whether the tracheal intubation device is present in the simulated esophagus,
The evaluation means may also employ a configuration in which a tracheal intubation technique is evaluated according to a measurement value of the position detection sensor in the esophagus.

(4) The model further includes a simulated part that can be moved manually, and an operation amount measurement sensor that can measure an operation amount of the simulated part,
The evaluation unit may be configured to evaluate a tracheal intubation procedure according to a measurement value of the motion amount measurement sensor.

  (5) Furthermore, it is preferable that the evaluation unit substitutes a value based on a measurement value of each sensor into a parameter of a preset evaluation function and calculates an evaluation value of the tracheal intubation technique. .

  According to the present invention, when a doctor, a paramedic or the like performs tracheal intubation training, an objective evaluation of the tracheal intubation technique for the training can be performed. By appropriately arranging each sensor at a site where care must be taken, the tracheal intubation technique can be evaluated in consideration of the points to be noted regarding the tracheal intubation procedure.

  In particular, according to the configuration of the above (1), the pressure sensor is arranged at a simulated site corresponding to a body site where a tracheal intubation device such as a tracheal intubation tube or a laryngoscope may come into contact. Objective evaluation of tracheal intubation procedure considering the points can be performed. Points to note here are, for example, whether the blade of the laryngoscope is placed at the proper position of the tongue base, whether the blade is not in contact with the maxillary anterior teeth, and whether the tracheal intubation tube is in contact with the vocal cords In addition, the pressure applied to the tracheal wall by the cuff of the tracheal intubation tube is appropriate.

  Further, according to the configuration of the above (2), by providing the intra-airway position detection sensor in a region in the simulated airway corresponding to the airway portion that should not allow the tracheal intubation instrument to enter during tracheal intubation treatment, Objective evaluation of tracheal intubation procedure taking into account points to note regarding false intrusions. The points to be noted here include, for example, whether or not the most distal side of the tracheal intubation tube reaches the bronchial portion.

  Furthermore, with the configuration of (3), the tracheal intubation device should not be allowed to enter the esophagus during the tracheal intubation procedure. Evaluation can be made.

  Further, according to the configuration of (4), it is required that a doctor, a paramedic, etc. incline the patient's head at an appropriate angle and open the lower jaw at an appropriate angle during tracheal intubation treatment. However, it is possible to objectively evaluate the preparation work for such a tracheal intubation treatment by measuring the movement amount of the simulated region such as the head and lower jaw with a movement amount measurement sensor.

  Further, with the configuration (5), the evaluation regarding the tracheal intubation procedure can be scored, and the result of the tracheal intubation training can be easily communicated to the trainer.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

  FIG. 1 shows a schematic configuration diagram of a tracheal intubation training apparatus according to the present embodiment. In this figure, a tracheal intubation training device 10 is a device for a trainer such as a doctor or a paramedic to perform tracheal intubation training using the tracheal intubation device 12, and as a result of the training, evaluation of the tracheal intubation technique is performed. Can be done. This tracheal intubation training apparatus 10 has an external shape that simulates the upper body part of a human body, and includes a model 14 in which tracheal intubation training using the tracheal intubation device 12 is performed, and a tracheal intubation technique performed on the model 14. And an evaluation means 15 for performing the evaluation.

  Here, the tracheal intubation device 12 includes a known tracheal intubation tube 17 and a laryngoscope 18.

  The tracheal intubation tube 17 includes a tube body 20 through which air passes, an air blowing portion 21 provided on the most distal side of the tube body 20, and a tube body 20 slightly behind the blowing portion 21. And a cuff 22 provided. The cuff 22 can inject air into the inside from the outside, and is provided in a balloon shape that can be expanded and contracted according to the amount of air injected. In the present embodiment, the surface of the cuff 22 is covered with the light-shielding reflecting material 23 so that the pressure measurement described later can be performed.

  The laryngoscope 18 is provided with a blade 25 that is substantially L-shaped in a side view on the tip side.

  The model 14 includes a cover 27 that simulates a surface portion of a human body, and a simulated body 28 that is covered with the cover 27 and that simulates a human body part necessary for tracheal intubation training.

  The simulated body 28 has a structure in which an airway structure from the mouth of the human body to the bronchus and an esophageal structure from the mouth are simulated. Specifically, as shown in FIG. 2, the simulated body 28 includes a head 30 corresponding to the head of a human body, a lower jaw portion 31 that extends to the upper right side of the head 30 in FIG. 2, and these heads. 30 and the lower jaw portion 31, and the upper mouth opening 32 fixed to the upper jaw portion 33 on the right side of the head 30 in FIG. 2, and the lower jaw portion 31 is provided on the left side in FIG. 2 and is disposed in the mouth interior 32, and the epiglottis 39 provided near the tongue root 37 on the back side of the mouth interior 32 to be the root of the tongue 36; A vocal cord part 41 provided on the right side in FIG. 2 of the epiglottis part 39, a trachea part 43 connected to the mouth interior 32 via the vocal cord part 41, and a mouth disposed on the lower side of the trachea part 43 in FIG. An esophageal portion 44 as a simulated esophagus that is connected to the inside 32 is provided. Here, the interior space of the mouth interior 32 and the trachea part 43 constitutes a simulated airway simulating the human airway. Further, the maxillary anterior teeth portion 34, the tongue portion 36, the tongue base portion 37, the epiglottis portion 39, and the tube wall 64 of the trachea portion 43 constitute a simulated part of the human body exposed in the simulated airway.

  The upper anterior teeth portion 34 is provided with pressure sensors 46 connected to the evaluation means 15 (see FIG. 1) at a plurality of locations on the surface of the mouth interior 32 side. As shown in FIG. 3, the pressure sensor 46 includes a base 48 fixed to the maxillary anterior teeth portion 34, a known photointerrupter 50 fixed on the base 48, and an elastic covering the periphery of the photointerrupter 50. A member 51 and a reflector 52 that covers the outer surface of the elastic member 51 are provided.

  The photo interrupter 50 includes a light emitting element 54 such as a light emitting diode and a light receiving element 55 such as a phototransistor.

  The elastic member 51 is formed of a gel-like member, but is not limited to this. The elastic member 51 is a member that has elasticity that can be deformed by an external pressing force and is formed of a translucent material. Anything is fine.

  The reflective material 52 has a predetermined light shielding property, specifically, prevents light emitted from the light emitting element 54 of the photo interrupter 50 from leaking outside the pressure sensor 46, and Light is prevented from entering the elastic member 51 from the outside.

  As described above, the pressure sensor 46 is configured so that the light emitted from the light emitting element 54 is reflected by the reflecting material 52 through the elastic member 51 and detected by the light receiving element 55. Here, when an external force is applied to the surface of the pressure sensor 46, the elastic member 51 is deformed according to the magnitude of the external force, and the distance from the photo interrupter 50 to the reflecting material 52 changes. Then, the amount of light detected by the light receiving element 55 changes, and the current value output from the light receiving element 55 changes. That is, the greater the pressure applied to the elastic member 51, the closer the photo interrupter 50 is to the reflecting material 52, the amount of light detected by the light receiving element 55 increases, and the current value output from the light receiving element 55 increases. As described above, the pressure sensor 46 is applied to the elastic member 51 by measuring the voltage associated with the change in the current value of the light receiving element 55 according to the deformation of the elastic member 51 due to the application of external force. The pressure can be grasped.

  The tongue portion 36 is formed in a shape close to the tongue by a material having elasticity close to that of a human tongue.

  As shown in FIG. 2, the tongue base portion 37 and the epiglottis portion 39 are attached with pressure sensors 57 having a structure substantially the same as the pressure sensor 46 provided on the maxillary anterior teeth portion 34 at a plurality of positions thereof. It has been. The pressure sensor 57 here is also connected to the evaluation means 15 of FIG.

  As shown in FIG. 4, the vocal cord portion 41 includes a tube portion 59, a pair of simulated vocal cords 60, 60 disposed on the left and right sides of the tube portion 59 in FIG. 4A, and each simulated vocal cord 60, 60 is provided on both the upper and lower surfaces in FIG. 4B, and includes a pressure sensor 62 connected to the evaluation means 15 in FIG.

  The tube portion 59 has an internal space that is continuous with each space of the mouth interior 32 and the trachea portion 43.

  The simulated vocal cords 60, 60 are provided in a thin plate shape and are arranged so as to close a portion other than the central portion of the internal space of the tube portion 59.

  The pressure sensor 62 has substantially the same structure as the pressure sensor 46 described with reference to FIG. 3, and the same reference numerals are used for the same or equivalent components as the pressure sensor 46, and description thereof is omitted. To do. Here, in the pressure sensors 62 and 62 positioned above and below in FIG. 4B, when a pressing force is applied to one of the elastic members 51, the one elastic member 51 is deformed, but the other side is deformed. The elastic member 51 is prevented from being deformed by a thin plate-like simulated vocal cord 60. Therefore, when an external force is applied to one of the pressure sensors 62 positioned above and below in FIG. 4B, the pressure is measured only by the one pressure sensor 62, and the other pressure sensor 62 has one pressure sensor. The external force applied to 62 is not affected.

  As shown in FIG. 5, the trachea portion 43 is provided with a tube wall 64, a plurality of pressure sensors 66 provided in the left region in the figure on the vocal cord portion 41 side and connected to the evaluation means 15 of FIG. 1, And a plurality of intra-airway position detection sensors 69 connected to the evaluation means 15 provided in the right region in FIG.

  As shown in FIGS. 5 and 6, the pressure sensor 66 is embedded in the pipe wall 64 in a state where it is exposed to the inside of the pipe wall 64 at intervals of about 120 degrees in the circumferential direction. A similar arrangement is provided. These pressure sensors 66 are provided at a portion where the cuff 22 of the tracheal intubation tube 17 must be positioned in order to perform proper tracheal intubation. Further, the pressure sensor 66 here has substantially the same configuration as the above-described pressure sensor 46 provided on the maxillary anterior tooth portion 34 except that the reflector 52 (see FIG. 3) is not provided. The same or equivalent components as those of the pressure sensor 46 are denoted by the same reference numerals and description thereof is omitted.

  Here, since the reflective material 23 described above is provided on the surface of the cuff 22 that expands inside each pressure sensor 66 during training, the light from the light emitting element 54 of the photo interrupter 50 of the pressure sensor 66 is transmitted to the cuff 22. Is reflected by the reflecting material 23 on the surface of the light and is detected by the light receiving element 55 of the same photo interrupter 50. Therefore, on the same principle as that of the pressure sensor 46 of the maxillary anterior tooth portion 34, the separation distance between the reflecting material 23 and the light receiving element 55 is changed by the expansion of the cuff 22, so that the tube wall 64 provided with each pressure sensor 66 is provided. It is possible to measure the pressure acting on the part. Further, since the pressure sensors 66 are provided at intervals of 180 degrees in the circumferential direction of the tube wall 64, it is possible to grasp whether or not the pressure applied from the cuff 22 to the tube wall 64 is uniform in the circumferential direction. Become.

  As shown in FIGS. 5 and 7, the airway position detection sensor 69 is composed of a pair of photointerrupters 71 and 71 that are relatively arranged at intervals of approximately 180 degrees in the circumferential direction, and the axial direction of the tube wall 64. It is arranged in multiple places. Here, the airway position detection sensor 69 is arranged in a posture rotated by approximately 90 degrees in the circumferential direction with respect to the adjacent sensor 69. Each photo interrupter 71 is embedded in the tube wall 64 in a state of being exposed inside the tube wall 64, and includes a light emitting element 54 and a light receiving element 55, similar to the photo interrupter 50.

  The pair of photointerrupters 71 and 71 that constitute each airway position detection sensor 69 is configured such that the light emitted from the light emitting element 54 of one photointerrupter 71 is irradiated with the other photointerrupter 71 as shown by the arrow in FIG. When the tracheal intubation tube 17 is positioned between the photointerrupters 71 and 71, light between the photointerrupters 71 and 71 is blocked, and light detection by the light receiving element 55 is detected. The amount will decrease. Therefore, by identifying the in-airway position detection sensors 69 provided at a plurality of locations in the axial direction in the tube wall 69, the voltage drop detected by the light receiving element 55 is specified, so that the most distal side of the tracheal intubation tube 17 is obtained. The position in the pipe wall 69 of the blowout part 21 can be grasped. These intra-airway position detection sensors 69 are provided in the vicinity of a portion where the blowing portion 21 should be positioned in order to perform proper tracheal intubation.

  As shown in FIG. 2, the esophagus portion 44 has a tube wall 75 that forms an internal space connected to the mouth interior 32, and a position in the esophagus that is provided in the tube wall 75 and connects to the evaluation means 15 in FIG. Sensor 76.

  The intra-esophageal position detection sensor 76 is a sensor having the same structure as the intra-airway position detection sensor 69, and has a configuration in which a pair of photo interrupters 77 are provided at a relative position of the tube wall 75 near the entrance of the esophagus portion 44. ing. This intra-esophageal position detection sensor 76 uses the same principle as the intra-esophageal position detection sensor 69 when the tracheal intubation tube 17 is erroneously inserted into the esophagus part 44, and the light between the photointerrupters 77 and 77 is tracheal intubation tube. Intrusion into the esophagus part 44 of the tracheal intubation tube 17 is detected by being interrupted by 17.

The evaluation means 15 is composed of software and hardware, and is composed of a plurality of program modules such as a processor, a processing circuit, and the like. The evaluation means 15 assigns numerical values to the parameters X _{1 to} X ₇ of the evaluation function stored in advance based on the measured values from the pressure sensors 46, 57, 62, 66 and the position detection sensors 69, 76. By substituting, the evaluation value Z of the tracheal intubation procedure is calculated.

The evaluation function here is expressed by the following equation.
Z = AX ₁ + BX ₂ + CX ₃ + DX ₄ + EX ₅ + FX ₆ + GX ₇ + H
A to H are constants.

The evaluation function obtains each numerical value to be assigned to the parameters X _{1 to} X ₇ in advance for each of a plurality of experts such as doctors and paramedics and a plurality of inexperienced persons, and performs a known discriminant analysis. The constants A to H are obtained so that the average of the evaluation values Z becomes 0, and it is determined that the greater the evaluation value Z, the better the tracheal intubation technique. In addition, a part or all of the constants A to H can be arbitrarily set by intentionally weighting.

As shown in FIG. 1, the evaluation means 15 includes a measuring unit 82 that obtains measurement results obtained by the pressure sensors 46, 57, 62, 66 and position detection sensors 69, 76, and an operation from the start to the end of training. A time counting unit 83 that counts time, a data calculation unit 85 that calculates values to be substituted into the parameters X _{1 to} X ₇ by a predetermined function from data of the measurement unit 82 and the timing unit 83, and a data calculation unit 85 An evaluation value calculation unit 86 for calculating the evaluation value Z and a display unit 87 for displaying the obtained evaluation value Z are provided by substituting the obtained values for the parameters X _{1 to} X ₇ of the evaluation function. It is configured.

In the data operation unit 85, values to be assigned to the parameters X _{1 to} X ₇ of the evaluation function are obtained from the measured values of the sensors 46, 57, 62, 66, 69, and 76 by a predetermined function. Here, the parameter X ₁ is a parameter related to the contact of the maxillary anterior 34 (see FIG. 2), is determined using the measured value of the pressure sensor 46 of the maxillary anterior 34. The parameter X ₂ is a parameter related to the contact of the tongue portion 36 and is obtained by using the measured values of the pressure sensor 57 of the tongue base portion 37 and the epiglottis portion 39. The parameter X ₃ is a parameter related to the contact of the vocal cord 41 and is obtained using a measurement value of the pressure sensor 62 of the vocal cord 41. Parameters X ₄ is a parameter related to the contact of the tube wall 64 of the trachea 43, is determined using the measured value of the pressure sensor 66 of the trachea 43. Parameters X ₅ is a parameter related to bronchial invasion is determined based on measurements of airway position detecting sensor 69. Parameter X ₆ is a parameter related to the esophagus intrusion is determined based on measurement of esophageal position detecting sensor 76. The parameter X ₇ is a parameter related to the treatment time, and the time measured by the time measuring unit 83 is used as it is.

The values substituted for the parameters X _{1 to} X ₇ are obtained as follows, for example. The numerical value to be substituted for the parameters X _{1 to} X ₄ is obtained by adding or subtracting the measured values of the pressure sensors 46, 57, 62, and 66 that are the targets of the parameters X _{1 to} X ₄ and multiplying by a predetermined gain. . Further, numerical values are substituted into the parameter X ₅ are the tracheobronchial position detecting sensor 69, and if the tracheal intubation tube 17 has been inserted is detected on the far side than the preset proper position, and if not A different constant can be assigned. Furthermore, a numerical value to be substituted for the parameter X ₆ is assigned a constant that differs depending on whether or not the tracheal intubation tube 17 is erroneously inserted into the esophagus portion 44 by the intra-esophageal position detection sensor 76. It is supposed to be.

In the evaluation value calculating unit 86, the value determined by the data operation unit 85 to the parameter X ₁ to X ₇ of the evaluation function is substituted, the evaluation value Z is calculated.

In addition, as parameters X _{1 to} X ₇ here, any index can be adopted as long as it is an index that influences the superiority and inferiority of the tracheal intubation technique. An evaluation function is obtained using discriminant analysis, and the evaluation function is applied. As other indicators, for example, at the time of tracheal intubation, a doctor or a paramedic or the like is required to tilt the patient's head at an appropriate angle and pull the lower jaw toward the chest to open it appropriately. However, the parameters relating to the operation may be set such that these parts can be operated by a trainee. At this time, the lower jaw 31 can be rotated with respect to the head 30, a potentiometer as an operation amount measuring sensor (not shown) is attached to the lower jaw 31, and a new parameter based on the detected angle can be set. Further, the potentiometer can be attached to the head 30 and a new parameter based on the detected angle can be set.

  Next, the flow of tracheal intubation training and evaluation using the tracheal intubation training apparatus 10 will be described.

  Time measurement by the time measuring unit 83 is started, and tracheal intubation training is started. Here, first, the blade 25 of the laryngoscope 18 shown in FIG. 1 is inserted into the mouth interior 32 by the trainee, and the trainee lifts the tongue 36 and uses the laryngoscope 18 to perform the epiglottis 39. And the presence of the vocal cord part 41 is confirmed. At this time, it is evaluated whether or not the blade 25 is in contact with the maxillary anterior teeth portion 34 based on the measurement value of the pressure sensor 46, and further, the tip side of the blade 25 is correct on the tongue base portion 37 based on the measurement value of the pressure sensor 57. It is also evaluated whether or not it is applied to the position.

  In this state, the trainee inserts the tracheal intubation tube 17 from the mouth interior 32 into the trachea 43. At this time, whether or not the tracheal intubation tube 17 interferes with the vocal cord part 41 is evaluated based on the measurement value of the pressure sensor 62, and the tracheal intubation tube is determined based on the measurement value of the esophageal position detection sensor 76. It will be evaluated whether 17 is erroneously inserted into the esophagus part 44.

  Then, when the trainee inserts the tracheal intubation tube 17 further into the tracheal part 43 and self-determines that the blowing part 21 of the tracheal intubation tube 17 is in an appropriate position before the bronchus, the tracheal intubation tube 17 Stop inserting. At this time, whether or not the tracheal intubation tube 17 is stopped at an appropriate position of the trachea portion 43 is evaluated based on the measurement value of the airway position detection sensor 69.

  Next, the trainer injects air into the cuff 22 from the outside of the body, inflates the cuff 22 to contact the tube wall 64 of the tracheal portion 43, and closes the gap around the tube body 20 by the cuff 22. At this time, whether or not the cuff 22 is in contact with the tube wall 64 with an appropriate pressure is evaluated based on the measurement value of the pressure sensor 66.

  Finally, the trainee sends air into the simulated body 28 through the tracheal intubation tube 17 and ends the training. At this time, the time from the start to the end of training is measured, and the time taken for tracheal intubation is evaluated.

  Therefore, according to such an embodiment, it is possible to evaluate a comprehensive tracheal intubation technique in consideration of points to be noted in tracheal intubation treatment.

  The evaluation means 15 obtains the evaluation value Z using the evaluation function, as described in the above embodiment, and based on the measurement values of the sensors 46, 57, 62, 66, 69, and 76. You may evaluate the technique. For example, each sensor 46, 57, 62, 66, 69, 76 is determined by determining whether or not the measured value of each sensor 46, 57, 62, 66, 69, 76 exceeds a preset threshold value. Depending on the points of attention of the procedure corresponding to the above, it may be determined whether it is good or bad, and may be evaluated and commented based on previously stored data.

  Further, the sensors 46, 57, 62, 66, 69, and 76 are not limited to the sensors having the structure described in the above embodiment, and may be replaced with sensors having other structures as long as the same function is achieved. You can also.

  Furthermore, an actuator that operates the tongue 36, the epiglottis 39, and the vocal cord 41 may be provided, and each of the parts 36, 39, and 41 may be configured to be movable or operable according to symptoms. By doing in this way, tracheal intubation training can be performed in a more realistic state.

  The model 14 simulates a human body, but simulates an airway part and an esophagus part of another animal, and has the same configuration as that of the present embodiment, so that the present invention can be used for animal tracheal intubation training. It is also possible to apply to an apparatus.

  In addition, the configuration of each part of the apparatus in the present invention is not limited to the illustrated configuration example, and various modifications are possible as long as substantially the same operation is achieved.

The schematic block diagram of the tracheal intubation training apparatus which concerns on this embodiment. The expanded sectional view of a simulation body. The expanded longitudinal cross-sectional view of a pressure sensor. (A) is sectional drawing of the airway near vocal cord part, (B) is sectional drawing which follows the AA line of (A). The expanded sectional view of a trachea part. Sectional drawing which follows the AA line of FIG. Sectional drawing which follows the BB line of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Tracheal intubation training apparatus 12 Tracheal intubation instrument 14 Model 15 Evaluation means 32 Inside of mouth (simulated airway)
34 Maxillary anterior teeth (simulated part)
36 Tongue (simulated part)
37 Tongue base (simulated part)
39 Epiglottis (simulated part)
41 Vocal cord part (simulated part)
43 Trachea (simulated airway)
44 Esophageal part (simulated esophagus)
46 Pressure sensor 57 Pressure sensor 64 Tube wall (simulated part)
66 Pressure sensor 69 Airway position detection sensor 76 Esophageal position detection sensor Z Evaluation value

Claims (5)

A model in which a simulated airway simulating a living airway is formed, and evaluation means for evaluating a tracheal intubation technique of a trainee who has inserted a tracheal intubation instrument into the simulated airway,
The model includes a simulated part of a living body that is exposed in the simulated airway, and a sensor that is disposed at each of a plurality of parts that must be handled carefully during a tracheal intubation procedure,
In the evaluation means, an evaluation function for calculating an evaluation value of the tracheal intubation procedure is stored in advance,
The evaluation function is obtained by multiplying a plurality of parameters into which values based on measurement values of the sensors are respectively substituted by constants weighted for some or all of the parameters and adding the obtained values. The tracheal intubation training apparatus is set to obtain the evaluation value . The tracheal intubation training apparatus according to claim 1 , wherein the constant is set so that an average of the evaluation values becomes 0 based on a result of a tracheal intubation procedure previously performed by a plurality of experts and inexperienced persons. . The trachea according to claim 1 or 2 , wherein the evaluation means obtains at least a part of values to be substituted for the parameter by multiplying a measured value of each sensor and multiplying by a predetermined gain. Intubation training device. The evaluation means includes a measuring unit that obtains a measurement result by each sensor, a time measuring unit that measures a required time from the start to the end of training, and data of the measuring unit and the time measuring unit according to a predetermined function. A data operation unit for obtaining a value to be substituted for the parameter of the evaluation function, and an evaluation value calculation unit for calculating the evaluation value by substituting each value obtained by the data operation unit for the parameter The tracheal intubation training apparatus according to claim 1, 2, or 3. The sensor is a pressure sensor capable of measuring a pressing force when the tracheal intubation instrument contacts the simulated site, and an intra-airway position capable of detecting whether the tracheal intubation instrument exists in a predetermined region of the simulated airway A detection sensor, a position detection sensor in the esophagus that can detect whether or not the tracheal intubation device is present in a simulated esophagus provided in the model by simulating a living body esophagus, and a simulated part that can be moved manually The tracheal intubation training apparatus according to claim 1, wherein the tracheal intubation training apparatus is at least one of an operation amount measurement sensor capable of measuring an operation amount .

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