RU115539U1 - BIO-MECHANICAL SIMULATOR OF FUTLAR NOVOCAIN BLOCKADE OF SEGMENTS OF EXTREMITIES - Google Patents

Abstract

Biomechanical simulator of novocaine case blockade of limb segments containing simulators of tubular bone, muscle tissue and skin of the limb, as well as a syringe with a metal needle, characterized in that the simulators of muscle tissue are filled with elastic porous material and placed in separate muscle cases, to the surfaces of which elastic conductive elements, the tubular bone simulator has a sheath made of a conductive material, and the conductive elements of the tubular bone simulator and muscle sheaths form normally open contact pairs, which are closed when injected with a metal needle of a syringe, providing the light and / or sound indication is turned on.

Description

The proposed simulator is intended for use at the preclinical stage in the educational process during the training and advanced training of medical personnel specializing in traumatology, in order to increase the effectiveness and provide objective quality control of training in the implementation of the case Novocain blockade of limb segments in the treatment of fractures of tubular bones.

Known simulator for teaching techniques to help a person in emergency conditions according to patent RU 2176822 C2. The simulator is made in the form of a human dummy, which consists of movably connected blocks of the head, neck, trunk, lower and upper extremities, contains a learning process control device in the form of an anatomical display, equipped with video simulators of vital internal organs and the human skeleton. The simulator allows you to simulate the pathophysiological conditions of the victim and provide control over the student's actions.

However, this simulator does not provide the possibility of objective quality control of training in the implementation of a case-based novocaine blockade of limb segments in the treatment of fractures of tubular bones, since it does not contain simulators of muscle cases and feedback elements, taking into account the features of novocaine blockade and signaling the presence or absence of errors made the trainee while performing novocaine blockade.

A known simulator for developing skills in conducting veterinary events according to patent RU 2082218 C1. The simulator is designed to acquire the skills of administering drugs to both the circulatory system and muscle tissue. The simulator contains a dummy of the head and neck, pressure sensors.

However, this simulator does not provide the possibility of training in the implementation of a case-based novocaine blockade of limb segments in the treatment of fractures of tubular bones, since it does not contain simulators of muscle cases made taking into account the features of novocaine blockade.

A known technique (method) for performing novocaine blockade, which consists in the following. A solution of novocaine is introduced into the fascial-muscular cases of the limb. Through the skin nodule, which is created outside the projection of the neurovascular bundle, a long needle, continuously introducing a solution of novocaine, penetrate to the bone. Then the needle is removed from the bone by 0.5 cm and the solution is injected under maximum pressure. Removing the needle, continue the introduction of the solution. See the book: N.V. Kornilov, E.G. Gryaznukhin. Traumatology and orthopedics. Hippocrates Publishing House, Moscow, 2006.622 p.

The traditional descriptions of this blockade do not provide a training system for the skills of blocking using technical means that provide feedback by tone, light and voice indication of errors made during training.

The specificity of novocaine blockade is as follows. A sufficient amount of novocaine solution must be introduced into the anterior or posterior muscular case by deep injection. For this, the limb is positioned accordingly and prepared, as for aseptic surgery. A small gum is made with a small syringe and a thin needle in a place located away from the projection of the neurovascular bundle. A skin needle is pierced with a long needle (10-20 cm) of the syringe, then the needle is carried deep into the bone. Here, a 0.25% solution of novocaine for case block on the thigh 120 - 200 ml is injected, for case block on the shoulder - 100 - 150 ml. The procedure must be carried out with utmost care: the needle should not scratch the bones, the injection should be done smoothly, without jolts - then for the patient this intervention will be completely painless. The solution washing the bone, being here under known pressure, will subsequently penetrate into the loose tissue of the partitions - second-order cases - and block the main mass of nerves.

Thus, the simulators known in this field do not provide objective quality control of the case of novocaine blockade, taking into account the above features and differences from conventional intramuscular injections, and do not provide an adequate simulation of conditions similar to the real ones that arise in clinical practice when performing case blockade.

In the proposed simulator, the technical result consists in increasing efficiency and in providing objective quality control of training in the implementation of a case Novocain blockade of limb segments in the treatment of fractures of tubular bones due to an adequate simulation of real conditions when performing a case block.

The specified technical result is achieved in that the simulators of the muscle tissue of the simulator are filled with elastic porous material and placed in separate muscle cases, to the surfaces of which elastic conductive elements are attached, the tubular bone simulator has a shell of conductive material, and the conductive elements of the tubular bone simulator and muscle cases form normally open contact pairs that are closed during injection by a metal needle of a syringe, providing the inclusion of light and (or) sound th indication.

The simulator is equipped with a low-voltage power supply, which ensure the functioning of the LED display, which signals whether the novocaine blockade is being performed correctly or incorrectly in accordance with the above method (method).

Novocainic blockade is performed in three stages, according to the number of muscle cases. At each stage, novocaine is introduced into one of the muscle cases.

At the first stage, novocaine is introduced into the anterior muscle box of the simulator. With the right direction of movement of the syringe needle, an electrical contact appears between the conductive element of the skin simulator and the conductive element located on the surface of the bone simulator, due to this, an LED (for example, white) is connected to the above power supply and its glow serves as a visual indication of the correctness of this stage of the novocain blockade. Then, the syringe needle is retracted approximately 0.5 centimeters from the bone (when the white LED is removed from the bone surface, it goes out) and the procaine solution is injected into the anterior muscular case.

In the second stage, novocaine is introduced into the posterior muscle case. The syringe needle retracted from the bone, located in the anterior muscle case, is laterally diverted to one side of the bone so that, with the further introduction of the needle, its point penetrates the posterior muscle case. In this case, the metal needle of the syringe creates an electrical contact between the conductive elements of the front and rear muscle cases, due to which an LED (for example, red) is connected to the above-mentioned power source and its glow serves as a visual indication of the correctness of this stage of novocaine blockade. If this stage of the novocaine blockade is performed incorrectly, and the needle reappears in the bone, then the white LED will glow as an indicator of this error.

In the third stage, novocaine is introduced into the inner muscle casing. At the third stage of the novocaine blockade, the syringe needle that is withdrawn from the bone, located in the anterior muscle case, is laterally diverted to another side of the bone so that, with the further introduction of the needle, its point penetrates the internal muscle case. At the same time, the metal needle of the syringe creates an electrical contact between the conductive elements of the front and inner muscle case, due to which an LED (for example, green) is connected to the above power source and its glow serves as a visual indication of the correctness of the third stage of novocaine blockade. If the third stage of novocaine blockade is performed incorrectly and the needle reappears in the bone, then the white LED will glow as an indicator of this error.

The technical implementation of the proposed simulator is schematically represented in figure 1. This figure shows the cross section of the simulator. The simulator includes a simulator of the tubular bone of an extremity 1 made of an insulating material, on the surface of which a shell 2 is mounted, made of an elastic conductive material, for example, conductive rubber with a thickness of one millimeter. A simulator of the anterior muscle case 3 is adjacent to the shell 2. The case 3 is filled with elastic porous material imitating muscle tissue. The section of the case 3 is provided with a conductive element 4 made of an elastic conductive material, for example, of conductive rubber with a thickness of one millimeter.

The internal muscle case 5, by analogy with 3, is filled with an elastic porous material that simulates muscle tissue. The case 5 is equipped with a conductive element 6 made of an elastic conductive material, for example, of conductive rubber with a thickness of one millimeter (by analogy with 2 and 4).

The back muscle case 7 is filled with elastic porous material that simulates muscle tissue. The case 7 is provided with a conductive element 8 made of an elastic conductive material, for example, of conductive rubber with a thickness of one millimeter.

As the material of the conductive elements 2, 4, 6, 8, rubber based on siloxane rubbers can be used. and conductive rubber based on synthetic rubbers.

The simulator is equipped with a feedback device to indicate the correct execution of the novocaine case blockade. The electrical circuit of this device with LED indication is shown in figure 2. White, red and green LEDs, respectively, 9, 10, 11 are connected in series with the resistors 12, 13, 14. The device is equipped with a low-voltage direct current source 15. Resistors 12, 13, 14 are necessary to limit the current passing through each of indicated LEDs.

The conductive element 2 is a sheath. Similarly for elements 4, 6, 8 of FIG. 1.

A significant difference of the proposed simulator is that when practicing and securing the skills of the novocaine blockade, the role of the electrically conductive element that closes the electric power supply circuit of the LED 9, 10, 11 is played by a metal needle 16 of the syringe. The needle provides electrical contact between the conductive elements 4 and 2, 6, 8.

Before using the simulator, a check of its performance is performed. To test the performance, the simulator is equipped with normally open push-button switches 17, 18, 19. When the button 17 is pressed, LED 9 is energized and its glow is observed. Similarly for buttons 18, 19 and, accordingly, LEDs 10, 11.

In parallel with the LEDs, devices with microcircuits can be connected, which, in addition to the light indication, also provide a tonal (in the form of sound signals) and (or) speech indication of the correct execution of the case novocaine blockade. Simulator operation

The presence of dynamic feedback with the indication makes it possible to increase the effectiveness of training and checking the correctness of the blockade by reducing training time and eliminating the influence of subjective factors in assessing the correct position of the syringe needle.

The direction is correct when the needle passes through soft tissue and abuts against the bone with its tip. Tactilely felt and simultaneously recorded contact of the needle tip with the bone is the main guideline for the correct movement of the needle and a criterion for the depth of penetration of the needle into the segment. In addition, this technique allows you to use the bone as a guideline, with the subsequent introduction of the needle into the back or medial (inner) cases.

Then the reverse movement is performed at a distance of 2-5 mm, depending on the anatomical features of a particular patient, and the drug is introduced into the front case. The simulators known to us do not provide for the controlled development of the skill of direct introduction of a solution of novocaine into the posterior and medial (inner) cases. After indicative determination of the correct needle position, direct administration of novocaine solution begins, which gives a faster analgesic effect than the expected soaking through interfascial cracks.

Bibliography

1. Lutaenko V.F., Kazimirov Yu.B., Perfilyev S.O. SIMULATOR FOR TEACHING HOW TO HELP HUMAN IN EMERGENCY CONDITIONS // DESCRIPTION OF THE INVENTION TO THE PATENT RU 2176822 C2. IPC 7 G09B 23/28.

2. Pozdnyakov V. D., Klenov V. A., Kaskinova N. N., Sechin V. A. SIMULATOR FOR THE DEVELOPMENT OF SKILLS FOR CARRYING OUT VETERINARY ACTIONS // DESCRIPTION OF THE INVENTION TO PATENT RU 2082218 С 1. IPC 6 G09B 9/00, G09B 23/36.

3. Kornilov N. V., Gryaznukhin E. G. .. Traumatology and orthopedics // Publishing house "Hippocrates", Moscow, 2006. 622 p.

Claims (1)

A biomechanical simulator of a case novocaine blockade of limb segments containing simulators of the tubular bone, muscle tissue and skin of the limb, as well as a syringe with a metal needle, characterized in that the simulators of muscle tissue are filled with elastic porous material and placed in separate muscle cases, to the surfaces of which are attached elastic conductive elements, the simulator of the tubular bone has a shell of conductive material, and the conductive elements of the simulator of the tubular bone and muscle s sheaths form a normally open contact pair closes when the metal injection syringe needle, providing a light switch, and (or) an audible indication.