RU2684187C1 - Method for practical auscultation skill training by means of a medical training equipment - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention relates to the field of medicine and can be used for practical skill training for the diagnosis of internal organs disorders by listening to the acoustical phenomena of the lungs, heart, stomach, intestines and blood vessels. Method of practical skill training of auscultation using a medical simulator includes a patient simulator module in the form of a dummy man consists in that a module for simulating auscultation is used, which includes a wireless simulator of a phonendoscope connected with a computer, and sound signals of functioning of internal organs are simulated. Dummy man is used, including a system for simulating cardiopulmonary resuscitation, a system for simulating the effects of a defibrillator, a system for simulating decompression of the chest, a system for simulating the drainage of the pleural cavity, a system for simulating the trachea intubation and conicotomy, a system for simulating the administration of drugs, a system for simulating bleeding and a system for simulating catheterization of the bladder. Contactless devices, detected by the phonendoscope simulator, are pre-built into said dummy man. Depending on the training scenario used, sound signals of the functioning of internal organs are modeled, physical effects are performed on a dummy man for resuscitation or medical procedures by affecting the above-mentioned systems. Physical effects on the simulating systems mentioned above, or their absence are detected. Impact data is transmitted to a computer for processing and the sound signals are modeled and transmitted to the wireless phonendoscope simulator system for reproduction through a dynamic head, depending on the physical effects exerted on the said dummy man in identifying and locating a contactless device.EFFECT: providing comprehensive training of doctors through the auscultation skill training during resuscitation and medical procedures.1 cl, 4 dwg

Description

The invention relates to medicine and can be used in patient simulators, as well as in medical simulators for developing practical skills in diagnosing disorders of internal organs by listening to sound phenomena of the lungs, heart, stomach, intestines and blood vessels (blood flow in arteries and veins).

An analogue is the surgical operating room simulator, which includes a patient simulator module that allows you to simulate the reaction (condition) of the patient being operated on depending on the selected scenario, medical history, and actions taken by a team of doctors. The patient simulator module is made in the form of a mannequin equipped with systems for simulating signs of human activity, systems for resuscitation, for example, cardiopulmonary resuscitation (CPR) system, intubation, mechanical ventilation (mechanical ventilation), drug delivery system, defibrillation, and systems that simulate urination, hemorrhage, tears, sweat, hyperemia, convulsions (patent RU No. 2546404, IPC G09B 23/28 (2006.01)). However, this simulator does not present the learning process for developing practical skills in auscultation. There is no technical implementation of the way the module simulates an auscultation system.

The prototype is a device for teaching auscultation and related methods, which is an auscultation system that includes a dummy having at least one built-in speaker, a contactless device built into the dummy and able to detect the proximity of an auscultation device, a controller that can interact with a contactless device and receive a signal, a second controller designed to override the first controller and a database that stores many sound files (patent U S 9064428 (B2), СРС G09B 23/28 (2013.01)). However, this device does not allow to simulate the reaction (condition) of the mannequin (patient simulator) depending on the actions taken by the doctor, that is, the feedback "the doctor’s action - the patient’s simulator reaction - modeling the sound signal in the auscultation device" is not implemented.

The objective of the claimed invention is to develop a method for operating the simulation module of the auscultation system as part of a medical simulator for the comprehensive training of doctors in diagnosing disorders of the human internal organs and providing first aid in various clinical situations.

The technical result is the creation of a medical simulator that simulates the sound signals of the functioning of the internal organs of a mannequin depending on the physical effects exerted on this mannequin during resuscitation or medical procedures.

The technical result is achieved by the fact that a method of developing practical auscultation skills using a medical simulator, including a patient simulator module in the form of a man dummy, which consists in using an auscultation simulation module, including a wireless phonendoscope simulator, connected to a computer, and model the sound signals of internal organs, according to the present invention, use a human dummy, including a system for simulating cardiopulmonary resuscitation, a system for simulating the effects of a defibrillator, a chest decompression imitation system, a pleural cavity drainage system imitation system, a trachea and conicotomy imitation system, a drug injection simulation system, a bleeding imitation system and a bladder catheterization imitation system, previously contactless devices detected by the phonendoscope simulator are built into the dummy , depending on the training scenario used, simulate the sound signals of the functioning of internal organs, They reveal the physical effects on the human dummy for resuscitation or medical procedures by influencing the mentioned systems, record the physical effects on the said imitation systems or their absence, transmit the data on the effects to the computer for processing, and simulate the sound signals and transfer them to the system a wireless phonendoscope simulator for reproduction through a dynamic head depending on the physical effects exerted on said dummy and identifying and locating a contactless device.

Thus, the technical result is achieved due to the full implementation of real-time feedback "the action of the subject (doctor) - the response of the patient simulator module - simulation of the sound signal into the system of a wireless phonendoscope simulator".

The invention is illustrated by drawings (Fig. 1 and 2), which shows a medical simulator for practicing practical auscultation skills, having a patient simulator module (respectively, front and rear views) and auscultation simulation module.

In FIG. Figure 3 shows a general view of a patient simulator module with specifically defined areas of physical impact over a human dummy.

In FIG. 4 is a structural diagram of a wireless phonendoscope simulator.

In FIG. 1-4 numbers indicate:

1 - medical simulator,

2 - patient simulator module,

3 - module simulating auscultation,

4 - computer (server),

5 - wireless phonendoscope simulator,

6 - contactless device (passive RFID card (label)),

7 is a mannequin of the human module of the patient simulator,

8 - subject (doctor) of interaction,

9 - a system for simulating cardiopulmonary resuscitation,

10 - a system for simulating the effects of a defibrillator,

11 - a system for simulating chest decompression,

12 is a system simulating the procedure of drainage of the pleural cavity,

13 is a system for simulating tracheal intubation and conicotomy,

14 - system for simulating the injection of drugs (intravenously, intramuscularly, intraosseous),

15 is a bleeding simulation system,

16 is a system for simulating catheterization of the bladder,

17 - the case of a wireless phonendoscope simulator,

18 - connector (groove) for installing a standard (traditional) stethoscope,

19 is a glass or plastic insert,

20 - electronic board wireless phonendoscope simulator,

21 - battery

22 - dynamic head (loudspeaker),

23 - LED lamp power indicator,

24 - LED lamp indicator of the battery charge,

25 - connector type micro-USB for connecting a charger,

26 - button on and off the wireless phonendoscope simulator.

The medical simulator 1 contains: a patient simulator module 2 and an auscultation simulation module 3 connected to a computer 4. Auscultation simulation module 3 includes a wireless phonendoscope simulator 5 and a contactless device 6 mounted on the body of a dummy 7 of the patient simulator 2 module with which the subject interacts 8. The contactless device 6 is located on the front and rear of the torso of the mannequin 7 of the patient simulator module 2.

The patient simulator 2 module contains: a cardiopulmonary resuscitation simulation system 9, a defibrillator 10 simulation system, a chest decompression simulation system 11, a pleural cavity drainage simulation system 12, a tracheal and conicotomy 13 intubation simulation system, a drug injection simulation system (intravenous , intramuscularly, intraosseously) 14, a system for simulating bleeding 15, a system for simulating catheterization of the bladder 16.

A wireless phonendoscope simulator 5 comprises: a housing 17 made in the form of a cylindrical shape, the upper part of which is made in the form of a connector (groove) 18 for installing a standard (traditional) stethoscope, and the lower part of which is made in the form of a glass or plastic insert 19, an electronic board 20 to which the battery 21, the dynamic head 22, the LED lamp 23 of the power indicator, the LED lamp 24 of the battery charge indicator, a micro-USB 25 connector for connecting the charger devices and power button 26.

The development of practical auscultation skills using a medical simulator is as follows. A method of developing practical auscultation skills using a medical simulator 1, including a patient simulator 2 module in the form of a man dummy 7, which consists in using an auscultation simulation module 3, including a wireless phonendoscope simulator 5, connected to computer 4, and simulate the sound signals of internal functioning organs.

The difference of the proposed method for practicing practical auscultation skills is that a mannequin 7 is used, including a system for simulating cardiopulmonary resuscitation 9, a system for simulating the effects of a defibrillator 10, a system for simulating a chest decompression 11, a system for simulating a pleural cavity drainage 12, a system for simulating a tracheal intubation and conicotomy 13, a system for simulating the administration of drugs 14, a system for simulating bleeding 15 and a system for simulating catheterization of the bladder 16, previously in the curled-up mannequin 7 incorporates contactless devices 6 detected by the phonendoscope simulator 5, depending on the training scenario used, simulate the sound signals of the functioning of internal organs, perform physical effects on the mannequin 7 person for resuscitation or medical procedures by influencing the mentioned systems, record the simulation systems physical effects or their absence, data on the effects are transmitted to the computer 4 for processing, and tvlyayut modeling sound signals and transmitting them to the system simulator wireless stethoscope for 5 through dynamic playback head 22 according to physical influences rendered to said dummy 7 at the identification and determination of the contactless device 6 position.

An example of a specific implementation.

The development of practical auscultation skills is carried out on the patient simulator 2 module, which is made in the form of a mannequin 7 people with an anatomically correct musculoskeletal structure (height - 183 cm, weight 70 kg, age 40-50 years). The patient simulator 2 module is primarily designed to simulate the widest possible range of clinical situations and to develop skills in performing cardiopulmonary resuscitation, conducting intensive therapy and a set of measures aimed at supporting life.

Thus, this allows you to get practical skills in conducting auscultation in various clinical situations, which in real life situations will allow you to correctly diagnose a person’s condition and correctly provide first aid.

The operation of the patient simulator 2 module is carried out using a computer algorithm 4, which ensures the operation of all systems for simulating vital signs on mannequin 7, depending on the scenario used. For example, when simulating heart complications on a mannequin 7, an imitation of the corresponding clinical picture occurs - a change in blood pressure, heart rate, and pulsation power value. When simulating respiratory complications - there is a change in the frequency of respiratory movements, the appearance of cyanosis, loss of consciousness, voice, various rales. And also during the simulation of injuries to the head, torso and limbs, various physiological reactions occur: the absence of a pupil reaction, an auscultatory picture on the left or right, pressure drop during blood loss, convulsions.

In this case, the auscultation simulation module 3 is as follows. A wireless phonendoscope simulator 5 is also connected to a computer software algorithm 4, which, depending on the scenario used, models the sound signals of the internal organs of the patient simulator 2 module on the mannequin 7, where further modeling (changing) of the sound signals depends on the actions or inaction of the subject ( doctor) 8 over the mannequin 7, that is, any medical procedures on the mannequin 7 are carried out or not carried out by the subject (doctor) 8.

The actions or omissions of the subject (doctor) 8 are as follows. Any manipulations on the mannequin 7: performing cardiopulmonary resuscitation on the simulation system 9, using a defibrillator on the simulation system 10, administering drugs using special syringes on the simulation system 14, performing intubation, mechanical ventilation and conicotomy using endotracheal tubes, LMA, Combitube and other devices on the imitation system 13, chest decompression in case of intense pneumothorax on the imitation system 11, pleural cavity drainage procedure on the imitation system 12, the application of a tourniquet during bleeding on the simulation system 15 and catheterization of the bladder on the simulation system 16 are recorded by special tracking devices of the patient simulator 2 module, the data of which are transmitted and processed by the software algorithm on computer 4 and are reflected on the condition of patient simulator 2, while being modeled sound signals about the state of the patient 2, which are sent to the system of a wireless simulator of a phonendoscope 5. For example, the result of feedback, if performed correctly, is cardiopulmonary of intensive care unit on the simulation system 9 is the stabilization of the state of the patient simulator 2 module, namely restoration of respiration (respiratory rate) and heart rate (heart rate), palpation of the pulse, automatic blinking and the reaction of the pupils to the light. However, improper actions or omissions of the subject (doctor) 8 can lead to an emergency and modeling of various sound signals for the system of a wireless phonendoscope simulator 5, depending on the scenario used.

Incorrect actions of the subject (doctor) 8 may be as follows. When you enter the drug on the simulation system 14, which causes an allergic reaction, an anaphylactic shock simulation algorithm is launched. Signs of anaphylaxis: tachycardia, tachypnea, low blood pressure. Breaks in heart massage on the simulation system 9 or the complete absence of resuscitation between the defibrillator discharges, applying a low or too high voltage discharge on the simulation system 10, applying the discharge against the background of small-wave fibrillation without taking measures that increase myocardial energy can lead to death simulation on the simulator module patient 2.

Thus, the reproduction of sound signals in the auscultation simulation module 3 directly depends on the physical effects on the mannequin 7 of the person, carried out by the subject (doctor) 8 during resuscitation or medical procedures.

The method of operation of a wireless phonendoscope simulator 5 is as follows. The electronic board 20 of the wireless phonendoscope simulator 5 is powered by an internal lithium battery 21 with a nominal voltage of 3.7 V. The power of the electronic board 20 is turned on and off using button 26. The built-in LED lamp for the power indicator 23 of the L-934SGC type indicates activity of a wireless phonendoscope simulator 5. Battery 21 has the ability to recharge with a voltage of 5 V using the built-in chip of a charge controller such as LTC4054 through a connector m type micro-USB 25 that connects to the battery charger. The built-in LED lamp 24 of the type L-934SRC-J4 indicates a discharged condition and the battery is fully charged 21.

An antenna (coil wound in the form of a ring) is mounted on the electronic board 20, which is covered by a glass or plastic insert 19 and is designed to detect a contactless device 6, which in turn is located on the front and back of the body of the mannequin 7. The contactless device 6 is made in the form passive RFID cards (tags) of the EM4100 type (EM4102, EM-Marin). The antenna of the electronic circuit board 20 generates a magnetic field with a frequency of 125 kHz. Once in the magnetic field of the antenna, a passive RFTD card (tag) 6 receives energy and begins to cyclically simulate the magnetic field of the antenna with a signal in which its identification code is encrypted. Moreover, the minimum detection distance of the passive RFID card 6 using the antenna is 3 cm, which allows you to install RFID card 6 directly on the body of the mannequin 7 under a layer of silicone, a material that simulates human skin. Thus, the recognition of the internal 40-bit identifier of card 6 is carried out using a microcontroller of the STM32F103T8U6 type and a microchip of the Bluetooth module of the WT32 type, built-in to the electronic circuit board 20, which provides information transfer via the radio channel (via the SPP profile) to the computer (server) 4. After processing this information from the computer (server) 4, an audio signal is sent via the reverse radio channel (through the A2DP profile) of the Bluetooth module to play the audio file through the dynamic head 22 of the wireless phonendoscope simulator 5. At the same time, the dynamic ION 22 is a connector 18 for mounting a standard (conventional) of a stethoscope, with which connection can hear the sound signals simulating sounds internal organs.

Depending on the scenarios of practical skills development, a certain sound signal is modeled for each individual RFID card 6 on a patient simulator 2 module on a computer (server) 4.

The use of the proposed medical simulator 1 allows, in comparison with the prototype, to carry out joint work of doctors both in providing first aid and in conducting auscultation, as well as to increase the practical skills of doctors in diagnosing a person’s condition in various clinical situations by developing practical auscultation skills in resuscitation events or medical procedures on the patient simulator module 2.

Claims (1)

A method of developing practical auscultation skills using a medical simulator, including a patient simulator module in the form of a man dummy, which consists in using an auscultation simulation module including a wireless phonendoscope simulator connected to a computer and simulating the sound signals of the functioning of internal organs, characterized in that use a mannequin, including a system for simulating cardiopulmonary resuscitation, a system for simulating the effects of a defibrillator, a system for simulating breast decompression cells, a simulation system for the pleural cavity drainage system, a simulation system for tracheal intubation and a conicotomy, a drug injection simulation system, a bleeding simulation system and a bladder catheterization simulation system, previously contactless devices detected by a phonendoscope simulator are built into the mentioned mannequin, depending on the scenario used training simulate the sound signals of the functioning of internal organs, carry out physical effects on a human dummy for conducting resuscitation measures or medical procedures by influencing the said systems, record the physical effects exerted on the mentioned simulation systems or their absence, the data on the effects are transmitted to a computer for processing and the sound signals are modeled and transmitted to a wireless phonendoscope simulator system for playback through a dynamic head depending on the physical effects exerted on said mannequin during identification and location determination device.

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