WO1999045522A1

WO1999045522A1 - Cardiopulmonary resuscitation (cpr) training model of the human body

Info

Publication number: WO1999045522A1
Application number: PCT/DE1999/000608
Authority: WO
Inventors: Harald Eikeland
Original assignee: Asmund S. Laerdal Medical Gmbh & Co. Betriebs Kg
Priority date: 1998-03-05
Filing date: 1999-03-02
Publication date: 1999-09-10
Also published as: GB2339323A; GB9924848D0

Abstract

The invention relates to a cardiopulmonary resuscitation (CPR) training model of the human body, with an imitation of the thoracic cage (6) and the head (1), comprising sensors (12, 21, 22, 31, 42, 48, 51) and a device (10) controlled by the sensor signals designed to generate voice error or correction messages, whereby the device controlled by the sensor signals is located inside the model. The signal controlled device is embodied is such a way that it can utter the sounds expected from a patient during CPR in addition to producing error and/or correction messages

Description

Model for practicing cardiopulmonary resuscitation (CPR) in a human

RP.writing

The invention relates to a model for practicing cardiopulmonary resuscitation (CPR) of a person with the features according to the preamble of claim 1.

Proper mastery of the CPR requires frequent practice. For this purpose, various forms of models are known which largely replicate the human torso including the head and contain a lung replica which can be artificially ventilated through an opening in the mouth and / or nose. Furthermore, the chest replica is designed and constructed in such a way that the model behaves realistically in both cardiac massage and artificial ventilation. It has been shown that the learning success in practicing the CPR is greatest when the corresponding model comes close to a human body, especially with regard to the expected reactions to the CPR to be carried out, but also in terms of appearance. This is the clearest way for the practitioner to remember to exercise the CPR correctly as soon as he is faced with the task of actually practicing the practiced CPR. Also in order to practice the individual actions to be carried out in the CPR as realistically as possible in one go, exercise models of the type specified above are already known, which record the individual actions, for example the chest compression during the cardiac massage and ventilation, for their correctness and built-in sensors in the event of incorrect actions, arrange for a corresponding device to be provided with error and / or correction messages (US 43 60 345, DE 36 38 192 AI). The device controlled by the signals from the sensors can have a screen which, for example, indicates correct placement of the hands during chest compression, this display being accompanied by a voice instruction via a loudspeaker. However, the disadvantage of this type of display is that it distracts the practitioner from concentrating on his own activity when he has to look from the model to the screen. Another known device is therefore limited to the representation of the correct action or the extent of the intensity with which the actions are to be carried out on a graphic display by means of an LCD display which can be set up in the immediate vicinity of the model, so that it can be is in the field of vision of the practitioner. However, there are no language instructions.

The invention has for its object to design a model of the type mentioned in such a way that the person practicing the CPR receives the error and / or correction instruction conveyed by the sensors in a manner which distracts him less from the execution of the exercise and him It also provides information that approximates the model even more closely to actual circumstances.

According to the invention, this object is achieved by the configuration according to patent claim 1. Since the device signal-controlled by the sensors according to the invention is accommodated in the replica, that is to say in the model, the linguistic error and / or correction messages generated act almost authentically as expressions of the model itself. Since it is part of the CPR practice, Concentrating on the behavior of the patient to be treated does not leave the area of attention of the practitioner through an instruction coming from the model itself. It has been shown that this means that the practitioner has to divide his attention less between the exercise to be carried out and the instruction given to him, even if it is clear that such behavior is not to be expected in an actual patient.

However, according to a preferred further embodiment of the invention, the model behaves particularly realistically in that the signal-controlled device generates vocalizations of a patient simulated by the model, which are to be expected from actual patients. This applies in particular if these utterances allow conclusions to be drawn about the patient's condition or even, if they occur during incorrect CPR actions, as to the type of error. Vocalizations are of different types and can be a grunt, cough or groan. Burping and choking and vomiting sounds can also be given, which do not only have to be the result of faulty CPR actions, but also if the patient's body is merely moved, e.g. B. already occur when laying an arm or head. Attempts to speak by patients are also quite realistic. In addition, there are vocalizations that the patient does not give through the windpipe and / or mouth, but inside the body due to air or gas displacement during chest compression and / or ventilation. The occurrence of all these utterances can be a kind of to the practitioner, especially if they are realistically assigned to the type of CPR action performed Provide experience that can often only be gained in real cases after the CPR has actually been carried out.

The signal-controlled device expediently comprises a computer unit (CPU) or a microprocessor which processes signals transmitted by sensors and transmits them to a loudspeaker for outputting the voice instructions or the utterances. It is important that the practitioner has the impression that the instructions and in particular the vocalizations come from the model itself. That is why the loudspeaker is either housed in the model itself or the CPU or the microprocessor is connected to a headphone that which is worn by the practitioner on the model. The device is expediently switched such that both a loudspeaker housed in the interior of the model and headphones can be used, the loudspeaker in the interior of the model being inoperative when the headphones are used. This proves to be an advantage if, in courses with a plurality of participants, each course participant practices a model. Because then, when using the headphones, it is avoided by each course participant that his concentration on the exercise is disturbed by instructions and / or utterances that come from the models of the neighboring course participants.

According to a further embodiment of the invention, it is also contemplated to design the signal-controlled device in such a way that it transmits error and / or correction messages in the form of linguistic instructions on the one hand and a patient's utterances on the other hand to separate loudspeakers. The loudspeaker which reproduces the linguistic instructions can even be connected to a loudspeaker located outside the model, which is a loudspeaker intended solely for the instructions or to which the loudspeaker is intended speakers housed inside the model can be switched. In this way, consideration can be given to people who feel irritated by language instructions coming from the model, who naturally cannot be given by a real patient to be resuscitated. In this case, the patient's utterances are emitted by a loudspeaker housed inside the model and / or a headphone, while the speech instructions come only from the outer loudspeaker.

The coordination of the instructions and / or utterances to be delivered by the signal-controlled device, their adaptation to one another and their sequence largely correspond to the real conditions and also to pedagogical aspects, the consideration of which results in an optimal impression on the practitioner. A selection of such aspects results from the following description of an exemplary embodiment with reference to the accompanying drawings and from subclaims. The drawings show:

Fig. 1 is a purely schematic perspective view of a model, in which the position of sensors housed inside the model is shown, and

Fig. 2 is a representation similar to Fig. 1, which shows the position of sensors located essentially on or near the outside of the torso.

The model according to the invention shown in FIGS. 1 and 2 consists of a head replica 1 and a torso 2 with arms 3. The torso 2 can continue in legs and feet, not shown. The head replica 1 is connected to the torso 2 via a neck replica 4 in such a way that it can be moved at least in the forward and backward directions, in order to thereby simulate the tilted head posture required for a proper CPR to be able to. Inside the head replica 1, a mouth and nose opening 11 is indicated in a partial section, which is connected to a lung replica 5 via a trachea replica 41. The lung replica 5 is a flat lying inflatable plastic bag. In the interior of the torso 2, under the lung replica 5, a spring mechanism (not shown) with a pressure plate is accommodated, which gives the torso replica 6 of the torso a resistance to compression forces exerted from above, which corresponds to that of a human thorax.

The swivel mechanism in the neck replica 4, by which the head replica 1 is connected to the chest replica 6, the arrangement of the lung replica 5 and its connection to the mouth / nasal cavity 11 and the spring mechanism (not shown) in the thorax replica 6, by means of the compression behavior of the human chest is reproduced, are known throughout the state of the art in a variety of configurations and therefore do not require any further explanation at this point. For example, reference is made to the constructions according to DE 36 38 192 AI, DE 42 01 768 AI and PCT / DE 98/00095, to which reference is hereby made.

The model according to the invention houses a number of sensors which are assigned to the individual body and organ replicas. A proximity sensor 12 is installed in the head replica 1, which responds to whether the practitioner closes the nostril during mouth-to-mouth ventilation or, if ventilation is provided through the nasal opening, the practitioner is correspondingly active. A sensor 42 is accommodated in the neck replica 4, which responds to whether or not the trachea replica 41 is continuous for ventilation. For example, if the head replica 1 is not properly tilted backward, then the trachea replica 41 will either remain, depending on the type of construction intended for this kinked or pinched between clamping elements and therefore impermeable to ventilation. In this case the sensor 42 can respond to an excessively increasing air pressure in front of the kink or clamping point during ventilation. However, it is also conceivable to design the sensor as a position sensor which scans the swivel position of the head replica 1 in the region of the neck replica 4.

In the neck replica 4 there is also a sensor 43 which, in the exemplary embodiment shown, effectively detects the position of the head replica 1 and can be, for example, a limit switch which, when the head replica 1 is pivoted, signals that the correct end position thereof has been reached.

A movement detector 31 is provided in the vicinity of the shoulder of the arm replica 3 and, similar to the sensor 43, can respond to actuations, here the arm replica 3. A sensor 51 is assigned to the lung replica 5, which sensor can also be designed as a measuring device for determining the air volume blown into the lung replica 5. This sensor speaks z. B. on the pressure exerted on him by the lung replica 5; it is also possible to determine the stroke of the upper chest wall of the model during the ventilation process as a measured variable for determining the air volume taken up.

FIG. 2 shows the arrangement of a plurality of pressure or tactile sensors 61 arranged in a circle, which define a “correct” area of the chest replica 6, within which the exercise of compressions is to be regarded as correct. The support with the hands outside or too far outside the area defined by the sensors 61 is to be regarded as faulty and gives feedback from the sensors 61 (cf. DE 36 38 192 AI). In the middle of the area delimited by the sensors, a detector 62 is arranged, through which the Compression depth of the chest replica 6 is measured and monitored.

In the area of the groin of the torso 2, at least one further sensor 21 is accommodated, which is intended to detect the posture of the entire body replica, for example the posture of the legs not shown in the exemplary embodiment. A sensor of the same type is suitable for this, which is used as sensor 43 in the neck replica 4.

Below the lung replica 5, a pressure sensor 22 is provided in the area of the abdomen, which is able to determine pressure changes in the abdomen and abdomen area caused, for example, by incorrect compressions of the chest replica 6.

All of the sensors or measuring devices described above are connected to a computer unit (CPU) 10 via corresponding lines and deliver signals to them which are processed therein. The CPU contains memory in which data is stored, which in turn is called up by the CPU when activated by a corresponding signal from one or more sensors and in the form of an error message, a correction instruction or a patient utterance, controlled by the CPU, by one Loudspeaker unit 20 are reproduced. In Fig. 2 a dash-dotted line indicates a connection between the loudspeaker unit 20 and a headphone 20 ', which is such that instructions and utterances can be given either by the loudspeaker unit 20 and the headphone 20' simultaneously or switchably separately. Furthermore, a dash-dotted line shows a connection between the CPU 10 and an external loudspeaker 20 ″, which can alternatively be provided for the case described at the outset that only loudspeakers of the model are present via the loudspeaker 20 and / or the headphones 20 ′ are reproduced, while verbal error and correction instructions from an instructor can only be heard via the outer loudspeaker 20 ″.

Error or correction notifications are initiated by sensors 12, 42, 43, 51 and 61. In the absence of actuation, the sensor 12 causes, for example, the linguistic indication that the nasal opening must be closed during mouth-to-mouth ventilation. The response of the sensor 42 causes a voice message through the loudspeaker 20 that the trachea replica 41 is blocked and it must be checked whether there is an obstruction of the trachea replica or the head replica 1 is not sufficiently tilted backwards. The latter is also detected by the sensor 43 in the form of a request to correctly pivot the head replica 1 backwards.

The sensor 51, which is also designed as a stroke detector for the lung simulation 5, causes one

Notification that - if applicable - too much air has been blown into the lung simulation 5 during ventilation. Finally, the sensors 61 respond to incorrect placement of the hands when carrying out the compression and cause a corresponding linguistic error message, possibly in connection with the request to keep the hands in the by the sensors

61 move certain "correct" area. There is a large one with regard to the type of error messages and any correction requests associated therewith

Diversity; for example, see US 43 60

345 referenced.

In addition to the described error or correction messages, which are triggered by the sensors responding and are output by the loudspeaker 20, the signals of the same sensors in the CPU 10 can also be coupled with data that are output by the loudspeaker 20 10

The patient's utterances. For example, a response of the sensor 43 can cause a grunt or pain from the patient, from which the practitioner deduces that the patient is still alive and the head replica 1 may have been swiveled too abruptly, too far or too vigorously. The sensor 51 can cause burping or strangling to occur if air is blown in excessively or too quickly during ventilation, so that appropriate compression of the stomach occurs in a real patient. Following the ventilation, which has not been carried out correctly, a grunt or cough can also be triggered as a vocalization by the sensor 51 and / or by the sensor 42. The response of the sensors 61, even in the case of correct compression, can also result in utterances in the form of a groan or similar sounds, which can be attributed to the compression of the chest area.

In addition to the above-described coupling of error and correction messages with utterances, which are triggered by sensors which monitor measures which are decisive for the implementation of the CPR, sensors can also be provided which only cause the patient to make utterances for the correct execution of the CPR but have less importance. These include, for example, the sensors 21 and 31, with restrictions also the sensor 22. The sensors 21 and 31 can trigger pain sounds or attempts to speak by the patient when the arm 3 or the legs are moved in order to realistically show that the patient is conscious and possibly injured. The same applies to the function of the sensor 22, which, however, also indicates excessive pressure in the chest replica 6 when the lung replica 5 is inflated too strongly or the chest replica 6 is compressed too much, which can result in air or gas displacements in the intestines of a patient. The sensor 22 can therefore cause abdominal gurgling as a vocal expression. 11

The voice with which the errors or errors stored in the CPU 10. Correction instructions issued by the loudspeaker 20 when appropriately activated do not suitably correspond to the voice assigned to the patient's utterances, although this is fundamentally possible. It goes without saying, however, that vocalizations in a model which is modeled on a female body are female in nature and correspondingly in a male model. In addition, a ranking order can also be programmed in the CPU 10, in which error and correction messages are given in order if several incorrect actions are carried out simultaneously. This can be, for example, that the ventilation is carried out too vigorously, but at the same time the sensor 12 responds because the nasal opening is no longer kept sufficiently closed. In this case, for example, the first indication would be that the nostril must be tightly sealed, and only then will excessive obstruction in the lung replica 5 be objected to. A ranking may also be prescribed in the order of error and correction notifications as well as utterances, which is expedient in order not to cause sound distortions or the like by simultaneous reproduction. For reasons of realism, however, it makes sense to first reproduce the patient's vocalization, to which the practitioner learns to react.

The type of electronic circuits that are required by means of the CPU 10 to generate linguistic error and correction instructions as well as patient utterances does not require any special description at this point, because such circuits are sufficiently familiar to the electronics specialist and can easily be achieved Functions described above can be realized. 12

Within the scope of the invention, it is possible to deviate from the exemplary embodiment described above. It is conceivable and also expedient to program the CPU 10 in such a way that it does not directly access data as a function of signals from the sensors, which data cause a corresponding error and / or correction message via the loudspeaker 20. Rather, the sensor signals can, for example, first be processed in the CPU 10 in accordance with the number of signal pulses or the number of incorrect pulse heights and can only initiate a corresponding notification when an excessive frequency is reached. This applies, for example, to the sequence of ventilation or compression surges. Analogously, the time intervals between the ventilation and compression surges can be measured, so that error messages and, if necessary, correction instructions are generated if the time intervals are too short or too long or a minimum number of such treatment surges is not carried out.

Claims

13 Patent claims

1. Model for practicing cardiopulmonary resuscitation (CPR) of a person with a replica (6) of the chest and head (1), the sensors and a signal-controlled device (10, 20) thereof for generating speech error and / or correction messages includes, characterized in that the signal-controlled device (10, 20) is accommodated in the model itself.

2. Model according to claim 1, characterized in that the signal-controlled device (10, 20) comprises at least a first and second memory, error and / or correction messages in the first memory and vocalizations of a patient modeled by the model in the second memory. cen are saved.

3. Model according to claim 2, characterized in that the patient's utterances are those which are to be expected in response to CPR actions remaining within the framework of the correctness. 14

4. Model according to claim 2 or 3, so that the patient's utterances are those which are to be expected in the case of an incorrectly executed CPR action.

5. Model according to claim 4, d a d u r c h g e k e n n z e i c h n e t that the patient's utterances are those that immediately allow a conclusion on the type of erroneous CPR action and do not require a verbal error and / or correction message.

6. Model according to claim 5, characterized in that the device (10, 20) is controlled in such a way that a verbal error and / or correction message only after a delay and / or after a predetermined period of time in which no corrected CPR action carried out, and / or if the incorrect CPR action is repeated.

7. Model according to one of claims 1 to 6, d a d u r c h g e k e n e z e i c h n e t that a sound source reproducing the vocalization (20) is housed at a location of the model that corresponds to the type of vocalization.

8. Model according to claim 7, d a d u r c h g e k e n n z e i c h n e t that a sound source for reproducing

Vocalizations such as groans, gargles, coughs and the like are housed in the head replica (1). 15

9. Model according to claim 7 or 8, d a d u r c h g e k e n n z e i c h n e t that a sound source (20) for reproducing vocalizations such as vomiting, gas or air displacements in the body is housed in the rib cage replica (6) or in an abdomen replica.

10. Model according to one of claims 4 to 9, that the sensors or the signal-controlled device respond to faulty CPR actions in the form of an excessive intensity of the CPR actions to be carried out.

11. Model according to claim 10, so that the sensors (51, 22, 62) or the signal-controlled device respond to excessive compression during the cardiac massage and / or excessive injection pressure during ventilation.

12. Model according to one of claims 4 to 11, that the sensors or the signal-controlled device respond to incorrect CPR actions in the form of incorrect time intervals between repeated CPR actions to be carried out.

13. A model according to claim 12, which also comprises the sensors or the signal-controlled ones

Respond to setup for ventilation or compression shocks that are too slow or too fast. 16

14. Model according to one of claims 1 to 3, d a d u r c h g e k e n n z e i c h n e t that the signal-controlled device determines a ranking of the playback of error and / or correction messages when simultaneous occurrence of multi-faulty CPR actions.

15. Model according to claim 14, so that the signal-controlled device specifies a simultaneous reproduction of an error message and a corresponding vocalization of the patient.

16. Model according to claim 14, so that the signal-controlled device specifies a patient's utterance and an error message in immediate succession.

17. Model according to one of claims 1 to 16, that the signal-controlled device comprises a CPU (10) and at least one loudspeaker (20).

18. Model according to claim 17, so that the loudspeaker is accommodated in the model and / or in a headphone (20 ').

19. Model according to claim 18, characterized in that the function of the speaker in the model (20) on the function of the headphone speaker (20 ') is switchable. 17

20. Model according to claim 17, so that at least one loudspeaker (20 '') is provided for error and / or correction messages and a further loudspeaker (20) for uttering a patient simulated by the model.

21. Model according to claim 20, so that the loudspeaker (20 ″) for error and / or correction messages is arranged outside the model.

22. Model according to claim 20, characterized in that a loudspeaker for error and / or correction messages is accommodated in the model and / or in a headphone (20 ') and a third loudspeaker (20' ') is arranged outside the model and that Function of the loudspeaker housed in the model and / or in the headphones can be switched to the function of the outer loudspeaker (20 '').