WO2011159172A1 - Simulateur de respiration - Google Patents

Simulateur de respiration Download PDF

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Publication number
WO2011159172A1
WO2011159172A1 PCT/NZ2011/000106 NZ2011000106W WO2011159172A1 WO 2011159172 A1 WO2011159172 A1 WO 2011159172A1 NZ 2011000106 W NZ2011000106 W NZ 2011000106W WO 2011159172 A1 WO2011159172 A1 WO 2011159172A1
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WO
WIPO (PCT)
Prior art keywords
airway
oxygen
mannequin
patient
pressure
Prior art date
Application number
PCT/NZ2011/000106
Other languages
English (en)
Inventor
Paul Baker
Original Assignee
Airway Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Airway Limited filed Critical Airway Limited
Publication of WO2011159172A1 publication Critical patent/WO2011159172A1/fr

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Classifications

    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G09B23/288—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine for artificial respiration or heart massage
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G09B23/30—Anatomical models

Definitions

  • the invention relates to simulation and/or monitoring of the supply or lack of supply of oxygen.
  • Embodiments of the invention are preferably used in combination with a mannequin configured to mimic the physical characteristics of an animal (particularly human) subject, namely the airway and features of the body that impact on the airway.
  • Mannequins have been designed and are commercially available for mimicking the characteristics of a patient. A subset of these have at least an artificial airway and lungs.
  • An example of such a device is VBMtechnik GmbH's- Airway Management Simulators "Bill I" (ref. no. 30-19-000), details on which can be found at http://www.vbm- medical.com/cms/files/kb vbm an sthesie 7.0 10.09 qb.pdf.
  • Prior art devices have limited functionality and cannot be used for the simulation of particular procedures. For example, prior art devices have limited, if any, capability for simulating "forced respiration" (i.e., a non-breathing patient) and/or monitoring parameters thereof. This would be useful to assess the performance of those attempting to practice procedures on such patients.
  • forced respiration i.e., a non-breathing patient
  • a system for simulating and/or monitoring the supply of oxygen to a patient including:
  • an airway and/or lungs preferably an artificial airway and/or lungs
  • the system includes a pressure sensor for detecting said pressure.
  • the system includes an artificial said airway and lungs.
  • the means for deriving is communicatively coupled to the sensor to receive said pressure and derive said content.
  • the oxygen content is a measure of oxygen saturation.
  • the means for deriving is configured to derive the oxygen content based on the algorithm set forth hereinafter in the section headed Detailed Description of Preferred Embodiments.
  • the means for deriving is embodied or incorporated in an otherwise conventional laptop or PC-based computer.
  • the system includes means for displaying one or more simulated parameters.
  • the parameters include at least the simulated oxygen saturation.
  • a chart may be displayed which shows the variation of oxygen saturation against time.
  • the system includes at least a partial mannequin having one or more anatomical features of a patient.
  • said mannequin includes at least a front portion of a neck.
  • said front portion covers at least a portion of the airway.
  • the front portion and/or the airway are configured to be incised to provide an opening therethrough.
  • an opening is preferably able to be provided using conventional surgical equipment and may be used, for example, for the simulation of cricothyroidotomy or cricothyrotomy procedures.
  • the system further includes a selectively closeable valve for blocking off at least a portion of the airway.
  • said valve is positioned between an open end of said airway (said open end being distal from said lungs) and said portion of the airway configured to be incised to provide an opening therethrough.
  • a method of simulating and/or monitoring the supply of oxygen to a patient including:
  • an airway and/or lungs preferably an artificial airway and/or lungs
  • the method of the invention preferably includes one or more of the steps of the algorithm set forth hereinafter in the section headed Detailed Description of Preferred Embodiments.
  • the invention includes computer-readable instructions which when executed on a suitably enabled computing device performs one or more features of the method of the invention. This may include or be substituted by one or more steps of the algorithm set forth hereinafter in the section headed Detailed Description of Preferred Embodiments.
  • a mannequin configured for use in the system of the first aspect and/or the method of the second aspect and/or in combination with the computer-readable instructions of the third aspect.
  • the mannequin preferably includes at least an airway and lungs.
  • At least a portion of the airway may be configured to be incised for simulating procedures such as cricothyrotomy.
  • the airway includes a valve for selectively closing the airway to provide a blockage.
  • a valve may be used to simulate a blockage that would require a cricothyrotomy to be performed.
  • Figure 1 is schematic representation of an embodiment of the system of the invention.
  • Figure 2 shows an example display.
  • Monitoring aspects of the invention may be at least partly embodied in software which when executed by a suitably enabled computing device and configured to receive one or more inputs, monitors the simulated impact of actions on a patient. More particularly, the oxygen saturation and related physics parameters of a patient are determined based on inputs received from sensor(s) associated with an artificial airway, such as that of the aforementioned "Bill I" mannequin.
  • an external pressure sensor may be coupled to the computing device via a USB interface, the pressure sensor being attached to and measuring the pressure in a latex lung model of a patient that physically simulates the inhalation and exhalation cycle.
  • a single pressure sensor connected to a small USB interface may provide a 10-bit pressure value (0-1024).
  • Conventional computing equipment may be used as the computing device, including but not limited to PCs.
  • Embodiments of the invention track oxygen supply and oxygen consumption, preferably producing a readout on physiological parameters on a simulated instrument common to those found in the medical industry.
  • Forced respiration is similar to inflating a balloon.
  • the amount of gas inside an inflatable bladder can be deduced by measuring the pressure difference between the inside and outside of the bladder. If the internal pressure is equal to the external pressure, the bladder must be substantially empty. When the internal pressure is higher than the external pressure, then there must be a certain amount of gas inside the bladder. Thus the pressure inside the bladder is a measure of the amount of gas present therein.
  • the respiration cycle completes with an exhalation after which a fresh oxygen rich gas can be inhaled.
  • the pressure in the lungs changes during the breathing cycle.
  • the pressure change over time is monitored as this is a measure of the amount of inhaled and exhaled gas.
  • the oxygen content of the gas may be determined. For normal air, oxygen makes up about 21% of the stream. In medical environments, typically a 100% oxygen stream is supplied to a patient. Therefore with every pressure increase, oxygen rich gas is added to the remaining oxygen poor gas in the lungs. The ratio is a function of pressure change and can be used to track what the total oxygen percentage of the lungs is at any point in time.
  • a preferred algorithm of the invention takes virtual oxygen from the gas present in the lungs and supplies this to the blood at a certain rate. This produces the Sp02 percentage reading that reports the oxygen saturation in the blood.
  • Sp02 is a measurement of the amount of oxygen being carried by red blood cells in the circulatory system. Sp02 is given as a percentage, and is typically around 96% in a healthy patient. Sp02 rises and falls dependent on how well a person is respiring and how well the circulation system is functioning.
  • Sp02 may be measured using a device clipped onto a patient's finger.
  • This lag can be several seconds, whereby the Sp02 readout is behind what the actual value is.
  • this lag is incorporated into the algorithm.
  • the response of a patient to supplied oxygen depends on the patient's ability to take in oxygen. A range of parameters are available that control the more detailed aspects of the algorithm.
  • levels of oxygen storage are considered since these can be used to determine the simulated Sp02. Firstly, the amount of oxygen stored inside the lungs is considered. This oxygen is absorbed and transferred to the blood, where it is consumed by the body as part of the respiration process. Both levels of supply and demand are relevant in order to calculate the simulated oxygen saturation in the blood.
  • the logic below may be used to determine state changes in time slices of 0.1 sec.
  • PartialOxygenPressure (LungPressure * LungOxygenPercentage) / 100
  • OxygenSaturationRecovery (OxygenConsumption * 0.1) where: LungPressure is a pressure value measured by the pressure sensor associated with the mannequin.
  • LungGassQuantity defines how much gas is assumed to be present in the lungs. Depending on the elasticity of the lungs and capacity, it is possible to make an assumption of how much volume of gas is represented by a measured pressure. This value is approximated by multiplying the LungPressure with an arbitrary factor that varies per patient.
  • LungOxygenPercentage tracks how much of the gas in the lungs is oxygen. Atmospheric air for example contains 21% oxygen which will reduce over time when having entered the lungs as oxygen is replaced by carbon dioxide.
  • PartialOxygenPressure represents the pressure in the lungs caused by oxygen gas molecules and affects how fast oxygen can be absorbed by the lungs. As the percentage of oxygen reduces due to transfer to the blood this partial pressure reduces as well. Absolute pressure remains the same because oxygen is replaced by carbon dioxide.
  • Oxygen Absorbsion Rate defines how fast a particular patient can absorb oxygen. This is a measure of the rate of transfer of oxygen from the lungs to the bloodstream. OxygenAbsorbed defines the amount of oxygen transferred to the bloodstream during a given time slice or period. " Absorption is not constant and depends on the PartialOxygenPressure that reduces as more oxygen is used up.
  • OxygenSaturationRecovery defines how much effect a certain amount of oxygen has on a patient's OxygenSaturation. This varies per patient and is dependent on blood quantity and other physiological parameters.
  • OxygenConsumption defines the rate at which oxygen is consumed by the body. A body in rest uses less oxygen than a body that is exercising. Consumption here is simply expressed as a percentage which may vary between time slices. OxygenSatu ration defines the percentage of oxygen in the bloodstream, with / ' and (/-1) notations indicative of determinations of successive time instances. The body consumes oxygen stored in the blood. Again this is a matter of supply and demand.
  • the algorithm preferably includes the aforementioned delay feature that better ensures that the reading on the simulated OxygenSaturation detector is, say, reported 5 seconds later to account for the oxygen enriched blood taking some time to move from the lungs to the fingertip where typically the OxygenSaturation sensor is placed.
  • the delay is preferably user configurable.
  • Simulated digital instruments and audio signals may replicate the workings of standard medical monitoring equipment while a graph plotter can be used to review performance (e.g. by plotting OxygenSaturation against time to ensure it remains at acceptable levels).
  • FIG. 1 A schematic representation of the apparatus and system of the invention is provided in Figure 1.
  • the system 1 shown in Figure 1 includes mannequin 10, sensor 16, computing device 18 and display 20.
  • Mannequin 10 may include a conventional medical mannequin, such as the aforementioned
  • Bill I mannequin which includes at least airway 12 and lungs 14 formed from inflatable bladders or balloons.
  • additional features can be added to improve realism and/or the suitability of the mannequin 10 for additional procedures.
  • an artificial mouth and/or nose may be provided at the end of the airway 12 distal from the lungs 14.
  • the neck of a Bill I mannequin was modified to improve anatomical accuracy. Further, a new surface was provided therefor from a specially designed silicon sheet. Under this a new "larynx" or surface therefor was designed to provide the correct anatomy. This was connected to customised tubing which represented the trachea and was joined to 500ml breathing bags to simulate the lungs. The replacement throat and tubing provided for improved simulation of cricothyrotomy procedures, as well as replacement thereof following such procedures. The upper airway was connected to a narrow tube and a "three-way-tap" 22 which simulated an upper airway obstruction.
  • the portion configured to be incised may be sheet of material bonded to or otherwise coupled to an open portion of the airway or the portion may form a part of the airway (i.e., be essentially tubular), such that only a portion of the airway requires replacing after incision.
  • the "trachea” tubing had a side port connected to sample tubing.
  • This sample tubing was connected to a pressure sensor (i.e. the sensor 16), which generates an electronic signal for output to a computing device such as a PC or laptop computer.
  • a computing device such as a PC or laptop computer.
  • This signal was representative of the pressure inside the lungs 14.
  • sensor 16 could be shown as being incorporated within mannequin 10.
  • one or more intermediary or additional devices may be used, as desired to store and/or transmit the data to a computer, including one remote from the mannequin 10. Any data communication described herein may be effected using any known forms of wired or wireless communications.
  • FIG. 2 An example display 20 according to the invention is provided in Figure 2. It will be appreciated that appropriately configured hardware could be used, but preferred embodiments present the display 20 as a window on a computer display, such as that associated with computing device 18. However, separate or remote displays may additionally or alternatively be used.
  • the invention provides a simulator that simulates and measures oxygen supply to a non-breathing person.
  • a wide range of procedures can be performed on this simulator since the device uses a pressure sensor attached to a mannequin. Such procedures depend on mannequin configuration and include but are not limited to:
  • the invention may also be said broadly to consist in the parts, elements and features referred to or indicated in the specification of the application, individually or collectively, in any or all combinations of two or more of said parts, elements or features.

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  • Engineering & Computer Science (AREA)
  • General Physics & Mathematics (AREA)
  • Physics & Mathematics (AREA)
  • Health & Medical Sciences (AREA)
  • Computational Mathematics (AREA)
  • Mathematical Optimization (AREA)
  • Medical Informatics (AREA)
  • Medicinal Chemistry (AREA)
  • Chemical & Material Sciences (AREA)
  • Algebra (AREA)
  • Theoretical Computer Science (AREA)
  • Educational Technology (AREA)
  • Mathematical Analysis (AREA)
  • General Health & Medical Sciences (AREA)
  • Mathematical Physics (AREA)
  • Pure & Applied Mathematics (AREA)
  • Business, Economics & Management (AREA)
  • Educational Administration (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

L'invention concerne un système et un procédé permettant de simuler l'apport d'oxygène à un patient. Le système comprend des moyens permettant de contrôler la pression à l'intérieur d'un tube pharyngé ou de poumons et des moyens permettant de déterminer un contenu d'oxygène du courant sanguin pour un patient qui résulte de la pression détectée. Cette invention est particulièrement utile pour la formation et l'évaluation des performances dans les procédures de cricothyrotomie.
PCT/NZ2011/000106 2010-06-14 2011-06-14 Simulateur de respiration WO2011159172A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NZ58613710 2010-06-14
NZ586137 2010-06-14

Publications (1)

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WO2011159172A1 true WO2011159172A1 (fr) 2011-12-22

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022264045A1 (fr) * 2021-06-15 2022-12-22 Fisher & Paykel Healthcare Limited Système d'entraînement par simulation de patient pour une assistance respiratoire ou un appareil respiratoire

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4430893A (en) * 1981-11-16 1984-02-14 Michigan Instruments, Inc. Pneumatic lung analog for simulation of spontaneous breathing and for testing of ventilatory devices used with spontaneously breathing patients
US5584701A (en) * 1992-05-13 1996-12-17 University Of Florida Research Foundation, Incorporated Self regulating lung for simulated medical procedures
US6296490B1 (en) * 2000-08-04 2001-10-02 O-Two Systems International Inc. Ventilation training analyzer manikin
US20040110117A1 (en) * 2002-12-06 2004-06-10 Van Oostrom Johannes H. Lung simulator for an integrated human patient simulator

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4430893A (en) * 1981-11-16 1984-02-14 Michigan Instruments, Inc. Pneumatic lung analog for simulation of spontaneous breathing and for testing of ventilatory devices used with spontaneously breathing patients
US5584701A (en) * 1992-05-13 1996-12-17 University Of Florida Research Foundation, Incorporated Self regulating lung for simulated medical procedures
US6296490B1 (en) * 2000-08-04 2001-10-02 O-Two Systems International Inc. Ventilation training analyzer manikin
US20040110117A1 (en) * 2002-12-06 2004-06-10 Van Oostrom Johannes H. Lung simulator for an integrated human patient simulator

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
""Bill V" for percutaneous tracheostomy", VBM SIMULATOR, 6 February 2008 (2008-02-06), Retrieved from the Internet <URL:http://web.archive.org/web/20080206211836/http://www.vbm- medical.de/cms/101-1-airway-simulators.html> [retrieved on 20110829] *

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022264045A1 (fr) * 2021-06-15 2022-12-22 Fisher & Paykel Healthcare Limited Système d'entraînement par simulation de patient pour une assistance respiratoire ou un appareil respiratoire

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