WO2017029398A1 - Mesures de ventilation - Google Patents

Mesures de ventilation Download PDF

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Publication number
WO2017029398A1
WO2017029398A1 PCT/EP2016/069728 EP2016069728W WO2017029398A1 WO 2017029398 A1 WO2017029398 A1 WO 2017029398A1 EP 2016069728 W EP2016069728 W EP 2016069728W WO 2017029398 A1 WO2017029398 A1 WO 2017029398A1
Authority
WO
WIPO (PCT)
Prior art keywords
manikin
ventilation
chest
value
measured
Prior art date
Application number
PCT/EP2016/069728
Other languages
English (en)
Inventor
Jan Håvard VASTVEDT
Per Helge AASLAND
Arild EIKEFJORD
Sigurd BÅRDSEN
Original Assignee
Laerdal Medical As
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 Laerdal Medical As filed Critical Laerdal Medical As
Publication of WO2017029398A1 publication Critical patent/WO2017029398A1/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

Definitions

  • the present invention relates to a system for measuring chest compressions in a manikin, especially a manikin for CPR training, comprising a proximity sensor for measuring the compression depth.
  • the present invention relates to the use of optical proximity sensors being used to measure distance between the back of the manikin and the chest of the manikin, and thus measure the compression depth of the chest.
  • optical proximity sensors being used to measure distance between the back of the manikin and the chest of the manikin, and thus measure the compression depth of the chest.
  • optical sensor is used to measure the compression depth by measuring the intensity of the light reflected toward the sensor. This, however does not take non-linearities in the optical measurements into account. Also, the spread among the produced proximity sensors are far too large to be used for accurate measurements. In addition, calibrating each manikin in production would be too costly for practical purposes.
  • the present invention thus provides a system capable of measuring the compressions based on a pre-stored list of values indicating the compression depth and also compensating for changes in the resting position of the chest or proximity sensor, providing a sufficient reliable low cost system.
  • Figure la illustrates a cross section of the manikin.
  • Figure lb illustrates the raw displacement data during a training session
  • Figure 2a illustrates the calibration sequence
  • FIG. 2b illustrates the practical use of the manikin.
  • FIG. 3 illustrates the analysis of the ventilation and compression data.
  • the present invention thus relates to a manikin 1 comprising a proximity sensor 2, preferably a light sensor measuring the distance D between the sensor 2 and a reflector 3.
  • the sensor 2 is position in the lower part of the manikin 1 representing the back, while the reflector 3 is positioned at the inside of the upper part representing the chest in relation to a chest plate 4.
  • the signal from the proximity sensor will represent the distance from the sensor to the reflector.
  • the proximity sensor may be of the type Vishay 4020, but other commercially available sensors may also be used.
  • the reflector 3 may simply be constituted by the inner surface of the manikin chest part, but is preferably constituted by a reflector having chosen reflectivity characteristics providing a reliable signal with consistent reflection. Preferably, it is made from a suitable reflex material providing a linear relationship between the compression depth and the signal received by the sensor. It should also tolerate some off axis movement relative to the direction between the sensor end the chest.
  • the reflector may be constituted by a reflector tape such as 3M 3290, however any reflector tape/surface such as 3M DG4090 may give the wanted characteristics.
  • the manikin in figure 1 includes an inflatable lung 5, e.g. constituted by a bladder, positioned between the chest plate 4 and the outer skin 6 of the manikin, the inflatable lung 5 being connected to the mouth of the manikin 1 where the user may blow into the manikin in order to inflate the lung.
  • an inflatable lung 5 e.g. constituted by a bladder
  • the inflatable lung 5 being connected to the mouth of the manikin 1 where the user may blow into the manikin in order to inflate the lung.
  • the proximity sensor 2 will then sense a downward movement or reduction of the distance D when the lung 5 is inflated.
  • Figure lb illustrates the displacement measurements obtained during compression periods 8 having large and fast displacements and low and slow displacements during ventilation periods 7.
  • both the magnitude of the movements and the frequencies may be used to distinguish between the two types of measurements, which allows for different types of filtering distinguishing the two.
  • the ventilation signals may be found providing a low pass filter chosen so as to filter out signals related to most of the faster compressions.
  • the calibration tables has to have sufficient number of steps to be able to distinguish between different amounts of ventilation. The accuracy of the ventilation amplitude will be less, but still sufficient to, along with the duration of the ventilation, provide a relevant indication of the performed ventilation.
  • the lower amplitude and accuracy of the measured ventilation amplitude may increase the number of false ventilation registrations, but this may, according to an embodiment of the invention be solved by analyzing the passiv movement when the lung is deflated. Contrary to the in flow controlled by the user blowing into the lung the outflow, exhaling, is characterized by the characteristics of the mechanical system. Thus the outflow would provide a consistent and thus recognizable movement in the chest plate, depending for example on the stiffness of the system and size of the lung, which makes it possible for the calculation unit in the system to recognize a ventilation by the typical movement in the exhaling phase.
  • the embodiment of the invention related to breast compression this is improved by first performing initial measurements during the production.
  • the Diff value is defined as the difference between measured value at a certain position, and the measured value at resting position (0 mm).
  • RAW values for different compression depths are measured for one baseline manikin, and a baseline calibration table is prepared based on this table 11.
  • a resting RAW value is found for the resting position of the chest, understood as the distance D when the chest is not touched by a user and thus is not moving.
  • RAW values for different compression depths are measured 12 for a number of manikins and compared with the baseline calibration table.
  • a value is calculated 13 indicating how much the gain in the signal measured by the proximity sensor is affected by the deviation in the RAW value at resting position, the value being defined as Relative_adjust_parameter.
  • the adjustment parameter is compared 14 at different manikins to see that variation between the manikins is below an acceptable threshold. More in detail this is performed in the following steps:
  • Baseline resting value [Raw] The raw value measured at the baseline sensor when no pressure is put on the manikin.
  • the raw value is measured 21. If the raw value does not change within a certain time period it is assumed 22 that the manikin is in the resting position and the current manikin resting-value is updated 23, and the raw value measurement 21 is repeated.
  • the current manikin resting value is subtracted from the measured raw value to obtain a relative raw value 24.
  • This in turn is used to find a distance value D, e.g. in millimeters, by comparing the relative raw values with the calibration table raw value 25.
  • the distance value found in the table is then multiplied with a function of the Relative_adust_parameter and the
  • the manikin If the raw values from the manikin does not vary more than A values for B seconds, and the raw values are between C and D, the manikin is assumed to be at resting position. Therefore, the raw value at this point is stored as the "Current resting value" for this manikin.
  • A is currently 20
  • C is currently 3000 (Used to avoid assuming resting position if the chest has been removed and the sensor measures ambient light)
  • the compression depth is calculated based on the formula:
  • Measured_value Baseline_lookup !i: (l-
  • FIG 3 a flow chart is shown illustrating the breast combination of compression measurements with the lung inflation measurement by inflating the lung 5. While guidelines for lung inflation refers to "chest rise" the system according to the present embodiment of the invention the proximity detector 2 measures this indirectly as the lowering of the chest plate 4 under the inflatable lung 5. Knowing the characteristics of the chest skin and possibly calibrating for that the measured lowing of the chest plate is equivalent to the required chest rise.
  • the method can be described As starting with the signal that is the finished calibrated distance used for compression depth.
  • a low pass filter is applied to the measured signal with a cut off frequency of 6Hz.
  • the filtering must be performed on the ventilation signal only. On the compression signal, this low pass filter would have altered the measured compression depth.
  • Ventilations are slower, and will not be influenced as much.
  • a low pass filter is used, e.g. a FIR filler with a cutoff frequenzy of 6 Hz.
  • the filtering must be performed on the ventilation signal only. On the compression signal, this low pass filter would have altered the measured compression depth. As ventilations are slower, they will not be influenced as much.
  • step 34 If a sufficient displacement (for example larger than 0.3 mm) is registered, but the displacement is slow, the process jumps to step 36.
  • step 35 If the displacement is fast, (for example larger than 100 mm/s) the process jumps to step 37.
  • the process is in the COMPRESSION INCREASING - state as a signal indicating a fast displacement has been registered.
  • step 38 If in the ventilation increasing state a fast or very high displacement (for example larger than 15 mm) is registered the process jumps to step 37.
  • step 36 has decreased sufficiently (for example more than 0.3 mm) and relative ( for example more than 30 %)) from local maximum the process jumps from 36 to 41.
  • step 46 If the compression value has decreased sufficiently (for example more than 0.5 mm) from local maximum the process jumps to step 46.
  • the process is in the VENTILATION DECREASING - state until too much time has passed since the ventilation started or the the ventiolation has decreased sufficiently.
  • step 44 If in step 44 an adequate value for local maximum (for example more than 1 mm ), ventilation duration (for example between 0.1 and 5 seconds) and an adequate decrease time is found is found, the process jumps 47 to the ventilation found step 48 while if no adequate value 49 is found the process returns to the no activity state in step 33.
  • ventilation duration for example between 0.1 and 5 seconds
  • the process jumps 47 to the ventilation found step 48 while if no adequate value 49 is found the process returns to the no activity state in step 33.
  • the passive exhalation from the manikin will not be affected by the user of the product, and should therefore be repeatable. However, higher ventilation volume will cause higher pressure, which will cause higher air flow.
  • the repeatable measure will be: (Average speed of the decrease in volume [mm/s])/ (Average ventilation (uncalibrated) volume during the decrease [mm]). This measure can be limited to between i.e. 2 [1/s] and 6 [1/s]. This measure will be different on compressions compared to ventilations.
  • step 40 If in step 40 the measured data indicates that the assumed compression has been found to decrease the process is in the COMPRESSION DECREASING - state until the decrease has stopped, e.g. being less than 3mm/s.
  • step 46 If the compression decrease in step 46 has stopped the process returns to the no activity state 33.
  • step 48 If, in the ventilation found step 48 the ventilation was the first ventilation after compression 53 the measurements are calibrated as the first ventilation in step 55.
  • the system relates to a state machine with the states:
  • the invention provides a system for measuring chest compressions in a manikin, especially a manikin for CPR training.
  • the system comprises an optical proximity sensor and a reflector, one of which being in the back part of the manikin and the other on the chest part opposite each other for measuring the movement or distances between them.
  • the system comprises a storage means containing pre-stored values representing a number of chest compression depths and also calculating means being adapted to compare the measured values with pre-stored values for determining a measured compression depth.
  • the pre-stored values may include a defined resting value, the system including a timer, and being adapted to define the resting value at a measured value having been constant for predetermined amount of time.
  • the pre-stored compression depths may relate to said measured values are adjusted according to a new resting value.
  • ambient light may affect the measurements and thus a preferred embodiment of the system include means for measuring ambient light and adjusting said pre-stored values for said ambient light.
  • the ambient light measurements may for example be a light sensor etc measuring the background light intensity.
  • the background measurements should also be able to measure and adjust for variations in the background, either fast changing such as related to the frequency of the power system or long term such as increasing the general light intensity in the room.
  • the manikin also comprises an inflatable lung or bladder suitable for ventilation training.
  • the bladder being positioned in the manikin chest between an upper skin layer and said reflector so as to push the reflector toward the sensor when inflating said bladder, and the manikin and bladder comprises means for pressing the air ventilated into the bladder out again after the ventilation.
  • This may be using a flexible bladder, springs in the manikin chest etc.
  • the calculation means may distinguish between the first and the following ventilations when calculating the movements form the table.
  • the rate of decrease in the lung volume may also be used as an indication of the ventilation volume.
  • the system may also include a low pass filter for filtering the signal from the detector at a frequency related to a chosen ventilation frequency, and wherein the calibration table has a resolution suitable for detecting chest movements resulting from said ventilation

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

Abstract

La présente invention concerne un système de mesure de compressions thoraciques sur un mannequin et, plus particulièrement, sur un mannequin d'entraînement à la réanimation cardio-respiratoire (CPR), ledit système comprenant un capteur de proximité optique et un réflecteur placés à l'opposé l'un de l'autre, l'un desdits éléments étant situé dans la partie arrière du mannequin et l'autre dans la partie de poitrine, afin de mesurer le déplacement entre les deux éléments. Le système comprend un moyen de mémorisation contenant des valeurs pré-enregistrées qui représentent un certain nombre de profondeurs de compression thoracique, le système étant apte à comparer les valeurs mesurées avec les valeurs pré-enregistrées afin de déterminer une profondeur de compression mesurée.
PCT/EP2016/069728 2015-08-20 2016-08-19 Mesures de ventilation WO2017029398A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
NO20151063 2015-08-20
NO20151063 2015-08-20
NO20161006A NO20161006A1 (en) 2015-08-20 2016-06-14 Ventilation measurements
NO20161006 2016-06-14

Publications (1)

Publication Number Publication Date
WO2017029398A1 true WO2017029398A1 (fr) 2017-02-23

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PCT/EP2016/069728 WO2017029398A1 (fr) 2015-08-20 2016-08-19 Mesures de ventilation

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3370220A1 (fr) * 2017-03-03 2018-09-05 Pinga Group bvba Système et produit-programme informatique pour le test formateur des compétences de réanimation cardio-pulmonaire
EP4064249A1 (fr) * 2021-03-25 2022-09-28 Ambu A/S Mannequin de formation
WO2022200228A1 (fr) * 2021-03-25 2022-09-29 Ambu A/S Mannequin de formation

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20130218055A1 (en) * 2010-10-26 2013-08-22 Laerdal Medical As Cpr monitoring system
US20130330698A1 (en) * 2012-06-11 2013-12-12 Seung-Jin Yang Simulator for cpr and defibrillator training
DE202014102161U1 (de) 2014-05-09 2014-05-22 3B Scientific Gmbh Wiederbelebungssimulator mit Kompressionsmessung
US8734161B1 (en) * 2009-07-17 2014-05-27 Physio-Control, Inc. CPR training system using consumer electronic device
DE202014005404U1 (de) * 2014-07-03 2014-07-22 Michael Poppe Übungsphantom für die Herzdruckmassage
KR20150086055A (ko) * 2014-01-17 2015-07-27 주식회사 이노소니언 심폐소생 훈련장치

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8734161B1 (en) * 2009-07-17 2014-05-27 Physio-Control, Inc. CPR training system using consumer electronic device
US20130218055A1 (en) * 2010-10-26 2013-08-22 Laerdal Medical As Cpr monitoring system
US20130330698A1 (en) * 2012-06-11 2013-12-12 Seung-Jin Yang Simulator for cpr and defibrillator training
KR20150086055A (ko) * 2014-01-17 2015-07-27 주식회사 이노소니언 심폐소생 훈련장치
DE202014102161U1 (de) 2014-05-09 2014-05-22 3B Scientific Gmbh Wiederbelebungssimulator mit Kompressionsmessung
DE202014005404U1 (de) * 2014-07-03 2014-07-22 Michael Poppe Übungsphantom für die Herzdruckmassage

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3370220A1 (fr) * 2017-03-03 2018-09-05 Pinga Group bvba Système et produit-programme informatique pour le test formateur des compétences de réanimation cardio-pulmonaire
EP4064249A1 (fr) * 2021-03-25 2022-09-28 Ambu A/S Mannequin de formation
WO2022200228A1 (fr) * 2021-03-25 2022-09-29 Ambu A/S Mannequin de formation
WO2022200229A1 (fr) * 2021-03-25 2022-09-29 Ambu A/S Mannequin de formation

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Publication number Publication date
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