WO2014089588A1

WO2014089588A1 - Method and device for training in artificial respiration

Info

Publication number: WO2014089588A1
Application number: PCT/AT2013/050239
Authority: WO
Inventors: Jens-Christian SCHWINDT; Ewald Unger; Michael Haller
Original assignee: Simcharacters Gmbh
Priority date: 2012-12-12
Filing date: 2013-12-10
Publication date: 2014-06-19
Also published as: AT513050B1; AT513050A4

Abstract

The invention relates to a method and a device for training in artificial respiration with a tube (1) for introduction into a simulated trachea (2) for endotracheal intubation, which tube (1) can be connected to a ventilator port (6), and with sensors (8) for measuring the position of the tube (1) in the simulated trachea (2) and a display (7) for indicating the correct position of the tube (1) as an indication of a correct intubation. For optimum simulation of respiration, a capnometer simulator (3) with a connector (4) for connection to the tube (1) and to the ventilator port (6) is provided, wherein sensors (9) are provided to monitor the connection of the tube (1) to the capnometer simulator (3), and wherein the display (7) indicating correct intubation and correct breathing is activated upon correct connection of the tube (1) to the capnometer simulator (3) and the correct position of the tube (1) in the simulated trachea (2).

Description

Method and device for training an artificial beat ^¬ ment

The invention relates to a method for training an artificial respiration, wherein for endotracheal intubation a tube is inserted into a trachea simulation and is connected to a respirator connection, wherein the position of the Tu ^¬ bus in the trachea simulation is measured and the correct Position of the tube is displayed as a sign of correct intubation.

The invention also relates to a device for training an artificial respiration with a tube for insertion into a trachea replica for endotracheal intubation, which tube is connectable to a respirator connection, and sensors for measuring the position of the tube in the trachea replica and a display for Display of the correct position of the tube as a sign of correct intubation.

The present invention is directed to the training of Intensivme ^¬ dizinern and nurses in intensive care. In particular, but not exclusively, the objective method and the device for training artificial ventilation in newborns and premature babies should be used. Applications in veterinary medicine are also not excluded.

In critically ill patients with inadequate or non-existent spontaneous breathing, artificial respiration is required. For the purpose of artificial respiration, a tube is usually inserted through the patient's mouth into the trachea

introduced and connected to a corresponding ventilator verbun ^¬ the. The insertion of the tube into the trachea requires ent ^{¬ appropriate} skill of the treating physicians, which is why the handling should be practiced regularly on simulation dolls. In order to provide the medical staff during the simulation feedback on the experienced intubation, such simulation dolls are equipped with appropriate sensors that the proper insertion of the tube into the trachea erfas ^¬ sen. For example, WO 2010/144663 A2 discloses A Medical ^¬ ULTRASONIC training system in which even an endotracheal Intubati ^¬ on can be simulated. However, since in this simulation system corresponding sensors are arranged on the tube, no commercially available tubes can be used for the training of intubation.

An apparatus for training an artificial respiration on a newborn has become known, for example, from CN 201590189 U.

However, disadvantages of known simulation methods and apparatus are that no commercial tubes can be used and the simulation or training facilities adequately simulate the reality and therefore do not meet the Trai ^¬ beginnings conditions of reality.

The aim of the present invention is therefore to provide an abovementioned training method and an abovementioned training device, by means of which artificial respiration can be trained as realistically as possible and by which the exercising person receives the best possible feedback on the performed simulated artificial respiration. The Trai ^¬ ningsverfahren and the training device should be feasible or produced as inexpensively. disadvantage

known methods should be avoided or at least reduced.

The object of the invention is achieved in terms of the method in that the tube is connected to a capnometer simulator and the capnometer simulator with the ventilator connection, the connection of the tube with the capnometer Si ^¬ mulator is controlled, and with proper connection of the tube with The capnometer simulator and correct position of the tube in the trachea replica indicate correct intubation and proper ventilation. The method according to the invention is characterized in that the artificial beat ^¬ tion under realistic conditions when using commercially available tubes and a capnometer simulator is performed. Capnometers measure and monitor the carbon dioxide content of the Exhaled air and thus give an optimal indication of a properly performed ventilation. In the present Trai ^¬ beginnings method, not only the proper introduction of the tube but also the connection of the tube with the Kapnome- ter simulator is thus controlled. As a result, the manipulations of the medical staff can be perfected and complications in the performance of artificial respiration can be reduced.

Preferably, the connection of the capnometer simulator with the ventilator connection is also checked and the correct intubation and proper ventilation are only displayed if the ventilator connection is correctly correctly connected to the capnometer simulator.

The correct intubation and proper ventilation is displayed before ^¬ preferably by changing the color of a display on Kapnometer- simulator. By such a measure, the exercising person, as in the usual disposable capnometers, a proper ventilation displayed. Instead of the color change at the capnometer, which in reality occurs due to the chemical reaction of exhaled carbon dioxide with an indicator, in the method according to the invention the correct intubation and proper ventilation is simulated by the activation of a colored light source. Unlike conventional disposable Kapnome ^¬ tern displaying the Capnometer simulator at elevated against ^¬ supervisory procedures can be deactivated again and a renewed training procedures are performed with the same Capnometer simulator.

The position of the tube in the trachea model can be measured with optical sensors. The advantage of optical sensors is that in principle all commercially available tubes can be used and no changes to the tube must be made. The optical sensors can be formed by reflected or transmitted light barriers or cameras or CCD (Charge Coupled Device) sensors.

Alternatively, the position of the tube in the trachea model can also be measured with magnetic sensors, in which case, however, the tube used is at least partially made of magnetic material. material must exist. This can be accomplished by incorporating magnetizable particles into the material of the tube or attaching appropriate magnetic materials to the tube.

The position of the tube in the trachea model can also be measured with electromechanical sensors. With such electromechanical sensors even further effects can be simulated, which may be important for ventilation training. For example, a mechanical resistance may be applied to the tube to simulate constrictions in the trachea or injury to the trachea as the tube is inserted. Of course, combinations of the above types of sensors are possible.

A more accurate conclusion on simulated intubation tref ^¬ fen, various positions of the tube can be measured in the trachea simulation and displayed. Depending on

Using different sensors, the position of the tube between two limit positions can be determined in coarse or fine screening. When using optical CCD sensors corresponding image processing software in ^¬ may play the exact position of the tube in the ^trachea-¬ After formation are determined by application.

The connection of the tube to the capnometer simulator and respectively or the connection of the capnometer simulator with the ventilation unit can be connected with pressure sensors, preferably strain gauges ^¬ be controlled. This represents a simple way of checking the proper connection of the capnometer simulator with the tube and / or the connection of the capnometer siumlators with the respirator connection. The use of such pressure sensors or strain gauges is associated with very low cost.

Alternatively or additionally, the connection of the tube with the capnometer simulator and / or the connection of the capnometer simulator with the ventilator connection can also be controlled in ^¬ directly by measuring the air flow via the differential pressure in the capnometer simulator. Over a Such air flow measurement, which can be carried out for example by means of temperature-sensitive resistors (NTC, Negative Temperature Coefficient Coefficient Thermistors), can easily identify leaks at the connections of the capnometer and thus infer a correct intubation and proper ventilation ^¬ . Differential pressure sensors are also particularly easy to miniaturize and can thus be easily installed in the capnometer simulator.

The indication of proper intubation and proper ventilation on the capnometer simulator may preferably be reset wirelessly. This can be an optimal workout of

artificial respiration can be made and various situations can be simulated by a trainer.

If the measured data are preferably transmitted wirelessly to a terminal, further processing of the data and subsequent analysis thereof can take place. In this way it is also possible to store the data for subsequent evaluations and documentations.

The object of the invention is also achieved by a device mentioned above, in which a capnometer simulator is provided with a connection for connection to the tube and a connection for connection to the respirator connection, where ^¬ in sensors for controlling the connection of the tube with the cape ^¬ pressure gauge simulator are provided, which sensors are connected to a control device, which control means are connected to the display, and is adapted for ord ^¬ voltage compound according of the tube with the capnometer simulator and the correct position of the tube in the trachea simulation to enable the display to display a correct intubation and ordnungsgemä ^¬ SEN ventilation. Such a training device can be made relatively inexpensive and robust. For the achievable advantages reference is made to the above description of the training method.

Preferably, sensors for checking the connection of the capnometer simulator with the ventilator connection vorgese ^¬ hen are are that sensors connected to the control device so that only with the correct additional connection of the ventilator connection with the capnometer simulator a correct intubation and proper ventilation on the display

can be displayed.

The indication of correct intubation and proper ventilation is preferably arranged at the capnometer simulator and configured such that the correct intubation and ordnungsge ^¬ Permitted ventilation is represented by a change in color of the display.

The sensors for controlling the position of the tube m of the Tra chea-replica can be formed by optical sensors, magnetic sensors or electromechanical sensors or combinations of.

The sensors for controlling the position of the tube in the trachea replica may be configured to detect multiple positions.

The sensors for checking the connection of the tube with the cape ^¬ pressure gauge simulator and respectively or the connection of the Kapnometer- simulator with the ventilator connection, by pressure ^¬ sensors, preferably strain gauges, or by sensors for measuring the air flow via the differential pressure in the capnometer Be formed simulator.

If a device is provided for resetting the indication of proper intubation and proper ventilation on the capnometer simulator, the trainer may re-treat the simulation.

The control device is preferably connected to a transmission ^device for preferably wireless transmission of the measured data to a terminal.

The display on the capnometer simulator can be formed by an OLED (Organic Light Emitting Diode) display. With such light sources, the aforementioned color change can also be compared with commercially available disposable capnomes with a purple coloration relatively easily. be felt.

The present invention will be explained in more detail with reference to the accompanying drawings. Show:

1 shows a block diagram of an embodiment of a device for training an artificial respiration;

2 shows a variant of the measurement of the position of the tube in the trachea replica using optical sensors;

3 shows a possibility of measuring the position of the tube in the trachea replica using electromechanical sensors;

4 shows an exemplary embodiment of the measurement of the position of the tube in the trachea simulation using magnetic sensors;

5 shows the variant of detecting the correct connection of the capnometer simulator with pressure sensors; and

Fig. 6 shows the measurement of the correct connection of the capnometer simulator by means of the air flow measurement.

1 shows a schematic block diagram of a device for training an artificial respiration. The training device comprises a tube 1, which is preferably formed by a han ^¬ delsüblichen tube. The tube 1 is in a

Trachea replica 2 introduced in a simulation dummy 20 and connected to a ventilator port 6. Inventive ^¬ according to the tube 1 is connected to a capnometer simulator 3, by reacting the corresponding terminal 4 is connected to the capnometer simulator 3 to the distal end of the tube. 1 The Kapnome ^¬ ter simulator 3 has in particular the shape and appearance of commercial capnometer, so that the training can proceed as realistic as possible. The ventilator connection 6 is connected to a further connection 5 on the capnometer simulator 3. According to the invention not only the correct Po ^¬ sition of the tube 1 is now determined in the trachea simulation 2, but also the proper connection of the tube 1 with the capnometer simulator 3. In the case of both a correct position of the tube 1 in the trachea replica 2, as well as a correct connection of the tube 1 with the capnometer simulator 3 is now a display 7 is activated, which indicates the correct intubation and proper ventilation. The display 7 may Example ^¬ example at Capnometer simulator 3 and be arranged to simulate a change in color of conventional disposable Capnometer upon detection of the carbon dioxide content of the exhaled air. Alternatively or additionally, the display 7 can also be arranged on an external terminal 11, which can be operated by a trainer. For measuring the position of the tube 1 in the trachea replica 2, corresponding sensors 8 are arranged in the trachea replica 2. The correct connection between the tube 1 and the capnometer simulator 3 is made via corresponding sensors 9 on the connection 4 of the capnometer simulator 3.

It is particularly advantageous if the correct connection of the capnometer simulator 3 to the ventilator connection 6 is also checked and only if the display 7 is activated, in addition to the above conditions (correct position of the tube 1 and correct connection of the tube 1 with the Kapnometer Si ^¬ mulator 3) and this connection between the capnometer simulator 3 and respirator connection 6 is in order and has no leak ^¬ points. Only in this case a proper Be ^¬ breathing is guaranteed. Also the connection between Kapnometer- simulator 3 and ventilator connection 6 can be made with a ent ^¬ speaking sensor 9 at the connection of the capnometer 5 simulator. 3

The measurement of the correct position of the tube 1 in the trachea replica 2 can take place by means of optical sensors (see FIG. 2), electromechanical sensors (see FIG. 3) or magnetic sensors (see FIG. 4) or combinations thereof. The correct connection of the tube 1 with the capnometer simulator 3 and the capnometer simulator 3 with the Ventilmungsgerätean ^¬ circuit 6 can be with simple pressure sensors 15 (see FIG. 5), for example, strain gauges, or indirectly by measuring the air flow in the capnometer Simulator 3 (see Fig. 6) take place.

All sensors 8, 9 are preferably provided with a control unit. device 10 connected to the gate, for example, in the simulation Capnometer-3 may be attached ^¬ classified in the simulation doll 20 or in the terminal. 11 A corresponding voltage supply 19 supplies the necessary electrical energy for all components. Via a transmission device 17, the data of the sensors 8, 9 can be forwarded to the control device 10 and to the external terminal 11. Via a terminal 11 disposed at the reset means 18, the display 7 can be of the correct intubation and ventilation proper preferably wireless rückge ^¬ sets.

2 shows an embodiment of a sensor 8 for measuring the position of the tube 1 in the trachea replica 2 in the form of optical sensors 12. In the illustrated example, a light source 21 and a detector 22 is arranged on the trachea replica 2 and with the control device 10, in particular ^¬ special a microcontroller connected. In this way, in the transmitted light principle, the position of the tube 1 in the trachea imitation 2 can be detected. Instead of the transmitted-light photoelectric barrier, it is also possible to use a reflex photoelectric sensor or a CCD sensor as the optical sensor 12. In case of using a CCD sensor may be relatively precisely and ER- summarizes possible to pass to the control device 10 and the terminal 11 wei ^¬ similar to an optical computer mouse by analyzing the surface structure of the tube 1, the position or the movement thereof.

In addition, a device 23 can be arranged in the trachea replica 2, which simulates a resistance or obstruction during insertion of the tube 1. This blocking device 23 can be formed, for example, by a wheel 24, which can be moved by means of a magnetic device 25 in the direction of the middle of the trachea replica 2 and presses on insertion of the tube 1 into the trachea replica 2 onto the tube 1.

Other embodiments of the blocking device 23 are, of course, also conceivable.

3 shows an embodiment of a sensor 8 for measuring the position of the tube 1 in the trachea replica 2 in the form of an electromechanical sensor 13. In the case of the embodiment shown in FIG. For example, two flexibly mounted rollers 26, 27 are installed in the trachea replica 2 so that they are correspondingly rotated during insertion of the tube 1 in rotation. One of the two rollers 26 includes a magnetic rod 28. In the vicinity of the roller 26 at least one magnetic field sensor 29 is arranged, which detects the movement of the roller 26 and the magnetic rod 28 therein. Via corresponding signals which are vorzugswei ^¬ se forwarded to the controller 10, can be deduced the position of the tube. 1 On the second roller 27, a pressure in the radial direction of the trachea replica 2 exerted on the tube 1, for example, via a magnetic device 25 and thus simulates a blockage and the Ein ^¬ lead the tube 1 are difficult. The activation of the

Magnetic device 25 of the blocking device 23 is preferably carried out remotely via the terminal 11.

Fig. 4 shows an imple mentation form of the realization of the sensors 8 for measuring the position of the tube 1 in the trachea imitation 2 by magnetic sensors 13. In this case, 2 corresponding magnetic sensors 13 and the tube 1 indicators on the trachea imitation 30 arranged of magnetic material. In this way, at least some positions of the tube 1 can be detected exactly. The disadvantage here, however, is that the Tu ^¬ bus 1 must be formed of magnetic material or corre ^¬ chende indicators 30 must have of magnetic material and thus no commercially available tubes can be used or must be adapted accordingly.

5 shows a detail of the capnometer simulator 3 with a connection 4 for the tube 1 and a connection 5 for connection to the respirator connection 6. The exact connection of the tube 1 to the connection 4 of the capnometer simulator 3 can be done, for example, with a pressure sensor 15 are made, for example, is realized by a strain gauge. The pressure sensor 15 is connected to the control device 10 in the capnometer simulator 3 and thus provides an accurate statement about the correct connection of the capnometer simulator 3 with the tube 1 from. A further pressure sensor 15 may be provided on the terminal 5 of the capnometer simulator 3 for connection to the ventilator ^¬ connection. 6 Also, this pressure sensor 15 is with the control device 10 connected.

Finally, Fig. 6 shows a variant of the measurement of the correct connections between Capnometer simulator 3 and the tube 1 or ventilator connection 6 by the air flow is detected in Kapnome ^¬ ter simulator 3. The air flow is preferably carried out indirectly in the differential pressure measuring method by measurement using two sensors 16. In this case, for example, temperature-sensitive resistors, in particular NTCs (Negative Temperature Coefficient Thermistors) can be used as sensors 16 for measuring the air flow. By such Luftströ ^¬ measurement measurement with corresponding sensors 16 leaks at the terminals 4, 5 of the capnometer simulator 3 can be detected and thus incorrect connections with the tube 1 and the beat ^¬ mungsgeräteanschluss 6 are detected.

The illustrated examples show only some of possible embodiments for constructing the subject apparatus for training artificial respiration.

Claims

Patent claims:

1. Method for training artificial ventilation, wherein for endotracheal intubation a tube (1) is inserted into a trachea replica (2) and is connected to a ventilator connection (6), the position of the tube (1) being in the Trachea replica (2) is measured and the correct position of the tube (1) is displayed as a sign of correct intubation, characterized in that the tube (1) with a capnometer simulator (3) and the capnometer simulator (3) is connected to the ventilator connection (6), the ^connection of the tube (1) to the capnometer simulator (3) is checked, and if the tube (1) is properly connected to the capnometer simulator (3) and the position is correct Tube (1) in the trachea replica (2) shows correct intubation and proper ventilation.

2. The method according to claim 1, characterized in that the connection of the capnometer simulator (3) to the ^ventilator connection (6) is checked and correct intubation and proper ventilation only with an additional correct connection of the ventilator connection (6) to the capnometer - Simulator (3) is displayed.

3. The method according to claim 1 or 2, characterized in that the correct intubation and proper ventilation is displayed by changing the color of a display (7) on the capnometer simulator (3).

4. The method according to any one of claims 1 to 3, characterized in that the position of the tube (1) in the trachea ^replica (2) is measured with optical sensors (8).

5. The method according to any one of claims 1 to 3, characterized in that the position of the tube (1) in the trachea ^replica (2) is measured with magnetic sensors (13).

6. The method according to any one of claims 1 to 3, characterized in that the position of the tube (1) in the trachea ^replica (2) is measured with electromechanical sensors (14).

7. The method according to any one of claims 1 to 6, characterized in that different positions of the tube (1) in the Tra ^¬ chea replica (2) are measured and the measured positions are displayed.

8. Method according to one of claims 1 to 7, characterized in that the connection of the tube (1) to the capnometer simulator (3) and/or the connection of the capnometer simulator (3) to the ventilator connection (6 ) is checked with pressure ^sensors (9), preferably strain gauges.

9. Method according to one of claims 1 to 7, characterized in that the connection of the tube (1) to the capnometer simulator (3) and/or the connection of the capnometer simulator (3) to the ventilator connection (6 ) is controlled indirectly by measuring the air flow via the differential pressure in the capnometer simulator (3).

10. The method according to any one of claims 1 to 9, characterized in that the display (7) of correct intubation and ^proper ventilation on the capnometer simulator (3) is preferably reset wirelessly.

11. Method according to one of claims 1 to 10, characterized in that the measured data are preferably transmitted wirelessly to a terminal (11).

12. Device for training artificial ventilation with a tube (1) for insertion into a trachea replica (2) for endotracheal intubation, which tube (1) can be connected to a ventilator connection (6), and sensors (8) for measuring the Position of the tube (1) in the trachea replica

(2) and a display (7) for displaying the correct position of the tube (1) as a sign of correct intubation, characterized in that a capnometer simulator (3) with a connection (4) for connection to the tube ( 1) and a connection

(5) is ^provided for connection to the ventilator connection (6), with sensors (9) being provided to control the connection of the tube (1) to the capnometer simulator (3). Sensors (9) are connected to a control device (10), which control device (10) is connected to the display (7), and is designed to do so when the tube (1) is properly connected to the capnometer simulator (3) and more correctly Position of the tube (1) in the trachea replica (2) to activate the display (7) to indicate correct intubation and proper ventilation.

13. Device according to claim 12, characterized in that sensors (9) are provided for checking the connection of the capnometer simulator (3) to the ventilator connection (6), which sensors (9) are connected to the control device (10). , so that correct intubation and proper ventilation can only be shown on the display (7) if the ventilator connection (6) is also correctly connected to the capnometer simulator (3).

14. The device according to claim 12 or 13, characterized in that the display (7) of the correct intubation and ^proper ventilation is arranged on the capnometer simulator (3) and is designed such that the correct intubation and ^proper ventilation are carried out a change in the color of the display (7) can be displayed.

15. Device according to one of claims 12 to 14, characterized in that the sensors (8) for checking the position of the tube (1) in the trachea replica (2) are formed by optical sensors (12).

16. Device according to one of claims 12 to 14, characterized in that the sensors (8) for controlling the position of the tube (1) in the trachea replica (2) are formed by magnetic sensors (13).

17. Device according to one of claims 12 to 14, characterized in that the sensors (8) for controlling the position of the tube (1) in the trachea replica (2) are formed by electromechanical sensors (14).

Device according to one of claims 12 to 17, characterized indicates that the sensors (8) for checking the position of the tube (1) in the trachea replica (2) are designed to detect several positions.

19. Device according to one of claims 12 to 18, characterized in that the sensors (9) for controlling the connection of the tube (1) to the capnometer simulator (3) and/or the connection of the capnometer simulator (3) with the ventilator connection (6) are formed by pressure sensors (15), preferably strain ^gauges .

20. Device according to one of claims 12 to 18, characterized in that the sensors (9) for controlling the connection of the tube (1) to the capnometer simulator (3) and/or the connection of the capnometer simulator (3) with the ventilator connection (6) are formed by sensors for measuring the air flow via the differential pressure in the capnometer simulator (3).

21. Device according to one of claims 12 to 20, characterized in that a device (18) for resetting the display (7) of correct intubation and proper ventilation on the capnometer simulator (3) is provided.

22. Device according to one of claims 12 to 21, characterized in that the control device (10) is connected to a ^transmission device (17) for preferably wireless transmission of the measured data to a terminal (8).

23. Device according to one of claims 12 to 22, characterized in that the display (7) on the capnometer simulator (3) is formed by an OLED (organic light emitting diodes) display.