U.S. patent application number 10/292192 was filed with the patent office on 2003-05-15 for interactive education system for teaching patient care.
This patent application is currently assigned to Gaumard Scientific, Inc.. Invention is credited to Eggert, John S., Eggert, Michael S., Vallejo, Phillip.
Application Number | 20030091968 10/292192 |
Document ID | / |
Family ID | 26894940 |
Filed Date | 2003-05-15 |
United States Patent
Application |
20030091968 |
Kind Code |
A1 |
Eggert, John S. ; et
al. |
May 15, 2003 |
Interactive education system for teaching patient care
Abstract
An interactive education system is described for teaching
patient care to a user. The system comprises a patient simulator,
as well as a virtual instrument for use with the patient simulator
in performing patient care activities. The systems also includes
means for sensing an interaction between the virtual instrument and
the simulator, and means for providing feedback to the user
regarding the interaction between the virtual instrument and the
simulator.
Inventors: |
Eggert, John S.; (Miami,
FL) ; Eggert, Michael S.; (Birmingham, AL) ;
Vallejo, Phillip; (Miami, FL) |
Correspondence
Address: |
HAYNES AND BOONE, LLP
901 MAIN STREET, SUITE 3100
DALLAS
TX
75202
US
|
Assignee: |
Gaumard Scientific, Inc.
Miami
FL
|
Family ID: |
26894940 |
Appl. No.: |
10/292192 |
Filed: |
November 11, 2002 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10292192 |
Nov 11, 2002 |
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09560949 |
Apr 28, 2000 |
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6443735 |
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09560949 |
Apr 28, 2000 |
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09199599 |
Nov 25, 1998 |
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6193519 |
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09199599 |
Nov 25, 1998 |
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08643435 |
May 8, 1996 |
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5853292 |
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Current U.S.
Class: |
434/262 |
Current CPC
Class: |
G09B 23/28 20130101;
G09B 23/30 20130101 |
Class at
Publication: |
434/262 |
International
Class: |
G09B 023/28 |
Claims
What is claimed is:
1. An interactive education system for teaching patient care to a
user, the system comprising: a patient simulator associated with at
least one virtual instrument; a processor operatively coupled to
the simulator; and a memory accessible to the processor for storing
a plurality of instructions for execution by the processor, the
instructions for: generating an interface having at least one menu,
wherein the menu includes a plurality of selectable options;
enabling an instructor to select at least one of the options from
the menu; and executing a scenario using the selected option,
wherein the scenario enables the user to receive feedback based on
patient care activities associated with using the virtual
instrument with the simulator.
2. The system of claim 1 wherein the interface is a graphical user
interface and the menu is a pull down menu.
3. The system of claim 1 wherein each option is associated with at
least one parameter, wherein the selection of the option will alter
the scenario in a predetermined manner using the parameter.
4. The system of claim 1 wherein the selected option alters a level
of performance expected from the user.
5. The system of claim 1 wherein the selected option is associated
with a training standard, so that the selection of the option
imposes the training standard on the user.
6. The system of claim 1 wherein the selected option is associated
with a vital sign representing a state of the patient
simulator.
7. The system of claim 1 wherein the selected option is associated
with a medication.
8. The system of claim 1 wherein the selected option is associated
with data representing a physical characteristic of the patient
simulator.
9. The system of claim 1 wherein the selected option is associated
with an intravenous fluid.
10. The system of claim 1 further comprising a graphical display
device accessible to the processor for providing the feedback to
the user.
11. The system of claim 10 wherein the graphical feedback is
textual.
12. The system of claim 10 wherein the graphical feedback includes
a first image of the patient simulator and a second image of the
virtual instrument.
13. The system of claim 10 wherein the graphical feedback is a
waveform.
14. The system of claim 1 further comprising an audio device
accessible to the processor for providing the feedback to the
user.
15. The system of claim 14 wherein the feedback provided by the
audio device replicates physiological sounds, so that placement of
the virtual instrument in a predefined area relative to the patient
simulator produces an appropriate sound.
16. The system of claim 15 wherein the selected option alters the
sound produced by the audio device.
17. A method for providing a scenario for teaching patient care to
a user, wherein the scenario is associated with using a virtual
instrument with a patient simulator, the method comprising:
providing a computer generated user interface; selecting at least
one parameter from a menu associated with the user interface;
executing the scenario using the selected parameter, wherein the
scenario includes at least one activity; and providing feedback to
the user based on the user's performance with respect to the
activity.
18. The method of claim 17 wherein the menu is a pull down menu in
a graphical user interface.
19. The method of claim 17 wherein the activity is an adult
critical care activity.
20. The method of claim 17 wherein the patient simulator includes a
sensor operable to interact with the virtual instrument, and
wherein the selected parameter alters the interaction of the sensor
with the virtual instrument.
21. The method of claim 20 wherein the interaction is altered to
correspond to a training standard.
22. The method of claim 17 further comprising customizing the menu
by altering the at least one parameter.
23. The method of claim 17 further comprising: detecting a sound
produced by the user; and selecting the parameter based on the
sound.
24. The method of claim 23 further comprising enabling interaction
between the user and the scenario based on a plurality of sounds
produced by the user.
25. A computer readable medium operable to store a plurality of
computer executable instructions associated with a patient
simulator, the medium comprising instructions for: providing a user
interface including at least one pull down menu, wherein the menu
has a plurality of user selectable options; enabling a user to
select at least one of the options; implementing the option in a
training scenario associated with the patient simulator; and
executing the training scenario to enable the user to interact with
the patient simulator in an activity defined by the training
scenario.
26. The computer readable medium of claim 25 further comprising
instructions for: providing a virtual instrument for use with the
patient simulator; and providing feedback to the user based on the
use of the virtual instrument.
27. The computer readable medium of claim 25 wherein the
instructions associated with the scenario define an adult critical
care activity.
28. The computer readable medium of claim 25 further comprising
instructions for creating customizable selectable options, wherein
customizable selectable options can be used to create customized
scenarios.
29. The computer readable medium of claim 25 wherein the options
are associated with at least one health state of the patient
simulator.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application is a continuation of co-pending U.S. Ser.
No. 09/560,949, filed Apr. 28, 2000, which is a
continuation-in-part of co-pending U.S. Ser. No. 09/199,599, filed
Nov. 25, 1998, which is a continuation of U.S. Ser. No. 08/643,435,
now U.S. Pat. No. 5,853,292, filed May 8, 1996.
BACKGROUND
[0002] The present embodiment relates generally to an interactive
education system for teaching patient care, and more particularly
to such a system having virtual instruments for use in conducting
patient care activity on a patient simulator.
[0003] While it is desirable to train students in patient care
protocols before allowing contact with real patients, textbooks and
flash cards lack the important benefit to students attained from
"hands-on" practice. Thus, patient care education has often been
taught using devices, such as a manikin configured to simulate a
patient, along with corresponding medical instruments to perform
patient care activity. However, one disadvantage of such a system
is that medical instruments are often prohibitively expensive, and
consequently, many users must settle for using a smaller variety of
instruments, even at the cost of a less comprehensive educational
experience. One solution to the foregoing problem is using a set of
relatively inexpensive, simulated medical instruments ("virtual"
instruments), as taught in U.S. Pat. No. 5,853,292, the entire
disclosure of which is hereby incorporated by reference.
[0004] Another problem in patient care education is teaching a user
to locate and interpret certain patient body sounds. Charts or
displays of audible locations are of little practical value, for
they do not provide the user with some form of realistic feedback,
such as audio, visual, or tactile responses to the user's activity.
For example, knowing that an apex heart sound is heard at the fifth
intercostal space along the midclavicular line is a very different
matter from actually finding the location and recognizing the sound
on a patient. In an attempt to provide a more realistic experience,
prior methods have disposed speakers playing body sounds at
locations throughout a manikin, but this is undesirable, as
speakers have a tendency to reverberate throughout the manikin,
thus allowing an unnatural juxtaposition of normally distal sounds.
Moreover, even if only one sound is played at a time, the nature of
a speaker results in the sound being heard over a wider anatomical
area than would be found in a real patient, thus reinforcing sloppy
sound location and detection by the user.
[0005] Therefore, what is needed is an interactive education system
using virtual instruments, such as a virtual stethoscope, in
cooperation with simulated patient treatment for rewarding the user
with realistic audible, and in some cases, visual feedback, thereby
enabling a user to learn comprehensive patient care skills.
SUMMARY
[0006] The present embodiment, accordingly, provides an interactive
education system for teaching patient care to a user. The system
includes a patient simulator associated with at least one virtual
instrument, a processor operatively coupled to the simulator, and a
memory accessible to the processor. The memory stores a plurality
of instructions for execution by the processor. The instructions
are for generating an interface having at least one menu, where the
menu includes a plurality of selectable options, enabling an
instructor to select at least one of the options from the menu, and
executing a scenario using the selected option. The scenario
enables the user to receive feedback based on patient care
activities associated with using the virtual instrument with the
simulator.
BRIEF DESCRIPTION OF THE DRAWINGS
[0007] FIG. 1a is a schematic view of an interactive education
system for teaching patient care using virtual instruments and a
patient simulator.FIG. 1b is a schematic view of an interactive
education system for teaching patient care using software-generated
virtual instruments and a software-generated patient simulator.
[0008] FIG. 2 is a schematic view of the interaction between a set
of virtual instruments and the simulator of the system of FIG.
1a.
[0009] FIG. 3 is a perspective view of a virtual PA catheter
instrument of the system of FIG. 1a.
[0010] FIG. 4a is a perspective view of a virtual stethoscope
instrument of the system of FIG. 1a.
[0011] FIG. 4b is a perspective view with a cutaway of the virtual
stethoscope instrument.
[0012] FIGS. 4c and 4d are a circuit diagram for an acquisition
control device of the virtual stethoscope instrument.
[0013] FIG. 4e is a circuit diagram for a sound control feature of
the virtual stethoscope instrument.
[0014] FIG. 4f is a circuit diagram according to another embodiment
of the circuits of FIGS. 4c-4e.
[0015] FIG. 4g is a perspective view with a cutaway of a sensor for
cooperating with the virtual stethoscope instrument.
[0016] FIGS. 5-7 are views of screen displays generated by a
program of the educational systems of FIGS. 1a-b.
[0017] FIGS. 8-17a are schematic views of modules contained in the
program.
[0018] FIGS. 17b-17f are views of screen displays generated by the
program for the Codemaker module.
[0019] FIG. 18 is a view of a screen display generated by the
program relating to the interaction between a software-generated
virtual instrument and a software-generated simulator of the system
of FIG. 1b.
[0020] FIGS. 19-23 are views of screen displays generated by the
program relating to virtual instruments of the systems of FIGS.
1a-b.
DETAILED DESCRIPTION
[0021] Referring to FIG. 1a, the reference numeral 10 refers, in
general, to an interactive education system for teaching patient
care protocols to a user. The system 10 comprises a set of virtual
instruments 12 used to simulate medical instruments, and a
simulator 14 used to simulate a patient for receiving patient care
activity from the user. In this embodiment, the virtual instruments
12 and simulator 14 are tangible objects. Thus, the virtual
instruments 12 look, feel, and operate like real medical devices in
conjunction with the simulator 14, which is understood to encompass
a variety of forms, including a fully articulating and adult-sized
manikin, as well as a fetus, a neonate, a child, a youth, or
portion of a manikin, such as the arm, torso, head, or pelvic
region. Patient care activity received by the simulator 14 is
sensed in a manner to be described, and in response to the
activity, the system 10 provides feedback to the user. It is
understood that feedback may comprise any audio, visual, or tactile
response.
[0022] Referring to FIG. 1b, a system 10' comprises a computer 15
having a program 15a a portion of which produces a
software-generated set of virtual instruments 12' and a
software-generated simulator 14'. Thus, the patient care activity
performed by the user comprises manipulating an icon relating to a
selected software-generated virtual instrument 12' to provide
patient care to the software-generated simulator 14'. In this
embodiment, the program 15a uses conventional means, such as
clicking the mouse or voice-activated software, to monitor activity
by the user, and provides feedback in response, as will be
described.
[0023] Returning to FIG. 1a, the system 10 further comprises a
communications interface module ("CIM") 16, which receives
operating power from a conventional power source 18, and contains a
microcontroller ("PIC") 20. Microcontrollers are available from
many vendors, such as Microchip Technology, Inc. (Chandler, Ariz.),
and are then customized.
[0024] As will be described, the PIC 20 receives input signals from
the user's activity, and is programmed to respond in a certain
manner to provide feedback to the user. For example, to provide
audio feedback, the CIM 16 additionally includes an audio chip 22
which is responsive to the PIC 20 for causing a speaker 24 to
produce realistic patient sounds, for example, heart, lung, blood
pressure (Korotkoff), intestinal, and the like. A control 26 is
included in the CIM 16 for adjusting the volume of the speaker
24.
[0025] Alternatively, depending on the complexity of the desired
feedback, the CIM 16 may be connected to the computer 15 and
program 15a. In the present example of audio feedback, the program
15a could be used to provide a vast library of body sounds.
[0026] The CIM 16 has a plurality of ports, collectively 28, for
receiving input signals occasioned by interaction between the
virtual instruments 12 and sensors 30 disposed on the simulator 14,
resulting from the user's patient care activity. It is understood
that the interaction between the virtual instruments 12 and the
sensors 30 may be electrical, optical, pressure differential,
tactile, temperature-controlled, or wireless, and furthermore, that
there may be more than one PIC 20, and more than one CIM 16, to
manage the input signals thus created.
[0027] Referring to FIG. 2, the virtual instruments 12 include at
least one IV needle, an endotracheal (ET) tube, an
electrocardiogram (ECG or EKG) monitor, a blood pressure (BP) cuff,
a pulse oximeter cuff, a temporary external pacer, an automatic
external defibrillator (AED), a manual defibrillator, a pulmonary
artery (PA) catheter or similar hemodynamic monitoring device, and
a virtual stethoscope, respectively 12a-j, each instrument having a
corresponding sensor 30a-j, as indicated by lines, collectively 36.
Unless otherwise indicated, the lines 36 are schematic, and merely
illustrate that the virtual instruments 12 and the sensors 30 are
functionally connected to each other for providing an interaction
created by the user's patient care activity, the interaction being
reported as an input signal to the CIM 16. When one of the lines 36
also represents a physical connection, it will be noted, and it is
understood that the sharing of such physical lines among
instruments 12, or sensors 30, is contemplated as well.
[0028] The IV needle 12a corresponds with a portion of the
simulator 14 capable of accepting medications. Generally speaking,
an electrical interaction (which would also provide the input
signal) could be created via a virtual instrument 12 having one
node and a sensor 30 with another node, both of which are
physically connected to the CIM 16, or by a virtual instrument with
two nodes and a sensor formed of conductive material, or vice
versa, only one of which may be physically connected to the CIM 16.
In the present embodiment, the antecubital region of an arm of the
simulator 14 may have a sensor 30a comprising an insulator
sandwiched between two layers of conductive material having an
appropriate thickness and weave density for permitting the needle
12a to pass through the cloth at a low acute angle (e.g.,
20.degree.). The conductive layers of the sensor 30a are
electrically coupled to the CIM 16 via line 36a', such that when
the needle 12a is correctly passed through the two conductive
layers, simulating cannulation of a vein of the simulator 14, a
circuit is completed between the layers and sensed by the CIM 16.
In one embodiment, the needle 12a has a selectable group of
specific drugs and dosages provided by the program 15a, and is part
of a medication tray with an assortment of labeled syringes for
dispensing the drugs to the simulator 14, with the effects of
administration controlled by the program 15a.
[0029] The ET tube 12b is used in simulated patient airway
management, the simulator 14 having a head, eyes, a nose, a mouth,
and a realistic airway capable of accepting conventional airway
adjuncts, with the airway configuration adjustable to display a
large tongue, an obstructed pharynx, or closed vocal cords, to
increase the difficulty of the patient care activity. In order to
confirm proper placement in the tracheal airway of the simulator
14, an optical sensor 30b is mounted in the wall of the trachea of
the simulator 14 and connected to the CIM 16 via line 36b'. Correct
placement of the ET tube 12b in the trachea is confirmed when the
tip of the ET tube interrupts the beam of the optical sensor 30b.
The sensor 30b may also be used to determine whether a fluid has
passed. The sensor 30b could alternatively be an electrical
device.
[0030] The ECG monitor 12c comprises a multi-lead system, including
a real-time trace monitor and R-wave sonic markers, and a line 36c
that connects to the CIM 16 at one end, and has a plurality of
color-coded patches at the opposite end for attachment to a
plurality of sensors, collectively 30c, mounted on the correct
regions of the torso of the simulator 14. The electrical
interaction between the patches and the sensors, as sensed by the
CIM 16, confirms proper placement.
[0031] The BP cuff 12d attaches to the simulator 14, for example
around an arm, and includes a line 36d that attaches to the CIM 16.
The simulator 14 contains a simulated heart, lungs, and other
organs. Palpable pulses may be found at carotid, brachial, radial,
femoral, and dorsalis pedis locations, and may change to represent
the condition of the simulated patient; for example, specific pulse
locations may become non-palpable as the systolic pressure falls.
The cuff 12d includes means 30d for sensing proper positioning of
the cuff 12d on the simulator 14, and is attached to the CIM 16 via
line 36d.
[0032] The pulse oximeter finger cuff 12e attaches to the simulator
14, for example around a finger, and includes a line 36e that
attaches to the CIM 16. Normal gas exchange lung dynamics are
virtual and are controlled by the program 15a, which may also
determine tidal volumes (TV) and functional residual capacity
(FRC). The cuff 12e includes means 30e for sensing proper
positioning of the cuff 12e on the simulator 14.
[0033] The temporary external pacer 12f contains a line 36f that
connects to the CIM 16 at one end, and has a plurality of anterior
and posterior pacer pads at the opposite end for attachment to a
plurality of sensors, collectively 30f, mounted on the correct
regions of the torso of the simulator 14. In this manner, the CIM
16 confirms proper placement of the temporary external pacer 12f on
the simulator 14. The pacer 12f has means for controlling pacer
rate, cap time, and current, as well as exhibiting rhythm pacing,
which is controlled by the program 15a.
[0034] The automatic external defibrillator (AED) 12g contains a
line 36g that connects to the CIM 16 at one end, and has an apex
and sternum AED pad at the opposite end for attachment to sensors,
collectively 30g, mounted on the correct regions of the torso of
the simulator 14, confirming via the CIM 16 that the AED 12g is
properly placed on the simulator. Upon selecting a software
generated shock button, the system 10 simulates defibrillation
shock, with the resultant conditions controlled by the program
15a.
[0035] The manual defibrillator 12h contains a line 36h that
connects to the CIM 16 at one end, and has apex and sternum
defibrillator paddles at the opposite end for attachment to a
plurality of sensors, collectively 30h, mounted on the correct
regions of the torso of the simulator 14, confirming via the CIM 16
that the manual defibrillator 12h is properly placed on the
simulator. Upon selecting a software-generated shock button, or
alternatively, by using dual shock buttons associated with manual
defibrillator 12h, the system 10 simulates defibrillation shock,
with the resultant conditions controlled by the program 15a.
[0036] Referring to FIGS. 2 and 3, the PA catheter, or similar
hemodynamic monitor, 12i is an endovascular catheter for insertion
in central vein sites (not depicted) of the simulator 14. The PA
catheter 12i comprises a long tube 300, with an inflatable balloon
302 at one distal end. The opposite end of the tube 300 contains a
divider 304, having a plurality of connectors 306a-d. Connector
306a is for proximal injectate; connector 306b is for distal
injectate; and connector 306c reports the pulmonary artery (PA)
pressure. Connector 306d is connected to a syringe 308 for
providing pressure to the balloon 302 for inflation. Proper
placement of the balloon 302 is determined by sensors 30i placed in
the simulator 14, and catheter data comprising important
hemodynamic indices such as PA occlusion pressure, cardiac output,
and mixed venous oxygen saturation are created by the program
15a.
[0037] Referring to FIGS. 2 and 4a, the stethoscope 12j is moved
from anatomical location to location on the simulator 14, engaging
sensors 30j as will be described, to allow the user to hear
realistic patient body sounds. In some respects, the appearance of
the stethoscope 12j resembles a standard stethoscope, having
earpieces 350a-b for hearing sounds, and being connected to
extenders 351a-b, which are joined to a bifurcated ear tube 352.
Similarly, the stethoscope further comprises a bell tube 354, and a
bell 356, preferably made of nonferrous material.
[0038] Unlike conventional stethoscopes, an electronic control box
358 is disposed between the ear tube 352 and the bell tube 354. The
control box 358 has an On/Off button 360 for activating the
stethoscope 12j, and a conventional indicator 362 for indicating a
potential loss of operating power, such as a low battery. A jack
364 is provided on the control box 358 for output to an external
speaker (not depicted), so that other users may hear the sounds
heard in the earpieces 350a-b. This not only increases the number
of users who benefit from the patient care activity, but allows an
instructor to test the user's ability, and correct the user's
technique if required.
[0039] Turning to FIG. 4b, the control box 358 retains a small
power source 366, such as a battery, an acquisition circuit 368
(FIGS. 4c and 4d) for reasons to be described, and a sound circuit
370 (FIG. 4e) for directing a small speaker 372, such as is
available from ADDAX Sound Company (Northbrook, Ill.), to play a
predetermined sound. FIG. 4f is an alternative circuit diagram
according to another embodiment of the circuits of FIGS. 4c-4e,
which uses less components.
[0040] The speaker 372 is disposed in the earpiece 350a, and
connected to the control box 358 via a wire 372a, allowing the user
to hear the sounds produced by the sound circuit 370 (FIG. 4e). It
is understood that a second, substantially identical speaker may be
disposed in the opposite earpiece 350b, and also connected to the
control box 358. The sound circuit 370 is also connected to the
jack 364 for allowing connection to an external speaker for the
above-described reasons. In an alternative embodiment, the speaker
may be disposed in the control box, and sounds transmitted via
conventional ear tubes to the ear pieces. A switch 374, having a
number of positions, is disposed on the control box 358 for
switching between groups of sounds, as will be described.
[0041] An RF (radio frequency) signal acquisition coil 376, such as
is available from M. C. Davis Co. (Arizona City, Ariz.), is
disposed in the interior of the bell 356 for transmitting and
acquiring RF signals, as will be explained. The acquisition coil
376 is a copper coil and circuitry having an associated wire 376a,
which is attached to the electronic control box 358. A polymeric
disc 378 is disposed between the acquisition coil 376 and the bell
356 to decrease noise from the bell.
[0042] Referring to FIG. 4g, at least one sensor 30j is placed at
an anatomical location on the simulator 14 where specific heart,
lung (including airway), Korotkoff, or other sounds are normally
heard. The sensor 30j provides at least one signal which is
identified by the acquisition circuit 368 (FIGS. 4c and 4d) of the
stethoscope 12j, thereby directing the sound circuit 370 (FIG. 4e)
to play a sound to the user appropriate for the anatomical location
of the sensor on the simulator 14. It is understood that the sound
circuit 370 (FIG. 4e) has a stored library of body sounds
corresponding to the location of the selected sensor 30j, and that
the sensor 30j represents any number of similar sensors.
[0043] The sensor 30j is disposed beneath the skin 14b of the
simulator to avoid visual detection by the user. Likewise, it is
advantageous that the sensor 30j have a minimal thickness to
prevent intentional or accidental detection, as some anatomical
locations, for example, intercostal spaces, must be palpated in
order to be located. In an alternative embodiment, the sensors 30j
may be affixed to an overlay (not depicted) substantially similar
to the skin 14b, thus allowing the overlay to be placed over other
simulators and models of patients, thereby converting those devices
to allow them to be used with the stethoscope 12j.
[0044] The sensor 30j comprises an RF ID tag 400, such as is
available from Microchip Technology, Inc. (Chandler, Ariz.) (Part
No. MCRF200-I/3C00A), which may be programmed using "Developer's
Tools" also sold by Microchip Technology, Inc. to engender a unique
signal that serves to identify the particular sensor 30j. A coil
402, such as is available from M. C. Davis Co. (Arizona City,
Ariz.), is operably connected to the tag 400. The tag 400 and coil
402 are potted in RTV potting material 404, or silicon rubber, such
as is available from M. C. Davis Co. (Arizona City, Ariz.), to
prevent damage. Once potted, the tag 400 and coil 402 collectively
form an RF transmitter 406 which emits a signal comprising a unique
train of frequencies.
[0045] In operation, referring to FIGS. 4b and 4g, the transmitter
406 may actively broadcast the frequencies, but preferably the
transmitter is passive, that is, only activated when interrogated
by the acquisition coil 376 in the stethoscope bell 356. In this
preferred embodiment, the acquisition coil 376 delivers a carrier
signal, such as a 125 kHz excitation frequency, which is received
by the transmitter 406 when the bell 356 is brought within a
predetermined proximity, or acquisition distance, of the
transmitter. The acquisition distance of the bell 356, and
therefore the acquisition coil 376, to the transmitter 406 is
determined by the strength to noise (S/N) ratio of the carrier
signal. Thus, adjustment of the S/N ratio of the carrier signal
provides a means for controlling the precision with which the user
must place the stethoscope bell 356 in relation to the anatomical
location of the sensor 30j, and therefore the transmitter 406.
Precise placement of the bell 356 on the simulator 14 by the user
is rewarded with feedback, in the form of an appropriate body
sound. Normally, the S/N ratio is set to require that the bell 356
be brought within approximately one-half to two centimeters of the
transmitter 406 of the sensor 30j.
[0046] In response to receiving a sufficiently strong carrier
signal, the transmitter 406 emits a train of two identifying
frequencies for use in a process conventionally known as frequency
shift keying (FSK), although other keying methods could be used.
The acquisition coil 376 in the stethoscope bell 356 receives the
emitted frequencies and relays the signal to the acquisition
circuit 368 (FIGS. 4c and 4d). The acquisition circuit 368 (FIGS.
4c and 4d) determines the identity of the sensor 30j. As the
anatomical position of each sensor 30j is known to the programmer,
a selection of appropriate body sounds associated with each sensor
is provided, and accessible to the sound circuit 370 (FIG. 4e).
Thus, by identifying the sensor 30j, the acquisition circuit 368
(FIGS. 4c and 4d) directs the sound circuit 370 (FIG. 4e) to play
an appropriate body sound for the anatomical position of the
transmitter 406, which is heard by the user through the speaker 372
disposed in the earpiece 350a.
[0047] It can be appreciated that to expose the user to a greater
selection of sounds, more sensors 30j could be added to the
simulator 14, or each sensor could correspond to more than one
sound. As depicted, the switch 374 (FIG. 4b) has five different
positions, and includes means for switching the sound circuit 370
(FIG. 4e) between five different groups of sounds. Thus, it is
understood that the number of switch positions corresponds to the
number of sounds that can be produced by a single sensor, i.e.,
with thirteen sensors and five switch positions, the user could
listen to up to sixty-five location-appropriate sounds, including
examples of normal and abnormal sounds. As shown in Table 1, the
exemplary normal and abnormal sounds may be those heard in an adult
patient.
1TABLE 1 Sensor Location Position 1 Position 2 Position 3 Position
4 Position 5 Base Right Base Sounds Base Sounds Fixed Split S2
Fixed Split S2 Fixed Split S2 Base Left Physiological Physiological
Physiological Split S2 Split S2 Split S2 Split S2 Split S2 LLSB
Paradoxical Opening Opening Snap Friction Rub Friction Rub Split S2
Snap Apex Apex Sounds Mid-Systolic S3 Intermittent Starr-Edwards
Click S4 Valve Trachea Tracheal Tracheal Stridor Stridor Stridor
Sounds Sounds Sounds Sounds Sounds Upper Bronchial Bronchial
Wheezing Wheezing Wheezing Anterior Sounds Sounds Sounds Sounds
Sounds Lower Bronchial Wheezing Pleural Pleural Med-Fine Anterior
Sounds Sounds Friction Friction Crackles Posterior Ronchi Coarse
Coarse Pulmonary Pulmonary Crackles Crackles Crackles Edema
Edema
[0048] Likewise, as shown in Table 2, the exemplary normal and
abnormal sounds may be those heard in a child. Of course, the
sounds listed in Tables 1 and 2 are given merely for illustrative
purposes, and any number of different sounds are contemplated.
2TABLE 2 Sensor Location Position 1 Position 2 Position 3 Position
4 Position 5 Base Right Aortic Aortic Venous Hum Venous Hum Venous
Hum Stenosis Stenosis Base Left Split S2 Systolic Systolic Fixed
Pulmonic Pulmonic Fixed S2 S2 Stenosis Stenosis LLSB Pulmonary
Pulmonary Split S1 Split S1 Split S1 Stenosis Stenosis Apex 1 Year
Heart 6 Year Heart Stills Murmur Split S1 Mitral Valve Regurg.
Trachea Normal Infant Normal Child Stridor Stridor Stridor Sounds
Sounds Sounds Upper Wheezing Wheezing Wheezing Wheezing Wheezing
Anterior Sounds Sounds Sounds Sounds Sounds Lower Wheezing Wheezing
Wheezing Wheezing Wheezing Anterior Sounds Sounds Sounds Sounds
Sounds Posterior Ronchi Ronchi Ronchi Ronchi Ronchi Crackles
Crackles Crackles Crackles Crackles
[0049] The stethoscope 12j is a significant improvement because
such predetermined body sounds can be pinpointed to exact locations
on the simulator 14 by selecting the proximity (via the S/N ratio)
required between the acquisition coil 376 and the sensor 30j, thus
better testing a user's patient care skills. Only one body sound is
heard by the user at a time, and then only in the correct
anatomical area for locating the sound.
[0050] In the preferred embodiment, the sound at a particular
sensor location is either heard or not heard, based on a threshold
proximity, as explained above. However, in an alternative
embodiment, the S/N ratio could be adjusted to overlap for signals
from two sensors 30j (and corresponding sounds), allowing the sound
to get clearer as the user moved the stethoscope bell 356 closer to
one sensor and away from the other sensor to simulate a real life
scenario. Referring to FIGS. 1a and 4b, another advantage of the
system 10, as regards the stethoscope 12j, is that the electronic
control box 358, which is understood to be an appropriately
developed CIM 16, is physically integrated into the virtual
instrument 12j, thus simplifying the system.
[0051] In another embodiment, the virtual stethoscope 12j is
appropriately developed to play Korotkoff sounds, and operably
connected to a CIM 16 attached to a standard blood pressure cuff or
the BP cuff 12d, a manikin arm (not depicted) equipped with a
sensor 30j, and air pressure measuring means. The BP cuff 12d is
placed around the arm, and it is understood that all the elements
are connected to the CIM 16 (tutorial software or an electronic
control box). A first user preselects a pulse rate, ausculation gap
(optional), systolic blood pressure, and diastolic blood pressure
for the arm. When a second user places the bell 356 of the
stethoscope within a predetermined proximity of the sensor 30j, a
brachial pulse is heard at the preselected pulse rate. The second
user then increases the pressure in the BP cuff 12d to a level
judged to be above the systolic pressure. If correct, the
heartbeats cease, providing audio feedback to the second user, as
well as to others if the external speaker is being used. Then, as
the second user reduces pressure in the BP cuff 12d, the first
Korotkoff sound (K1), representing the systolic pressure, will be
heard in synchrony with the selected pulse rate. As pressure is
further reduced, sounds including the second, third, and fourth
Korotkoff sounds (K2, K3, and K4) will be heard, followed by
silence upon reaching the diastolic pressure. The second user
records his estimate of the systolic and diastolic pressures, which
can be compared to the preselected values. If an ausculation gap
has been selected, the second user may have estimated the systolic
pressure far below the preselected value, thus "misdiagnosing" a
case of hypertension, and gaining valuable experience for future
patient care activities.
[0052] Referring now to FIG. 5, an introductory screen display 40
of the program 15a is presented on the computer 15. The display 40
includes several decorative features: a title box 42, an ECG box
44, and a vital signs box 46. The display 40 also contains a
teaching box 48, a testing box 50, and a virtual instruments box
52.
[0053] The screen 40 also displays a group of selectable patient
care modules 54a-54p provided by the program 15a, which furnish
information on medical topics and associated concepts. As will be
described, each module has a single topic, and represents an
interactive patient care training session for the user. The modules
54a-g are disposed in the teaching box 48, the modules 54h-j are
disposed in the testing box 50, and the modules 54k-p are disposed
in the virtual instruments tutor box 52. An exit box 56 for exiting
the program 15a is also disposed in the testing box 50.
[0054] Referring to FIGS. 5 and 6, if one of the modules is
selected by the user, such as by voice recognition or selection
with a mouse of the computer 15, the program 15a displays a menu
screen, listing information categories specific to the topic of the
selected module. For example, if the BLS module 54a is selected by
a user, the program 15a displays an instruction screen 60, as shown
in FIG. 6. The instruction screen 60 contains an information box
62, which contains information regarding a menu bar 64 of the Basic
Life Support information items 66-74 of module 54a. It is
understood that an item, such as items 66-74 of the BLS module 54a,
may be selected from the screen 60 via the menu bar 64, and that
each module 54a-p has its own instruction screen with its own menu
of specific informational items, as will be described.
[0055] Referring to FIG. 7, selection of an item from a menu, other
than an exit item, causes an information display screen 76 to be
displayed. The screen 76 has an information box 78, which may
contain text and/or illustrations topical to the selected menu
item. It is understood that the information screen 76 is used as an
example of any number of screens, and furthermore, such screens can
be displayed in sequential order, or a series, for each item.
[0056] A series of screens, such as screen 76, comprises a tutorial
regarding patient treatment protocols for the selected menu item.
Thus, the user can review information from a library of topics by
selecting the appropriate module from the teaching box 48, and
navigating through a series. Navigation in a series of screens is
attained by the user's selection between three boxes: 80, 82, and
84, comprising "Back", "Next", and "Exit", respectively, with
corresponding function among the screens, such as proceeding
backwards or forwards in the series. If no "Back" or "Next"
function is possible, as respectively would be the case of the
first and last screen of a series, the boxes 80 or 82 may be
unselectable. The display screen 76 also has a menu, in this
example the pull down menu 64 corresponding to the module 54a, and
thus the user may switch between items within the selected module
at any point during a series by using the menu bar.
[0057] Referring to FIG. 8, the module 54a contains a group of
items relating to Basic Life Support: an Intro item 66, a CPR item
68, an FBO (foreign body obstruction) item 70, a Practice item 72,
and an Exit item 74 for returning to the display screen 40.
Selection of an item begins a series of information display screens
(FIG. 7) with appropriate information being supplied by the program
15a, or an item may also be divided into sub-items before the
series begins, for example, if the CPR item 68 is selected, the
user must select between a set of sub-items 68a and 68b, for one
person and two person CPR, respectively.
[0058] If the Practice item 72 is selected, the user may practice
CPR on the simulator 14 (FIG. 1a), and the program 15a senses the
user's compression and ventilation, via the CIM 16 (FIG. 1a) and
sensors 30 (FIG. 1a). The heart and lungs of the simulator 14 are
connected to pressure transducers confirming airway ventilation and
cardiac compression; for example, an air line may be mounted in
tracheal wall of the simulator 14 and connected to a sensor 30
connected to the CIM 16, so that when CPR ventilation is performed
on the simulator, the CIM 16 monitors the timing and magnitude of
the pressure and volume of the ventilation activity, via the air
line and the sensor. Similarly, a compression bladder may be
embedded within the chest cavity of the simulator 14 for sensing
and confirming proper timing and magnitude of a CPR chest
compression procedure, when connected by an air line to a
compression sensor 30 attached to the CIM 16. The program 15a
compares the information pertaining to the user's activity with
predetermined standards, and thus provides an interactive training
session.
[0059] The predetermined standards are selectable, and reflect
medical protocols used around the world, including BLS and ACLS
guidelines set forth by the American Heart Association and others.
At least seven major protocols for cardiopulmonary resuscitation
(CPR) are stored and selectable by the user. Moreover, a user may
update the protocols, or enter and store a "New Protocol"
reflecting the local protocol regarding depth, duration, and
frequency of cardiac compressions and airway ventilations. The
program will use this series of acceptable limits to generate a new
CPR waveform for testing CPR.
[0060] The Practice 72 item contains a group of sub-items 86-100
displayed by the program 15a, as shown. The Product Type sub-item
86 is provided for specifying the type of simulator 14. Upon
selection of the CPR Practice sub-item 88, the user may select
among a plurality of action sequences 88a-f, to receive training in
CPR with one rescuer, CPR with two rescuers, CPR ventilation and
compression techniques with one rescuer, or with two rescuers,
rescue breathing, or chest compression, respectively. The CPR test
speed sub-item 90 prompts the user to select between action
sequences 90a or 90b for either one or two rescuers, respectively.
The Setup sub-item 92 enables the user to specify that the action
sequences comprise 2, 4, 6, 8, 10, or 20 compression/ventilation
cycles, respectively 92a-f. The Results/Print sub-item 94 directs
the program 15a to record the time and magnitude of the compression
and ventilation activity executed by the user on the simulator 14.
The Sound sub-item 96 comprises a group of choices (not depicted)
for CIM beeps, realistic sounds, or no sound. The Comm port
sub-item 98 allows selection between a group of choices (not
depicted) for serial port 1 and serial port 2. Selection of the
Exit sub-item 100 directs the program 15a to exit from the Practice
item 72, and return to the module 54a.
[0061] Referring to FIG. 9, selection of the Airways module 54b
(FIG. 5) directs execution of the program 15a to provide
information items 102-108 directed to Anatomy, Opening the Airway,
Action Sequence, and Exit, respectively. The Anatomy item 102 can
be selected to display a series of informational screens pertaining
to airway anatomy, including the upper torso, neck, head, mouth,
and vocal cords. The Opening the Airway item 104 includes sub-items
104a-f regarding introduction, hyperventilation, patient position,
vocal cords, endotracheal tube, and confirming placement,
respectively. The Action Sequence item 106 includes sub-items 106a
and 106b regarding situations where the patient is breathing, and
where the patient is not breathing, respectively. The Exit item 108
is selected to exit the Airways module 54b and return to the
display 40 (FIG. 5).
[0062] Referring to FIG. 10, selection of the Intravenous module
54c (FIG. 5) directs execution of the program 15a to a provide
information items 110-118 directed to Introduction, Peripheral,
Endotracheal, Central, and Exit, respectively. The Peripheral item
112 can be selected to display a series of informational screens
pertaining to peripheral sites such as the antecubital vein,
external jugular vein, saphenous vein, and intraosseous access. The
Endotracheal item 114 can be selected to display a series of
informational screens pertaining to the administration of atropine,
lidocaine, epinephrine (ALE) drugs in an ET tube. The Central item
116 can be selected to display a series of informational screens
pertaining to central sites including the femoral vein, subclavian
vein, and internal jugular vein. The Exit item 118 is selected to
direct the program to exit the Intravenous module 54c and return to
the display 40 (FIG. 5).
[0063] Referring to FIG. 11, selection of the Electrical module 54d
(FIG. 5) directs execution of the program 15a to provide
information items 120-136 for ECG, Defib/Cardio, Vital Signs, Ext.
Pacing, Implants, Virtual Stethoscope, Instrumentation, ECG Sounds,
and Exit, respectively. The ECG item 120 can be selected to display
a series of informational screens pertaining to theory, use, and
virtual ECG. The Defib/Cardio item 122 includes sub-items for
manual defibrillation 122a and automatic defibrillation 122b
("AED"). The Vital signs item 124 can be selected to display a
series of informational screens pertaining to blood pressure, heart
rate, and oxygen saturation. The External Pacing item 126 can be
selected to display a series of informational screens pertaining to
theory, use, virtual defibrillation, and a virtual pacer. The
Implants item 128 has sub-items for a pacemaker 128a and a
defibrillator 128b. The Virtual stethoscope item 130 can be
selected to display a series of informational screens pertaining to
using the software-generated stethoscope, which will be described
in greater detail below at FIG. 18, of the program 15a with respect
to the virtual instruments tutor box 52. The Instrumentation item
132 has a set of choices (not depicted) for enabling, disabling, or
checking the connections between the virtual instruments 12, the
sensors 30, and the CIM 16. The ECG Sounds item 134 has set of
choices (not depicted) for enabling or disabling the sounds. Exit
item 136 is selected to direct the program 15a to exit from the
Electrical module 54d, and return to the display 40 (FIG. 5).
[0064] Referring to FIG. 12, selection of the Arrhythmias module
54e (FIG. 5) directs execution of the program 15a to a provide
information regarding Arrhythmias, Treatment, Trace, and Exit,
respectively items 138-146. The items 138 and 140 include a group
of choices for information about a number of problems and
treatments, respectively 138a and 140a. The Trace item 142 has
controls for starting and stopping the trace, collectively 142a.
The ECG Sounds item 144 has set of choices (not depicted) for
enabling or disabling the sounds. Selection of the Exit item 146
directs the program 15a to exit from the Arrhythmias module 54e,
and return to the display 40 (FIG. 5).
[0065] Referring to FIG. 13, selection of the Drugs module 54f
(FIG. 5) directs execution of the program 15a to provide
information regarding drugs, divided alphabetically into items
150-154, respectively Medications A-D, E-N, and O-V. These items
include a group of choices 150a-154a for information including the
dosage, indications, uses, actions, side effects, and precautions
for the alphabetically grouped drugs. Selection of the Exit item
156 directs the program 15a to exit from the Drugs module 54f, and
return to the display 40 (FIG. 5).
[0066] Referring to FIG. 14, selection of the Treatments module 54g
(FIG. 5) directs execution of the program 15a to provide
informational algorithms regarding treatment action sequences,
including the items General Algorithm 158, Treatments 160, Help
162, and Exit 164. The General Algorithm 158 allows the user to
work through a treatment scenario by answering questions as to a
program-simulated patient's status. The Treatments item 160
includes a group of choices 160a to receive information on topics
including atrial flutter, AMI heart attack, asystole, automatic
external defibrillation, bradycardia, cardioversion, shock,
hypothermia, manual external defibrillation, pulseless electrical
activity, PSVT, temporary external pacer, tachycardia, ventricular
fibrillation, ventricular tachycardia, and wide complex
tachycardia. The Help item 162 provides information regarding using
the Treatments module 54g. Selection of the Exit item 164 directs
the program 15a to exit from the Treatments module 54g, and return
to the display 40 (FIG. 5).
[0067] Referring back to FIG. 5, selection of a test module 54h-j
from the test box 50 directs execution of the program 15a to
provide a testing sequence to help test the user on patient care
protocols, such as CPR and other responses to Code scenarios. The
program 15a paces through the steps of a patient distress scenario,
giving the user a predetermined time to respond or complete the
task required, thus enabling the user to experience the pressure of
a Code situation. For example, the program 15a may test the user by
presenting choices from which the user must select in order to
treat the patient, wherein the user must complete the correct
choice before the sequence proceeds to the next event. The program
15a enables the user to enable, disable, or check the virtual
instruments 12 and sensors 30 for connection to supply input to the
CIM 16.
[0068] If the virtual instruments 12 (FIGS. 1a and 2) are enabled,
the user may implement patient care activity on the simulator 14
using the virtual instruments 12, with the results and quality of
response being monitored by the program 15a. Alternatively, the
user may use software-simulated instruments 12' (FIG. 1b) generated
by the program 15a. The program 15a advances through the scenario
until the patient recovers, and provides a running critique of the
user's responses, with an explanation of each incorrect choice or
action. Features of the test modules 54h-j include items that
enable the user to specify that action sequences prescribed by the
scenario comprise a predetermined number of compression/ventilation
cycles on the simulator 14, or to allow the user to record the time
and magnitude of the compression and ventilation activity performed
on the simulator 14, orto select among a group of choices for
hearing realistic sounds.
[0069] Referring to FIG. 15, selection of the BLS Test module 54h
(FIG. 5) directs execution of the program 15a to provide items
170-182, respectively, Product type, CPR Test, Setup, Print, Sound,
and Comm port, to help test the user on CPR techniques. The Product
type item 170 is provided for specifying the type of simulator 14.
Upon selection of the CPR test item 172, the user may select among
a plurality of action sequences, to receive training in CPR with
one rescuer 172a, or with two rescuers 172b. The Setup item 174
enables the user to specify that the action sequence comprises 2,
4, 6, 8, 10, or 20 compression/ventilation cycles, respectively
174a-f. The Print item 176 directs the program 15a to record the
time and magnitude of the compression and ventilation activity
executed by the user on the simulator 14. The Sound item 178
comprises a group of choices for CIM beeps, realistic sounds, or no
sound, respectively 178a-c. The Comm port item 180 allows selection
between a group of choices for serial port 1 and serial port 2,
respectively 180a-b. Selection of the Exit item 182 directs the
program 15a to exit from the BLS test module 54h, and return to the
display 40 (FIG. 5).
[0070] Referring to FIG. 16, selection of the ACLS Test module 54i
(FIG. 5) allows the user to select among a plurality of items
184-194, for Scenarios, Instrumentation, Logging, Scene Response,
ECG Sounds, and Exit, respectively. The Scenarios item 184 contains
a group of action sequences 184a, comprising a pulseless 77 year
old female, a 55 year old male with chest pain, an 18 year old male
short of breath, a 50 year old pulseless male, a 65 year old male
short of breath, a 72 year old unresponsive female, a 50 year old
female with weakness and fatigue, a 60 year old male with chest
pain in a rural area, a 40 year old male marathon runner, and a 22
year old football player. The user selects from the group 184a and
then navigates a series of information screens while responding to
queries as to the proper procedure for the selected action
sequence. More specifically, the program 15a supplies details of
the selected sequence, as well as a box (not depicted) showing the
patient's ECG trace and vital signs. The Instrumentation item 186
enables the user to enable 186a, disable 186b, or check for
connection 186c, the virtual instruments 12 and sensors 30 that
supply input from the simulator 14 to the CIM 16. The user may use
software-simulated instruments generated in the module 54i by the
program 15a, or, alternatively, if the instrumentation is enabled
by selecting sub-item 186a, the user may implement patient care
activity on the simulator 14, with the results and quality of
response being monitored by the program 15a. The Logging item 188
comprises sub-items 188a-c to enable, disable, or view a record of
the time and magnitude of the compression and ventilation activity
executed by the user on the simulator 14. The Scene Response item
190 has a group of choices 190a-c for selecting between a two,
eight, or fifteen second scene response. The ECG Sounds item 192
has a group of choices (not depicted) for enabling or disabling the
sounds. Selection of the Exit item 194 directs the program 15a to
exit from the ACLS module 54i, and return to the display 40 (FIG.
5).
[0071] Testing may be defined by the program 15a, as above, or by
the user. For example, selection of the Codemaker Test module 54j
(FIG. 5) allows a first user, for example, an instructor, to create
a scenario to test a second user, for example, a student. Referring
to FIG. 17a, the Codemaker test module 54j includes a plurality of
items 200-210, for Instrumentation, Logging, ECG Sounds, Comm.
Port, Help, and Exit, respectively. The Instrumentation item 200
enables the user, by further selecting from a group of choices
200a-c to enable or disable or check the virtual instruments 12 and
sensors 30 that supply input from the simulator 14 to the CIM 16.
The Logging item 202 comprises a group of choices 202a-b to hide or
view a record of the time and magnitude of the compression and
ventilation activity executed by the user on the simulator 14. The
record produced by the Logging item 202 can be used to provide
feedback to the user.
[0072] Alternatively, if the instruments are disabled (item 200b),
the student may institute appropriate treatment using
software-generated instruments. The ECG Sounds item 204 has a group
of choices 204a and 204b for enabling or disabling the sounds. The
Comm port item 206 allows selection between a group of choices 206a
and 206b for communication ports one and two, respectively. The
Help item 208 provides direction for using the module 54j.
Selection of the Exit item 210 directs the program 15a to exit from
the Codemaker module 54j, and return to the display 40 (FIG.
5).
[0073] Referring to FIGS. 17b-17f, views of screen displays
generated by the program for the Codemaker module are shown. The
screen displays 211 have a menu bar 211a containing navigation
items 200-210, for Instrumentation, Logging, ECG Sounds, Comm.
Port, Help, and Exit, respectively. The screen displays also have
an ECG chart 212, Vital Signs monitor 213, patient status update
box 214, total elapsed time clock 215, and a data box 216 with
conventional functions to save a session, open files, delete files,
or print. A user may select a preliminary information button 217,
or may be prompted to prompted to supply such information.
Selection of the button 217 creates an internal display screen 217'
(FIG. 17c), where the user may input preliminary data.
[0074] An Action box 218 retains buttons 218a-g for instructors to
further customize conditions. For example, selection of the button
218f creates an internal display screen 218f' (FIG. 17d), where the
instructor may input vital signs and cardiac rhythms which will be
realistically reflected in the vital signs monitor 213. Thus, using
buttons 217 and 218a-g, the instructor defines the patient
simulator (virtual or tangible) of the testing scenario by entering
a set of preliminary patient parameters regarding information such
as sex, weight, and age, as well as patient indications, like
shortness of breath, chest pain, mental awareness, and circulation.
These patient indications are summarized in box 214 (FIG. 17d). An
instructor defined testing system allows the instructor to test the
student on local, national, or international patient care
protocols. Many algorithms are selectable by opening files,
including BLS, ACLS, Pediatric, and Obstetric (OB) emergencies.
Other algorithms may be created and stored, and algorithms may be
linked together as well.
[0075] Action may be taken in response to the conditions by the
student via buttons 218h-n. For example, selection of the button
218m creates an internal display screen 218m' (FIG. 17e), where the
student may select among virtual instruments to use to render
patient care activities. The student may then perform the patient
care activities virtually, or using the a tangible simulator.
[0076] All of the student and instructor actions are noted in the
log 219 (FIG. 17f) along with time markers for later review. Action
can be paused and resumed.
[0077] Benefits of this module include flexibility for instruction
and the ability to detect mastery of the subject. An
instructor-defined algorithm would presumably vary from well-known,
structured algorithms, and thus avoid the problem of rote
memorization of responses by the student.
[0078] Use of the modules 54k-p of the virtual instruments tutor
box 52 provides information about instruments commonly used in Code
scenarios. In some instances, opportunities to practice using some
of the virtual instruments 12 in patient care protocols with the
simulator 14 are provided.
[0079] Referring to FIG. 18, selection of the Sounds module 54k
(FIG. 5) by the user causes the program 15a to display a series of
screens, such as display 220. The display 220 includes a Sounds box
222 containing an On/Off button 222a, and a list of selectable
heart and lung sounds, respectively 222b and 222c. Selection of a
sound from the lists 222b-c will direct the program 15a to display
a tutorial box 222d with information relating to the selected
sound. The display is navigated by the Back, Next, and Exit
buttons, respectively 80-84, and additionally contains a
representation of a human torso 224 (e.g., 14' of FIG. 1b), such
that when a stethoscope icon 226 (e.g., 12' of FIG. 1b),
corresponding to the position of a mouse (not depicted) of the
computer 15, is moved around the torso, the stethoscope icon glows
when placed in the correct anatomical area for hearing the selected
sound and the program 15a plays the sound. Thus, the program 15a
displays both audio and visual feedback for learning the location
for detecting selected body sounds in a patient. An Exit item 228
is provided for exiting the module 54k and returning to the display
40 (FIG. 5).
[0080] Alternatively, the portion of the program 15a controlling
the sounds and stethoscope icon may be excerpted and saved to a
portable data storage device, such as a CD-ROM, to create a
learning system for locating selected body sounds in a patient
featuring both audio and visual feedback.
[0081] Referring to FIG. 19, selection of the Vital Signs module
54l (FIG. 5) causes the program 15a to display a series of screens,
such as display 230. The display 230 includes a Vital signs monitor
box 232 containing indicator boxes for systolic pressure, diastolic
pressure, heart rate, and oxygen saturation, 232a-d, respectively.
The display 230 is navigated by the Back, Next, and Exit buttons,
respectively 80-84. A Sample Rhythms item 234 contains a group of
selectable rhythms for the user to observe, such as a normal sinus
rhythm, sinus bradycardia, idioventricular rhythm, ventricular
tachycardia, and ventricular fibrillation. An Exit item 236 is
provided for exiting the module 541 and returning to the display 40
(FIG. 5).
[0082] Referring to FIG. 20, selection of the Virtual ECG Monitor
module 54m (FIG. 5) causes the program 15a to display a series of
screens, such as display 240. The display 240 includes an
Electrocardiograph box 242 for displaying the ECG sweep 242a, and
having a heart rate indicator 242b and On/Off button 242c. The
display 240 is navigated by the Back, Next, and Exit buttons,
respectively 80-84. A Sample Rhythms item 244 contains a group of
selectable rhythms for the user to observe, such as a normal sinus
rhythm, sinus bradycardia, idioventricular rhythm, ventricular
tachycardia, and ventricular fibrillation. An ECG Sounds item 246
allows the user to enable or disable the associated sounds. An Exit
item 248 is provided for exiting the module 54m and returning to
the display 40 (FIG. 5).
[0083] Referring to FIG. 21, selection of the Automatic
Defibrillator module 54n (FIG. 5) causes the program 15a to display
a series of screens, such as display 250. The display 250 includes
a Control box 252 having an advisories box 252a, and On/Off,
Analyze, and Shock buttons 252b-d. The display 250 also has an ECG
box 254 having a sweep 254a, and On/Off button 254b. The display
250 is navigated by the Back, Next, and Exit buttons, respectively
80-84. A Sample Rhythms item 256 contains a group of selectable
rhythms for the user to observe, such as a normal sinus rhythm,
sinus bradycardia, idioventricular rhythm, ventricular tachycardia,
and ventricular fibrillation. An ECG Sounds item 258 allows the
user to enable or disable the associated sounds. An Exit item 259
is provided for exiting the module 54n and returning to the display
40 (FIG. 5).
[0084] Referring to FIG. 22, selection of the Manual Defibrillator
module 54o (FIG. 5) causes the program 15a to display a series of
screens, such as display 260. The display 260 includes a Control
box 262, having an imbedded ECG sweep 262a, an advisories box 262b,
buttons 262c-g, respectively On/Off, Energy Select, Charge, Shock,
and Synchronize, as well as a heart rate display 262h, and a
selected energy indicator 262i. The display 260 is navigated by the
Back, Next, and Exit buttons, respectively 80-84. A Sample Rhythms
item 264 contains a group of selectable rhythms for the user to
observe, such as a normal sinus rhythm, sinus bradycardia,
idioventricular rhythm, ventricular tachycardia, and ventricular
fibrillation. An ECG Sounds item 266 allows the user to enable or
disable the associated sounds. An Exit item 268 is provided for
exiting the module 54o and returning to the display 40 (FIG.
5).
[0085] Referring to FIG. 23, selection of the Electrocardiograph
module 54p (FIG. 5) causes the program 15a to display a series of
screens, such as display 270. The display 270 includes an ECG box
272, having an associated ECG sweep 272a, a heart rate indicator
272b, and an On/Off button 272c. A Pacer box 274 is also provided
by the program 15a and has buttons for power, mode, rate, and
output, 274a-d, respectively, having associated status indicators
274e-h. The display 270 is navigated by the Back, Next, and Exit
buttons, respectively 80-84. A Sample Rhythms item 276 contains a
group of selectable rhythms for the user to observe, such as sinus
bradycardia and idioventricular rhythm. An ECG Sounds item 278
allows the user to enable or disable the associated sounds. An Exit
item 279 is provided for exiting the module 54p and returning to
the display 40 (FIG. 5).
[0086] Although illustrative embodiments have been shown and
described, a wide range of modifications, changes, and
substitutions are contemplated. In some instances, certain features
may be employed without a corresponding use of the other features
in the foregoing disclosure. Furthermore, it is understood that
variations may be made in the foregoing embodiments without
departing from the scope of the disclosure. Accordingly, it is
appropriate that the appended claims be construed broadly.
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