U.S. patent application number 15/192342 was filed with the patent office on 2016-12-29 for suction simulation system.
The applicant listed for this patent is IngMar Medical, Ltd.. Invention is credited to Amanda Dexter, Stefan Frembgen.
Application Number | 20160379526 15/192342 |
Document ID | / |
Family ID | 57602623 |
Filed Date | 2016-12-29 |
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United States Patent
Application |
20160379526 |
Kind Code |
A1 |
Frembgen; Stefan ; et
al. |
December 29, 2016 |
Suction Simulation System
Abstract
A suction simulation device includes a suction catheter and a
suction unit in fluid communication with the suction catheter. The
suction unit includes a reservoir for holding fluid and the suction
unit is configured to provide vacuum capability to the suction
catheter. The suction simulation device also includes a pump in
fluid communication with the suction unit, the pump configured to
flow the fluid from the reservoir. The suction simulation device is
adapted for use with a manikin comprising an airway. Also disclosed
is a suction simulation system and a method of simulating a
scenario requiring mechanical ventilation.
Inventors: |
Frembgen; Stefan;
(Pittsburgh, PA) ; Dexter; Amanda; (Pittsburgh,
PA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
IngMar Medical, Ltd. |
Pittsburgh |
PA |
US |
|
|
Family ID: |
57602623 |
Appl. No.: |
15/192342 |
Filed: |
June 24, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62185097 |
Jun 26, 2015 |
|
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|
Current U.S.
Class: |
434/272 |
Current CPC
Class: |
G09B 23/285
20130101 |
International
Class: |
G09B 23/30 20060101
G09B023/30; G09B 19/24 20060101 G09B019/24 |
Claims
1. A suction simulation device for use with a manikin having an
airway comprising: a suction catheter; a suction unit in fluid
communication with the suction catheter, the suction unit
comprising a reservoir for holding fluid and the suction unit
configured to provide suction to the suction catheter; and a pump
in fluid communication with the suction unit, the pump configured
to flow the fluid from the reservoir, wherein the suction
simulation device is adapted for use with the manikin's airway.
2. The suction simulation suction simulation device of claim 1,
wherein the suction unit further comprises a secondary reservoir in
fluid communication with the reservoir.
3. The suction simulation device of claim 1, further comprising an
endotracheal tube comprising a proximal end and a distal end, and
further comprising a distal end pressure transducer positioned at
the distal end of the endotracheal tube to read a pressure at the
distal end of the endotracheal tube and a proximal end pressure
transducer positioned at the proximal end of the endotracheal tube
to read a pressure at the proximal end of the endotracheal tube,
the endotracheal tube in fluid communication with the suction
catheter when the suction catheter is used to remove a fluid from
the manikin's airway.
4. The suction simulation device of claim 1, further comprising an
endotracheal tube comprising a proximal end and a distal end, and
further comprising a distal end pressure transducer positioned at
the proximal end of the endotracheal tube to read a pressure at the
distal end of the endotracheal tube and a proximal end pressure
transducer positioned at the proximal end of the endotracheal tube
to read a pressure at the proximal end of the endotracheal tube,
the endotracheal tube in fluid communication with the suction
catheter when the suction catheter is used to remove a fluid from
the manikin's airway.
5. The suction simulation device of claim 4, wherein the
endotracheal tube further comprises a lumen in fluid communication
with the distal end pressure transducer, the endotracheal tube in
fluid communication with the suction catheter when the suction
catheter is used to remove a fluid from the manikin's airway.
6. The suction simulation device of claim 1, further comprising an
endotracheal tube comprising a proximal end and a distal end, and
further comprises a pressure transducer configured to determine a
pressure differential between the distal end and proximal end of
the endotracheal tube, the endotracheal tube in fluid communication
with the suction catheter when the suction catheter is used to
remove a fluid from the manikin's airway.
7. The suction simulation device of claim 3, further comprising a
fluid inlet tube comprising a distal end and a proximal end, the
fluid inlet tube is in fluid communication with the reservoir.
8. The suction simulation device of claim 7, wherein the fluid
inlet tube co-acts with the endotracheal tube, such that the distal
end of the fluid inlet tube is positioned proximate the distal end
of the endotracheal tube.
9. The suction simulation device of claim 7, wherein the proximal
end of the fluid inlet tube is in fluid communication with the
pump.
10. The suction simulation device of claim 1, further comprising a
control device in communication with the pump and configured to
control the pump.
11. A suction simulation system comprising: a manikin comprising an
airway configured to hold fluid; and a suction simulation device
comprising: a suction catheter; a suction unit in fluid
communication with the suction catheter, the suction unit
comprising a reservoir for holding the fluid and the suction unit
configured to provide vacuum capability to the suction catheter
such that the suction catheter can aspirate the fluid from the
airway of the manikin; and a pump in fluid communication with the
suction unit, the pump configured to flow the fluid from the
reservoir to the manikin.
12. The system of claim 11, further comprising a breathing
simulator in fluid communication with the airway of the manikin and
configured to flow gas into the airway of the manikin.
13. The system of claim 12, wherein the breathing simulator is
configured to cause a physical response from the manikin.
14. The system of claim 11, further comprising simulation software
for executing a mechanical ventilation scenario.
15. The system of claim 11, wherein the airway of the manikin is in
fluid communication with the pump.
16. A method of simulating a scenario requiring mechanical
ventilation comprising: providing a manikin comprising an airway
configured to hold fluid; providing a suction simulation device
comprising: a suction catheter; a suction unit in fluid
communication with the suction catheter, the suction unit
comprising a reservoir for holding fluid and the suction unit
configured to provide vacuum capability to the suction catheter;
and a pump in fluid communication with the suction unit and the
airway of the manikin, the pump configured to flow the fluid from
the reservoir; and running a mechanical ventilation scenario.
17. The method of claim 16, wherein running the mechanical
ventilation scenario comprises: flowing fluid from the suction unit
to the airway of the manikin using the pump; and suctioning some of
the fluid from the airway of the manikin using the suction
catheter.
18. The method of claim 16, further comprising: providing a
breathing simulator in fluid communication with the airway of the
manikin; and flowing gas from the breathing simulator to the airway
of the manikin.
19. The method of claim 16, further comprising: providing
simulation software, wherein running the mechanical ventilation
scenario comprises executing the simulation software.
20. The method of claim 16, wherein the suction simulation device
further comprises a control device in communication with the pump,
wherein running the mechanical ventilation scenario comprises
controlling the pump using the control device.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional
Application No. 62/185,097, filed on Jun. 26, 2015, the disclosure
of which is hereby incorporated in its entirety by reference.
BACKGROUND OF THE INVENTION
[0002] Field of the Invention
[0003] The present invention relates to a suction simulation
device, system, and method for flowing simulated mucus into the
airway of a manikin for training students to properly use a suction
unit for mechanical ventilation.
[0004] Description of Related Art
[0005] A frequent complication during mechanical ventilation is the
build-up of mucus in a patient's airway. The effect of such
build-up is a gradual or sometimes catastrophic obstruction of the
patient's airway, such as a mucus plug. It may lead to the
inadvertent modification of ventilation in a way that is
detrimental to the patient. Therefore, it is important for students
being trained in mechanical ventilation to recognize and manage the
build-up of mucus in the patient's airway, both in a hospital
setting and in a home care setting where mechanical ventilation has
become a more frequently accepted form of treatment.
[0006] The remedy for the build-up of mucus in a patient's airway
is suction of the airway using a suction unit. This remedy
introduces the risk of infection, specifically in intubated
patients, and injury due to inappropriate settings of the vacuum of
the suction unit. Suction of the airway is a special skill that
requires training. To enable such training, it is necessary to have
a simulation system that is capable of generating simulated mucus
build-up inside of the airway of a manikin simulator and software
to realistically simulate situations requiring mechanical
ventilation.
SUMMARY OF THE INVENTION
[0007] In one embodiment, a suction simulation device for use with
a manikin having an airway includes a suction catheter and a
suction unit in fluid communication with the suction catheter. The
suction unit includes a reservoir for holding fluid and the suction
unit is configured to provide suction to the suction catheter. The
suction simulation device also includes a pump in fluid
communication with the suction unit, the pump configured to flow
the fluid from the reservoir. The suction simulation device is
adapted for use with the manikin's airway.
[0008] The suction simulation device may include an endotracheal
tube which may include a proximal end and a distal end, and further
have a distal end pressure transducer positioned at the distal end
of the endotracheal tube to read a pressure at the distal end of
the endotracheal tube and a proximal end pressure transducer
positioned at the proximal end of the endotracheal tube to read a
pressure at the proximal end of the endotracheal tube, where the
endotracheal tube is in fluid communication with the suction
catheter when the suction catheter is used to remove fluid from the
manikin's airway. Alternatively, the endotracheal tube may include
a proximal end and a distal end, and further include a distal end
pressure transducer positioned at the proximal end of the
endotracheal tube to read a pressure at the distal end of the
endotracheal tube and a proximal end pressure transducer positioned
at the proximal end of the endotracheal tube to read a pressure at
the proximal end of the endotracheal tube, and this endotracheal
tube may further include a lumen in fluid communication with the
distal end pressure transducer, where the endotracheal tube is in
fluid communication with the suction catheter when the suction
catheter is used to remove fluid from the manikin's airway.
Alternatively, the endotracheal tube may have a proximal end and a
distal end, and further have a pressure transducer configured to
determine a pressure differential between the distal end and
proximal end of the endotracheal tube, where the endotracheal tube
is in fluid communication with the suction catheter when the
suction catheter is used to remove fluid from the manikin's
airway.
[0009] The suction unit may further include a secondary reservoir
in fluid communication with the reservoir. The suction simulation
device may include a fluid inlet tube having a distal end and a
proximal end, the fluid inlet tube being in fluid communication
with the reservoir. The fluid inlet tube may co-act with the
endotracheal tube such that the distal end of the fluid inlet tube
is positioned proximate the distal end of the endotracheal tube.
The proximal end of the fluid inlet tube may be in fluid
communication with the pump. The suction simulation device may
include a control device in communication with the pump and
configured to control the pump. The fluid from the reservoir may be
a viscous fluid.
[0010] In another embodiment, a suction simulation system may
include a manikin comprising an airway configured to hold fluid and
a suction simulation device. The suction simulation device may
include a suction catheter and a suction unit in fluid
communication with the suction catheter. The suction unit may
include a reservoir for holding the fluid and the suction unit may
be configured to provide vacuum capability to the suction catheter
such that the suction catheter can aspirate the fluid from the
airway of the manikin. The suction simulation device may also
include a pump in fluid communication with the suction unit, the
pump configured to flow the fluid from the reservoir to the
manikin
[0011] The suction simulation system may further include a
breathing simulator in fluid communication with the airway of the
manikin and configured to flow gas into the airway of the manikin.
The breathing simulator may be configured to cause a physical
response from the manikin. The suction simulation system may
further include simulation software to execute a mechanical
ventilation scenario. The airway of the manikin may be in fluid
communication with the pump.
[0012] In another embodiment, a method of simulating a scenario
requiring mechanical ventilation includes: providing a manikin with
an airway configured to hold fluid; providing a suction simulation
device having a suction catheter, a suction unit in fluid
communication with the suction catheter, the suction unit having a
reservoir for holding fluid and the suction unit configured to
provide vacuum capability to the suction catheter and a pump in
fluid communication with the suction unit and the airway of the
manikin, the pump configured to flow the fluid from the reservoir;
and running a mechanical ventilation scenario.
[0013] Running the mechanical ventilation scenario may include
flowing fluid from the suction unit to the airway of the manikin
using the pump and suctioning some of the fluid from the airway of
the manikin using the suction catheter. The method may further
include providing a breathing simulator in fluid communication with
the airway of the manikin and flowing gas from the breathing
simulator to the airway of the manikin. The method may further
include providing simulation software, where running the mechanical
ventilation scenario includes executing the simulation software.
The suction simulation device may further include a control device
in communication with the pump, and the step of running the
mechanical ventilation scenario may include controlling the pump
using the control device.
[0014] These and other features and characteristics of the present
invention, as well as the methods of operation and functions of the
related elements of structures and the combination of parts and
economies of manufacture, will become more apparent upon
consideration of the following description and the appended claims
with reference to the accompanying drawings, all of which form a
part of this specification, wherein like reference numerals
designate corresponding parts in the various figures. It is to be
expressly understood, however, that the drawings are for the
purpose of illustration and description only and are not intended
as a definition of the limits of the invention. As used in the
specification and the claims, the singular form of "a", "an", and
"the" include plural referents unless the context clearly dictates
otherwise.
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] FIG. 1 shows a schematic process flow diagram of one
embodiment of a simulation system having a manikin inlet;
[0016] FIG. 2 shows a schematic diagram of one embodiment of a
suction unit having a modified reservoir and a secondary
reservoir;
[0017] FIG. 3 shows a schematic diagram of one embodiment of a pump
unit used in the simulation system according to the present
invention;
[0018] FIG. 4 shows a schematic diagram of one embodiment of an
endotracheal tube inserted into the airway of a manikin with a
suction catheter inserted into the endotracheal tube;
[0019] FIG. 5 shows a schematic diagram of another embodiment of an
endotracheal tube having a second lumen inserted into the airway of
a manikin with a suction catheter inserted into the endotracheal
tube:
[0020] FIG. 6 shows a schematic diagram of one embodiment of an
endotracheal tube connected to a fluid inlet tube and inserted into
the airway of a manikin together with a suction catheter inserted
into the endotracheal tube;
[0021] FIG. 7 shows a schematic diagram of one embodiment of an
endotracheal tube having a single pressure transducer with a
suction catheter inserted into the endotracheal tube; and
[0022] FIG. 8 shows a cross-section of one embodiment of the
manikin showing fluid and air being flowed into the airway.
DETAILED DESCRIPTION OF THE INVENTION
[0023] For purposes of the description hereinafter, the terms
"upper", "lower", "right", "left", "vertical", "horizontal", "top",
"bottom", "lateral", "longitudinal", "proximal", "distal", and
derivatives thereof shall relate to the invention as it is oriented
in the drawing figures. However, it is to be understood that the
invention may assume various alternative variations and step
sequences, except where expressly specified to the contrary. It is
also to be understood that the specific devices and processes
illustrated in the attached drawings, and described in the
following specification, are simply exemplary embodiments of the
invention. Hence, specific dimensions and other physical
characteristics related to the embodiments disclosed herein are not
to be considered as limiting.
[0024] Referring to FIG. 1, a suction simulation system (1) is
shown that includes a suction simulation device (3) and a manikin
(10) having an airway (11). The manikin (10) can be connected to a
ventilator (5), such as coupled to an endotracheal tube (70)
inserted into the airway (11) of the manikin (10). The airway (11)
can hold fluid, such as simulated mucus (25), and the airway (11)
may be an anatomically correct representation of a human airway
(11). The simulated mucus (25) can be a viscous fluid. The suction
simulation system (1) is configured to run mechanical ventilation
scenarios (simulations). The manikin (10) may include an
anatomically correct representation of a torso (13) and a head (15)
of a human. During a simulation, the manikin (10) may exhibit
physical responses pertinent to patients having an obstructed
airway (11), such as breathing, coughing, burping, snoring,
choking, gurgling, etc.
[0025] In one embodiment, simulated mucus (25) is flowed into the
manikin (10) through a manikin inlet (12) and is aspirated out of
the manikin (10) through a manikin outlet (14), such as a nose (19)
or mouth (17) of the manikin (10). Simulated mucus (25) flows into
the manikin (10), preferably at a flow rate of 1-50 mL/min, but
this flow rate may be different should a given simulation scenario
so require. The simulated mucus (25) is a viscous liquid gel that
is purchased or made from "recipes" known in the art. Preferably,
the simulated mucus (25) is made from non-food ingredients (e.g.,
cellulose or other gel-forming hydrophilic lubricants). Preferably,
the simulated mucus (25) includes no organics and is not a suitable
host for microorganisms.
[0026] Referring to FIGS. 1 and 2, the suction simulation system
(1) includes the suction simulation device (3) that is adapted for
use with the manikin (10), including the airway (11). The suction
simulation device (3) may include a suction catheter or suction
tube (22) in fluid communication with a suction unit (16). The
suction catheter (22) may include a proximal end proximate the
suction unit (16) and a distal end proximate the airway (11) when
the suction catheter (22) is used to suction the manikin (10). The
suction unit (16) may be a commercially-available suction unit (16)
as commonly found in hospital intensive care units (ICUs) or
emergency rooms (ERs). Examples of commercially available suction
units (16) include the Laerdal Compact Suction Unit.RTM. 4 or the
Vacu-Aide.RTM. QSU Suction Unit. Alternatively, the suction unit
(16) can be a vacuum pump. The suction unit (16) has a suction unit
power source (18). The suction unit (16) also includes a suction
control (20). The suction control (20) powers on/off the suction
unit (16) and varies the intensity of the vacuum capability of the
suction catheter (22) controlled by a student (23), as shown in
FIG. 1. In some embodiments of the present invention, vacuum
adjustment capability of the suction unit (16) ranges from 50-550
mmHg and has a free flow of about 27 L/min. The vacuum capability
of the suction unit (16) provides a negative pressure differential
between the trachea and the distal end of the suction catheter (22)
or suction which may be such that the suction catheter (22) can
aspirate the simulated mucus (25) from the airway (11) of the
manikin (10).
[0027] The suction unit (16) also includes a reservoir (24) which
collects the simulated mucus (25) aspirated from the manikin (10)
and the endotracheal tube (70) using the suction catheter (22). The
reservoir (24) may include an exit region (26), as shown in FIGS. 1
and 2, to flow simulated mucus (25) out of the reservoir (24). A
suction exit tube (28) is included in the suction unit (16) to flow
simulated mucus (25) out of the reservoir (24) through the exit
region (26).
[0028] In some embodiments of the invention, the total volume of
simulated mucus (25) in the suction simulation system (1) is less
than or equal to the maximum volume of the reservoir (24), such as
800 mL. However, in other embodiments of the invention, the suction
unit (16) includes a secondary reservoir (30). The secondary
reservoir (30) is another container for holding additional
simulated mucus (25), and the secondary reservoir (30) is in fluid
communication with the reservoir (24) such that the simulated mucus
(25) stored in the secondary reservoir (30) may be flowed into the
reservoir (24) and ultimately introduced into the suction
simulation system (1). Since simulated mucus (25) may be lost
during the running of a simulation, simulated mucus (25) from the
secondary reservoir (30) may be flowed into the reservoir (24) to
keep the total volume of simulated mucus (25) in the suction
simulation system (1) at a sufficient level. A pump (27) can be
provided in communication with a secondary reservoir tube (31),
which runs between the reservoir (24) and the secondary reservoir
(30), to permit simulated mucus (25) to travel to and from the
secondary reservoir (30) and the reservoir (24). The pump (27) is
controlled by a control box (38). This embodiment allows for the
simulation to continue even if simulated mucus (25) is lost to the
environment during the simulation. In another embodiment, the
secondary reservoir (30) may be eliminated, and the simulated mucus
(25) need not be returned to the reservoir (24) after use.
[0029] Referring to FIGS. 1 and 3, the suction simulation device
(3) also includes a pump unit (32). The pump unit (32) is housed in
its own enclosure and attached proximate to the suction unit (16).
The pump unit (32) includes a pump unit power source (34), a pump
(36), the control box (38), and a pump exit tube (40). In one
embodiment of the invention, the pump (36) is a peristaltic pump.
The pump (36) is electrically connected to and controlled by the
control box (38). The pump (36) at least has the capability of
pumping simulated mucus (25) at a flow rate of between 1-50 mL/min,
or any other flow rate realistic in a training scenario. The pump
(36) may be in fluid communication with the suction unit and may
pump simulated mucus (25) from the reservoir (24) via the suction
exit tube (28) on one end and flow simulated mucus (25) toward the
manikin (10) on the other end by way of the pump exit tube (40).
The control box (38) causes various functions of the suction
simulation system (1) to occur, including causing the pump (36) to
stop, start, increase flow rate, decrease flow rate, etc.
[0030] Referring back to FIG. 1, in one embodiment, the pump exit
tube (40) flows the simulated mucus (25) into the manikin inlet
(12), which is located at one or multiple points along the manikin
(10), and into the airway (11) of the manikin (10). In one
embodiment, the manikin inlet (12) is defined in the torso (13)
region of the manikin (10). The manikin inlet (12) is in fluid
communication with the pump (36) and the airway (11) of the manikin
(10) to allow simulated mucus (25) to flow from the pump (36) to
the airway (11) of the manikin (10). The simulated mucus (25) is
flowed to obstruct the airway (11) of the manikin (10) to produce
the effects that students (23) need to learn and practice
mechanical ventilation.
[0031] With continued reference to FIG. 1, in one embodiment of the
invention, the suction simulation device (3) may include a control
device (42) in electrical communication with the pump (36) to
control the pump (36). For instance, the control device (42) may
allow for an instructor or individual to control the flow of
simulated mucus (25) through the suction simulation system (1). The
control device (42) may control the pump (36) through a wired or
wireless connection. The control device (42) may be a dedicated
radio controller, a smartphone application, a tablet PC, any
networked PC, or any other suitable device configured to
communicate with and control the pump (36).
[0032] In another embodiment of the invention, simulated mucus (25)
flow is controlled by a computer (66) running a simulation software
(68) (i.e., the simulation software (68) executes a mechanical
ventilation scenario). The computer (66) may communicate with the
breathing simulator (64) using a wired or wireless connection. The
computer (66) may also communicate with the control box (38) using
a wired or wireless connection. In this embodiment, the simulated
mucus (25) flow is not controlled by the control device (42) but is
controlled as part of a mechanical ventilation scenario of the
simulation software (68). A mechanical ventilation scenario is a
practice scenario used to train a student (23) (or other user) on
how to properly mechanically ventilate a human patient by
simulating real life situations in which mechanical ventilation is
required using the anatomically correct manikin (10). The
mechanical ventilation scenarios are based on realistic situations
that occur in hospitals or in the field (such as a home health
setting or emergency medical situation) that require use of a
suction unit (16). The mechanical ventilation scenarios allow
students (23) to practice proper techniques in mechanical
ventilation and to prepare the students (23) to handle real-life
situations.
[0033] The simulation software (68) may include at least one
non-transitory computer-readable medium including program
instructions that, when executed by at least one computer (66)
including at least one processor, causes the at least one computer
(66) to execute one of the mechanical ventilation scenarios. The
simulation software (68) may control the entire mechanical
ventilation scenario including the functions of the manikin (10)
and its respiratory mechanics.
[0034] During the execution of the mechanical ventilation scenario,
the simulation software (68) may control the flow rate of simulated
mucus (25) in the suction simulation system (1) and the physical
responses exhibited by the manikin (10) (such as breathing,
coughing, gurgling, etc.). During the execution of the mechanical
ventilation scenario, the simulation software (68) may relay
simulated medical information of the manikin (10) (i.e., the
simulated patient) to the at least one monitor viewable by the
student (23) training on the suction simulation system (1). The
simulation software (68) also provides feedback to the student (23)
(and/or the student's (23) instructor) after the mechanical
ventilation scenario in order for the simulation to be analyzed.
This may include overlaying simulated medical information with
information from the suction unit (16) to analyze the student's
(23) technique for aspirating the manikin's (10) clogged airway
(11).
[0035] With continued reference to FIG. 1, the suction simulation
system (1) may also include a breathing simulator (64). For
instance, the suction simulation system (1) may include the ASL
5000 Breathing Simulator from IngMar Medical, Ltd. of Pittsburgh,
Pa. In some embodiments, the simulation software (68) is an add-on
to the breathing simulator (64). The breathing simulator (64) may
be used to cause physical responses of the manikin (10). For
instance, the breathing simulator (64) may cause the manikin (10)
to breath, cough, gurgle, snore, and other typical patient
responses. In one scenario, the breathing simulator (64) may
initiate a cough from the manikin (10) when suction is detected,
which is a typical patient response in real-life circumstances. The
breathing simulator (64) may also flow gas, such as air or oxygen,
through a breathing simulator tube (65) into the airway (11) of the
manikin (10) as part of the suction simulation system (1). In other
words, the breathing simulator (64) is in fluid communication with
the airway (11) via the breathing simulator tube (65) to flow air
into the airway (11) (see FIG. 1).
[0036] In one embodiment, airflow readings from the endotracheal
tube (70) inserted into the manikin's (10) airway (11) to ventilate
the manikin (10) may be sent to the breathing simulator (64) to
perform calculations as part of the overall simulation.
Alternatively, pressure signals from pressure transducers or
pressure gauges on the endotracheal tube (70) (described in detail
below) may transmit their pressure readings to the breathing
simulator (64) to perform calculations for the simulation. The
breathing simulator (64) may recognize that suction is occurring by
reading a significant negative pressure in the manikin's (10)
airway (11).
[0037] Referring to FIGS. 4-7, the endotracheal tube (70) may
include a proximal end (44) configured to fit with a tube connector
(46). The endotracheal tube (70) may also include a distal end (48)
terminating in a tube end (50), which is an opening at the distal
end (48) of the endotracheal tube (70). The endotracheal tube (70)
may include a cuff (72). The cuff (72) engages the endotracheal
tube (70) in place in the trachea, in a manner known in the art.
The endotracheal tube (70) may be inserted into the airway (11) of
the manikin (10) with the distal end (48) first being inserted into
the airway (11). The endotracheal tube (70) may be coupled to the
ventilator (5). To clear the endotracheal tube (70) and the airway
(11) of simulated mucus (25), the ventilator (5) may be decoupled
from the endotracheal tube (70), and the suction catheter (22) may
then be inserted into the endotracheal tube (70) to suction the
simulated mucus (25) in the endotracheal tube (70) and causing an
obstruction in the manikin's (10) airway (11). The suction catheter
(22) may then be removed and the ventilator (5) recoupled to the
endotracheal tube (70). In embodiments in which the endotracheal
tube (70) is not inserted into the manikin's (10) airway (11), the
suction catheter (22) may be inserted directly into the airway (11)
to suction the simulated mucus (25).
[0038] Referring to FIGS. 4-5, the endotracheal tube (70) may
include a plurality of pressure transducers or pressure gauges (a
proximal pressure transducer (52) and a distal pressure transducer
(54)), which are in communication with the simulation software
(68). The proximal pressure transducer (52) may read the pressure
at the proximal end (44) of the endotracheal tube (70). The distal
pressure transducer (54) may read the pressure at the distal end
(48) of the endotracheal tube (70). As shown in FIG. 4, in one
embodiment, the proximal pressure transducer (52) may be positioned
at the proximal end (44) of the endotracheal tube (70), while the
distal pressure transducer (54) may be positioned at the distal end
(48) of the endotracheal tube (70) near the tube end (50). In
another embodiment, the proximal pressure transducer (52) may still
be positioned on the proximal end (44) of the endotracheal tube
(70), and the distal pressure transducer (54) may also be
positioned at the proximal end (44) of the endotracheal tube (70).
The distal pressure transducer (54) may be positioned at the
proximal end (44) of the endotracheal tube (70) when the
endotracheal tube (70) includes a lumen (56), which may be
connected to the endotracheal tube (70). The lumen (56) is used to
pneumatically transmit the pressure at the distal end (48) of the
endotracheal tube (70) to the distal pressure transducer (54) (see
FIG. 5). In other words, the lumen (56) is in fluid communication
with the distal pressure transducer (54) such that the distal
pressure transducer (54) may still read the pressure at the distal
end (48) of the endotracheal tube (70). This embodiment may also
require flow of gas into the manikin (10) through the endotracheal
tube (70). The lumen (56) may be positioned within the endotracheal
tube (70) itself. The lumen (56) may also be positioned just below
the endotracheal tube (70), as shown in FIG. 5.
[0039] The pressure transducers (52, 54) of the endotracheal tube
(70) allow the student (23) to determine whether the simulated
mucus (25) has been sufficiently cleared from the airway (11). The
pressure differential (.DELTA.P) (between the proximal end (44) and
the distal end (48) of the endotracheal tube (70)) together with
information about airflow allows the flow resistance of the
artificial airway (11) to be calculated. For a given size of the
endotracheal (70), this resistance is known. If simulated mucus
(25) causes an obstruction in the airway (11), the resistance will
be dramatically increased, which is an indication that suction is
necessary from the suction catheter (22). This increase will also
be shown to the student (23) in a ventilator waveform of pressure
and flow projected on a monitor. Once the airway (11) is properly
ventilated, the resistance value will return to normal levels. As
previously mentioned, the information about airflow is fed from a
breathing simulator (64) to perform calculations as part of the
overall mechanical ventilation scenario controlled by the
simulation software (68). The pressure (or pressure differential
(.DELTA.P)) signals may be transmitted to the breathing simulator
(64) to perform these calculations.
[0040] The distal pressure transducer (54) of the endotracheal tube
(70) also allows the technique of the student (23) handling the
suction catheter (22) to be assessed to ensure proper technique.
The pressure at the distal end (48) of the endotracheal tube (70)
is an indicator of proper technique because no excessive negative
pressures should be used for suctioning a patient, and the distal
pressure transducer (54) may monitor this pressure.
[0041] Referring to FIG. 6, another embodiment of the suction
simulation system (1) flows simulated mucus (25) into the airway
(11) of a manikin (10) through a fluid inlet tube (58) inserted
into the manikin outlet (14) in addition to, or in lieu of, the
simulated mucus (25) flown into the manikin (10) through the
manikin inlet (12). In certain embodiments, the fluid inlet tube
(58) is provided instead of the manikin inlet (12). The fluid inlet
tube (58) is in fluid communication with the pump (36), and the
fluid inlet tube (58) may co-act with the endotracheal tube (70) so
that the endotracheal tube (70) and fluid inlet tube (58) are
configured to be inserted into the airway (11) of the manikin (10)
together. The fluid inlet tube (58) may include a proximal end (60)
through which simulated mucus (25) enters the fluid inlet tube (58)
and a distal end (62) through which the simulated mucus (25) exits
the fluid inlet tube (58) and flows into the airway (11) (when
inserted into the manikin (10)). As shown in FIG. 6, the fluid
inlet tube (58) may be a separate tube running next to the
endotracheal tube (70) and may be connected to the endotracheal
tube (70). The simulated mucus (25) introduced into the airway (11)
through the fluid inlet tube (58) may then be suctioned out by the
suction catheter (22) inserted into the endotracheal tube (70)
after the ventilator (5) has been decoupled from the endotracheal
tube (70).
[0042] It is noted that in the embodiment shown in FIG. 6 in which
simulated mucus (25) enters the airway (11) of the manikin (10)
through the fluid inlet tube (58) instead of the manikin inlet
(12), the fluid inlet tube (58) may be incorporated into the
suction simulation system (1) shown in FIG. 1 to replace the
manikin inlet (12). In this situation, the fluid inlet tube (58) is
in fluid communication with the pump (36) (rather than the pump
(36) being in fluid communication with the manikin inlet (12)).
Thus, in one embodiment, simulated mucus (25) may be pumped from
the suction unit (16) by the pump (36) and enter the manikin (10)
via the fluid inlet tube (58) where it is subsequently suctioned
out of the manikin (10) by the suction catheter (22) and back into
the suction unit (16). The embodiment in FIG. 6 provides the
advantage of allowing critical "mucus-wetted" components to be
completely removed from the manikin (10), allowing for easier
periodic cleaning of the suction simulation system (1).
[0043] Referring to FIG. 7, another embodiment of the endotracheal
tube (70) is shown. This embodiment may include a single pressure
transducer (57) which determines the pressure differential between
the proximal end (44) and the distal end (48) of the endotracheal
tube (70). The pressure transducer (57) can determine this pressure
differential by any sufficient means. In one embodiment, the
pressure transducer (57) is positioned at the proximal end (44) of
the endotracheal tube (70) to read the pressure at the proximal end
(44) of the endotracheal tube (70) and to read the pressure at the
distal end (48) of the endotracheal tube (70) using the lumen (56).
Thus a single transducer (57) may be used to determine the pressure
differential across the endotracheal tube (70).
[0044] Flow of simulated mucus (25) in the suction simulation
system (1) begins by flowing simulated mucus (25) from the
reservoir (24) of the suction unit (16) to the airway (11) of the
manikin (10) (via the manikin inlet (12) and/or the fluid inlet
tube (58)) using the pump (36). The simulated mucus (25) obstructs
the airway (11) of the manikin (10). The suction catheter (22) is
then inserted into the endotracheal tube (70) in the airway (11)
after the endotracheal tube (70) is decoupled from the ventilator
(5), and at least some of the simulated mucus (25) is then
aspirated out of the airway (11) by the suction catheter (22)
controlled by the student (23). The endotracheal tube (70) is then
recoupled to the ventilator (5) after the simulated mucus (25) is
removed by the suction catheter (22), which is also removed from
the endotracheal tube (70). As previously discussed, gas fed into
the airway (11) by the breathing simulator (64) may be
simultaneously aspirated out of the airway (11). The simulated
mucus (25) suctioned by the student (23) then returns to the
reservoir (24) of the suction unit (16). Thus, the simulated mucus
(25) is "recycled" for multiple passes, which reduces the amount of
simulated mucus (25) needed and the amount of simulated mucus (25)
that is later cleaned away.
[0045] The suction simulation system (1) is used to train students
(23) to recognize the signs of an obstructed airway (11), to
properly mechanically ventilate the obstructed airway (11), and to
recognize the indications that the patient's airway (11) has been
successfully cleared.
[0046] A mechanical ventilation scenario (simulation) starts with
the manikin (10) having an unobstructed airway (11). The manikin's
(10) simulated medical information is relayed to the student (23)
by displaying the simulated medical information on monitors, such
as vital signs and oxygen saturation. The student (23) may also see
physical responses exhibited by the manikin (10), such as seeing
the manikin's (10) simulated breathing. Next, simulated mucus (25)
is delivered to the manikin (10), either by an instructor using the
control device (42) to control the pump (36) or as dictated by a
scenario of the simulation software (68). The breathing simulator
(64) may also flow gas into the airway (11) of the manikin (10).
The simulated mucus (25) delivered to the manikin (10) accumulates
in the airway (11) of the manikin (10) to create an obstruction,
such as a mucus plug. Meanwhile, the monitors continue to display
the manikin's (10) simulated medical information, allowing the
student (23) to notice a change in factors, such as the respiratory
rate and oxygen saturation as simulated mucus (25) builds up in the
manikin's (10) airway (11). The student (23) also looks for changes
in the physical responses exhibited by the manikin (10), such as
coughing, gurgling, or irregular breathing. The instructor or the
simulation software (68) have control over the flow of simulated
mucus (25), including both the rate of simulated mucus (25)
delivered to the manikin (10) and the timing at which the flow rate
of simulated mucus (25) changes in order to accurately reproduce
realistic scenarios requiring mechanical ventilation. The student
(23) then passes the suction catheter (22) into the endotracheal
tube (70) to clear any mucosal obstruction introduced to the
manikin's (10) airway (11). The manikin's (10) simulated medical
information is still monitored at this stage so that the student
(23) can evaluate whether the manikin (10) is being properly
ventilated and to determine when the manikin's (10) airway (11) is
no longer obstructed. The student (23) also looks for physical
responses exhibited by the manikin (10) that indicate that the
airway (11) is no longer obstructed. The suction catheter (22) is
then removed from the endotracheal tube (70), and the endotracheal
tube (70) is recoupled to the ventilator (5).
[0047] In some embodiments, during a simulation, the simulation
software (68) may collect information that is later used to debrief
the student (23). Information collected includes the simulated
medical information that is continuously monitored from the manikin
(10) during the simulation, such as vital signs and oxygen
saturation. It may also collect the flow rate of the simulated
mucus (25) from the pump (36). This information is used by the
instructor to create timelines and graphs that show the students
(23) how the events of the simulation (e.g., development of mucus
plug, start of aspiration, successful aspiration of the patient's
airway (11)) match up to the simulated medical information of the
manikin (10). Ultimately, the feedback from the debriefing helps
train students (23) to properly mechanically ventilate an
obstructed airway (11).
[0048] Referring to FIG. 8, a cross-section of the manikin (10)
shows simulated mucus (25) and air being flowed into the airway
(11) of the manikin (10). In this embodiment, air can be flowed
from the breathing simulator (64) through the breathing simulator
tube (65) and into the airway (11) of the manikin (10). The
breathing simulator tube (65) can enter the manikin (10) through
the manikin inlet (12) and continue on to the airway (11) (such
that the breathing simulator (64) is in fluid communication with
the airway (11) via the breathing simulator tube (65)). The
simulated mucus (25) exiting the pump (36) (not shown) can flow
through the pump exit tube (40) and into the airway (11) of the
manikin (10). In some embodiments, the pump exit tube (40) enters
the manikin (10) through the manikin inlet (12), but the pump exit
tube (40) can enter the manikin (10) at any point along the manikin
(10), such as at a point along the torso (13) of the manikin (10)
as in FIG. 8. Thus, the pump (36) is in fluid communication with
the airway (11) via the pump exit tube (40).
[0049] In one embodiment, the manikin (10) of the suction
simulation system (1) is easily cleaned based on the design of the
manikin (10). In one embodiment, the airway (11) of the manikin
(10) is configured with all "sensitive" components, such as
electromechanical and electronic components, located outside of the
manikin (10), for instance, in an external control box (not shown),
such as, for example, pressure flow transducers, gas valves,
analogs, etc. Thus, the manikin (10) that has simulated mucus (25)
flowing into its airway (11) during a simulation may easily and
rigorously be cleaned afterwards. In another embodiment previously
described in connection with FIG. 6, all critical "mucus-wetted"
components may be completely removed from the manikin (10),
allowing for easier periodic cleaning.
[0050] Although the invention has been described in detail for the
purpose of illustration based on what is currently considered to be
the most practical and preferred embodiments, it is to be
understood that such detail is solely for that purpose and that the
invention is not limited to the disclosed embodiments, but, on the
contrary, is intended to cover modifications and equivalent
arrangements that are within the spirit and scope of the appended
claims. For example, it is to be understood that the present
invention contemplates that, to the extent possible, one or more
features of any embodiment can be combined with one or more
features of any other embodiment.
* * * * *