• 专利附录
  • 专利说明
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  • 类似技术
  • 同族专利
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    • 专利摘要:
    In a patient simulator (1), in particular preterm, neonatal or child simulator, comprising a thorax replica (2), a pneumatic lung simulator (3) and a trachea simulator (4) leading to the lung simulator (3), the thorax replica (2) being a thorax replica with at least one raisable and lowerable thorax element (5) for simulating a thorax elevation and depression, the at least one elevatable and lowerable thorax element (5) interacts with a lifting and lowering mechanism (69) which can be controlled independently by the lung simulator (3).
    公开号:AT518851A1
    申请号:T317/2016
    申请日:2016-07-05
    公开日:2018-01-15
    发明作者:
    申请人:Simcharacters Gmbh；
    IPC主号:
    专利说明:

    The invention relates to a patient simulator, in particular premature infant, neonatal or child simulator, comprising a replica of at least one body part of a human patient.
    Since the care of a critically ill premature or newborn is a relatively rare event, it requires a quick, thoughtful and structured action of the medical staff, which is why there are always problems in the implementation of medical actions and teamwork. Failure to take the right steps to care for a premature or newborn baby who is life-threatened can have a lifelong impact on the child's future development. Especially in pediatrics, therefore, the implementation of simulation training is an ethical obligation. Only in this way can the necessary experience and skills for the care of critically ill premature or newborn babies be acquired, without endangering the life or health of the patients. The quality standard of today's medicine requires that even rare events be trained in order to save lives on the one hand and to improve the quality of life after an emergency situation on the other hand.
    Currently available infant and neonatal pupae do not allow the simulation of many pathologies due to the small size and thus required miniaturization of engineering and control elements. In addition, such simulation dolls often lack realism, whereby manipulation of the doll does not automatically improve the activities in reality.
    In WO2012 / 155283A1 a lung simulator is described, which is equipped with at least one air chamber, which is designed for example as a silicone bellows in order to best simulate the lung function in disease and healthy state. A disadvantage of the lung model disclosed in WO2012 / 155283A1 is that, due to its size, it can not be arranged within a lifelike simulator (doll), but is located outside the pupa.
    The present invention therefore aims to improve a patient simulator, in particular a premature infant simulator, in such a way that the fidelity to reality is improved and the simulation of various pathological conditions is made possible even in a small-scale embodiment for premature infant simulation.
    To solve this problem, the invention according to a first aspect provides a patient simulator, in particular a premature infant, neonatal or child simulator, comprising a thorax replica, a lung simulator and a trachea simulant leading to the lung simulator, the thorax replica a chest simulation with at least one raised and lowered Chest element for simulating a breast lift and -senkung has, wherein the at least one raisable and lowerable thorax element cooperates with an independently controllable from the lung simulator lifting and lowering mechanism.
    The invention is thus based on designing the lung simulator and the simulation of the thorax raising and lowering as functionally separate units, which can be controlled separately from one another for carrying out simulation processes. A lung simulator is understood to be the simulation of the fundamental respiratory mechanical parameters of a human being, in particular the respiratory resistance (resistance) and the extensibility of the lung (compliance). In the simplest case, a lung simulator comprises a pneumatic series connection of a resistance and a compliance. The pulmonary simulator serves to diagnose various conditions of the lungs of a patient, e.g. in terms of resistance and compliance, which is particularly advantageous for the practice of mechanical ventilation using a patient simulator on real respirators. In order to enable endotracheal intubation in this context, the patient simulator according to the invention comprises a tracheostomy simulation leading to the lung simulator and preferably an anatomical laryngeal simulation.
    Conventional embodiments of patient simulators are a pneumatic lung model, usually an elastic hollow body, which is connected to a spontaneous breathing pressure source to periodically fill and deflate the hollow body in accordance with the simulated respiration, thereby periodically expanding and contracting the hollow body. The thorax replica is formed in conventional embodiments with a raisable and lowerable thorax element, under which the elastic hollow body of the lung simulator is arranged so that the chest lift is carried out by the pressure of the expansive hollow body and the rib cage lowering by elastic recovery of the thorax or the hollow body. The movement of the rib cage is thus on the
    Spontaneous breathing simulation and ventilation of the lung simulator directly coupled.
    In contrast, in the embodiment of the invention, the rib cage elevation and depression can be simulated independently of the current state of the lung simulator because the elevatable and lowerable thorax element is driven by a lifting and lowering mechanism which is mechanically or physically independent from the lung simulator. The lung simulator and the thorax raising and lowering are thus designed as functionally separate units which can be separately controlled to perform simulation operations. As a result, not only physiologically normal states, but also various pathological states can be simulated realistically and extended exercise possibilities for the exercise participant can be created. In addition, the possibility is created to arrange the lung simulator or individual components of the same at a different location than immediately below the raisable and lowerable thorax element, whereby a space-saving arrangement is facilitated. A preferred embodiment of the invention provides in this context that the lung simulator is arranged within the thorax replica and / or within an abdominal replica. In particular, the lung simulator or individual components thereof can be arranged within the abdominal replica.
    The independent actuation of the lifting and lowering mechanism offers the further advantage that the lifting and lowering movements can be performed in a simple manner on a screen placed on a device, such as a monitor. a PC, displayed graphical user interface can be displayed.
    In this case, the graphical user interface preferably comprises a graphical representation of the simulated patient, the graphical user interface interacting with the patient simulator or a control device that controls it, such that an elevation and a lowering of the thorax of the patient shown is synchronized with the graphic user interface the thorax elevation and depression caused by the lifting and lowering mechanism of the patient simulator.
    In order to simulate physiologically normal states of the respiratory system, in particular of the lungs, the lifting and lowering mechanism of the thorax replica is actuated such that the at least one elevatable and lowerable thorax element rises and falls in synchrony with the air filling and emptying of the lung simulator. This is particularly the case when performing ventilatory exercises with the patient simulator, such as e.g. Ventilation exercises with mask and resuscitation bag. In this case, the simulator can preferably be ventilated when the head is in the neutral position and the respiratory mask is correctly sealed. When the chest raises on the simulator, it is obvious to the user (according to reality) that he is effectively ventilated. For the technical implementation of such a simulation, it is preferably provided that the lung simulator has at least one cavity, preferably two cavities, namely one for the simulation of the right lung and one for the simulation of the left lung, which can be filled with air from a ventilator, wherein pressure sensors for measuring the pressure in the or the cavity (s) are provided. The signals of or
    Pressure sensors / s are preferably fed to a control device for controlling the lifting and lowering mechanism of the thorax replica in order to raise and lower the at least one elevatable and lowerable thorax element as a function of the pressure signals. The pressure sensors are preferably arranged and designed to determine the ventilation pressure and the ventilation volume. The at least one cavity of the lung simulator is preferably designed to be adjustable in volume for this purpose. The volume can be dynamically adjusted according to the physical principles of compliance and resistance. The calculation of the current volume is based e.g. on a customized algorithm within a microcontroller. To set the physiological and pathological breathing parameters of the lung simulator, an electric drive is preferably provided.
    Alternatively, the lung can also be performed passively. For this purpose, the chamber is flexible, for example, as a chamber with an open side, which is covered by a flexible membrane. The expansion of the membrane as a function of the ventilation pressure allows the simulation of the tidal volume. By choosing the thickness, the material or the adjustability of the tension of the membrane, the compliance of the lung can be adapted to a real comparable equivalent.
    In the context of the simulation of pathological conditions, the respiratory distress syndrome is of particular importance. In the context of a respiratory distress syndrome effective breathing and ventilation of the lungs is difficult. Due to the negative pressure in the lungs, which is difficult to fill with air, the diaphragm is pulled towards the chest. The ribcage barely rises and apparently sinks when tensing the diaphragm. This creates the impression of a swing breathing or paradoxical breathing, as the chest lowers when inhaled and apparently exhales when exhaling. The opposite movement of the abdomen enhances this impression. The simulation of a rocking breathing is in the context of the invention by the pulmonary simulator independent control of the lifting and lowering mechanism of at least one raisable and lowerable thorax element allows, the control unit of the lifting and lowering mechanism is arranged to raise the at least one thorax element, if a Exhalation is simulated and lowered when an inhalation is simulated. In addition, it can be provided that an abdominal replica of the patient simulator has a raisable and lowerable abdominal plate, which is driven by a lifting and lowering mechanism of the abdominal replica. The visual impression of a swinging breathing is achieved here by the fact that the abdominal plate lifts during inhalation and at the same time lowers the ribcage and lowers the abdominal plate during exhalation and raises the chest at the same time.
    Furthermore, a pneumothorax can be simulated with the patient simulator according to the invention. Pneumothorax is a dreaded complication in premature babies. This leads to a tear in the lungs and thus to an acute emergency situation. This is recognizable by the fact that the ribcage no longer lifts on the side in question. A preferred embodiment for simulating a pneumothorax provides that at least one right raising and lowering thorax element for the right half of the thorax and at least one left ascending and lowerable thorax element for the left half of the thorax are provided, which can be raised and lowered separately from one another and each cooperating with its own controllable lifting and lowering mechanism, the lifting and lowering mechanism for the right thorax element and the lifting and lowering mechanism for the left thorax element are independently controllable. Due to the arrangement of separate lifting and lowering mechanisms for the right and left half of the chest, it is easily possible to simulate a pneumothorax both in self-breathing as well as in any form of ventilation. For this purpose, only one of the two lifting and lowering mechanisms (right or left) is controlled. This results in a one-sided elevation of the ribcage, which is well recognizable to the training participant as a one-sided pneumothorax.
    A preferred embodiment provides that the lifting and lowering mechanism (s) is or are arranged in the thorax replica, in particular under the at least one raisable and lowerable thorax element.
    The lifting and lowering mechanism can in principle be driven as desired, e.g. pneumatic, hydraulic or electric. Preferably, the raising and lowering of the chest member by means of an electric motor, for which purpose the lifting and lowering mechanism (s) each having an electric motor drive unit, which preferably comprises a pivotable movements driven arm. The swivel arm allows a space-saving design of the lifting and lowering mechanism while allowing a lifting and lowering movement with a relatively large stroke.
    With regard to the lung simulator, it is preferably provided that it has at least one adjusting element for setting the compliance and resistance. The adjustment of the lung can be formed by a chamber with a controllable piston, which can vary the trailing lung volume as a function of pressure and time, whereby both the compliance and the resistance can be adjusted by changing the pressurization of the piston.
    In a simplified, alternative lung control, the biological parameters compliance and resistance are preferably regulated separately from each other and at least each have a control for compliance and resistance. In this preferred embodiment, to control compliance, the elasticity is formed by differential tensioning of the pulmonary wall of the simulator. The regulation of the airway resistance (Resistance) is controlled separately with an adjustable or quick-switching valve for adjusting the air resistance.
    To realize the adjustment of the improvement of oxygenation in a surfactant deficiency syndrome after administration of a surfactant preparation or an adjustment of this drug with a liquid is in the thorax replica, especially in a respiratory device, preferably in the
    Trachea replica, a sensor provided. Preferably, the sensor is interchangeably incorporated in a wall of the airway simulation and comprises a liquid-adsorbing material, in particular a foam material · and one integrated into the material
    Humidity sensor. The sensor detects the injection of a liquid, e.g. a surfactant preparation, in the airway and / or the lungs by the dry material, in particular foam material absorbs the liquid and thus changes its electrical conductivity property. Once the surfactant preparation has been detected, the patient simulator shows a change in the pathological parameters and, according to a time course, reduces the values of compliance and resistance of the lung simulator according to the clinical reality.
    In addition to the sensory function of the surfactant sensor, the sensor with the foam material fulfills the function of a dirt filter for the lung simulator and, when changing the sensor, opens the possibility of cleaning the airway by flushing with a cleaning liquid over a cleaning plug.
    The replaceable humidity sensor with a foam core is accordingly integrated in the airway for detecting liquids and filtering the breathing air.
    For a more realistic representation of a respiratory distress syndrome a so-called intercostal retraction of the skin can be simulated. With a respiratory distress syndrome the inhalation is impeded. The oppression of the chest during inhalation causes the skin and tissue to contract against the more rigid portions (skeleton) of the flexible sections. This is particularly visible in the region of the intercostal spaces.A preferred embodiment of the invention provides in this context that the at least one elevatable and lowerable thorax element has a plurality of
    Rib simulations comprises and the thorax replica has a skin replica, which covers the rib replica and can be raised and lowered together with the at least one raisable and lowerable thorax element, wherein on at least one raisable and lowerable thorax element acting on the skin simulation train or pressure means, such as eg at least one thread or a rod-shaped tension element is attached, and wherein the at least one raisable and lowerable thorax element carries a drive element, in particular an electric motor for displacing the traction device, in order to effect intercostal collection of the skin replica. Due to the fact that the drive element is arranged or fastened for displacing the traction means on the raisable and lowerable thorax element, the drive element is moved along with the lifting and lowering movements of the thorax element which simulate the respiration, so that the simulation of the intercostal retraction is independent of the current elevation of the thorax element can be made. In a further embodiment, the collection can be achieved by magnetic force effect by incorporating magnetic elements into the skin and attracting them in a synchronized manner by electrically actuated magnetic coils in at least one intercostal space.
    Furthermore, it can preferably be provided that the patient simulator is designed to simulate the pathological state of necrotizing enterocolitis. Necrotizing enterocolitis (NEC) is a z.T. Dramatic bowel disease that is feared as a complication in the treatment of preterm infants. It represents the most common acute disease of the gastrointestinal tract in this group of patients with sometimes dramatic consequences for the premature baby. Decreased blood flow (reduced perfusion) of the intestinal wall in connection with an infection leads to tissue necrosis in the intestinal wall in the NEC. This usually occurs in the area of the ileal and ascending colon and is often associated with the formation of putrefactive gases in the intestinal wall (Pneumatosis intestinalis). With increased damage, the intestinal wall can perforate and it comes to leakage of intestinal contents in the free abdominal cavity. Inflammatory reaction, peritonitis and sepsis are the result.
    Clinical sign of necrotizing enterocolitis is a z.T. massively distended abdomen with enlarged intestinal loops, a lack of peristalsis and therefore missing bowel sounds. The local infection with leakage of intestinal contents leads to a livid (white, greyish, bluish) discoloration of the abdominal skin and to the emergence of veining in this area of varying severity. As a result of the flatulence of the intestine and thus of the entire abdomen, there is sometimes a massive restriction of spontaneous breathing, as the overblown stomach pushes the lungs up into the thorax and thus compresses. As a result, spontaneous breathing is often massively impaired. Therefore, preterm neonates with a severe NEC often need to be intubated intently and mechanically ventilated.
    To simulate the NEC, the patient simulator is designed to perform the following operations. The simulation of flatulence and hardening of the abdomen is done by raising the abdominal plate. For this purpose, the belly plate is placed in the maximum position and held in this. If a force is exerted from the outside, it is preferably provided that the drive of the brook plate elevation exerts an adjustable, maximum counterforce in order to simulate the hardening. At the same time, a reduction in the compliance of the lung preferably takes place via the physiological control circuits of the lung model. The lung volume is reduced and ventilation requires a higher ventilation pressure. The possibly provided implementation of the discoloration of the simulator is preferably carried out by colored LEDs, which illuminate the skin simulation of the simulator in the abdominal area from the inside and shimmer in the required color. These LEDs can mix the primary colors red, green and blue according to the specification to compensate for any discoloration in the silicone skin. To simulate the protruding vessel drawing, the vessels on the inside of the skin replica are color-coded or incorporated into the wall of the skin replica. Under the direct or diffuse illumination by the LEDs of the lifting plate, these vessel replicas are then visible through the taut skin.
    An independent second aspect of the present invention, which may be combined with any other aspect of the invention, in this context provides a patient simulator, particularly a premature infant simulator, comprising a lung simulator and abdominal replica comprising a raisable and lowerable abdominal plate is driven by a lifting and lowering mechanism, wherein a control device is adapted to lift the abdominal plate and at the same time to increase the ventilation resistance of the lung model. In a preferred manner, it is provided that the abdominal replica including the abdominal plate is covered by a replica of a skin, the inside of which can be illuminated by bulbs arranged in the abdominal replica.
    Furthermore, the patient simulator according to the invention can be designed to simulate the symptom of "head bobbing", a sign of increased work of breathing in premature and newborn babies.The lowering of the compliance of the lung thereby leads to the activity of the respiratory aid musculature in the area of the head (M. To simulate this symptom, a servomotor or similar drive element may be provided which, through the intermediary of a linkage or similar flexible translating element, such as a cable, the angle between the head replica and the thorax replica This movement is preferably synchronized with the breathing activity via the central control.
    An independent third aspect of the present invention, which may be combined with any other aspect of the invention, provides in this context a patient simulator, in particular a premature infant simulator, comprising a lung simulator, a thorax replica, which has a raisable and lowerable thoracic element is driven by a lifting and lowering mechanism, and a head simulation, which cooperates with a tilting mechanism to change the angle between head simulation and thorax simulation, wherein a control device is adapted to the
    Tilting mechanism to drive a periodic tilting movement of the replica head, wherein the periodic tilting movement is synchronized with the raising and lowering movement of the thorax element.
    According to a fourth, independent aspect of the invention which may be implemented in a patient simulator according to the first, second or third aspect of the invention, there is provided a patient simulator, in particular preterm, neonatal or child simulator, comprising a head model comprising a skull replica which is covered by a skin replica, wherein at least one light source is arranged in and / or on the skull replica. This can be simulated in the head area discoloration of the skin or skin replication. In the case of a blue discoloration, for example, a cyanosis can be simulated. Cyanosis indicates reduced oxygen saturation of the blood and may be a symptom of a life-threatening disorder if it occurs in an acute condition. Infants and newborns physiologically have cyanosis in the first few minutes after birth. This manifests itself especially in the area of the head and the trunk. As breathing becomes more efficient, cyanosis disappears in the first few minutes of its life. If it persists beyond this, it can be an important sign of a pathological condition. This can affect both breathing and cardiovascular function (e.g., congenital heart disease). Furthermore, the light source can also simulate a red coloration / reddening of the head which, for example, occurs in hyperoxia, i. an oversupply of oxygen and an associated increase in the oxygen partial pressure in the blood occurs. For the supply of an early and
    Newborns, cyanosis and hyperoxia are thus crucial clinical parameters that crucially affect the acting team's actions.
    Due to the fact that the at least one light source is arranged in and / or on the cranium replica, the light is not introduced directly into the replica of the skin, which would only lead to a punctual, localized light effect on the skin, but it comes as a result of the light introduction into the skull imitation there to a light distribution, so that a larger surface area of the skin replica is illuminated relatively evenly from the inside. This leads to a realistic simulation of a change in the skin color of the patient simulator. In contrast, the direct placement of light sources, e.g. LEDs, under the skin, although lead to a clear, but altogether unrealistic picture. The punctual cyanosis at the site of the light source placement e.g. on the cheeks or in the mouth, would be physiologically incorrect and would appear unnatural.
    A preferred embodiment provides that the at least one light source is formed by an RGB LED whose color channels are independently controllable independently of one another. The use of multicolor RBG LEDs allows the implementation of different shades in a simple manner. Such LEDs preferably have at least three individual LED elements of different colors. To cover the entire spectrum of visible light (and thus, in particular, the different nuances for cyanosis and hyperoxia) are preferably the three LED colors red, green and blue of the LED source additively mixed. Due to developments in the field of microelectronics, there are currently various options for driving the RGB LEDs, ranging from the application of the combination of discrete-drive individual LED devices to highly integrated devices with a digital control line for adjusting the color temperature , Another advantage of RGB LEDs is the space-saving design option of multiple light elements, especially if they can be cascaded together in series via a serial bus. In the case of serial cabling, only one control line is required for programming the modules, with the serial data signal consisting of e.g. Eight bits per color of each light module is composed and the information passed through all the modules. It thus follows that, according to the number of modules, an equal number of 3 color bytes must be generated in order to set all modules in the chain with a color information.
    The entire color gamut of the RGB LEDs preferably comprises> 4 million, in particular> 16 million possible colors and thus includes the entire visible color spectrum from white to black. This makes it possible to select a suitable color in a simple manner, a realistic color of the skin replica. For the management of the color control and the data exchange, a separate microcontroller is preferably provided which receives control commands from a main controller and passes them to the individual RGB LEDs. For the realization of a skin discoloration in the forehead region of the replica head, it is preferred if a light source is arranged on the inner surface of the skull of the skull replica. The resulting indirect illumination inside the skull replica leads to a homogeneous, uniform light distribution. For this purpose, the LED module provided for this purpose can preferably be adhesively bonded medially to the base of the skull and thus indirectly illuminates the inner part of the skull. The reflection occurring via the skull formation, which is preferably formed in white color, thus illuminates the entire forehead area and the side parts of the skull homogeneously. In combination with a cheek light, this leads to a uniform illumination of the entire upper head area. The result is an extremely realistic representation of cyanosis and hyperoxia in the head area. For the realization of a skin discoloration in the nasal mouth of the head replica, it is preferred that a light source in the skull replica the medial fossa of the skull is arranged from the inside. The direct illumination of the cranial bones of the skull replica from the inside of the skull replica, in the area of the middle fossa, results in a homogeneous and realistic light distribution, which radiates at the interfaces between the skull replica and the skin replica. This leads to extremely realistic staining in the area of the nasal mouth. Also with regard to series production, the irradiation of the bones from the inside of the skull means a clear advantage. The light modules are thus protected against any mechanical stress and can be easily constructed and replaced. In addition to the good light distribution and advantages for mass production and durability, further results in a reduction of the energy requirement for the light source, since this method results in no energy loss through the connection of an optical waveguide via an adapter.
    A homogeneous illumination of the skin replica is preferably achieved in that the skull replica is made of a polymeric, translucent, in particular white, material and the replica skin is transparent or translucent, in particular of a silicone material. For lighting difficult to access areas, e.g.
    Mouth and chin zone, due to limited space, the use of optical fibers is advantageous. The space conditions are limited in particular when the replica of the head comprises a replica of the upper respiratory tract. A preferred embodiment in this context provides that a light source is connected to an optical waveguide which extends arcuately in the chin region of the head imitation and is designed to emit light along the arc, wherein the light-emitting arcuate region of the optical waveguide preferably between the skin replica and a Respiratory Tract or the lower jaw is arranged. The radiation in the arcuate region is advantageously achieved by roughening and / or indenting the outer surface of the optical waveguide. As a result, a diffuse and planar radiation is also achieved. Preferably, the optical waveguide is arranged so that the light-emitting arcuate region is guided parallel to a lower jaw replica.
    According to a fifth independent aspect of the invention, which may be implemented in a patient simulator according to any one of the preceding aspects of the invention, there is provided a patient simulator, in particular prematurity, neonatal or child simulator, comprising a head replica with a nose replica with two flexible nostrils , wherein at the nostrils leading into the interior of the replica head drive element, such as at least one thread or lever, acts to simulate a widening and narrowing of the nostrils. The so-called "Nasenflügeln" shows up as breath synchronous widening of the nostrils with the inhalation and represents a symptom of a Atemnotsyndroms.
    The operation of the nose wing movement is preferably carried out in that a lever mechanism with a drive element, such as an electromagnet, cooperates to move the lever. The lever mechanism is constructed so that upon activation of the electromagnet, the opposite ends of the lever move in opposite directions and thus when the levers to the magnet to the magnets spread the ends in the nostrils. When activating the magnet, this causes an enlargement of the nostrils. When deactivating the electromagnet, there is a provision of the nostrils due to the elastic versions of the nostrils with a corresponding plastic.
    A breath-synchronous movement of the nostrils is preferably achieved in that a central control device is provided which is designed to control the lifting and lowering mechanism of the thorax replica and for driving the drive element of the nasal wings such that the expansion of the nostrils and the lifting of at least one lever - And lowerable thorax element synchronously.
    A sixth, independent aspect of the invention addresses another problem associated with
    Patient simulators exists. For evaluation of the lung and the heart as well as the abdomen, it is advantageous for training purposes to be able to listen to sounds with the aid of a stethoscope. In conventional patient simulators, this is accomplished by installing speakers in the area of the respective organs. However, this has significant disadvantages. Most are just a speaker for the heart, two speakers for the lungs and possibly a speaker for bowel sounds above the abdomen. As a result, the user must precisely hit the speaker, which is not visible from the outside, in order to clearly hear the noise. But even if the user hits the position of the desired speaker, usually secondary sounds of the simulator mechanics are also heard, which irritate and ultimately do not allow proper listening.
    To overcome these drawbacks, according to a sixth independent aspect of the invention, which may be implemented in a patient simulator according to any one of the preceding aspects of the invention, there is provided a patient simulator, in particular preterm, neonatal or child simulator, comprising a chest replica, an abdominal replica , one
    A stethoscope simulator and an audio generator, the thorax replica and the abdominal replica having at least two distance sensors which cooperate with a stethoscope head of the stethoscope simulator for determining the position of the stethoscope head, wherein the determined position data can be supplied to the audio generator, the audio generator having a memory for audio files and a processing means for Mixing of the audio files in response to the position data to a mixed audio signal that can be fed to an earphone of the stethoscope simulator. In this case, a distance sensor is understood to be a sensor which outputs a signal which is proportional to the distance, in particular the spherical distance, between the sensor and the stethoscope head. The position of the stethoscope head can preferably be determined based on the distance data by mathematical triangulation in order to obtain position data. The calculation of the position data from the distance data can be done either in the patient's copy or externally. The audio generator is preferably located outside of the patient replica. The invention is thus based on the idea not to generate auscultating noises in the patient simulator, but that only the position of the stethoscope is detected in the patient simulator and the sounds are generated according to the position in the stethoscope itself or in an external unit.
    It is preferably provided here that the simulator has a near-field transmitter and the stethoscope has a resonant receiver circuit. The near field transmitter of the simulator generates an electromagnetic near field with a predetermined frequency. For example, a defined carrier frequency of, for example, 100 kHz is used.
    In the simulator itself are transmitter coils, which are tuned to the carrier frequency. Depending on the distance to the receiver, the resonance frequency and amplitude in the associated resonant circuit changes. The distance data obtained in this way, represented by the amplitude and frequency, are evaluated for position determination and the result is fed to the audio generator, in which a
    Processing device ensures that stored audio files are mixed depending on the position to a common audio signal that can be fed to an earphone of the stethoscope simulator. The distance or position data may preferably be supplied to the audio generator as analog signals, whereby a weighting of the volume of the audio files, such as sounds of the lungs, the heart, the stomach, as well as artificial background noise in response to a correct, quiet Aufsetzten the stethoscope can be done and the audio files can be mixed to form a resulting audio signal. Therefore, for the trainee, there is the situation that when positioning the stethoscope simulator on the left thorax a clear lung noise is blended or when cardiac positioning primarily heart sounds are mixed.
    Alternatively it can be provided that the near field transmitter is arranged in the stethoscope and the receiver circuit in the simulator. The implementation of the sender and receiver is accordingly interchangeable depending on the application.
    The audio generator can be arranged either in a stethoscope replica of the stethoscope simulator or in an external unit separate from the patient replica of the patient simulator and from the stethoscope replica. The audio signal mixed by the audio generator arranged in an external unit may preferably be transmitted by means of wireless data transmission, e.g. Bluetooth wirelessly transmitted to a receiver unit of the Stethoskopsimulators and therefore be heard without unpleasant noise through an integrated earphones.
    A preferred embodiment provides that at least one audio signal which represents noises of the human body at the corresponding position can be mixed for each position on the thorax or abdominal replica. The sounds are weighted depending on the stethoscope head position from at least one stored audio file and output in the stethoscope.
    The individual audio files each represent a simulated noise source, such as a murmur, a lung sound, a stomach sound, and the like, and are therefore assigned to the position of the respective noise source. Furthermore, the processing device for mixing the audio files is advantageously designed so that an audio file is added to the mixed signal with an even greater volume, the smaller the distance of the stethoscope head from the position associated with this audio file or this simulated noise source.
    When generating the mixed audio signal, additional parameters can be taken into account in addition to the position information. For example, it is advantageous if the heart sound is adjusted so that it detects the heart rate. The same applies to the lung noise for the respiratory rate. Furthermore, the sounds may naturally vary depending on pathological conditions. A preferred embodiment of the invention in this context provides that each audio file with physiological noise can be replaced by an audio file with pathological noise and this is mixed for the output of the position-linked audio signal corresponding to the stethoscope head position.
    In order to be able to reproduce the most diverse noise sources of the human body as realistically as possible, it is preferably provided that at least one audio file simulates a heart sound and is therefore assigned to the position of the heart of the thorax replica, that an audio file simulates a first lung noise and therefore the position of the left lung of the lung Associated with a thorax reconstruction, that an audio file simulates a second lung sound and is therefore associated with the position of the right lung of the thorax replica and / or that an audio file simulates a stomach sound and is therefore associated with the position of the stomach of the abdominal replica.
    In general, in any of the aspects of the invention described above, it is preferable for the patient simulator to designate a complete body of the particular patient, i. especially a premature baby, a newborn or
    Child represents and therefore in addition to a thorax, an abdomen, a head replica also includes replicas of the extremities. Furthermore, the patient simulator is sized and sized for its replicated body parts to suit the dimensions and proportions of a real patient, i. of a human premature baby, newborn or child.
    The invention will be explained in more detail with reference to embodiments shown schematically in the drawing. In this Fig.l shows a
    4 shows a further illustration of the premature infant simulator, FIG. 5 shows a detailed view of the premature infant simulator with an intercostal recovery mechanism, FIG. 6 and FIG 7 is a representation of the simulation of skin in two different states of intercostal recovery;
    Fig. 10 is a front view of the skull simulation of the premature infant simulator, Fig. 11 is a detailed representation of cranial replica around the nose, Fig. 12 is a stethoscope replica in cooperation with the premature infant simulator, Fig. 13 14 shows an overview of the control logic of the patient simulator, in particular concerning the lung model, and FIG. 15 shows an overall view of the patient simulator, including control and monitoring components.
    FIG. 1 shows a premature infant simulator 1 comprising a thorax replica 2, a lung simulator 3 and a tracheotomy 4 leading to the lung simulator 3. The thorax replica 2 comprises a right raisable and lowerable thorax element 5 for the right half of the thorax and a left raisable and lowerable thorax element for the left thoracic half (not shown in FIG. 1). Furthermore, the simulator 1 comprises a skull replica 6. The two thorax elements 5 are formed separately raised and lowered and each equipped with its own controllable lifting and lowering mechanism. The lifting and lowering mechanism arranged in the interior of the simulator 1 comprises on both sides in each case an electromotive drive unit 7 which drives a gearwheel 8. The gear 8 engages in a trained on pivotally mounted arm 10 teeth 9, wherein the arm 10, the respective right or left thorax element 5 is fixed, so that the rotational movement of the gear 8 depending on the direction of rotation in a lifting or lowering movement of the arm 10th is translated with the thorax element 5 in the direction of the double arrow 12. The left and right rib cage elements 5 each have a rib replica 11.
    Furthermore, the simulator 1 comprises an abdominal replica 13, which has a raisable and lowerable abdominal plate 14, wherein the raising and lowering of the abdominal plate 14 - analogous to the raising and lowering of the thorax elements 5 - by an electric motor drive unit 15 which drives a gear 16, which in turn engages in a toothing 17, which is formed on a pivotally mounted arm 18, to which the belly plate 14 is attached.
    FIG. 2 shows the abdominal plate 14 and the thorax elements 5 in the lowered position, and FIG. 3 shows the abdominal plate 14 and the thorax elements 5 in the raised position.
    Upon actuation of the electric motor drive unit 15 (not shown in Figure 2 and Figure 3), the gear 16 rotates and a raising / lowering of the belly plate 14 in the direction of arrow 19 by engagement of the gear 16 in the toothing 17 and the induced thereby pivoting of the drivable arm 18 causes. Depending on the direction of rotation of the gear 16, a simulation of Abdomenhebung or -senkung is possible.
    4 shows the complete anatomical support structure of the simulator 1 over which a replica of a skin 20 (not shown in FIG. 4) lies, which covers the entire simulator 1, that is also the thorax replica 2 with the
    Rib replica 11, and the abdominal replica 13 covered with the abdominal plate 14. In particular, the simulated skin 20 encloses the thorax replica 2 as well as the abdominal replica 13. The replica skin 20 is made of an elastic material, such as ankle. made of a silicone material, made to allow the raising and lowering of the thorax elements 5 and the abdominal plate 14.
    It is further shown in FIGS. 5 to 7 that, to simulate an intercostal retraction, 20 engaging traction means 21 are provided on the skin replica. The traction means 21 extend between the individual ribs of the rib replica 11 and are at their end facing away from the skin replica 20 each attached to pivot rods 21 '. The pivot rods 21 'are rigidly mounted on a common axis and therefore pivotable about this axis, wherein the pivot drive an electromotive drive unit 22 is provided which drives the gear 23 for rotational movement, which engages in the on the axis of the pivot rods 21' attached gear 24 , The pivoting of the pivot rods 21 'in the direction of the double arrow 25 causes the replica skin 20 is pulled between the rib replicas 11 and is moved back to its normal position. Depending on the direction of rotation of the drive 22, a simulation of the intercostal collection or the normal position of the skin replica 20 is thus possible. The drive 22 is in this case attached to the arm 10, which is responsible for the raising and lowering of the rib replicas 11. By moving the drive 22 with it when lifting or lowering the arm, the simulation of the intercostal collection of the skin replica 20 can be carried out independently of the respective position of the rib replica 11.
    FIG. 6 shows the simulated skin 20 in the normal position and in FIG. 7 in simulated, intercostal recovery.
    8 and 9 show a head simulation 26 of the simulator 1, which has a skull simulation 6. Within the skull replica 6, the light sources 27, 28, 29, 30 and 31 are arranged.
    The light sources 27 and 28 are attached to a support plate arranged in the cranial cavity and directed in the region of the forehead against the inner surface of the skull of the skull replica 6. The light sources 29 and 30 are located in the middle cranial fossa of the skull replica 6. A further light source 31 is arranged in the interior of the skull replica 6 and feeds an optical waveguide 32, which extends arcuately in the chin region 33 of the replica 26.
    By virtue of the fact that the skull replica 6 and the skin replica 20 are translucent, upon actuation of the light sources 27 to 31, an illumination pattern as shown in FIG. 10 results which is characteristically blue in a present cyanosis and characteristic red areas in a hyperoxia.
    11 shows the head model 26 of the simulator 1 with a nose replica 34, which has two flexible nose wings 35, wherein on the nose wings 35 in the interior of the replica head 26 leading levers 36 attack, which consist of a magnetizable material. Furthermore, a control device 37 is provided, which carries electromagnets 38, wherein upon actuation of the control device 37, the electromagnets 38 are activated and the magnetic levers 36 are tightened according to the arrows 39, which in turn causes an expansion of the nostrils in the direction of arrows 40.
    Fig. 12 shows a skin replica 20 which covers the entire simulator 1, i. Also, the thorax replica 2 with the rib replica 11, and the abdominal replica 13 covered with the abdominal plate 14. In particular, the simulated skin 20 encloses the thorax replica 2 as well as the abdominal replica 13. The replica skin 20 is made of an elastic material, such as ankle. made of a silicone material, made to allow the raising and lowering of the thorax elements 5 and the abdominal plate 14.
    12 shows a stethoscope simulator 41, wherein the thorax replica 2 and the abdominal replica 13 have three distance sensors 43, 44, 45, which are connected to a stethoscope head 46 of the stethoscope simulator 41 for determining the distance between the stethoscope head 46 and the respective distance sensor 43, 44, 45 Interaction to obtain distance-proportional signals. The control unit 48 comprises a memory for audio files and a processing device for mixing the audio files as a function of the distance data to a mixed-up audio signal which is supplied to the earphones 47 of the stethoscope simulator 41.
    FIG. 13 schematically shows a circuit diagram, wherein it can be seen that the distance sensors 43, 44, 45 (not shown in FIG. 13) of the patient simulator 1 are designed as a near-field transmitter with a transmitter resonant circuit 49 and the stethoscope head 46 has a resonant receiver resonant circuit 50 , The near-field transmitters of the patient simulator 1 thereby generate an electromagnetic near field with a predetermined frequency, wherein the carrier frequency is defined, for example, as 100 kHz. The transmitter resonant circuits 49 are tuned to this carrier frequency, wherein the resonance frequency and the amplitude in dependence on the distance to the receiver resonant circuit 50 change. The resonance frequency and the amplitude of the two transmitter oscillation circuits 49 are evaluated in an evaluation device 51 and wirelessly transmitted as a distance to the stethoscope head 46 representing distance data to a central external control device 48, such. transmitted a control computer. In the controller 48, the distance data is received by the receiving module 52. The distance data may be supplied directly to the audio generator 42 or first, e.g. be converted by triangulation method, into position data. In the audio generator, a processing device ensures that stored audio files 53 are mixed into a common audio signal as a function of the distance or position data. The audio signal is transmitted wirelessly to a receiver module 54 of the stethoscope simulator 41 where it is amplified in an amplifier 55 and supplied to the earphones 47. The stethoscope simulator 41 further includes a power supply, not shown, which supplies not only the receiver module 54 and the amplifier 55, but also the receiver resonant circuit 50 via the lines 56.
    In Fig. 14, the control of the lung simulator and the separate control of the lifting and lowering mechanism of the rib cage simulation is shown in more detail.
    The lung simulator 3 comprises a rigid-walled, preferably metallic cylinder 57, in which a piston 58 is arranged so as to be adjustable in the axial direction by means of a drive 59 (for example a stepping motor). The piston 58 limits a working volume or a cavity 60 of the lung simulator 3, into which a trachea replica 4 opens, into which the tube 67 of a respirator (not shown) can be inserted. At the transition from the trachea reproduction 4 in the cavity 60, a constriction 61 is provided through which the
    Flow cross-section of the air in the trachea replica 4 undergoes a constriction. There are further provided pressure sensors 62 and 63 with pressure relief valve (not shown) for limiting the maximum allowable pressure, which are arranged to measure the pressure in the cavity 60 and in the trachea replica 4.
    To simulate the individual lung functions, a computer-assisted control device 64, in particular a computing device, is provided, which cooperates with a physiological calculation model 65, with which physiological relationships of the simulated parameters of the lung simulator can be simulated. The control device 64, the signals of the pressure sensors 62 and 63 and the signals of a sensor 66 for detecting the current position of the piston 58 are supplied. The control device 64 generates control commands for the piston drive 59 for controlled activation and movement of the piston 58, whereby the behavior of a flexible membrane provided in conventional lung simulators can be adjusted by the use of a fast control system and due to the rigid design of the cavity-limiting walls.
    To simulate a patient to a connected ventilator, it is sufficient to simulate the tidal volume of the ventilated patient, which represents only a small proportion of the total capacity of the lung.
    The cavity 60 of the lung simulator is therefore sized to correspond, in the maximum piston position, to the tidal volume, plus a volume reserve for control, of a human patient, particularly a preterm, neonatal or child.
    In order to simulate a lung for a ventilator, the volume and pressure course over time must be within the range of physiological or pathological parameters.
    This ensures that the use of respirators (mechanical and manual) in combination with the integrated lung replica leads to the display of realistic ventilation parameters and allows setting of realistic ventilator pressures and volumes on respirators. This also leads to the realistic triggering of pressure and volume alarms on the ventilator.
    To simulate the tidal volume of the patient simulator, the volume of the cavity 60 in the inspiratory simulation is increased by appropriately moving the piston 58 and decreased in the exhalation simulation. For the simulation of the compliance, both the current pressure in the cavity 60 and the current volume of the cavity 60 are determined. The compliance is here defined as the increase in volume AV per increase of the applied gas pressure Δρ, wherein the dependence of the volume increase AV on the pressure increase Δρ is non-linear, i. the AV / Δρ ratio decreases towards the end of inhalation (even a small volume increase produces a large increase in pressure). The pressure p is measured by means of the pressure sensor 62. The volume V results from the known cross section of the cylinder 57 and the piston position measured with the sensor 66. If the pressure changes differently than the piston position (directly proportional to the volume), the piston position can be tracked with the aid of the electromechanical drive 59. The temporal
    Resolution of the control must be chosen as high as possible, so that no quantization levels are recognizable. In the selected structure, a volume flow sensor can additionally be realized by a second pressure sensor in the working volume in conjunction with a bottleneck at the piston outlet, which can be used to refine the image.
    From the ventilator's point of view, only the pressure at the end of the tube is relevant. This circumstance can be used to simulate the resistance through the dynamic component of the control loop. This also adds a temporal component to the system. With increased flow resistance in the airways, the filling of the lungs is delayed or is so difficult that no gas exchange in the intended time is possible.
    With an increased resistance, there is a backflow of the respiratory gases in the tube, the pressure increases, the volume flow decreases. Low Resistance R in the lungs creates a low back pressure p in the tube, the volume flow V is maximum.
    To simulate this effect with only a single piston 58, it is necessary to adjust the pressure in the cavity 60 to the pressure in the tube 67. At low resistance, the pressure in the cavity 60 is kept lower than or equal to the pressure in the tube 67 in order to facilitate the inflow of the gases. With increased resistance in the cavity 60, an increased back pressure is generated, which hinders the influx of respiratory gases. The reduction or increase of the back pressure is accomplished by the adjustment of the piston 58. In the control of the piston position thus two influencing variables are taken into account. On the one hand the piston position resulting from the compliance as a function of the pressure in the cavity 60, on the other hand the setting of a counter-pressure resulting from the resistance.
    By detecting the pressures in the cavity 60, as well as in the tube 67 and based on the known diameter of the bottleneck can be inferred in addition to the current flow.
    Another aspect is the evaluation of the volumetric flow, since the two pressure sensors with the constriction form a volumetric flow sensor which measures the volumetric flow directly.
    Based on the measured values of the pressure sensors 62 and 63 and on the basis of the piston position determined by the sensor 66, the volume of the cavity 60, the volume flow into and out of the cavity 60 and the pressure in the cavity 60 are present in the control device 64. With the physiological calculation model 65, information about the compliance and the resistance can be calculated from this, or vice versa corresponding values for the pressure, the volume flow and the volume can be calculated from a predetermined compliance value and a predetermined resistance value.
    The physiological computing model is configured to define the current fill volume from the values for compliance, resistance, and breathing empathies (e.g., rocking breath), and further to separately generate the position data for the current position of the chest replica and tummy plate, which are passed to the animation controller 68. In the animation control 68, control signals for the lifting and lowering mechanism 69 cooperating with the rib cage simulation and for the lifting and lowering mechanism 70 interacting with the abdominal plate are generated therefrom, so that the breathing movements are simulated synchronously with and corresponding to the simulation state of the lung simulator 3.
    In Fig. 15 is an overall view of a
    Simulation system comprising the patient simulator 1 and the control and monitoring components shown. The patient simulator 1 represents a replica of the entire body of an early, newborn or child. The system further includes. a server 71, a graphical user interface 72, a patient monitor 73, and a simulation calculator 74.
    The simulation computer 74 is responsible for the communication of the patient simulator 1 with the graphical user interface 72 and the patient monitor 73 and is preferably integrated into the patient simulator 1. The simulation computer 74 takes over the computationally intensive preparation of the control commands and sensor data acquisition. In this case, the simulation computer 74 communicates with the components installed in the simulator 1 and collects various sensor data of the simulator 1, processes it and subsequently generates control signals with which, for example, the servomotors of simulator 1 are controlled.
    The simulation calculator 74 includes the physiological calculation model 65 and the animation control 68 with respect to the lung simulator (FIG. 14).
    The trainer controls the entire simulation system via the graphical user interface 72. This user interface allows the trainer to enter the framework conditions for the training scenario. In the course of the exercise, the desired pathological changes are controlled here and the measures taken by the exercise participant can be made visible to the trainer on the user interface by visualizing the sensor data of the system. For this purpose, the parameters and the individual functions of the simulator 1, such as breathing and heartbeat, first to the
    Pass simulation computer 74 and generated there the corresponding control commands for the patient simulator 1.
    The user interface is preferably divided into three areas: 1.) the representation of the new or
    Premature babies, with the controls for e.g. ECG, saturation monitoring and peripheral access, 2.) the area for controlling the respiratory functions, and 3.) the area for imaging and controlling the patient monitor 73. At the center of the user interface are the 3D model of the lung and the 3D model of the simulator in the current simulation state. The control elements allow the "remote control" of the simulation system via the intermediate layer of the simulation computer 74. The simulation computer 74 continuously determines the current state in which the simulator 1 is currently located and transmits it to the graphical user interface 72, which reproduces this state exactly on the surface ,
    This allows e.g. a live presentation of actions taken by the training participants, e.g. Chest compressions. For the presentation of the simulated vital signs of the simulated patient, the system comprises a patient monitor 73. To the patient monitor 73, the adjustable and measured vital signs, which are displayed in real time on the graphical user interface 72, are preferably wireless therefrom, e.g. via WLAN. This visualizes the physiological data of the simulated patient for the training participants. The realistic representation of these values is crucial for the decision-making and the initiation of appropriate measures for the trainees. For the operation of the monitor, such as the acknowledgment of alarms, this has a touch screen.
    The optional server 71 is used to manage and communicate data related to the patient monitor 73 and not mapped in the model of the simulator 1.
    权利要求:
    Claims (28)
    [1]
    claims:
    A patient simulator, in particular preterm, neonatal or child simulator, comprising a thorax replica, a lung simulator and an anatomical tracheal simulation leading to the lung simulator, the thorax replica having a chest replica with at least one raisable and lowerable thorax element for simulating a thorax elevation and depression in that the at least one raisable and lowerable thorax element interacts with a lift and lowering mechanism which can be controlled independently by the lung simulator.
    [2]
    2. Patient simulator according to claim 1, characterized in that at least one sensor for measuring the state of the lung simulator, in particular at least one pressure sensor for measuring the pressure in at least one cavity of the lung simulator, is provided, the signals of a control device for controlling the lifting and lowering mechanism the thorax replica are supplied to raise and lower the at least one raisable and lowerable chest member in response to the signals, wherein the pressure sensor is preferably arranged and adapted to determine the ventilation pressure.
    [3]
    3. Patient simulator according to claim 1 or 2, characterized in that at least one right raisable and lowerable thorax element for the right half of the thorax and at least one left raised and lowered thorax element are provided for the left half of the thorax, which are formed separately raised and lowered and which each interact with its own controllable lifting and lowering mechanism, the lifting and lowering mechanism for the right thorax element and the lifting and lowering mechanism for the left thorax element are independently controllable.
    [4]
    4. Patient simulator according to claim 1, 2 or 3, characterized in that the lung simulator has at least one adjusting element for adjusting the compliance and / or at least one adjusting element for adjusting the resistance.
    [5]
    5. Patient simulator according to one of claims 1 to 4, characterized in that the lifting and lowering mechanism (s) in the thorax replica, in particular under the at least one raisable and lowerable thorax element, is or are arranged.
    [6]
    6. Patient simulator according to one of claims 1 to 5, characterized in that the lifting and lowering mechanism (s) each having an electric motor drive unit, which preferably comprises a pivotable movements driven arm.
    [7]
    7. Patient simulator according to one of claims 1 to 6, characterized in that in the thorax replica, in particular in a respiratory simulation, preferably in the tracheotomy, a moisture sensor is provided, which is the injection of a liquid, such. a surfactant preparation in which airway simulation and / or the lung is detected and cooperates with the lung simulator such that the values of compliance and / or resistance of the lung simulator upon detection of a fluid are changed.
    [8]
    8. Patient simulator according to claim 7, characterized in that the moisture sensor is arranged on or in a liquid-adsorbing material, in particular a foam material.
    [9]
    9. Patient simulator according to one of claims 1 to 8, characterized in that the at least one raisable and lowerable thorax element comprises a plurality of rib replicas and the thorax replica has a skin replica, which covers the rib replica and together with the at least one raisable and lowerable thorax element can be raised and lowered, wherein on at least one raisable and lowerable thorax element acting on the skin replica train or pressure means, such as at least one thread or a rod-shaped tension element, in particular an electromechanical tension or pressure means, is fastened and wherein the at least one raisable and lowerable thorax element carries a drive element, in particular an electric motor, for displacing the traction means in order to effect an intercostal retraction of the skin replica.
    [10]
    10. A patient simulator, in particular preterm, neonatal or child simulator, in particular according to one of claims 1 to 9, comprising a head model comprising a skull simulation which is covered by a simulated skin, wherein at least one light source is arranged in and / or on the skull simulation.
    [11]
    11. Patient simulator according to claim 10, characterized in that the at least one light source is formed by an RGB LED whose color channels are independently controllable independently.
    [12]
    12. Patient simulator according to claim 10 or 11, characterized in that a light source is arranged on the inner surface of the skull of the skull replica.
    [13]
    13. Patient simulator according to claim 10, 11 or 12, characterized in that a light source in the skull replica, the middle cranial fossa is arranged from the inside to light up.
    [14]
    14. Patient simulator according to one of claims 10 to 13, characterized in that the skull replica of a polymeric, in particular white, material and the skin replica transparent or translucent, in particular of a silicone material is formed.
    [15]
    15. Patient simulator according to one of claims 10 to 14, characterized in that a light source is connected to an optical waveguide which extends arcuately in the chin region of the replica head and is designed to emit light along the arc, the light-emitting arcuate region of the optical waveguide preferably between the replica of the skin and a respiratory simulation.
    [16]
    A patient simulator, in particular preterm, neonatal or child simulator, in particular according to one of claims 1 to 15, comprising a head model with a nose replica with two flexible nostrils, wherein on the nostrils a drive element leading into the interior of the replica head, such as e.g. at least one thread or lever, acts to simulate a widening or narrowing of the nostrils.
    [17]
    17. Patient simulator according to claim 16, characterized in that the nostrils are designed to be elastic in order to bring about an automatic return to the initial position when the traction means are released.
    [18]
    18. Patient simulator according to claim 16 or 17, characterized in that a central control device is provided, which is designed to control the lifting and lowering mechanism of the thorax replica and for driving the drive element for the nasal wings such that the widening of the nostrils and the lifting of the at least one raisable and lowerable thorax element take place synchronously.
    [19]
    19. A patient simulator, in particular preterm, neonatal or child simulator, in particular according to one of claims 1 to 18, comprising a thorax replica, an abdominal replica, a stethoscope simulator and an audio generator, the thorax replica and the abdominal replica having at least two distance sensors with a stethoscope head the stethoscope head for determining the position of the stethoscope head interaction, wherein the determined position data can be fed to the audio generator, the audio generator having a memory for audio files and a processing means for mixing the audio files in response to the position data to a mixed audio signal, which can be fed to an earphone of the stethoscope simulator is.
    [20]
    20. A patient simulator according to claim 19, characterized in that for each position on the thorax or Abdomennachbildung at least one audio signal is mixed, representing the sounds of the human body at the corresponding position, wherein the noise weighted depending on the Stethoskopkopfposition of at least one stored audio file and output in the stethoscope.
    [21]
    21. Patient simulator according to claim 19 or 20, characterized in that the processing means for mixing the audio files is advantageously designed so that an audio file is added to the mixed signal with an even greater volume, the smaller the distance of the stethoscope head of the audio file assigned Position is.
    [22]
    22. Patient simulator according to one of claims 19 to 21, characterized in that each audio file with physiological noise can be replaced by an audio file with pathological noise and this is mixed for the output of the position-linked audio signal corresponding to the Stethoskopkopfposition.
    [23]
    23. Patient simulator according to claim 19, characterized in that at least one audio file simulates a heart sound and is associated with the position of the heart of the thorax reproduction, that an audio file simulates a first lung noise and is associated with the position of the left lung of the thorax replica an audio file simulates a second lung sound and is associated with the position of the right lung of the thorax replica and / or that an audio file simulates a gastric sound and is associated with the position of the stomach of the abdominal replica.
    [24]
    24. Patient simulator according to one of claims 19 to 23, characterized in that the simulator or the stethoscope has a near field transmitter and the stethoscope or the simulator each having a receiver coil.
    [25]
    25. Patient simulator, in particular preterm, neonatal or child simulator, in particular according to one of claims 1 to 24, comprising a lung simulator and an abdominal replica, which has a raisable and lowerable abdominal plate, which is driven by a lifting and lowering mechanism, wherein a Control device is adapted to raise the abdominal plate and at the same time to increase the ventilation resistance of the lung model.
    [26]
    26. Patient simulator according to claim 25, characterized in that the abdominal replica comprises a light source for illuminating a skin replica in the abdominal region from the inside.
    [27]
    27. Patient simulator, in particular preterm, neonatal or child simulator, in particular according to one of claims 1 to 26, comprising a lung simulator, a thorax replica, which has a raisable and lowerable thorax element, which is driven by a lifting and lowering mechanism, and a Head mimic cooperating with a tilt mechanism to change the angle between head replica and thorax replica, wherein a control device is adapted to drive the tilt mechanism to periodically tilt the head replica, wherein the periodic tilt is synchronized with the elevation and elevation of the chest member.
    [28]
    28. A patient simulator, in particular premature newborn or child simulator, in particular according to one of claims 1 to 27, comprising a lung simulator, a thorax replica, which has a raisable and lowerable thorax element which is driven by a lifting and lowering mechanism, and a head simulation, which interacts with a tilting mechanism for changing the angle between head simulation and thorax reproduction, wherein a user interface and a monitor display for prescribing and displaying patient-specific biosignals and respiratory parameters are implemented on two, preferably wireless, coupled systems.
    类似技术:
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    同族专利:
    公开号 | 公开日
    ES2873698T3|2021-11-03|
    MX2019000018A|2019-07-10|
    BR112019000212A2|2019-04-16|
    RU2743410C2|2021-02-18|
    SG11201900053QA|2019-02-27|
    RU2019102908A3|2020-08-05|
    CN109564739B|2020-12-22|
    WO2018006107A8|2019-01-03|
    EP3482386B1|2021-02-24|
    JP2019522237A|2019-08-08|
    RU2019102908A|2020-08-05|
    US20190259304A1|2019-08-22|
    AU2017292892A1|2018-12-20|
    AT518851B1|2018-04-15|
    EP3852086A1|2021-07-21|
    PL3482386T3|2021-07-26|
    CN109564739A|2019-04-02|
    EP3852087A1|2021-07-21|
    DK3482386T3|2021-05-25|
    EP3852088A1|2021-07-21|
    EP3482386A1|2019-05-15|
    WO2018006107A1|2018-01-11|
    CA3029852A1|2018-01-11|
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    RU115539U1|2011-11-17|2012-04-27|Федеральное государственное бюджетное образовательное учреждение высшего профессионального образования "Петрозаводский государственный университет"|BIO-MECHANICAL SIMULATOR OF FUTLAR NOVOCAIN BLOCKADE OF SEGMENTS OF EXTREMITIES|
    CN203397591U|2013-08-08|2014-01-15|刘萍|Dynamic flail-chest teaching model|
    WO2016030393A1|2014-08-28|2016-03-03|Les Hopitaux Universitaires De Geneve|Thorax simulator|CN110136557B|2019-04-19|2021-01-19|江苏医药职业学院|Experimental device and method for action of pulmonary alveolar surfactant|
    RU2740727C1|2020-07-06|2021-01-20|Федеральное государственное автономное образовательное учреждение высшего образования "Дальневосточный федеральный университет" |Model of human respiratory tract|
    DE102020130404B3|2020-11-18|2022-02-24|Audi Aktiengesellschaft|Test system with a humanoid dummy and respiratory function module for such a dummy|
    法律状态:
    优先权:
    申请号 | 申请日 | 专利标题
    ATA317/2016A|AT518851B1|2016-07-05|2016-07-05|patient simulator|ATA317/2016A| AT518851B1|2016-07-05|2016-07-05|patient simulator|
    SG11201900053QA| SG11201900053QA|2016-07-05|2017-06-28|Patient simulator|
    US16/315,013| US20190259304A1|2016-07-05|2017-06-28|Patient simulator|
    CN201780041995.8A| CN109564739B|2016-07-05|2017-06-28|Patient simulator|
    PL17739176T| PL3482386T3|2016-07-05|2017-06-28|Patient simulator|
    ES17739176T| ES2873698T3|2016-07-05|2017-06-28|Patient simulator|
    EP21020092.9A| EP3852087A1|2016-07-05|2017-06-28|Patient simulator|
    EP21020093.7A| EP3852088A1|2016-07-05|2017-06-28|Patient simulator|
    MX2019000018A| MX2019000018A|2016-07-05|2017-06-28|Patient simulator.|
    EP21020091.1A| EP3852086A1|2016-07-05|2017-06-28|Patient simulator|
    RU2019102908A| RU2743410C2|2016-07-05|2017-06-28|Patient simulator|
    CA3029852A| CA3029852A1|2016-07-05|2017-06-28|Patient simulator|
    EP17739176.0A| EP3482386B1|2016-07-05|2017-06-28|Patient simulator|
    DK17739176.0T| DK3482386T3|2016-07-05|2017-06-28|Patientsimulator|
    AU2017292892A| AU2017292892A1|2016-07-05|2017-06-28|Patient simulator|
    JP2018569088A| JP2019522237A|2016-07-05|2017-06-28|Patient simulator|
    PCT/AT2017/000053| WO2018006107A1|2016-07-05|2017-06-28|Patient simulator|
    BR112019000212A| BR112019000212A2|2016-07-05|2017-06-28|patient simulator|
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