GB2516907A

GB2516907A - Patient simulating manikin for simulating tracheal deviation during tension pneumothorax

Info

Publication number: GB2516907A
Application number: GB201314031A
Authority: GB
Inventors: Ryan Colhoun
Original assignee: TRUCORP Ltd
Current assignee: TRUCORP Ltd
Priority date: 2013-08-06
Filing date: 2013-08-06
Publication date: 2015-02-11
Anticipated expiration: 2033-08-06
Also published as: GB2516907B; GB201314031D0

Abstract

A patient simulating manikin comprises a body or torso 2 defining a thoracic cavity and having a moveable member 12 mounted within the body and being displaceable between a first position and a second position. A simulated trachea 6 supported by said moveable member is biased towards a neutral position, and laterally displaceable to simulate tracheal deviation. An inflatable bladder 20 is provided within the thoracic cavity and upon inflation displaces the moveable member to its second position. The inflatable bladder further incorporates a hollow cavity 22 located within the thoracic cavity in a position corresponding to the 2nd intercostal space at the mid clavicle line. A user may insert a needle 34 into the hollow cavity to deflate the inflatable bladder, thus simulating needle decompression and returning the simulated trachea to its neutral position.

Description

Patient Simulating Manikin for Simulating Tracheal Deviation During Tension Pneumothorax

Field of the invention

The present invention relates to a patient simulating manikin for simulating a clinical sign of tension pneumothorax, in particular tracheal deviation. Such patient simulating manikin may be used for training clinicians in the process of needle decompression.

Background to the invention

Tension Pneumothorax is a life threatening condition. Tension pneumothorax is the progressive build-up of air within the pleural space, usually due to a lung laceration or chest injury which allows air to escape into the pleural space but not to return.

Positive pressure ventilation may impair this one-way-valve' effect. Progressive build-up of pressure in the pleural space leads to circulatory instability and may result in traumatic arrest.

The classic sign of a tension pneumothorax is lateral deviation of the trachea away from its neutral at rest position, from the affected side to the non-affected side of the body. This is due to the continuous trapping of air in one side of the thoracic cavity between the chest cavity and the lung with no relief or escape, thus displacing all organs or bodily parts laterally within the thoracic cavity towards the non-affected side of the body.

This build up of pressure in the pleural space may be relieved by needle decompression at the 2nd intercostal space at the mid clavicle line, wherein a hollow needle is inserted into the pleural space between the 2nd and 3rd ribs to vent the pleural space. Following the release of pressure by successful needle decompression the trachea reverts back to its resting/neutral position.

The accurate determination of tracheal deviation is important to determine if the pneumothorax is either under tension or is somewhat lesser in severity.

An object of the present invention is to provide a patient simulation manikin that can accurately simulate tracheal deviation and the treatment of tracheal deviation by needle decompression.

There are currently no simulation models on the market that offer tracheal deviation identification and/or offer a feature on a simulation model that can treat this warning sign and revert the trachea back to its neutral resting position.

Summary of the invention

According to the present invention there is provided a patient simulating manikin comprising a body defining a thoracic cavity therein, a moveable member being mounted within the body, a simulated trachea being supported by said moveable member, said moveable member being displaceable between a first position, wherein the simulated trachea is located in a neutral position, and a second position, wherein the simulated trachea is laterally displaced to simulate tracheal deviation, said moveable member being biased towards its first position by biasing means, an inflatable bladder being provided within the thoracic cavity, wherein inflation of said inflatable bladder displaces the moveable member to its second position, said inflatable bladder incorporating or communicating with a hollow cavity located within the thoracic cavity in a position corresponding to the 2nd intercostal space at the mid clavicle line, whereby a needle may be inserted into the hollow cavity to deflate the inflatable bladder, simulating needle decompression and returning the simulated trachea to its neutral position.

At least portion an outer wall of said hollow cavity may be formed from silicone rubber or a similar self sealing polymeric material, through which portion said needle may be inserted.

Preferably a simulated rib cage is located in an anterior portion of the thoracic cavity, the rib cage preferably being formed from a resilient material to provide lifelike recoil during chest compressions.

Preferably the body includes a flexible covering over an anterior portion of the thoracic cavity, simulating skin. The hollow cavity defining a needle decompression insert is preferably located beneath or within said flexible covering. Preferably the hollow cavity comprises a replaceable insert located beneath or within said flexible covering. The replaceable insert may be formed from silicone rubber or a similar self sealing polymeric material.

Preferably the manikin defines at least a torso and head of a patient.

The simulated trachea and/or the inflatable bladder may be made from latex.

A flexible covering may be provided over a neck portion of the manikin, said simulated trachea passing though said neck portion whereby the simulated tracheal deviation and reversion can be visualized and palpitated through the overlying flexible covering.

In one embodiment the moveable member may be pivotally mounted within said thoracic cavity for pivotal movement between said first and second positions. The moveable member may comprise a support plate pivotally mounted on a base member of the manikin for pivotal movement about a horizontal axis substantially aligned with a central axis of the base member. The support plate may be provided with a horizontally aligned guide aperture located in an upper region of the support plate through which the simulated trachea passes, said guide aperture being aligned with the central axis of the base member when the support plate is in its first position and being laterally displaced to one side of the central axis of the base member when the support plate is in its second position.

Brief Description of the drawings

An embodiment of the invention is now described by way of example and with reference to the accompanying drawings, in which:-Figure 1 is a perspective view of a patient simulating manikin in accordance with an embodiment of the present invention; Figure 2 is a perspective view of the patient simulating manikin of Figure 1 with outer parts removed for clarity; Figure 3 is an end view of the patient simulating manikin of Figure 1 with outer parts removed for clarity; and Figure 4 is a plan view of the patient simulating manikin of Figure 1 with outer part removed for clarity.

Detailed descrirjtion of the drawings A patient simulating manikin in accordance with an embodiment of the present invention is shown in Figure 1. The manikin comprises an anatomically correct simulated human torso 2 which may be adapted to enable clinicians to practice a number of surgical procedures, comprising needle decompression and optionally other procedures, such as chest drain of haemothorax and cardio pulmonary resuscitation (CPR). The torso 2 may be coupled to a simulated head (not shown), adapted to provide training in a range of airway management and resuscitation techniques.

The torso 2 is covered by a flexible covering 4, simulating skin and underlying fat tissue and muscle. A thoracic cavity is defined within the Torso. An artificial rib cage (not shown in the drawings) is located beneath the flexible covering 4, located in an anterior region of the hollow thoracic cavity. The rib cage may be adapted to provide lifelike recoil during chest compressions.

A simulated trachea 6 extends through the thoracic cavity and passes through the neck into the simulated head, a flexible neck covering (not shown) being provided over the simulated trachea 6, whereby the position of the trachea 6 can be palpitated (felt by the clinician through the flexible neck covering) in a realistic manner. The neck may also be adapted to display jugular vein distension during simulated tension pneumothorax by means of an inflatable tube located within the neck to simulate the jugular vein.

Figures 2 to 4 show the manikin with the outer covering and other components removed for clarity. The manikin comprises a planar base member 10 upon which the other components of the manikin are mounted.

A support plate 12 is pivotally mounted on the base member 10 to be pivotal about a horizontal pivot axis 14 aligned with a central axis of the base member 10. The simulated trachea 6 passes through and is retained in a guide aperture 16 in an upper part 18 of the support plate 12. The support plate 12 is pivotally mounted on the base member 10 for movement about said pivot axis 14 between a rest or neutral position, wherein a base part 19 of the support plate 12 lies horizontally and the guide aperture 16 is aligned with the central axis of the base member 10 such that the simulated trachea 6 is held in its central neutral position, and a tilted position (shown in the drawings), wherein the base part 19 of the support plate 12 is tilted to one side and the guide aperture 16 is displaced to one side of the thoracic cavity, displacing the simulated trachea 6 to one side to simulate tracheal deviation.

An inflatable bladder 20 is located beneath the pivotal support plate 12 to one side of the central axis of the base member 10. The inflatable bladder 20 can be selectively located on either side of the central axis of the base member 10 to selectively simulate the build up of pressure in the pleural space on either side of the body and thus to simulate tracheal deviation to either side of the body, as desired. Inflation of the inflatable bladder 20 pushes upwardly against one side of the support plate 12, displacing the support plate 12 to its tilted position. A return spring 15 may provided for biasing the support plate to its rest or neutral position when the inflatable bladder 20 is deflated.

A hollow needle decompression insert 22 is located beneath or within the flexible covering 4 of the torso 2 in a position corresponding to the 2nd intercostal space at the mid clavicle line (i.e. between the 2nd and 3rd ribs). The needle decompression insert 22 may be formed tram silicone rubber or a similar resealable material such that a hollow needle can be inserted into the decompression inert 22 to vent the insert 22 and removed several times, the material resealing the hole upon removal of the needle. The use of such material may enable the repeated insertion of a needle (for example up to 50 times) and subsequent re-pressurisation of the insert 22 before the insert 22 requires replacement. A pocket may be provided within or beneath the flexible covering 4 of the torso 2 having an open side to facilitate replacement of the insert 22.

An air inlet 24 is provided in a lower end of the base member 10 communicating with a three way connector 26, having a first branch 28 communicating with the inflatable bladder 20, a second branch 30 communicating with the needle decompression insert 22 and an optional third branch 32 communicating with a further feature, such as a venous engorgement (e.g. one or more inflatable tubes simulating the carotid arteries or jugular veins).

Air under pressure is supplied to the air inlet 24, inflating the inflatable bladder 20 and pressuring the needle decompression insert 22. The inflated bladder 20 acts against an underside of the support plate 12, displacing the support plate 12 to its tilted position and displacing the trachea to one side by virtue of the lateral movement of the guide aperture 16, thus simulating tracheal deviation.

At this point the system is now airtight. To simulate needle decompression, a needle 34 may be inserted into the needle decompression insert 22 located beneath the chest, relieving the air pressure in the system and causing the inflatable bladder to deflate, thus allowing the pivot member 12 to return to its rest or neutral position under the action of the return spring and causing displacement of the trachea 6 back to its back to its neutral position.

The whole process can then be repeated approximtaley 50 times before the needle decompression insert 7 requires replacement.

The patient simulation manikin in accordance with the present invention enables the user to identify tracheal deviation by physically visualizing and palpitating the deviated trachea and its overlaying ligaments. The reverting of the trachea back to its neutral position can also be visualised and palpitated.

The invention is not limited to the embodiment(s) described herein but can be amended or modified without departing from the scope of the present invention.

Claims

CLIAMS: 1. A patient simulating manikin comprising a body defining a thoracic cavity therein, a moveable member being mounted within the body, a simulated trachea being supported by said moveable member, said moveable member being displaceable between a first position, wherein the simulated trachea is located in a neutral position, and a second position, wherein the simulated trachea is laterally displaced to simulate tracheal deviation, said moveable member being biased towards its first position by biasing means, an inflatable bladder being provided within the thoracic cavity, wherein inflation of said inflatable bladder displaces the moveable member to its second position, said inflatable bladder incorporating or communicating with a hollow cavity located within the thoracic cavity in a position corresponding to the 2nd intercostal space at the mid clavicle line, whereby a needle may be inserted into the hollow cavity to deflate the inflatable bladder, simulating needle decompression and returning the simulated trachea to its neutral position.
2. A patient simulating manikin as claimed in claim 1, wherein at least portion an outer wall of said hollow cavity is formed from silicone rubber or a similar self sealing polymeric material, through which portion said needle may be inserted.
3. A patient simulating manikin as claimed in any preceding claim, wherein a simulated ribcage is located in an anterior portion of the thoracic cavity.
4. A patient simulating manikin as claimed in any preceding claim, wherein said body includes a flexible covering over an anterior portion of the thoracic cavity, simulating skin.
5. A patient simulating manikin as claimed in claim 4, wherein said hollow cavity is located beneath or within said flexible covering.
6. A patient simulating manikin as claimed in claim 5, wherein said hollow cavity comprises a replaceable insert located beneath or within said flexible covering.
7. A patient simulating manikin as claimed in any preceding claim, defining at least a torso and head of a patient.
8. A patient simulating manikin as claimed in any preceding claim, wherein the simulated trachea and/or the inflatable bladder are made from latex.
9. A patient simulating manikin as claimed in any preceding claim, wherein a flexible covering is provided over a neck portion of the manikin, said simulated trachea passing though said neck portion whereby the simulated tracheal deviation and reversion can be visualized and palpitated through the overlying flexible covering.
10. A patient simulating manikin as claimed in any preceding claim, wherein said moveable member is pivotally mounted within said thoracic cavity for pivotal movement between said first and second positions.
11. A patient simulating manikin as claimed in claim 10, wherein said moveable member comprises a support plate pivotally mounted on a base member of the manikin for pivotal movement about a horizontal axis substantially aligned with a central axis of the base member.
12. A patient simulating manikin as claimed in claim 12, wherein the support plate is provided with a horizontally aligned guide aperture located in an upper region of the support plate through which the simulated trachea passes, said guide aperture being aligned with the central axis of the base member when the support plate is in its first position and being laterally displaced to one side of the central axis of the base member when the support plate is in its second position.
13. A patient simulating manikin substantially as herein described with reference to the accompanying drawings.