Abstract:
The instant invention provides an apparatus, and a method of its use, for enabling an instructor to train a student in learning a procedure which embodies at least two alternative sequences of steps and conditions. The invention, in order, enables the student to initiate the procedure; enables communication of at least one condition or an instruction required for prompting the student to initiate at least one step following in the sequence, at a time, to the student; enables the instructor to provide an alternative sequence; and, enables the student to initiate at least one step of said procedure in response to said alternative sequence.

Description:
BACKGROUND OF THE INVENTION 
     Although the instant invention has broad application to substantially any control system by which an instructor can manually generate an educational signal to prompt a response in a subject, it will be described herein with particular reference to an automatic external defibrillator simulator, the preferred species of the invention&#39;s broadest application. 
     DESCRIPTION OF THE PRIOR ART 
     Emergency treatment of cardiac anomalies which may involve defibrillation or the oversight of the electrical activity of a patient&#39;s heart imposes a great stress on attendant medical and/or paramedical personnel. The patient&#39;s life may well depend on the speed and accuracy by which such personnel perform their skills. A typical sequence of steps first includes the attachment of the cable leads from a defibrillator/monitor to electrode pads, and then the application of the electrode pads to the patient&#39;s chest. 
     A first conventional placement pattern is referred to, as the anterior/anterior arrangement. Here, one pad is positioned lateral to the upper sternum and below the right clavicle, while the other pad is positioned on the patient&#39;s lower left chest, below and lateral to the cardiac apex. 
     A second conventional pattern is referred to as the anterior/posterior arrangement. Here, the anterior pad is positioned over the precordium, while the posterior pad is positioned on the patient&#39;s back, behind the heart. 
     It should thus be appreciated that proper placement of the pads is a critical factor in the successful achievement of defibrillation. Once the pads are properly placed according to either of the foregoing conventional patterns, the attendant must then use the defibrillator monitor to display and interpret the patient&#39;s electrocardiogram (“ECG”), and if indicated, apply a pulse of energy to the patient&#39;s heart to achieve defibrillation. 
     Although, at first blush, the above described procedure might appear simple and forthright, the emergency conditions under which it is typically performed can subject it to human error. Thus there is a long felt need for a simple and efficient means by which emergency personnel can be thoroughly trained in all aspects of the procedure. 
     U.S. Pat. No. 5,275,572, discloses a training electrode for use in training emergency personnel in electrocardiogram defibrillation and monitoring. 
     U.S. Pat. No. 5,137,458, teaches a defibrillation training system for use in training individuals in the proper positioning of defibrillation electrodes on a patient. 
     U.S. Pat. No. 4,360,345, discloses a computer controlled interactive health instruction system. 
     U.S. Pat. No. 3,662,076, shows a training mannikin for use in simulating various cardiac conditions in the human body. 
     To the extent that the foregoing prior art is pertinent to the instant invention, it shows that a long felt need exists for a simple, relatively low cost, device which enables an instructor to teach automated external defibrillation to a student. 
     BRIEF SUMMARY OF THE INVENTION 
     The invention as hereafter described, provides an apparatus, and a method of its use, for enabling an instructor to train a student in learning a procedure which embodies at least two alternative sequences of steps and conditions. In the following order, the invention: (a) enables the student to initiate the procedure; (b) enables communication by: (i) an automated audio voice message, (ii) a light emitting diode, or (iii) a lightable indicia, of at least one condition or instruction required for prompting the student to initiate at least one step which follows in the sequence to the student, at a time; (c) enables the instructor to provide alternative steps or conditions in the sequence; and, (d) enables the student to initiate at least one step of the procedure in response to the instructor&#39;s alteration of the procedure. Although not specifically limited thereto, the invention will hereafter be specifically illustrated with regard to performing automated external defibrillation procedure on a mock patient. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 shows a photograph of the instant apparatus showing the “ON,” “ANALYZE,” and “SHOCK” switches, and “CHECK ELECTRODES,” “MOTION DETECTED,” “NO SHOCK ADVISED,” and “CHECK PULSE” instruction indicia. 
     FIG. 2 shows a flows chart which illustrates two alternative sequential modes of instruction. 
     FIG. 3 shows the circuit diagram of the apparatus of the instant invention. 
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Referring to FIG. 1, the apparatus includes three switches labeled “ON,” “ANALYZE,” and “SHOCK,” respectively; and means for communicating the following four instructions or conditions to the student: (a) check the electrodes on the mock patient, (b) motion is detected in the mock patient, (c) no shock to the mock patient is advised, and (d) check the pulse of the mock patient, respectively. An automated audio voice message, light emitting diodes, or lightable indicia, can be used as the means for communicating the instruction or condition to the student. 
     In reference to FIG. 2, the invention further contemplates a first alternative sequence of steps in which the apparatus of the invention can be manipulated: (a) the student attaches the electrodes to the mock patient, (b) the student is instructed to engage the switch labeled “ON,” (c) the student is instructed to engage the switch labeled “ANALYZE,” (d) the instructor enables a time delay in the procedure of about Six (6) to Twelve (12) seconds, (e) the student is instructed that a shock to the mock patient is not advised, (f) the student is instructed to engage the switch labeled “SHOCK,” and finally, (g) the student is instructed to check the pulse of the mock patient. The apparatus of the invention can still further be manipulated to provide a second alternative sequence of training steps: (a) the student is instructed to engage the switch labeled “ON,” (b) the student is instructed to engage the switch labeled “ANALYZE,” (c) the instructor enables a time delay in the procedure of about Six (6) to Twelve (12) seconds, (d) the student is instructed that a shock to the mock patient is not advised, (e) the student is advised that motion has been detected in the mock patient, and to check the electrodes on the mock patient, and that no shock to the mock patient is advised, and (f) the student is instructed to check the pulse of the mock patient. 
     FIG. 3 shows a circuit diagram as applied to a device for instructing automatic external defibrillation. Table No. 1 shows all components of the circuit diagram, including typical values and identification, where applicable: 
     
       
         
               
               
               
             
           
               
                                                    TABLE 1 
               
               
                   
               
               
                   
                 TYPICAL VALUE 
                   
               
               
                 DRAWING 
                 (WHERE 
                 COMPONENT 
               
               
                 NUMBER 
                 APPLICABLE) 
                 DESCRIPTION 
               
               
                   
               
             
             
               
                 1a,b 
                   
                 9 volt battery 
               
               
                 2 
                   
                 ON/OFF switch 
               
               
                 3 
                   
                 ON lamp 
               
               
                   
                   
                 Relay C 
               
               
                 4 
                   
                 Normally closed        contacts 
               
               
                 33 
                   
                 Coil 
               
               
                   
                   
                 RELAY A 
               
               
                 5 
                   
                 Normally closed contacts 
               
               
                 8 
                   
                 Normally open contacts 
               
               
                 9 
                   
                 Coil 
               
               
                 7 
                   
                 Analyze switch 
               
               
                 10 
                 100 Ohms 
                 Resistor 
               
               
                 11 
                   
                 Analyze lamp 
               
               
                 12 
                 300 K Ohms 
                 Resistor (RC time constant 1) 
               
               
                 13 
                   
                 Capacitor (RC time constant 1) 
               
               
                 14 
                   
                 Silicon oontrolled rectifier 
               
               
                   
                   
                 RELAY B 
               
               
                 17 
                   
                 Normally open contacts 
               
               
                 15 
                   
                 Coil 
               
               
                 16 
                 100 Ohms 
                 Resistor 
               
               
                 20 
                   
                 SHOCK ADVISED/ 
               
               
                   
                   
                 NO SHOCK ADVISED SWlTCH 
               
               
                 18 
                   
                 Shock advised contact 
               
               
                 19 
                   
                 No shock advised contact 
               
               
                 21 
                   
                 OPTION SWITCH 
               
               
                 24 
                   
                 Motion detected contact 
               
               
                 22 
                   
                 Check electrodes contact 
               
               
                 23 
                   
                 Neither LEDs contact 
               
               
                 25 
                   
                 Shock lamp 
               
               
                 26 
                   
                 Capacitor (RC time constant 2) 
               
               
                 27 
                 10 K Ohms 
                 Resistor (RC time constant 2) 
               
               
                 28 
                 1 Meg Ohms 
                 Resistor 
               
               
                 31 
                   
                 Speaker 
               
               
                 32 
                   
                 Shock switch 
               
               
                 34 
                 100 Ohms 
                 Resistor 
               
               
                 35 
                   
                 Silicon control rectifier 
               
               
                 36 
                 500 K Ohms 
                 Resistor (RC time constant 3) 
               
               
                 37 
                   
                 Capacitor (RC time constant 3) 
               
               
                 38 
                   
                 No shock LED 
               
               
                 39 
                   
                 Motion detected LED 
               
               
                 40 
                   
                 Check electrodes LED 
               
               
                   
               
             
          
         
       
     
     The operation of the circuit shown in FIG. 3, can be described by the following steps of its operation: 
     The “OFF” Position 
     The Two (2)-Nine (9) volt batteries  1   a,    1   b,  are arranged in parallel with each other and are in series with the ON/OFF Switch  2 . When the ON/OFF switch is placed in the “OFF” position, the circuit is open. 
     The “ON” Position 
     The ON/OFF switch  2  is a DPDT, lighted latching type switch. Typically, when it is turned to the “ON” position, the circuit portion defined by: batteries  1   a,    1   b;  switch  2 ; ON/OFF lamp  3 ; normally closed contacts  5  of relay A; and “CHECK PULSE” LED  6  is completed, thus causing the ON/OFF lamp  3  and the “CHECK PULSE” LED to become lighted. 
     The “ANALYZE” Position 
     The “ANALYZE” switch  7  is a SPST type momentary switch. When it is depressed, the circuit portion defined by: analyze switch  7 ; normally open contacts  8  of relay A; the coil  9  of relay A; resistor  10 ; “ANALYZE” lamp  11 ; resistor  12 ; capacitor  13 ; silicon controlled rectifier  14 ; coil  15  of relay B; and resistor  16  is completed in connection with the previously “ON” position circuit portion, thus causing the “ANALYZE” switch  7  to become closed; the normally closed contacts  5  of relay A to become open, thereby extinguishing the “CHECK PULSE” LED  6  and lighting the “ANALYZE” lamp  11 . In addition, the RC time constant  1  circuit defined by resistor  12  and capacitor  13  is completed and the voltage across node A is caused to ramp-up. A voltage potential is created across the normally open contacts of relay B,  17 , and at the anode of silicon controlled rectifier  14  which is initially in the “OFF” position. When the voltage at node A reaches approximately Five (5) volts (approximately Ten (10) seconds), the gate of the silicon controlled rectifier  14  causes the rectifier to be turned on, thereby completing the circuit to the coil of relay B,  15 , and thereby closing the normally open contacts of relay B,  17 . 
     The “SHOCK ADVISED” SWITCH (POSITION “A”) 
     When the circuit is completed across the coil of relay B,  15  and the normally open contacts of relay B,  17  are closed, as previously described, with the “SHOCK ADVISED/NO SHOCK ADVISED”  20  (a DPST switch), in the “SHOCK ADVISED” position  18 , the circuit defined by: “SHOCK ADVISED” LED  25 , capacitor  26 , resistor  27 , resistor  28 , Zenner diode  29 , transistor  30  and speaker  31 , is completed. When this portion of the circuit is completed by engagement of the “SHOCK ADVISED” switch (position  20 - 18 ), the “SHOCK” button lamp  25  is caused to light; the RC time constant  2  circuit, defined by resistor  27  and capacitor  26  is completed and voltage begins to ramp up at nodes B and C, thereby completing the circuit portion across transistor  30 , resistor  28  and RC time circuit  26 ,  27 , at node B, thereby causing speaker  31  to emit a ramping, low tone. When the ramping voltage reaches approximately Five (5) volts (approximately Ten (10) seconds), the circuit portion across the Zenner diode  29 , connected to the RC time circuit  26 ,  27 , at node C breaks down causing transistor  30  to drive speaker  31  to a louder and higher pitch. 
     The “SHOCK” Button 
     The audio speaker tone and the visual lighted “SHOCK” button lamp, both prompt the student to depress the “SHOCK” button  32 , a SPST switch, thereby completing the circuit defined by the coil  33  of relay C and resistor  34 , and thereby causing the normally closed contacts of relay C,  4  to open momentarily; thus interrupting the circuit at that point and resetting and completing that portion of the circuit which includes the ON/OFF switch, the “ON” lamp  3  and the “CHECK PULSE” LED  6 , thereby causing them to become lit. 
     The “SHOCK ADVISED” Switch (Position “B”) 
     When the normally open contacts of relay B,  17 , are caused to close due to the completion of the circuit across the coil of relay B,  15  and the positioning of the “SHOCK ADVISED/NO SHOCK ADVISED” switch  20  to the “NO SHOCK” position  19 , the circuit portion defined by: option switch  21 , silicon controlled rectifier  35 , resistor  36 , capacitor  37 , “NO SHOCK ADVISED” LED  38  is either completed or not, depending on the position of option switch  21 . When it is engaged so as to complete the circuit, the “MOTION DETECTED” LED  39  and the “CHECK ELECTRODE” LED are both caused to become lighted. When this portion of the circuit is completed, voltage is established across the anode of the silicon controlled rectifier  35 , and the RC time constant  3  circuit defined by resistor  35  and capacitor  37  and the voltage is caused to ramp up at node D. 
     The “NO SHOCK ADVISED” Led is Lit 
     As above noted, when the option switch  21  is caused to complete the circuit of which it is a part, the “MOTION DETECTED” LED and the “MOTION DETECTED” LED are caused to become lighted. When the option switch is caused to break the circuit of which it is a part, then neither LED is caused to become lighted. When the RC time constant circuit  36 ,  37  voltages reaches approximately Five (5) volts (approximately Ten (10) seconds) at node D, a sufficient voltage is established across the silicon controlled rectifier  35  to cause the circuit across the coil of relay C,  33 , to be completed thereby causing the normally closed contacts of relay C,  4 , to open momentarily, thereby breaking the circuit at that point but resetting the circuit defined by the “ON/OFF” switch, the “ON” lamp, the “CHECK PULSE” LED, thereby causing the latter two LEDs to become lighted. 
     Preferred values of individual circuit components include but are not necessarily limited to: all capacitors are typically 200μ farads; all relays are typically Hamlin (trademark) HE3321 C0500; the speaker is typically a Mallory (trademark) MSR320. 
     Although the invention has been described with reference to certain preferred embodiments, it will be appreciated that many variations and modifications my be made within the scope of the broad principles of the invention. Hence, it is intended that the preferred embodiments and all of such variations and modifications be included within the scope and spirit of the invention, as defined by the following claims.