Patent Publication Number: US-2016247417-A1

Title: Apparatus for adapting a defibrillator for training

Description:
TECHNICAL FIELD 
     The present disclosure generally relates to apparatuses for adapting a defibrillator for training. 
     BACKGROUND 
     Defibrillators are medical devices widely used for treatment of cardiac dysrhythmias and ventricular fibrillation. The treatment applied consists in applying an electrical current to the heart. 
     Defibrillators are classified as manual or automated defibrillators. Manual defibrillators are designed for medical professionals, while automated defibrillators, also called Automated External Defibrillators (AED), are designed for use by the general public. 
     Defibrillating simulators have been developed for training users to practice defibrillating procedures. Defibrillating simulators are typically provided with a mannequin simulating a human body and having predetermined contacts areas for receiving defibrillator electrodes (i.e. paddles and/or sticks), and receiving the electrical discharge generated by the defibrillator delivered through the electrodes. Current defibrillating simulators lack realism because of the visible contact areas and restricted defibrillator electrodes positioning on predetermined contact areas that cannot be changed for simulating different human anatomical characteristics. Moreover, current defibrillating simulators require to be used with specifically configured mannequins, thus portability between different platforms is not possible. The mannequins used in connection with defibrillating simulators are typically provided with electrical circuits mounted therein for collecting the electrical discharge delivered through the electrodes of the defibrillating simulators. Mannequins embedding additional simulated patients&#39; functions like a breathing function and breathing movements, the visible contact areas and corresponding electrical circuits required to receive the electrical discharge generated by the defibrillating simulators lead to increased risks of electrical shocks and electronic interferences with other electrical and electronic components within the mannequin. 
     It would therefore be desirable to provide an apparatus for adapting a defibrillator for training that would reduce at least one of the above-mentioned drawbacks of current defibrillating simulators. 
     SUMMARY 
     It is an object to obviate or mitigate at least one disadvantage of previous apparatuses for training for defibrillation procedures. 
     It is another object to provide unrestricted defibrillator electrode positioning on a simulated body or surface to be defibrillated to improve realism of a defibrillating training. 
     It is another object to provide an apparatus for adapting a conventional defibrillator for training. 
     Accordingly, there is provided an apparatus for adapting a defibrillator for training, the apparatus comprising a pair of electrode covers to be mounted on electrodes of the defibrillator, the pair of electrode covers receiving an electrical discharge generated by the defibrillator and delivered through the electrodes. The apparatus has an impedance to absorb some of the received electrical discharge and generate an electrically reduced electrical discharge. The apparatus also has an analyzer for analyzing the electrically reduced electrical discharge and providing analysis data representative of the electrical discharge. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Embodiments of the disclosure will be described by way of example only with reference to the accompanying drawings, in which like numerals represent like parts: 
         FIG. 1  is a schematic diagram of an apparatus for adapting a defibrillator for training; 
         FIG. 2  is a schematic diagram of an apparatus for adapting a defibrillator for training adapted for receiving external data; and 
         FIG. 3  is a schematic diagram of a defibrillating simulator. 
     
    
    
     DETAILED DESCRIPTION 
     The foregoing and other features will become more apparent upon reading of the following non-restrictive description of illustrative embodiments thereof, given by way of example only with reference to the accompanying drawings. Various aspects of the present disclosure generally address one or more of the problems of simulating defibrillating procedures. 
     The present apparatus and simulator are particularly well suited for training medical professionals to the use of any defibrillator available on the market (i.e. monophasic and biphasic). According to further aspects, the general public may also be trained to the use of an Automated External Defibrillator (AED), as it will become apparent below. For simplicity purposes, the term ‘user’ will be used herethrough to refer to both medical professionals and any person who use the present apparatus and simulator for training in defibrillating procedures. 
     As mentioned above, existing defibrillating training apparatuses lack realism, as they work solely with specific defibrillators and rely on positioning of the electrodes on predetermined contact areas. 
     The present disclosure eliminates this disadvantage in providing an apparatus for adapting any defibrillator for training purposes, and enabling unrestricted electrode positioning on a surface on which an electric discharge is delivered. 
     Referring to  FIG. 1 , there is shown a schematic diagram of an example of an apparatus  100  for adapting a defibrillator  10  for simulation and training. The defibrillator  10  may be any defibrillator available on the market, and having a pair of electrodes  12 ,  14  for delivering an electrical discharge to a patient or mannequin (not shown). The electrical discharge may be a defibrillation discharge and/or a pacing discharge. 
     The apparatus  100  is provided with a pair of electrode covers  112 ,  114  to be affixed on the electrodes  12 ,  14  of the defibrillator  10  for receiving an electrical discharge generated by the defibrillator  10  and delivered through the electrodes  12 ,  14 . The term ‘electrodes’ in the present specification refers to any of the following: paddles, sticks, pads and patches. In the illustrated embodiment, each of the electrode covers  112 ,  114  comprises a conductive medium  116 , for contacting an operating surface  16  of the electrodes  12  or  14 , and an insulator  118 . The electrode covers  112 ,  114 , when affixed to the electrodes  12 ,  14  of the defibrillator  10 , provide a conductive arrangement for receiving the electrical discharge generated by the defibrillator  10  through the electrodes  12 ,  14 . The insulator  118  extends around the conductive medium  116  to fully electrically insulate the electrodes  12 ,  14  and electrically protect the users of the apparatus  100 . The electrode covers  112 ,  114  and the insulator  118  may be affixed to the electrodes  12 ,  14  by any way known in the art that does not reduce the electrical insulation of the electrodes  12 ,  14 . 
     For electrodes of the paddles or sticks type, one or several pressure sensors  120  are embedded within the electrode covers  112 ,  114  for sensing a pressure applied by a user of the electrodes  12 ,  14  to a defibrillation surface. The pressure sensors  120  are embedded within the electrode covers  112 ,  114  in such a manner as to be electrically protected from the electrical discharge delivered by the electrodes  12 ,  14 . The pressure sensors(s)  120  may for example be two positions sensors designed to sense the pressure applied by the user of the electrodes  12 ,  14  to the defibrillating surface in two distinct positions for each electrode  12 ,  14 . Other pressure sensors  120  and arrangements thereof could also be considered to determine the pressure applied by the user of the electrodes  12 ,  14  on multiple positions of each paddle  12 ,  14 , so as to ensure that the user of the electrodes  12 ,  14  uniformly applies pressure on the electrodes  12 ,  14  and identify during simulations potential risks such as damaged ribs or burned skin. The pressure detected by the pressure sensors  120  is communicated to an analyzer  140  which will be discussed further. 
     Position detectors  122  are also provided with each of the electrode covers  112 ,  114  for detecting a position of each one of the electrodes  12 ,  14  in space, or a relative position of the electrodes  12 ,  14  with respect to one another. The position detectors  122  may consist for example of a Global Positioning System receiver, or any type of wired or wireless position detection sensor, receiver, either passive or active, embedded in each conductive cover  112 ,  114 , electrically protected from the electrical discharge delivered by the electrodes  12 ,  14 , so as to monitor and report the detected position of the electrodes  12 ,  14 , or the detected relative position of the electrode  12 ,  14  with respect to one another. The detected position or detected relative position is communicated to the analyzer  140 . For simplicity purposes, the expression ‘detected position’ will be used hereinafter to refer to the one or both of the detected position and the detected relative position. 
     Although not particularly shown on  FIG. 1 , the electrode covers  112 ,  114  could further be equipped with an accelerometer to sense the movement of the electrodes  12 ,  14  in space, performed by the user when using the electrodes  12 ,  14  with the conductive covers  112 ,  114  installed thereon. The accelerometer provides the sensed movement of the electrodes  12 ,  14 , to the analyzer  140 . 
     The pressure sensors  120 , the position detectors  122  and the accelerometer provide separately and/or combined important manipulation information about the use of the electrodes  12 ,  14  by the user to the analyzer  140 , so as to allow the analyzer  140  to evaluate the performance of the user during a defibrillation training or simulation, and ultimately improve the user&#39;s skills when performing real-life defibrillation procedures. 
     The pressure sensors  120 , the position detectors  122  and the accelerometer communicate either by wire connection with the analyzer  140 , or wirelessly using any known communication protocol (such as for example Bluetooth™, WiFi, etc.) with a communication module  150  in electrical communication with the analyzer  140 . 
     Each conductive medium  116  are electrically connected to an impedance  130 . The impedance  130  may be located directly within the electrode covers  112 ,  114  (not shown on the Figures) or located within proximity of the analyzer  140  as shown on the Figures. The impedance  130  may be selected so as to simulate impedance of a human body. Alternatively, the impedance  130  is not specifically selected to simulate impedance of a human body, but rather to receive the electrical discharge and absorb and/or dissipate a portion of the electrical discharge. The electrical discharge generated by the defibrillator  10  is a high voltage discharge of several hundred Volts, and the impedance  130  generates an electrically reduced electrical discharge adapted to be handled by electronic components for further processing. The impedance  130  may for example consist of a pair a voltage reducing resistors  132 ,  134  serially connected with the conductive medium  116 , or of any electrical component or group or electrical components electrically connected with the conductive medium  116  so as to reduce the electrical discharge generated by the defibrillator  10  by absorbing a portion of the delivered electrical discharge. A plurality of impedance values where each impedance value corresponds to a specific type of defibrillation (for example a baby, a young adult, an elderly, a thin person, an obese person . . . ) could also be provided together with a selection mechanism. 
     The analyzer  140  receives one or several of the following: the electrically reduced electrical discharge, the sensed pressure by the pressure sensors  120 , the detected position from the position detectors  122  and the accelerator information. The analyzer  140  analyzes the electrically reduced electrical discharge generated by the impedance  130 , the sensed pressure by the pressure sensors  120  and the position information from the position detectors  122  and generates corresponding analysis data. The analysis data includes one or several of the following information: the number of electrical discharges generated by the defibrillator  10  during a defibrillation training procedure or simulation, a duration of each electrical discharge delivered, a timeframe between each electrical discharge delivered, a power level of the generated electrical discharge delivered, a distance between the electrodes  12 ,  14  for each electrical discharge delivered, a movement of the electrodes  12 ,  14  between each electrical discharge delivered, pressure applied by the the electrodes  12 ,  14  onto a defibrillating surface, and if several impedances are present together with a selection mechanism, the impedance selected for each electrical discharge delivered. 
     The analyzer  140  may be implemented as hardware, software, firmware or combination thereof. For example, an electronics board with hardware circuits may be used for performing the analysis of the received signals. Alternatively, or concurrently, a processor may be used for receiving the electrically reduced electrical discharge or the characteristics thereof, the position detected by each of the position detectors  122 , the pressure sensed by the pressure sensors  120 , and the accelerometers data. The processor of the analyzer  140  executes software code which when executed analyzes characteristics of the electrically reduced electrical signal, the position detected, the pressure sensed and the movement collected by the accelerometers to generate the analysis data. 
     Reference is now made to  FIG. 2 , which shows an example of an apparatus  200  for adapting a defibrillator for training, which further comprises a processing unit  210  for receiving external data and a control unit  220 . The external data may include expected value(s) or range(s) of expected value(s) for one or many of the following: the power of electrical discharge, the duration of the electrical discharge, the delay between the electrical discharges, the sensed pressure, the detected position, the movement of the electrodes  12 ,  14 , etc. 
     The external data is received directly by the processing unit  210  (shown on  FIG. 2 ) or through the communication module  150  (not shown on  FIG. 2  for simplicity purposes). The processing unit  210  further receives the analysis data from the analyzer  140  and correlates the analysis data with the external data. More particularly, the processing unit  210  compares the analysis data with the external data to identify whether the defibrillating procedure is performed within the expected value(s) or range(s). When the defibrillating procedure is performed within the expected value(s) or range(s), the processing unit  210  instructs the control unit  220  to pursue with the defibrillating procedure. When the defibrillating procedure is not performed within the expected value(s) or range(s), the processing unit  210  instructs the control unit  220  to inform the user of the electrodes  12 ,  14  of the aspects of the procedure which were not performed within the expected value(s) or range(s). The control unit  220  may further provide recommendations to the user of the electrodes  12 ,  14  to improve the way the electrodes  12 ,  14  are used to perform the defibrillating procedure. The processing unit  210  and the control unit  220  may be co-located with the analyzer  140  and the communication module  150  or part of a separate electronic device, such as a PC or a tablet electrically or wirelessly connected to the analyzer  140 . The processing unit  210  and the control unit  220  may be co-located with the analyzer  140 , or embodied by a separate computer, tablet or smart phone in electronic or wireless communication with the analyzer  140 . 
     Referring now to  FIG. 3 , there is shown a schematic diagram of an example of a defibrillating simulator  300 . In  FIG. 3 , the defibrillating simulator  300  is provided with the apparatus  200  for adapting a defibrillator as illustrated in  FIGS. 1 and 2 . The defibrillating simulator  300  further comprises a scenario unit  310  for providing at least one training scenario and corresponding physiological model. The physiological model comprises a simulated electrocardiogram signal including waveform shape, frequency and amplitude corresponding to a beating heart. The physiological model is provided to the defibrillator  10  for display thereon and to the processing unit  210  as external data. 
     The scenario unit  310  is adapted for simulating any type of heart condition or defibrillating event such as a ventricular fibrillation or a ventricular tachycardia as non-limitative examples, heart conditions for which a user needs to perform a defibrillating procedure. The scenario unit  310  comprises a memory for storing a plurality of training scenarios, each training scenario corresponding to a heart condition or defibrillating event. The memory may consist of any type of memory used in electronic products, such as for example Random Access Memory, Read Only Memory, flash memory, etc. Although not shown on  FIG. 3 , the scenario unit  310  may further comprise processing capability, an input/output module for electronically or wirelessly communicating with the defibrillator  10 , the processing unit  210 , the analyzer  140  and the communication module  150 . The input/output module of the scenario unit  310  may further provide communication with an electronic device, such as for example a computer, a tablet or a smart phone to allow an instructor to select a training scenario or modify a training scenario to be generated by the scenario unit  310 , and forwarded to the processing unit  210  and the defibrillator  10 . The scenario unit  310  may be co-located with the analyzer  140 , co-located with the processing unit  210  or physically separated there from. 
     The processing unit  210  receives the training scenario. The processing unit  210  correlates the analysis data with the training scenario to provide training results for subsequent display on a screen of the defibrillator  10  or on a display (not shown) of the defibrillating simulator  300 . In one exemplary embodiment, the training scenario comprises an abnormal event requiring a predetermined procedure. Corresponding physiological data, such as for example an electrocardiogram data, are displayed to the user of the defibrillating simulator  300  either through the defibrillator  10  display, or through a separate display (not shown). The user of the defibrillating simulator  300  performs the defibrillating procedure by positioning the electrodes  12 ,  14  against the surface to be defibrillated (e.g. a mannequin, a standardized patient, or a virtual patient), exercises a pressure against the surface to be defibrillated, and actuates electrical discharge by the electrodes  12 ,  14 . The electrical discharge generated by the electrodes  12 ,  14  is collected by the conductive medium  116  of the electrode covers  112  and  114  and electrically conducted to the impedance  130 . The impedance  130  generates a corresponding electrically reduced electrical discharge that is analyzed in the analyzer  140 . The analyzer  140  further receives the pressure sensed by the pressure sensors  120  and the position of the electrodes  12 ,  14  determined by the position detectors  122 , analyzes the received electrically reduced electrical discharge, the pressure sensed, the position of the electrodes  12 ,  14  and generates therefor the analysis data. The analyzer  140  forwards the analysis data to the processing unit  210  which compares the analysis data with the training scenario. In the case where the electrically reduced electrical discharge, the pressure sensed and the position of the electrodes correspond to a range of acceptable values for the training scenario, the processing unit  210  provides successful training results for display to the user either on the defibrillator  10  or on a separate display (not shown) of the simulator  300 . For example, the successful training results is a normal electrocardiogram signal displayed on the display of the defibrillator  10 . The user of the simulator  300  is hence confirmed that the defibrillating procedure was successful. In the event of an insufficient electrical discharge or absence thereof, and/or the pressure sensed and/or the position and/or the movement of the electrodes  12 ,  14  do not correspond to acceptable values for the training scenario, the processing unit  210  provides training results for display to the user that indicate that the defibrillating procedure was not successful or not performed properly. 
     Once a simulation has been started through the scenario unit  310 , the scenario unit  310  forwards to the defibrillator  10  virtual electrocardiogram signal to be displayed. The user of the simulator  300  monitors the virtual electrocardiogram signal displayed and operates the defibrillator  10  in a manner very similar to a real defibrillating procedure. Upon operation of the defibrillator  10  by the user, the training results are displayed on the defibrillator  10 . 
     The defibrillator simulator  300  may be used independently, or with a mannequin simulating various physiological functions of a human body. When the defibrillator simulator  300  is used with a mannequin, the control unit  320  is in communication with the mannequin so as to control the mannequin in accordance with the simulated defibrillation procedure. 
     In the present disclosure, contrary to what is proposed in the prior art, the means for detecting the electrical discharge is embedded in an electrically isolated closed loop circuit. This is of great advantage for reducing risks of potential high voltage shocks when the user interacts with the mannequin for other simulation purposes such as a cardiopulmonary resuscitation (CPR) simulation for example. The present disclosure also enables to simplify the design of a mannequin devised for healthcare simulation since the required components have not to be installed inside such mannequin. 
     Although the present disclosure has been described hereinabove by way of non-restrictive, illustrative embodiments thereof, these embodiments may be modified at will within the scope of the appended claims without departing from the present claims.