Physiological simulator for use as a brachial plexus nerve block trainer

• US 8,556,635 B2
• Filed: 10/14/2011
• Issued: 10/15/2013
• Est. Priority Date: 10/23/2000
• Status: Active Grant

• Current Assignee: Christopher C. Toly
• Original Assignee: Christopher C. Toly
• Inventors: Toly, Christopher C.
• Primary Examiner(s): Musselman, Timothy A
• Application Number:
  US13/274,251
• Publication Number:
  US 20120034587A1
• Time in Patent Office: 732 Days
• Field of Search: 434262-275, 273/447, 714/742
• US Class Current: 434/272
• CPC Class Codes: G09B 23/285 for injections, endoscopy, bronchoscopy, sigmoidscopy, insertion of contraceptive devices or enemas
• CPC Class Codes: G09B 23/30 Anatomical models G09B23/281 - G09B23/288 take precedence

Abstract

Conductive elastomeric circuits representing three brachial plexus nerve bundles and sheaths that surround each nerve bundle are embedded in a neck tissue portion of a simulated physiological structure for use in training and evaluating a user in performing a brachial plexus nerve block procedure. An electrically conductive probe is provided for the user to insert within a neck tissue structure and to attempt to contact a sheath, but not the nerve bundle within the sheath of a desired nerve bundle. The probe is electrically coupled to a voltage source. A simulated nerve stimulator is connected to the conductive elastomeric circuits (electrically insulated from each other) and detects when the probe contacts a nerve or sheath, producing an output signal. The output signal is input to a computer that displays a simulated ultrasound image hi-lighting a nerve and/or sheath that has been contacted by the probe, for evaluating the user'"'"'s performance.

Claims

1. A physiological training and evaluation simulator system suitable for training and testing personnel in regard to administering a nerve block, comprising:

(a) a simulated physiological structure within which are disposed a pair of circuits, including a first circuit representing a nerve, and a second circuit representing a sheath, wherein the sheath defines a region where an energized nerve stimulator will just start to stimulate the nerve enclosed by the sheath surrounding the nerve, the nerve and sheath each being formed of an electrically conductive elastomer, but being electrically insulated from each other;

(b) a simulated nerve stimulator that is electrically coupled to the first circuit and to the second circuit;

(c) a voltage source;

(d) an electrically conductive probe that is electrically coupled to the voltage source and which can be manipulated by a user of the physiological training and evaluation simulator system, for insertion into the simulated physiological structure where the pair of circuits are disposed, in an attempt by the user to contact only the second circuit representing the sheath, but not the first circuit representing the nerve, the simulated nerve stimulator detecting when the electrically conductive probe contacts either the first circuit or the second circuit, or both the first circuit and the second circuit, and producing an output signal in response thereto, the output signal indicating whether one or both of the first circuit and the second circuit has been contacted by the probe, the output signal being used to evaluate whether the user has inserted the electrically conductive probe into the simulated physiological structure correctly at both a proper depth of insertion and at a proper location so as to contact only the second circuit representing the sheath and thus, the region that would be stimulated by an energized nerve stimulator, or has improperly inserted the electrically conductive probe at too great a depth or at an improper position so as to contact the first circuit representing the nerve, which would result in improperly administering a nerve block to the nerve with a nerve stimulator; and

(e) a computing device coupled to the simulated nerve stimulator to receive the output signal, a display being included with the computing device and responding to a software program executed by the computing device to produce a simulated ultrasound image in which each nerve and sheath represented by a circuit contacted by the probe is visually hi-lighted on the display.

2. The physiological training and evaluation simulator system of claim 1, further comprising at least one additional pair of circuits within the simulated physiological structure, each additional pair of circuits including an electrically conductive elastomer representing another nerve and an electrically conductive elastomer representing another sheath surrounding said nerve, each circuit comprising each additional pair of circuits being electrically insulated from other circuits and from the first circuit and the second circuit, the simulated nerve stimulator detecting when the probe contacts any of the circuits comprising each additional pairs of circuit and producing the output signal so as to indicate which circuit or circuits has been contacted, to evaluate whether the user has inserted the electrically conductive probe into the simulated physiological structure correctly so as to contact any circuit in each additional pair of circuits representing a sheath of a desired nerve or has improperly inserted the electrically conductive probe into the simulated physiological structure so as to contact any circuit in each additional pair of circuits representing a nerve, or so as to contact a sheath that was not surrounding the desired nerve.

3. The physiological training and evaluation simulator system of claim 2, wherein the electrically conductive elastomer of the second circuit and of each additional pair of circuits that represents the sheath of each additional pair of circuits also represents a region proximal to the sheath.

4. The physiological training and evaluation simulator system of claim 2, wherein the output signal is used to visually indicate on the display whether the user correctly or incorrectly inserted the probe into the simulated physiological structure and to visually identify which of the nerves and sheaths the user contacted with the probe.

5. The physiological training and evaluation simulator system of claim 2, wherein the nerves represented by the first circuit and by one circuit of each additional pair of circuits represent brachial plexus nerve bundles.

6. The physiological training and evaluation simulator system of claim 5, wherein the simulated physiological structure comprises a neck tissue structure, and wherein the electrically conductive elastomers are embedded within the neck tissue structure.

7. A method for enabling a performance of a user in performing a medical nerve block procedure to be evaluated, using a simulated physiological structure, comprising:

(a) embedding a pair of circuits within the simulated physiological structure, the pair of circuits including a first circuit formed of an electrically conductive elastomer representing a nerve to which a nerve block is to be administered, and a second circuit formed of an electrically conductive elastomer representing a sheath surrounding the nerve, wherein the sheath defines a region where an energized nerve stimulator will just start to stimulate the nerve surrounded by the sheath, the first and second circuits being electrically insulated from each other;

(b) providing a probe for manipulation by the user, for insertion into the simulated physiological structure in an attempt by the user to employ the probe to contact the second circuit representing the sheath, but not the nerve;

(c) coupling a voltage source to the probe;

(d) sensing whether the user has contacted either the first circuit or the second circuit with the probe based on an electrical connection being detected between the probe and either the first circuit or the second circuit, or both the first circuit and the second circuit, and in response, producing an output signal that indicates whether one or both of the first circuit and the second circuit has been contacted by the probe; and

(e) using the output signal for producing a simulated ultrasound image in which each nerve and sheath represented by a circuit contacted by the probe is visually hi-lighted, and for evaluating the performance of the user, where the output signal indicates that the user has correctly inserted the probe into the simulated physiological structure at a proper position and to a proper depth, so that the probe contacted only the second circuit representing the sheath and thus, the region that would be stimulated by an energized nerve stimulator, but not the first circuit representing the nerve, which would result in improperly administering a nerve block to the nerve with a nerve stimulator.

8. The method of claim 7, further comprising the step of embedding at least one additional pair of circuits within the simulated physiological structure, each additional pair of circuits including a circuit representing an additional nerve and a circuit representing an additional sheath surrounding said nerve, each circuit representing an additional nerve and each circuit representing an additional sheath being formed of an electrically conductive elastomer and being electrically insulated from each other and from the first and second circuits.

9. The method of claim 8, wherein the electrically conductive elastomer of the second circuit and of each additional pair of circuits that represents the sheath of each additional pair of circuits also represents a region proximal to the sheath.

10. The method of claim 8, wherein using the output signal to evaluate the performance of the user comprises visually displaying an indication of which of the nerves and sheaths the user contacted with the probe.

11. The method of claim 8, wherein nerves represented by the first circuit and one circuit of each additional pair of circuits correspond to brachial plexus nerve bundles.

12. The method of claim 11, wherein the pairs of circuits formed of electrically conductive elastomers are embedded within a neck tissue structure comprising at least a portion of the simulated physiological structure.

13. A physiological training and evaluation simulator system suitable for training and testing personnel in regard to administering a nerve block, comprising:

(a) a simulated physiological structure within which are disposed a pair of circuits, including a first circuit representing a nerve, and a second circuit representing a sheath surrounding the nerve, the nerve and sheath each being formed of an electrically conductive elastomer, but being electrically insulated from each other;

(b) a simulated nerve stimulator that is electrically coupled to the first circuit and to the second circuit;

(c) a voltage source;

(d) an electrically conductive probe that is electrically coupled to the voltage source and which can be manipulated by a user of the physiological training and evaluation simulator system, for insertion into the simulated physiological structure where the pair of circuits are disposed, in an attempt by the user to contact only the second circuit representing the sheath, but not the first circuit representing the nerve, the simulated nerve stimulator detecting when the electrically conductive probe contacts either the first circuit or the second circuit, or both the first circuit and the second circuit, and producing an output signal in response thereto, the output signal indicating whether one or both of the first circuit and the second circuit has been contacted by the probe, the output signal being used to evaluate whether the user has inserted the electrically conductive probe into the simulated physiological structure correctly so as to contact only the second circuit representing the sheath, or has improperly inserted the electrically conductive probe so as to contact the first circuit representing the nerve; and

(e) a display responsive to the output signal that produces a simulated ultrasound image in which each nerve and sheath represented by a circuit contacted by the probe is visually hi-lighted.

14. A method for enabling a performance of a user in performing a medical nerve block procedure to be evaluated, using a simulated physiological structure, comprising:

(a) embedding a pair of circuits within the simulated physiological structure, the pair of circuits including a first circuit formed of an electrically conductive elastomer representing a nerve to which a nerve block is to be administered, and a second circuit formed of an electrically conductive elastomer representing a sheath surrounding the nerve, the first and second circuits being electrically insulated from each other;

(b) providing a probe for manipulation by the user, for insertion into the simulated physiological structure in an attempt by the user to employ the probe to contact the second circuit representing the sheath, but not the nerve;

(c) coupling a voltage source to the probe;

(d) sensing whether the user has contacted either the first circuit or the second circuit with the probe based on an electrical connection being detected between the probe and either the first circuit or the second circuit, or both the first circuit and the second circuit, and in response, producing an output signal that indicates whether one or both of the first circuit and the second circuit has been contacted by the probe;

(e) using the output signal to evaluate the performance of the user, where the output signal indicates that the user has correctly inserted the probe into the simulated physiological structure so that the probe contacted only the second circuit representing the sheath, but not the first circuit representing the nerve; and

(f) in response to the output signal, producing a simulated ultrasound image in which each nerve and sheath represented by a circuit contacted by the probe is visually hi-lighted.