Parametrically Adjustable Intubation Mannequin With Real-Time Visual Feedback
Parametrically Adjustable Intubation Mannequin With Real-Time Visual Feedback
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DOI：
10.1097/sih.0b013e3182415b4d
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发表时间：
2012-06-01
影响因子：
2.4
通讯作者：
Hastings, Randolph H.
中科院分区：
文献类型：
--
作者：
Delson, Nathan;Sloan, Conan;Hastings, Randolph H.
简介：直接喉镜检查的培训很大程度上依赖于患者的练习。在某种程度上，人体练习的必要性可能会被具有精确气道解剖结构、喉镜检查过程中真实“感觉”、对许多患者配置进行建模的能力以及向学员和教练提供反馈的手段的插管人体模型所取代。该项目的目标是（1）构建和评估具有真实尺寸和触觉感觉的气道模拟器，该模拟器可以对影响喉镜检查难度的多个功能进行一系列调整；（2）开发一个用于显示信息的系统方法：原型是一个现有的二维 (2D) 气道模型，它非常接近牙科和外科文献中的头部、颈部和气道解剖结构测量结果。通过沿冠状轴添加层，在三维上扩展了现成的气道模型，将舌头、咽部、喉部和气管内置到面部中。使用力和运动感应喉镜构建了反馈系统，并通过测量模型尺寸来评估解剖精度，并通过测量喉镜力和运动与患者的喉镜进行比较。结果：挤压的 2.5 维模型与原始 2D 模型中的解剖测量结果保持密切一致。通过面部长度、下巴长度和张力、张口和牙齿状况的多种设置进行调整，喉镜轨迹与患者的喉镜轨迹形状相似，但力更大，约为 50 N，而患者的喉镜运动约为 30 N。在手术过程中可以实时显示喉镜通过人体模型气道的运动，从而建立反馈手段。结论：该模型包含有助于掌握喉镜的新颖功能。需要进一步研究可调节性和反馈如何影响人体模型上喉镜检查的价值（Sim Healthcare 7:183-191, 2012）。
Introduction: Training for direct laryngoscopy relies heavily on practice with patients. The necessity for human practice might be supplanted to some extent by an intubation mannequin with accurate airway anatomy, a realistic "feel'' during laryngoscopy, the capacity to model many patient configurations, and a means to provide feedback to trainees and instructors. The goals of this project were (1) to build and evaluate an airway simulator with realistic dimensions and haptic sensation that could undergo a range of adjustments in several features that affect laryngoscopy difficulty and (2) to develop a system for displaying information on laryngoscopy force and motion in real time.Methods: The prototype was an existing 2-dimensional (2D) airway model that closely approximated cephalometric measurements of head, neck, and airway anatomy from the dental and surgical literature. The 2D model was extended in a third dimension by adding layers along the coronal axis. An off-the-shelf airway model provided the tongue, pharynx, larynx, and trachea. Adjustability was built into the face, jaw, mouth, teeth, and spine components. A feedback system was constructed with a force-and motion-sensing laryngoscope and motion sensors incorporated in the mannequin head, jaw, and larynx. Anatomic accuracy was assessed by measuring model dimensions. Realism was evaluated by measuring laryngoscopy force and motion compared with laryngoscopy in patients.Results: The extruded 2.5-dimensional model maintained a close conformity to the anatomic measurements present in the original 2D model. The model could be adjusted through multiple settings for face length, jaw length and tension, mouth opening, and dental condition. The laryngoscopy trajectory had a similar shape to laryngoscopy trajectories in patients, but force was greater, on the order of 50 N, compared with roughly 30 N in patients. The movement of the laryngoscope through the mannequin airway could be displayed in real time during the procedure, establishing a means for feedback.Conclusions: The model incorporates novel features that could aid in developing mastery of the laryngoscopy procedure. Further work is needed to investigate how adjustability and feedback impact the value of laryngoscopy practice on mannequins. (Sim Healthcare 7:183-191, 2012)