Abstract: An intubation scope assembly adapted to facilitate the positioning of an endotracheal tube in a patient comprising an electromagnetic or sound energy source which enters the vocal cords exteriorly of the neck of the patient with energy having a direction, wavelength and intensity capable of entering the trachea, substantially avoiding encompassing the entire pharynx and capable of being transmitted cephalad substantially between and/or around the vocal cords. A suitable sensor for the energy emitted by such source comprises a stylet assembly, the distal end of which can detect or collect the energy transmitted between and/or around the vocal cords and the proximal end of which can monitor the detected or collected energy to thereby locate the vocal cords for positioning an endotracheal tube therebetween. A system and method of intubating a patient with the foregoing assembly are also disclosed.

Abstract: A method of ventilating a patient comprises initially determining the class of the lungs of a given patient, selecting a pressure or flowrate inspiratory waveform and other ventilatory parameters like inspiratory pause and inspiratory time, among others, appropriate for that lung class, and then ventilating the patient with the selected inspiratory waveform and other ventilatory parameters. New ventilation inspiratory waveforms are provided which have been found to be advantageous for certain lung classes.

Abstract: A combination ventilation apparatus and anesthesia delivery system comprises a circulation loop within which oxygen and air or other clinical gas, or a mixture of air, oxygen, nitrous oxide or other clinical gas and anesthetics, are circulated by a variable speed centrifugal blower to a Y-piece which connects the circulation loop to an endotracheal tube or other airway device communicating with a patient. A proportional flow control valve is operative to actively control the pressure or flow at the Y-piece in response to signals from pressure or flow sensors which are positioned to provide measurements representative of the actual pressure and flow conditions within the patient's lungs. Constant circuit volume is maintained by computer control of gas make-up valves in response to the movement of a weighted bellows located between the proportional flow control valve and centrifugal blower.

Abstract: The subject invention pertains to a system for imaging the human airway having highly advantageous optical and physical characteristics. In a specific embodiment, the human airway can be imaged during the intubation procedure. The excellent characteristics of the imaging system of the subject invention result, in part, from the use of plastic optic fibers. Plastic fibers are more robust than the glass optical fibers used in currently available imaging systems, and are therefore capable of being bent and/or twisted with less concern of breakage. In addition, the lower costs of plastic fibers enables scopes of the subject invention, in a specific embodiment, to be manufactured for single patient use thereby eliminating the requirement for cleaning, special care, the maintenance of expensive inventory, and most importantly eliminating the opportunity for cross contamination between patients.

Abstract: A method and apparatus for operating a ventilator in a primary electronic mode or in a back-up pneumatic mode during primary electronic mode failure. A method and apparatus for operating a ventilator in an advanced mode, having a number of ventilatory modes, or in a basic mode, having a limited number of ventilatory modes is also disclosed.

Abstract: An integrated patient simulator for training or other purposes capable of realistically reacting to a current physiological state and physiological model. A patient simulator and method of patient simulation wherein a physical gas composition representative of a simulated alveolar gas composition in a lung model is determined, and a simulated blood gas machine simulates an output representative of a simulated physiological state based at least in part on the simulated alveolar gas composition.

Abstract: An apparatus and method for injecting and volatilizing a volatile drug in a patient simulator, including a manikin, a gas supply and a drug volatilization device. The drug volatilization device includes a thermal conductor defining a gas propagation cavity, a sintered insert, and a needle accepting cavity. A simulated response to the drug is calculated, and an output device associated with the manikin is actuated to simulate the effect of the drug.

Abstract: A gas blender comprising a plenum for mixing gases, at least one flow valve, an oxygen sensor, a microprocessor, and driver circuits. The inlet gas port is adapted to be in fluid communication with a supply of a desired gas and the flow valve is disposed between the supply of gas and the inlet of the plenum. At least one driver circuit adjusts the flow valves to change the gas flow rate therethrough and, accordingly, the rate at which gas enters into the plenum. The oxygen sensor measures the percentage composition of oxygen exiting from, or inside, the plenum and generates an output based on the measured percentage composition of oxygen. The microprocessor controls the percentage composition of oxygen exiting from the plenum and is electrically coupled to the output of the oxygen sensor. The microprocessor compares the output of the oxygen sensor to a predetermined level of oxygen and generates a response signal based on the comparison, which is communicated to the driver circuits.

Abstract: A method and an apparatus for quantifying the amount of fluid administered to a patient simulator during simulated medical surgery. A fluid administered to a manikin and delivered to a reservoir associated with the manikin. The quantity of fluid administered is determined based on the change of weight of the reservoir. A simulated response to the administered fluid can be computed, based on the determined quantity of fluid administered.

Abstract: A method and apparatus for simulating lung sounds in real time in an integrated patient simulator uses a manikin having an associated simulated lung comprising at least one bellows and at least one sensor for sensing the position of the bellows. Based on a physiological state of the patient simulator, a audible lung sound is directed through a plurality of sound output devices located at different locations on the manikin. The lung sound corresponds to an appropriate physiological sound at that particular location on the manikin and is synchronized with the position of the bellows. Synchronization occurs by continuously determining a volume of the bellows to determine a respiratory phase and a transition in the respiratory phase. The respiratory phase is determined by calculating a first derivative of the bellows volume over time and the transition in the respiratory phase is determined by calculating a second derivative of the bellows volume over time.

Abstract: An apparatus and method of simulating breathing sounds in real time involves the use of a manikin having a lung bellows. A sensor associated with the lung bellows is used to continuously determine the volume such that, using standard mathematical procedures based on the time and volume determined, a first derivative of the bellows volume over time can be calculated to determine the phase of the respiratory cycle (e.g. inhalation or exhalation). In addition, by calculating a second derivative of the bellows volume over time, a transition in phase of the respiratory cycle can be determined. Based upon the first and second derivatives of the bellows volume over time, a sound is output through an output device, such as a speaker, located proximate the mouth of the manikin. The outputted sounds are pre-recorded audible sounds of breathing corresponding to appropriate physiological sounds.

Abstract: An apparatus and method for detecting and identifying a drug administered in real time in an integrated patient simulator uses a manikin which receives the administration of the drug. A bar code is affixed to an implement for administering the drug, wherein the implement is an intravenous drip bag or a syringe. A scanner is used to scan the bar code to identify the type and concentration of the drug contained within the implement. The information obtained by the scanner is then used by a computer associated with the patient simulator to effect a response in the manikin.

Abstract: An apparatus and method for simulating bronchial resistance or dilation in real time in an integrated patient simulator during simulated medical procedures is realized by a manikin having a simulated trachea and a simulated lung, a conduit interconnecting the simulated trachea and the simulated lung for propagating a flow of gas, and a restricting device for variably restricting the flow of gas through the conduit. The restricting device includes a nautilus shaped cam and a stepper motor for rotating the cam such that a selected surface of the cam is disposed within a opening in the conduit so as to continuously vary the size of the opening.

Abstract: An apparatus and method for synchronizing output devices related to a cardiac rhythm in real time in an integrated patient simulator during simulated medical surgery includes a manikin, at least one output device including devices for simulating a cardiac pulse and a radial pulse, a first computer associated with the patient simulator for generating an electric cardiac rhythm synchronizing pulse, a second computer for receiving the cardiac rhythm synchronizing pulse and generating a simulated response thereto, and a distributed processing network for transmitting the cardiac rhythm synchronizing pulse between the first computer and the second computer and for transmitting the simulated response between the second computer and the output device. In this way, a time offset to allow for simulated travel time or lag of the simulated cardiac pulse through the body can be added by the second computer where appropriate for certain subsystems or monitors associated with the patient simulator.

Abstract: A self-regulating, simulated lung for use in real time in simulated medical procedures comprises at least one bellows capable of receiving and expelling gas, a means for actuating the bellows depending upon a time- and event-based script, a computer model or a combination thereof, at least one mass flow controller capable of directing the gas into the bellows, and a volumetric pump for continuously expelling a constant flow rate of gas from the bellows. The means for actuating the bellows comprises a double acting piston connected to the bellows and having a first constant pressure and a second variable pressure acting on respective sides of the piston, whereby non-linear compliances may be simulated.

Abstract: An intubation scope assembly adapted to facilitate the positioning of an endotracheal tube in a patient comprising an electromagnetic or sound energy source which enters the vocal cords exteriorly of the neck of the patient with energy having a direction, wavelength and intensity capable of entering the trachea, substantially avoiding encompassing the entire pharynx and capable of being transmitted cephalad substantially between and/or around the vocal cords. A suitable sensor for the energy emitted by such source comprises a stylet assembly, the distal end of which can detect or collect the energy transmitted between and/or around the vocal cords and the proximal end of which can monitor the detected or collected energy to thereby locate the vocal cords for positioning an endotracheal tube therebetween. A system and method of intubating a patient with the foregoing assembly are also disclosed.

Abstract: A method and associated apparatus for simulating neuromuscular stimulation in real time during simulated medical surgery using a manikin, such as ulnar nerve stimulation to detect the degree of neuromuscular blockade and external stimulation of nerves to produce evoked potentials so as to monitor the integrity of nerves during surgery is provided. Such simulation allows for the active participation of trainees with the simulation apparatus to experience real world medical procedures in a setting that closely mimics the real world.

Abstract: The heating of blood or other medical fluids supplied to a patient is provided by a system and method of feedback control. The temperature of the blood is sensed by receiving infrared energy from the medical fluid as it flows within a sterile and disposable tube from a fluid source to the patient. Feedback control stabilizes the temperature at a desired value. A second sensor may optionally be used to determine if the fluid is too hot within the microwave device itself. The disposable tube has at least one window or thin membrane portion which allows infrared radiation to pass therethrough in order to be sensed by the sensor. One arrangement of the present invention uses a microprocessor with adaptive control to provide precise and accurate control of the temperature of the medical fluid.

Abstract: A diagnostic monitor checks the carbon dioxide (CO.sub.2) content of a gas exiting a patient during endotracheal or esophageal intubation. A plurality of composition portions substantially change color in response to exposure to the carbon dioxide. The composition portions change color in response to different times of exposure to carbon dioxide. A magnifying or condensing lens may be positioned on the monitor to enhance viewing of the color change. The monitor may advantageously be made part of an intubation system through which the gases from a patient exit the patient. The differences in time of exposure needed to cause the color change may be accomplished by using semipermeable membranes having differing thicknesses, CO.sub.2 permeabilities, and/or surface areas with each membrane corresponding to a particular one of the composition portions. An arrangement is provided whereby the monitor is automatically activated by the normal assembly steps of a patient breathing circuit.

Abstract: Described here are a novel means and device for noninvasively quantifying important blood constituents. Total hemoglobin, arterial oxygen content, hematocrit, and other parameters can all be determined quickly and easily without the need for skin puncture or lengthy laboratory analysis. The invention described here concerns the simultaneous measurement of volume changes and changes in the mass of either oxyhemoglobin, total hemoglobin, or reduced hemoglobin. The data obtained by these measurements is used to quantify the parameters of interest.