An Interactive Endotracheal Suctioning Simulator Which Exhibits Vital Reactions: ESTE-SIM

This paper describes a next-generation nursing education simulator, the endotracheal suctioning training environment simulator (ESTE-SIM), which is capable of interactively reproducing vital reactions. With the spread of home treatment, care providers who have received a certain level of nursing education should be increased, not limited to conventional health-care professionals. A great gap exists between simulations under restricted conditions that have been practiced in conventional nursing education and those in the actual clinical site, thus creating a burden on nurses and patients. If a simulator that approaches real clinical situations can be developed, it will not only contribute to lessening the burden on nurses but also improve the quality of nursing care. The ESTE-SIM, which simulates endotracheal suctioning, can measure the movements of the suction catheter inserted in the trachea. The measurement information is used to estimate the progress of the nursing maneuver, which is then used to reproduce vital reactions, including dynamic facial expression changes based on projection mapping and monitor-displayed vital signs. To design and control the vital reactions, a mathematical model to determine the behavior of the simulator is formulated based on the actual measurement data of the vital reactions of patients and the experiential knowledge of nurses. By integrating these element technologies, we developed a novel interactive nursing education simulator capable of recreating typical vital reactions that occur during the basic endotracheal suctioning maneuver.

Injuries and vital reactions patterns in hanging

Hanging is a form of ligature strangulation in which the force applied to the neck is derived from the gravitational drag of one?s own body weight. A furrow - dessication is the most common form of ligature mark on the skin. The furrow is a postmortem phenomenon due to ligature pressure and it is more detectable as the suspension time becomes longer. Vital reaction is a phenomenon that shows if the injury was premortal. Vital signs could be present at the injury site, thus it is termed as local, but they could also be remote from the injury site, and then they are termed general vital signs. The presence and recognition of any vital reaction in each pathoforensic case indicate vitality of certain injury, which is sometimes exceptionally useful in solving the case under investigation. Although in cases of hanging there is usually no question about the vitality of injury, this does not mean that one should not recognize the type of vital reactions and location of occurrence of these phenomena in such cases. Most often they can be also useful in the reconstruction of the mechanism. This paper presents most common vital reactions in hanging, with explanation of their underlying mechanisms, and their significance in forensic pathology is pointed out.