WO2007127194A2

WO2007127194A2 - Trauma training system

Info

Publication number: WO2007127194A2
Application number: PCT/US2007/009922
Authority: WO
Inventors: Lynn R. King
Original assignee: U.S. Government As Represented By The Secretary Of The Army
Priority date: 2006-04-24
Filing date: 2007-04-24
Publication date: 2007-11-08
Also published as: US20110111380A1; EP2018637B1; US9342996B2; CA2650540A1; US20070243512A1; EP2018637A4; US7887330B2; US10347157B2; US8342852B2; US20160260357A1; CA2650540C; WO2007127194A3; EP2018637A2; US20130078604A1

Abstract

A system for simulating one or more hemorrhages in order to provide a more dynamic and realistic hemorrhage simulation in order to train medical personnel and other critical care givers, such as first responders, medics, and emergency medical technicians (EMTs) on treating hemorrhages. The system includes a reservoir, a flow controller, and at least one conduit connected to at least one simulated wound site wherein the system supplies fluid to the simulated wound site in order to simulate a hemorrhage. The system may further include a plurality of wound sites that have their respective fluid flows controlled by the fluid flow controller. In at least one embodiment, the reservoir and the flow controller are housed within a bag. In at least one embodiment, the system further includes an audio system for providing audio cues to the simulation participants to enhance the realism of the simulation.

Description

Trauma Training System

I. Field of the Invention

This invention relates to a system and method for simulating one or more hemorrhages in order to provide a more dynamic and realistic hemorrhage simulation in order to train medical personnel and other critical care givers, such as first responders, medics, and emergency medical technicians (EMTs) on treating hemorrhages.

II. Background of the Invention

Trauma training systems, such as mannequins and other treatment simulation devices, are used to train individuals in a variety of medical situations. These medical situations may span a wide range of simulations - from cardiopulmonary resuscitation (CPR) to emergency room situations. Because of this wide range of applications, the complexity of many of these devices is impacted by the simulations intended to be performed with the device. One of the more common simulation devices is the basic mannequin. A basic mannequin may be either a partial or whole human body - depending on the intended use - that allows a user, typically a trainee, to interact with it. For example, a CPR mannequin allows for chest compressions and assisted breathing but could not be used to simulate other medical situations. At the other end of the trauma training device spectrum are much more complex devices that are typically mannequins that provide simulation capabilities for many different or more detailed simulations to be performed. These mannequins are typically controlled by preprogrammed software that allows a trainer to use a variety of optional simulations based on feedback from the users but requires extensive preparation prior to a simulation. These simulations provide an interactive "simulation tree" such that the simulation reacts to the choices made by the trainees. Consequently, these complex treatment devices are not suited for large training situations, at least in part because of the need to train the trainers on how to use the entire system. In addition, as the complexity of these treatment devices increases, so does the fragility of the devices such that the devices are not well-suited for in-field training and the ability to have multiple units for a mass casualty situation is limited given the high cost of these systems.

Other training situations use humans acting as injured individuals in mass trauma simulations with cards telling them what their respective injuries are and what to do. A problem with these simulations is that the injuries are static such as a wound i being liquid soaked clothes possibly with make-up with the actor providing additional feedback and information in response to the treatment received.

Notwithstanding the usefulness of the above-described methods, a need still exists for a trauma training system that provides dynamic and realistic bleeding simulation to at least one simulated wound site in order to replicate a live traumatic bleeding situation.

III. Summary of the Invention

In at least one exemplary embodiment, the invention includes a trauma training system for replicating at least one hemorrhage, the system comprising: a collapsible reservoir capable of storing fluid, a pump in fluid communication with the reservoir, at least one valve in fluid communication with the pump, a controller connected to the pump an enclosure housing said reservoir, said pump, said at least one value, and said controller, and the at least one valve, and at least one wound site detachably in fluid communication with the valve, wherein fluid is provided to the wound site to simulate a hemorrhage,

In at least one exemplary embodiment, the invention includes a trauma training system comprising: a collapsible reservoir, a pump in fluid communication with the cavity of the reservoir, a valve connected to the pump, a controller connected to the pump and the valve, a housing containing the reservoir, the pump, and the valve, and at least one wound site detachably connected to the valve.

The invention in at least one embodiment provides an easy to use system with minimal training required prior to use while maintaining extreme flexibility for a simulation.

IV. Brief Description of the Drawings The present invention is described with reference to the accompanying drawings.

FIGs. 1A and 1 C illustrate block diagrams of exemplary embodiments of the trauma training system in accordance with the present invention.

FIG. 1B illustrates an exemplary connection between a reservoir and a pump in accordance with an exemplary embodiment of the present invention.

FIG. 1D illustrates an extremity or foot of a trauma training system in accordance with an exemplary embodiment of the present invention.

FIGs. 2A and 2B illustrate block diagrams of exemplary embodiments of the trauma training system in accordance with the present invention. FIG. 3 illustrates an exemplary portable embodiment of the trauma training system in accordance with the present invention.

FIG. 4 illustrates a refill system in accordance with an exemplary embodiment of the present invention. FIG. 5 illustrates a portable trauma training system in accordance with the present invention.

FIG. 6 illustrates a portable trauma training system in accordance with the present invention.

FiG. 7 illustrates a portable trauma training system in accordance with the present invention.

Given the following enabling description of the drawings, the apparatus should become evident to a person of ordinary skill in the art. V. Detailed Description of the Drawings

The present invention includes a trauma training system that simulates bleeding wounds such as hemorrhages. As illustrated in FIG. 1A, the invention includes a reservoir (a container or other fluid source) 110, a fluid flow controller 120 in communication with the reservoir 110, and at least one simulated wound site 102 in communication with the fluid flow controller 120. The reservoir 110 and the fluid flow controller 120 are illustrated as being housed in an enclosure (or container) such as an elastic bag (or pouch) that shrinks to fit around its contents. The enclosure 100 is capable of placement, for example, into a mannequin, a body suit, or a bag/backpack among other types of housings. The fluid supplied to the wound sites 102 replicates bleeding wounds and permits the system to be utilized in training individuals, such as medical care providers and first responders, in the treatment of traumatic injuries, particularly bleeding wounds.

The connection between the reservoir 110 and the fluid flow controller 120 can be accomplished in a variety of ways including having the fluid flow controller located within the container, for example, a submersible pump including being integrated into the cap of the reservoir (as illustrated by pump 122 of the fluid flow controller, for example, in FIG. 1B); the fluid flow controller having a conduit inserted into the reservoir with the fluid flow controller attached to the connector; and the fluid flow controller connected to the reservoir with conduit. The connection between the fluid flow controller and the at least one wound site also can be accomplished in a variety of ways including having a conduit system between the fluid flow controller and the at least one wound system with some embodiments placing additional components in the conduit system, and the fluid flow controller attached to the at least one wound system to pump the fake blood right to the at least one wound system. In FIGs. 1A and 1C, the connection between these components is illustrated as a line that is representative of these different ways. In some exemplary embodiments as illustrated in FIG. 1C, the system further includes a remote controller 160 in communication with the fluid flow controller 120. The remote control 160 signals a switch or adjustable controller within the fluid flow controller 120 and allows the simulation to be controlled externally of the system by, for example, a trainer. The remote operation in at least one embodiment allows for additional control over the routing of fluid through the system including development of additional hemorrhage sites during the course of a particular simulation such as in response to restrictions (like tourniquets) on blood flow or general degradation of the patient over time.

Exemplary reservoirs 110 include flexible membranes and containers that are capable of holding fluid for dispensing through the system to simulate bleeding and that are collapsible as fluid is drawn out of the reservoir to keep the pump 120 primed. In at least one embodiment, the reservoir 110 is housed within an elastic bag that constricts as fluid is drawn from the reservoir 110. In other embodiments, the reservoir 110 is an elastic container that sizes to fit the volume of fluid. Depending upon the implementation, the reservoir can range in size from several milliliters to 10 liters and higher depending upon the space that is allotted for the reservoir. Different embodiments as described below include body suits, bag enclosures, and backpacks for housing parts or all of the system and as such different levels of space will be available all of which collective are housings. The range of sizes will become more apparent in connection with the discussion of different exemplary embodiments below. The reservoir 110 can be integrally formed within the enclosure that houses it. For example, in the mannequin, utility belt and backpack embodiments the reservoir can be formed as its own compartment within the interior of the mannequin or in the utility belt and the backpack. In contrast, in a retrofit situation, the reservoir 110 is a separate component that is placed in the structure.

FIG. 1 D illustrates an exemplary simulated wound site(s) that may be located anywhere on the body, including extremities such as the arms, legs and feet. FIG. 1 D, for example, illustrates simulated wound site 102 located on the top of the foot 108F. FIG. 1D also illustrates an example of a stream of fake blood 1022 being dispensed from the simulated wound site 102. The location of the wound site 102 could be placed anywhere on a mannequin or a human and may be in multiple locations as appropriate, for example, to teach the need to carefully check a patient for multiple hemorrhage sites.

FIGs. 2A and 2B illustrate different exemplary embodiments for the fluid flow controller 120 being connected to a plurality of conduits each having a respective connector 158 for attaching to the wound site(s) 102 via conduit 150.

FIG. 2A illustrates an exemplary embodiment of the flow controller 120B having a power supply 130 and a controller 126 connected to a pump 122 and a valve 124 such as a solenoid, pin, or needle valve. The controller 126 may include a manually activated component such as, for example, a switch, button, or dial. The controller 126 may also be activated by a remote controller 160 illustrated, for example, in FIG. 1C. The variable adjustment of the power supplied to the pump 122 allows the fluid volume to be controlled to provide varying amounts of fake blood flow during a particular simulation. The adjustable power supplied to the pump 122 may be provided by a variable adjuster such as a rheostat. The power may also be adjustably supplied to provide a pulsating flow to the simulated wound site(s) that simulates pumped blood.

The embodiment as illustrated in FIG. 2A includes a manifold 128 connected to the output of the valve 124, which in at least one embodiment is omitted. The manifold 128 provides an output of fake blood to multiple flow lines such that artificial blood may be provided to various simulated would site(s) 102. Check valves 125 are provided between the manifold 128 and the simulated wound site(s) 102 in order to prevent fluid backflow when the direction of flow for the fake blood is up from the check valve 125. In at least one embodiment, the check valves 125 are replaced with an adjustable valve such as solenoid, needle, and/or pin valves. Also illustrated are quick connectors 158, 159 (although other types of connectors can be used that includes a diaphragm or other rubber seal capable of resealing upon disconnection to prevent flow of fluid from the end) located in conduit 150 connecting the wound site(s) 102 to the fluid flow controller 120. The quick connectors 158, 159 allow quick and easy line connections to be able to connect different wound site(s) 102 depending upon the desired simulation.

The system allows for injured body parts or feeds to be connected to the hub, which acts as the hub for the system. The body part locations, for example, include a right arm, a right leg, a left leg, a left arm, and a head along with outer layers of the torso being able to be interchanged to provide a variety of wound site combinations. Alternatively, a body part could be omitted as a potential host of a wound site 102 and thus eliminate one of the connectors and corresponding portion of the flow controller. Each wound site for a body part will include a wound site 102, a conduit 150, and a connector 159. The conduit 150 connects the wound site 102 to the connector 159. The connector 159 of the body part is designed to attach to a respective connector 158.

FIG. 2B illustrates an exemplary embodiment of the flow controller 120C of the present invention, including a programmable controller 127 connected to pump 122, valve 124 and manifold 128. In some embodiments, controller 126 is integrally formed with the programmable controller 127. The programmable controller 127 allows a user to select which simulated wound site(s) 102 receives fake blood flow. The programmable controller 127 also allows the user to select the flow rate to each simulated wound site(s) 102.

FIG. 3 illustrates an exemplary embodiment with a portable container 100B. The reservoir 110 and the flow controller 120, similar to embodiments illustrated in FIG. 2A and 2B₁ are enclosed in the container 100B. Container 100B may, for example, be a backpack, shoulder bag or elastic bag having an opening such as a zipper. In at least one embodiment, the elastic bag will contract onto the contents as fluid is dispensed from the reservoir 110 allowing the pump to remain in contact with the fluid still present in the reservoir 110 and thus primed for pumping. The portable container allows live participants to attach the system of the present invention to their bodies and locate the simulated wound sites 102 at a variety of locations on their bodies. This allows for a more realistic simulation of a live casualty by enabling the live participant to provide more meaningful feedback to the trainee. The valves 128 include means that can restrict flow through the fluid pathway including clamps applied to the conduit. FIG. 3 also illustrates an exemplary refill conduit 152 and refill connector 174. The conduit 152 in at least one embodiment passes through a cap of the reservoir 110 and in other embodiments passes through its own opening proximate to the pump's location in the reservoir 110. FIG. 4 illustrates an exemplary refill system 170. The refill system includes an external container 172 and a male quick release connector 174 attached to a hose. The container 172, as illustrated, is a manually pressurized container that can be used to refill the reservoir 110 with a pressurized stream of fluid. However, a variety of other external containers 172 may be used to accomplish the function of refilling the fluid reservoir 110. As illustrated in FIG. 1B, the refill system 170 includes a conduit 152 connected to the reservoir 110 via a T-connector 154 that provides a connection point into the fluid system. However, as illustrated in FIG. 3, the conduit 152 may bypass the pump 122. The illustrated refill conduit 152 includes a female quick release connector 1522 to connect to the external container 172 having a male quick release connector 174.

FIG. 5 illustrates an exemplary embodiment of the present invention utilizing a bag 100C for storing the trauma training system. The bag 100C may be a backpack, body bag, shoulder bag, elastic bag, or the like, and is used to enclose and attach the trauma training system to a system or live participant. The bag 100C preferably includes a compartment for storing all components of the trauma training system, including the container, controller and flow tubes. The bag 100C may be designed to fit closely to the body of the system or live participant 300 such that it is not disruptive to the training process. The bag 100C may also include one or more holes for tubes 150 to pass through to the simulated wound sites 102 as illustrated in FIG. 5. The bag 100C may include shoulder straps 202 and/or a belt 204 to help secure the bag. The bag 1800 may also include a detachable harness (not shown) to mount the bag to the system or live participant 1810. In other embodiments, the bag 100C is incorporated into a body suit 100D.

FIG. 6 illustrates an exemplary embodiment of the trauma training system that utilizes a body suit 100D. The body suit 100D which may be made of a stretch material, such as elastic or Spandex®, is provided on a mannequin or live participant to simulate wounds. An exemplary simulated wound site 102 is shown on a participant 300 wearing a body suit 100D. The illustrated wound site 102 is located on a partial body suit or belt that covers the abdomen. The partial body suit may be made of the same stretch material as the body suit 100D. The flow controller may be contained either inside the enclosure or contained inside the body suit 100D. Another location for reservoir 110 and flow controller 120 is to be located in a fake utility belt 100E illustrated in FIG. 7 with shell areas for holding the components and connecting to conduit 150 laid below the surface of the body suit 100D or embedded in the body suit 100D. The body suit 100D also conceals the fluid flow conduits placed underneath the body suit, and one exemplary location the fluid conduits are along the seams of the body suit or between layers of material. This allows the simulated wound sites 102 to be exposed on the body suit or to be hidden underneath clothing worn over the body suit 100D. The body suit 100D may provide various levels of body coverage, including full body coverage and partial body coverage covering, for example, the abdomen, torso, an arm or leg. The components of the system may also be stored in a belt, such as a utility belt. The utility belt may be fashioned to conceal the components so as to provide additional realism to the system.

FIG. 7 illustrates an exemplary embodiment with a belt such as a utility belt housing the system. A reservoir 110 shaped like a canteen is on one part of the belt and a storage bin contains the fluid flow controller 120 with the two components being connected via conduit 150. The housing for the reservoir 110 in at least one embodiment where the reservoir 110 is collapsible includes a door that allows the user to prime the pump 122 by compressing the collapsible reservoir 110. In at least one embodiment, an elastic band (or bag) rings the reservoir 110 to facilitate the reservoir in collapsing on itself. In at least one embodiment, the pump 122 is a submersible pump in the reservoir 110. The fluid flow controller 120 is illustrated as having two conduits 150 attached to it for providing fake blood to wound sites 102. Based on this disclosure, one of ordinary skill in the art will appreciate that a variety of number of wound sites could be feed by the fluid flow controller 120. As mentioned above, the conduits 150 connected to wound sites 102 could be feed beneath clothing, incorporated into the material of the clothing, or run above the clothing worn by an individual or mannequin.

In at least one embodiment, the system will include multiple pairs of reservoirs and pumps to supply a common manifold. Having multiple reservoirs allows for the individual reservoirs to be smaller and more easily placed on a participant and hidden from trainees. In further embodiments, the smaller reservoir with a pump will be located proximate to the wound site.

It will be understood that each block of the block diagrams and combinations of those blocks can be implemented by means for performing the illustrated function.

The exemplary and alternative embodiments described above may be combined in a variety of ways with each other.

Fluid communication as used in this description means that components that are in fluid communication have a pathway between them in which fluid can go from one component to the other component.

It should be noted that the present invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, the embodiments set forth herein are provided so that the disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art. The accompanying drawings illustrate exemplary embodiments of the invention.

Although the present invention has been described in terms of particular exemplary and alternative embodiments, it is not limited to those embodiments. Alternative embodiments, examples, and modifications which would still be encompassed by the invention may be made by those skilled in the art, particularly in light of the foregoing teachings.

Those skilled in the art will appreciate that various adaptations and modifications of the exemplary and alternative embodiments described above can be configured without departing from the scope and spirit of the invention. Therefore, it is to be understood that, within the scope of the appended claims, the invention may be practiced other than as specifically described herein.

Claims

IN THE CLAIMS:

1. A trauma training system for replicating at least one hemorrhage, said system comprising: a collapsible reservoir capable of storing fluid, a pump in fluid communication with said reservoir, at least one valve in fluid communication with said pump, a controller connected to said pump and said at least one valve, an enclosure housing said reservoir, said pump, said at least one value, and said controller, and at least one wound site detachably in fluid communication with said valve, wherein fluid is provided to said wound site to simulate a hemorrhage.

2. The trauma training system according to claim 1 , wherein said at least one wound site includes: a first wound site conduit connected to said valve, a first wound site connected to said first wound site conduit, a second wound site conduit connected to said valve, and a second wound site connected to said second wound site conduit.

3. The trauma training system according to claim 1, wherein said at least one valve includes a solenoid electrically connected to said activation mechanism.

4. The trauma training system according to claim 1, wherein said controller is selected from a group consisting of a switch, a dial, a button, and a circuit.

5. The trauma training system according to claim 1 , further comprising: a manifold connected to said at least one valve, a second of said at least one valve connected to said manifold, a first wound site conduit connected to said second valve and one of said at least one wound site, a third of said at least one valves connected to said manifold, and a second wound site conduit connected to said third valve and a second of said at least one wound site.

6. The trauma training system according to claim 5, wherein said flow controller further includes a check valve in at least one of said first and second wound site conduits.

7. The trauma training system according to any one of claims 1-6, further comprising: a back flow system, wherein said back flow system includes: a branch connector connected to said pump, a back flow conduit connected to said branch connector, a check valve present in said back flow conduit, and a back flow container connected to said back flow conduit; and a wound site conduit connecting said branch connector to said at least one wound site.

8. The trauma training system according to any one of claims 1-6, further comprising a back flow system including: a branch connector connected to said pump, a back flow conduit connected to said branch connector and said reservoir, a check valve present in said back flow conduit, and a wound site conduit connecting said branch connector to said wound site.

9. The trauma training system according to any one of claims 1-6, further comprising: a branch connector fluidly connected to said reservoir having one branch forming a flow path with said at least one wound site and a second branch; and a refill conduit connected to said second branch, said refill conduit having a connector for connection to an external fluid source.

10. The trauma training system according to any one of claims 1-6, further comprising a remote control for controlling the operation of said controller.

11. The trauma training system according to any one of claims 1-6, further comprising: a manifold connected to said at least one valve, a plurality of conduit connected to said manifold for connection to a wound site, and wherein said controller includes a programmable controller in communication with at least one of said pump, said valve, and said manifold, wherein said programmable controller controls the delivery of fluid to each of said wound site.

12. A trauma training system comprising: an enclosure, a reservoir housed in said enclosure, a flow controller in fluid communication with said reservoir and housed in said enclosure, and at least one wound site in fluid communication with said flow controller, wherein fluid is delivered from said reservoir to said wound site to simulate a hemorrhage.

13. The trauma training system according to claim 12, wherein said at least one wound site comprises multiple wound sites disposed at various locations on said body.

14. The trauma training system according to claim 12 or 13, wherein said flow controller includes: a pump in fluid communication with said reservoir, a valve in fluid communication with said pump, a power supply connected to said pump and said valve, a manifold in fluid communication with said valve, and a plurality of conduits connected to said manifold, each conduit includes a connector on its free end.

15. A trauma training system comprising: a collapsible reservoir, a pump in fluid communication with the cavity of said reservoir, a valve connected to said pump, a controller connected to said pump and said valve, a housing containing said reservoir, said pump, and said valve, and at least one wound site detachably connected to said valve.

16. The trauma training system according to claim 15, further comprising: a manifold connected to said valve, a plurality of conduit connected to said manifold, each conduit having a connector at its free end, said connector includes a seal, and each of said at least one wound site includes a conduit with a connector configured to engage a connector of a conduit connected to said manifold.

17. The trauma training system according to claim 15 or 16, further comprising: a refill conduit in fluid communication with said reservoir, said refill conduit having a connector at its free end, said connector includes a seal.

18. The trauma training system according to any one of claims 15-17, further comprising at least one of a belt or harness configured to hold the system against the object on which the system is placed.

19. A trauma training system comprising: a belt having at least two compartments, a reservoir contained in one of said compartments, a fluid flow controller in fluid connection with said reservoir and in at least one of said compartments, at least one conduit in fluid communication with said fluid flow controller, and at least one wound site in detachable fluid communication with said at least one conduit.

20. The trauma training system according to claim 19, wherein said fluid flow controller includes a submersible pump in said reservoir, and at least one valve connected to said submersible pump via conduit, said at least one valve housed in a compartment separate from said reservoir.

21. The trauma training system according to claim 19, wherein said fluid flow controller includes a pump in flow communication with said reservoir, at least one valve in fluid communication with said pump, and a manifold in fluid communication with said valve.

22. A trauma training system comprising: a collapsible reservoir, a pump in fluid communication with the cavity of said reservoir, a valve connected to said pump, a controller connected to said pump and said valve, at least one conduit connected to said valve, at least one wound site detachably connected to said valve through at least one conduit, and a body suit housing said reservoir, said pump, said valve, said controller, and said conduit.

23. The trauma training system according to claim 22, further comprising: a manifold connected to said valve, a plurality of conduit connected to said manifold, each conduit having a connector at its free end, said connector includes a seal, and each of said at least one wound site includes a conduit with a connector configured to engage a connector of a conduit connected to said manifold.

24. The trauma training system according to claim 22, wherein said wound site is present on the outside of said body suit.

25. The trauma training system according to any one of claims 22-24, wherein said conduit is sewn into said body suit.

26. The trauma training system according to any one of claims 22-24, wherein said conduit is between two layers of said body suit.

27. The trauma training system according to any one of claims 22-24, wherein said conduit is located in seams in said body suit.

28. A trauma training system according to any one of claims 15-18 and 22-27, wherein said controller includes a programmable controller.

29. A trauma training system according to any one of claims 1-27, further comprising a programmable controller for controlling the flow of fluid through the system.

30. A trauma training system comprising: a bodysuit; a reservoir in communication with said bodysuit; a flow controller in fluid communication with said reservoir; and at least one wound site in fluid communication with said flow controller, wherein said fluid is provided to said wound site to simulate a hemorrhage.

31. The trauma training system according to claim 26, wherein said at least one wound site includes: a first wound site; a first wound site conduit connected to said first wound site; a second wound site; and a second wound site conduit connected to said second wound site.

32. The trauma training system according to claim 27, wherein said bodysuit includes at least one extremity, and said at least one wound site is located on said at least one extremity.

33. A portable trauma training system comprising: a bag worn by a person or system; a reservoir housed within said bag, said reservoir capable of holding fluid; a flow controller housed within said bag and in fluid communication with said reservoir; and at least one conduit in fluid communication with said flow controller, wherein said at least one conduit has at least one wound site and said fluid is provided to said wound site to simulate a hemorrhage.

34. The portable trauma training system according to claim 29, wherein said at least one wound site includes: a first wound site; a first wound site conduit connected to said first wound site; a second wound site; and a second wound site conduit connected to said second wound site.

35. A trauma training body suit being substantially as herein described with reference to the accompanying figures.

36. An arterial bleeding training system being substantially as herein described with reference to the accompanying figures.

37. A hemorrhage training system being substantially as herein described with reference to the accompanying figures.