OBJECTIVE: To investigate whether the accuracy of 3D laser scanning is influenced by the angles and number of scans. METHODS: Using a 3D laser scanner, 10 manikins with facial markers were scanned at 7 horizontal angles (front view and at 20degrees, 45degrees, and 60degrees angles on the right and left sides). Three-dimensional facial images were reconstructed by 6 methods differing in the number and angles of scans, and measurements of these images were compared to the physical measurements from the manikins. RESULTS: The laser scan images were magnified by 0.14 - 0.26%. For images reconstructed by merging 2 scans, excluding the front view; and by merging 3 scans, including the front view and scans obtained at 20degrees on both sides; several measurements were significantly different than the physical measurements. However, for images reconstructed by merging 3 scans, including the front view; and 5 scans, including the front view and scans obtained at 20degrees and 60degrees on both sides; only 1 measurement was significantly different. CONCLUSIONS: These results suggest that the number and angle of scans influence the accuracy of 3D laser scanning. A minimum of 3 scans, including the front view and scans obtained at more than 45degrees on both sides, should be integrated to obtain accurate 3D facial images.
Manikins

Anthropometry ; Head ; Manikins

Three combinations of cloths were evaluated for the protective effects of different kinds of clothings in cold environments. Table 1 shows tile components of tile three models of clothings. A prototype was made by putting a sheet of vinyl at the middle layer of raw cotton in a fabric-quilt cloths. A glove mannequin was covered by each of these cloths. The globes contained 1,000 cc of hot water about 40 degrees C. Tele-thermisters were fixed in order to check the temperature of cloths space and water temperature for evaluation of caloric-loss and climate of clothings. Results are summarized as follows : 1) Without wind, there is no significant difference of air temperatures between ski-parka and quilt wear clothing. 2) The prototype with vinyl sheet best protects against wind, the next is the ski-parka. Quilt-wear protects the least. 3) It is well-known that a working-clothing needs not have any separate liners nor outers. 4) For innermost layer of a clothing preventing cold, a cotton-fabrics is recommended and a water-proof cloths for outer layer. 5) Heat-loss was calculated from the cooling degrees of water. Calorie-loss was 910ca1/m2/hr. when bared, but with the prototype of vinyl sheets the calorie-loss was 350cal/m2/hr. (38.5% of bared). Quilt-wear and ski-parka were 380(41.8%) and 440 cal/m2/hr. (48.4%) respectively.
Climate ; Clothing* ; Manikins ; Water ; Wind*

PURPOSE: The objective of this study is to determine whether application of ventilation in line with compression rate in performance of CPR for cardiac arrest patients was helpful in maintaining an adequate ventilation rate. METHODS: Volunteers who received education on the revised 2010 CPR guidelines were randomly assigned to either a conventional ventilation (CV) group or a compression-adjusted ventilation (CAV) group. During performance of CPR, compression rate and ventilation rate were measured every minute, and the participants' roles were changed every two minutes; CPR was performed for a total of eight minutes. RESULTS: A total of 57 volunteers participated in this study. No statistically significant difference was observed between the compression rate of the CV group and that of the CAV group. However, regarding adequacy of the ventilation rate, greater improvement was observed in the CAV group, compared with the CV group (adequate ventilation: 86.2% vs. 46.4%, p<0.001). In addition, the median value of the ventilation rate was 8.4/min (IQR: 7.7-9.6) in the CV group and 9.5/min (IQR: 9.0-10.0) in the CAV group (p=0.003). CONCLUSION: When no other valid approach is available, use of the CAV method is conducive to maintenance of an adequate ventilation rate.
Cardiopulmonary Resuscitation ; Heart Arrest ; Humans ; Manikins ; Ventilation

PURPOSE: To maintain high quality cardiopulmonary resuscitation (CPR), optimal alternating rescuers is important. Stronger and faster chest compression has recently been emphasized in the 2010 guidelines. Therefore, this study compared and evaluated changes in the quality of chest compression in a 2-min scenario group and a 1-min scenario group. METHODS: Among the 88 participants, two-rescuer pairs were randomly allocated. After the training and a one-day break, participants were asked to perform continuous chest compressions for 2 min on a manikin and to take a one-day break, followed by continuous chest compression for 1 min. In all simulated CPRs, the total number of chest compressions and those with appropriate depth were counted. Chest compression quality index was calculated as the proportion of chest compressions with appropriate depth. RESULTS: The mean overall chest compression depth was lower in the 2-min scenario group, compared with the 1-min scenario group. In particular, compression rate (p=0.110), abnormal hand position (p=0.181), and chest recoil (p=0.892) showed no significant difference between the two groups. However, the quality index, mean depth (p=0.018) and too shallow compression depth (p=0.020) 1-min scenario was better than that of the 2-min scenario group. The difference in the CPR quality index reached statistical significance. CONCLUSION: Switching compressors at an interval of 2 min is reasonable for performance of CPR by a lay-bystander. However, alternating rescuers every 1 min may be an alternative method during continuous chest compression.
Cardiopulmonary Resuscitation ; Fatigue ; Hand ; Manikins ; Thorax

PURPOSE: Inflation of an endotracheal tube cuff with adequate pressure is an important procedure. Passive release technique (PRT) is a useful and convenient method for inflating the cuff. To date, no study comparing this method with minimal occlusive volume technique (MOVT), one of the most commonly used methods for inflating the cuff, has been reported. We conducted this study for comparison of effectiveness, difficulty, and preference between the two methods. METHODS: We conducted a prospective, crossover, randomized study in which participants used each technique, one at a time. Participants inflated the cuff of an endotracheal tube inserted into a manikin after receiving brief education on use of the two methods. After inflating the cuff using each method, pressure and volume of the inflated cuff were measured using a portable manometer and syringes, respectively. Then, difficulty of each method was investigated using the visual analogue scale (VAS) and preference for each method was investigated. RESULTS: A total of 47 participants were enrolled in the study. The mean pressure between the two methods was not statistically different (p=0.27). However, adequate pressure was achieved in 37 (78.7%) and 16 (34.0%) of participants in PRT and MOVT, respectively (p<0.01). The mean volume was 6.0+/-0.4 ml in PRT and 5.7+/-0.6 ml in MOVT (p<0.01). The VAS score for diffculty was 17.7+/-15.8 in PRT and 76.0+/-15.8 in MOVT (p<0.01). Preference for PRT was 46(97.9%) and that for MOVT was 1 (2.1%). CONCLUSION: PRT is an easier, more preferred, and more effective method for cuff inflation than MOVT.
Inflation, Economic ; Intubation ; Manikins ; Prospective Studies ; Syringes

OBJECTIVE: To compare the effectiveness of the GlideRite stylet with the conventional malleable stylet (CMS) in endotracheal intubation (ETI) by the Macintosh laryngoscope. METHODS: This study is a randomized, crossover, simulation study. Participants performed ETI using both the GlideRite stylet and the CMS in a normal airway model and a tongue edema model (simulated difficult airway resulting in lower percentage of glottic opening [POGO]). RESULTS: In both the normal and tongue edema models, all 36 participants successfully performed ETI with the two stylets on the first attempt. In the normal airway model, there was no difference in time required for ETI (TETI) or in ease of handling between the two stylets. In the tongue edema model, the TETI using the CMS increased as the POGO score decreased (POGO score was negatively correlated with TETI for the CMS, Spearman’s rho=-0.518, P=0.001); this difference was not seen with the GlideRite (rho=-0.208, P=0.224). The TETI was shorter with the GlideRite than with the CMS, however, this difference was not statistically significant (15.1 vs. 18.8 seconds, P=0.385). Ease of handling was superior with the GlideRite compared with the CMS (P=0.006). CONCLUSION: Performance of the GlideRite and the CMS were not different in the normal airway model. However, in the simulated difficult airway model with a low POGO score, the GlideRite performed better than the CMS for direct laryngoscopic intubation.
Edema ; Intubation ; Intubation, Intratracheal* ; Laryngoscopes* ; Manikins* ; Tongue

OBJECTIVES: The current study aims to develop Korean Social Affective Visual Stimuli (K-SAVS) to arouse social affect. METHODS: K-SAVS is composed of pictures of social situations among East Asians. Each picture contains a negative, positive, or neutral affect. Positive and negative stimuli were presented to one group of subjects. Negative and neutral stimuli were presented to another group of subjects. All subjects were required to fill out Affective Valence and Arousal Manikin. RESULTS: In the initial test, 18 positive affective stimuli pictures (1 set) and 36 negative affective stimuli pictures (2 sets) were chosen from 95 stimuli pictures. Positive affective stimuli pictures showed higher valence (p < 0.001) and lower arousal (p < 0.001) than negative affective stimuli pictures. In the confirmatory test, 18 neutral stimuli pictures (1 set) were additionally selected out of the total of 79 pictures of neutral stimuli pictures and the pictures used in the former experiment. Neutral stimuli pictures showed higher valence (p < 0.001) and lower arousal (p < 0.001) than negative affective stimuli pictures. CONCLUSION: K-SAVS can be a valid and useful tool for inducing specific social affects of Koreans.
Arousal ; Asian Continental Ancestry Group ; Humans ; Manikins

PURPOSE: To minimize an interruption in chest compression, reduce the hands-off time, the American Heart Association has recommended changing the ratio of chest compression to ventilation ratio to 30:2. However, current studies have shown that the hands-off time was >10 seconds with that method. For this reason, we reasoned that a chest compression to ventilation ratio of 15:1 would be a more suitable way to reduce hands-off time because this ratio will not change the total compression and ventilation count. METHODS: The subjects were asked to perform CPR for 5 cycles with a compression to ventilation ratio of 30:2. The subjects rested for 5 minutes, then performed CPR with a compression to ventilation of 15:1. The skill performance was measured and analyzed using a statistical program. RESULTS: In the group which performed CPR with a chest compression to ventilation ratio of 30:2, the average number of compressions per minute was 76+/-9, while at a chest compression to ventilation ratio of 15:1, the average number of compressions per minute was 68+/-9. Between the compression to ventilation ratios of 30:2 and 15:1, the count gap was 8.3+/-3.2. When CPR was performed at a chest compression to ventilation ratio of 30:2, the average hands-off time was 9.3+/-1.9. When CPR was performed at a chest compression to ventilation ratio of 15:1, the average hands-off time was 6.7+/-1.3. Between chest compression to ventilation ratios of 30:2 and 15:1, the time gap of the average hands-off time was 2.7+/-1.2 seconds. CONCLUSION: When the chest compression to ventilation ratio was 15:1, the hands-off time was significantly reduced, but the compressions per minute were also reduced.
American Heart Association ; Cardiopulmonary Resuscitation ; Manikins ; Thorax ; Ventilation

BACKGROUND: Insertion of supraglottic airway devices (SADs) can be technically easier to perform for novices than endotracheal intubation (ETI), particularly in a situation with difficult airway management. We evaluated the efficacy and usefulness of the ProSeal laryngeal mask airway (PLMA), I-gel, and ETI when used by novices in a simulated difficult airway scenario. METHODS: A total of 109 novices participated in a brief educational session about PLMA, I-gel and ETI. The sequence of the airway devices was randomized for each participant using a computer-generated random table, and the devices were inserted in a manikin with restricted cervical spine movement. A nasogastric (NG) tube was then inserted through each SAD. In the case of ETI, the NG tube was inserted through the manikin's nostril. RESULTS: The success rate at the first insertion attempt was 93.6% for the I-gel compared with 72.5% for the PLMA and 19.3% for ETI. The I-gel also enabled a significantly shorter insertion time than the PLMA (I-gel 26.3 ± 21.9 sec and PLMA 36.0 ± 35.4 sec). The novices showed high success rates for NG tube insertion using SADs (PLMA 96.3% and I-gel 98.1%) compared with ETI (24.8%). CONCLUSIONS: We found that the I-gel provided a better first time success rate and a shorter insertion time than PLMA and ETI, which indicated that the I-gel may be preferable for difficult airway management by novices.
Airway Management ; Intubation ; Intubation, Intratracheal ; Laryngeal Masks* ; Manikins ; Spine