PURPOSE: The study evaluated changes in the quality of chest compressions over 2 min in 30:2 cardio-pulmonary resuscitation (CPR) by lay-persons and analyzed rescuer factors affecting the quality of chest compressions over time. METHODS: CPR training courses attended by 538 adult hospital and university workers (lay-person) were conducted at a university hospital. After 4-hour CPR training, tests were performed using a manikin with Skill-ReporterTM. Data of 459 subjects were analyzed concerning the quality of chest compressions over time and rescuer factors such as age, gender, body mass index, prior CPR training and CPR experience were also analyzed to determine their effect on the change in the quality of chest compressions. RESULTS: Compression depth (p=0.002) showed significant change over 2 min, but the rate (p=0.133), chest recoil (p=0.442) and hand placement (p=0.991) were insignificant. Ineffective compression depth (mean proportions of correct depth<70%) was not observed during the 2 min CPR. Female gender (p<0.001; OR, 5.882, 95% CI, 3.098-11.167) and no CPR training (p=0.004; OR, 2.163, 95% CI, 1.277-3.663) were associated with decline of compression depth. Time-dependent analysis revealed significant ineffective compression depth (<70%) in females and underweight patients (p<0.001). CONCLUSION: Switching compressors at an interval of 2 min is reasonable for 30:2 CPR by lay-persons. But, significant decline of correct compression depth over time in female and underweight rescuers was evident.
Adult ; Body Mass Index ; Cardiopulmonary Resuscitation ; Chest Wall Oscillation ; Fatigue ; Female ; Hand ; Humans ; Manikins ; Thinness ; Thorax

PURPOSE: Standard chest compression is useful for cardiopulmonary resuscitation of victims but may be difficult to perform in a confined space if the victim is lying on his side. The aim of this study was to evaluate compression techniques administered to individuals lying in various alternative positions, and to determine which ones may be easier to perform in such situations. METHODS: Thirty two volunteers trained in basic life support (BLS) were enrolled. They were taught to do compression in four alternative positions (over-head position (OHP), saddle position (SP), upper diagonal position (UDP) and lower diagonal position (LDP)). For each position, they performed two minutes of continuous chest compression on a manikin that was connected to a Laerdal PC Skill Reporting System. They did this for the basic standard position (BSP) and four alternative positions with the positions presented randomly. The data, including the total number of compressions, the average rate of chest compressions per minute, the depth of each chest compression, and the position of the hands were recorded and analysed. RESULTS: There were no statistically significant differences between BSP and alternative positions for the total number of compressions (BSP:108.8 min-1; OHP:109.5 min-1; SP:107.8 min-1; UDP:108.5 min-1; LDP:107.7 min-1) of chest compressions. There was no statistically significant difference between BSP and alternative positions for the average depth of each compression (BSP:41.9 mm; OHP:44.4 mm; SP:41.8 mm; UDP:42.9 mm; LDP:41.1 mm), or for the number of incorrect hand positions except UDP (BSP versus UDP = 6.4 versus 32.5). p<0.054 is not normally considered significant. The p value has to be 0.050 or smaller. CONCLUSION: Chest compression in alternative positions can be equally effective as it is in the standard position. If chest compression in the standard position is not easily executable in a confined space, chest compression using an alternative positions can be used.
Cardiopulmonary Resuscitation ; Chest Wall Oscillation ; Confined Spaces ; Deception ; Hand ; Manikins ; Thorax ; Uridine Diphosphate

PURPOSE: Standard chest compression is useful for cardiopulmonary resuscitation of victims but may be difficult to perform in a confined space if the victim is lying on his side. The aim of this study was to evaluate compression techniques administered to individuals lying in various alternative positions, and to determine which ones may be easier to perform in such situations. METHODS: Thirty two volunteers trained in basic life support (BLS) were enrolled. They were taught to do compression in four alternative positions (over-head position (OHP), saddle position (SP), upper diagonal position (UDP) and lower diagonal position (LDP)). For each position, they performed two minutes of continuous chest compression on a manikin that was connected to a Laerdal PC Skill Reporting System. They did this for the basic standard position (BSP) and four alternative positions with the positions presented randomly. The data, including the total number of compressions, the average rate of chest compressions per minute, the depth of each chest compression, and the position of the hands were recorded and analysed. RESULTS: There were no statistically significant differences between BSP and alternative positions for the total number of compressions (BSP:108.8 min-1; OHP:109.5 min-1; SP:107.8 min-1; UDP:108.5 min-1; LDP:107.7 min-1) of chest compressions. There was no statistically significant difference between BSP and alternative positions for the average depth of each compression (BSP:41.9 mm; OHP:44.4 mm; SP:41.8 mm; UDP:42.9 mm; LDP:41.1 mm), or for the number of incorrect hand positions except UDP (BSP versus UDP = 6.4 versus 32.5). p<0.054 is not normally considered significant. The p value has to be 0.050 or smaller. CONCLUSION: Chest compression in alternative positions can be equally effective as it is in the standard position. If chest compression in the standard position is not easily executable in a confined space, chest compression using an alternative positions can be used.
Cardiopulmonary Resuscitation ; Chest Wall Oscillation ; Confined Spaces ; Deception ; Hand ; Manikins ; Thorax ; Uridine Diphosphate

BACKGROUND: Pulmonary contusion is the most common pulmonary parenchymal injury in blunt chest trauma and may constitute a life-threatening thoracic injury. In this study, we evaluated the usefulness of high-frequency chest wall oscillation (HFCWO) therapy in patients with pulmonary contusion. METHODS: Patients with lung contusion either received HFCWO therapy using the Vest system (Vest group; n = 18) or received conventional chest physiotherapy (non-Vest group; n = 23). The physiological parameters of the patients, length of stay in hospital and ICU, and the duration of mechanical ventilation were compared between the two groups. Variables, including pulmonary contusion score, percentage of patients receiving mechanical ventilation therapy, and PaO2/FiO2 ratio, were also analyzed. RESULTS: The pulmonary contusion score was higher in the Vest group (p < 0.01), and mechanical ventilation was used more frequently in the Vest group (p = 0.027). Improvement in the PaO2/FiO2 ratio over the first 48 h did not differ between the Vest and Non-Vest groups. No significant differences in the physiological parameters, hospital and ICU stays, and duration of mechanical ventilation were observed between the two groups. CONCLUSIONS: The therapeutic effect of the Vest system in patients with pulmonary contusion was similar to that of conventional chest physiotherapy. Therefore, the Vest system could be considered as an airway clearance technique in the management of patients with pulmonary contusion.
Chest Wall Oscillation ; Contusions ; Humans ; Length of Stay ; Lung ; Lung Injury ; Respiration, Artificial ; Thoracic Injuries ; Thorax

PURPOSE: This investigation aimed to determine the effects of treadmill training (TT) and high frequency chest wall oscillation (HFCWO) on pulmonary function and walking ability in stroke patients as well as propose an exercise program to improve cardiovascular function. METHODS: Twenty hemiplegic stroke patients were randomized to either the control group (CG) (n=10) or the experimental group (EG), which received TT and HFCWO (n=10). Pulmonary function was quantitated using patient forced vital capacity (FVC) and forced expiratory volume at one second (FEV1) while walking speed was assessed by the 10m walking test (10MWT). Further, walking endurance was determined utilizing the 6-minute walk test (6MWT). Subjects of the EG performed the study protocol for 60 minutes, five times a week for six weeks; CG patients did not participate in regular exercise. To determine significance for the differences observed before and after exercise, within-group and between-group comparisons were conducted utilizing paired and independent t-tests, respectively, with the level of significance set at α=0.05. RESULTS: Within-groups, significant differences were observed in both FVC and FEV1 (p<0.01) following completion of the study protocol. Further, between-group comparisons demonstrated significant differences in both FVC (p<0.05) and FEV1 (p<0.01). Post-exercise, significant changes in the 10MWT and 6MWT score were observed between the EG and CG (p<0.01). Further, statistically significant differences were observed in 6MWT scores between-groups (p<0.05). CONCLUSION: The TT and HFCWO effectively improved pulmonary function and walking ability in subjects with stroke. The proposed program can be applied to stroke patients as a useful therapy.
Chest Wall Oscillation* ; Forced Expiratory Volume ; Humans ; Stroke* ; Vital Capacity ; Walking*

In order to pick up breath signal from correlated noise background of the pulse of heart and artery etc, an algorithm based on wavelet de-noising has been introduced. With wavelet db4, the raw signal was decomposed into the scale space of six layers; threshold treatment was done with the self-adaptive threshold created by Stein's Unbiased Risk Estimate; then the wavelet coefficients were reconstructed. The result showed that the noise was significantly depressed.
Algorithms ; Artifacts ; Chest Wall Oscillation ; methods ; Humans ; Monitoring, Physiologic ; instrumentation ; methods ; Respiration ; Respiratory Sounds ; Signal Processing, Computer-Assisted ; Wavelet Analysis

To have a thorough understanding of the CPR quality based on patients' various physiological states, the doctors must do something to simulate the chest compression physiological feedback parameters (CCPFP). The CCPFP simulation plays an important role in raising efficiency of CPR training and improving chest compression quality. In this study, the CCPFP, including cardiac output (CO), coronary perfusion pressure (CPP), partial pressure of End-tidal CO2 (PETCO2) and mean arterial relaxation pressure (MARP), was simulated using Charles F. Babbs' Model. Simulation results showed that the effect of compression depth upon CCPFP was important in the range of 2-6 cm, whereas compression rate had little effect on the CCPFP higher than 100/min; the thoracic factor is inversely proportional to the CCPFP with fixed compression depth and compression rate. The CCPFP simulation can be implemented at the various physiological statuses, and verified well with the animal experimental results and the clinical results.
Blood Pressure ; physiology ; Carbon Dioxide ; blood ; Cardiac Output ; physiology ; Chest Wall Oscillation ; Computer Simulation ; Feedback, Physiological ; physiology ; Humans ; Models, Biological ; Partial Pressure