Human thoracic stiffness varies and may affect the performance during external chest compression (ECC). The Extra Compression Spring Resusci® QCPR Anne manikin is a high-fidelity training model developed for ECC training that can account for varying levels of thoracic stiffness. The aim of this study was to use this training model to investigate the effects of thoracic stiffness on ECC biomechanics and qualities. Fifty-two participants performed standard ECC on the manikin with different thoracic springs to simulate varying levels of thoracic stiffness. The MatScan Pressure Measurement system was used to investigate the ECC pressure and force distribution. The hard spring group’s performance had a better complete recoil ratio (90.06 ± 24.84% vs. 79.75 ± 32.17% vs. 56.42 ± 40.15%, p < 0.001 at second minute), but was more inferior than the standard and soft spring groups in overall quality, ECC depth (34.17 ± 11.45 mm vs. 41.25 ± 11.42 mm vs. 51.88 ± 7.56, p < 0.001 at second minutes), corrected depth ratio, and corrected rate ratio. The hard spring group had less radial-ulnar peak pressure difference (kgf/cm²) than the other two groups (−0.28 ± 0.38 vs. −0.30 ± 0.43 vs. −0.47 ± 0.34, p = 0.01), demonstrating that more symmetrical pressure was applied in the hard spring group. The soft spring group had better ECC depth, corrected depth ratio, corrected rate ratio, and overall quality, but its performance in complete recoil was inferior, and unbalanced pressure was more liable to cause injury. Hard springs caused operator fatigue easily. The thoracic stiffness greatly affected the performance of ECC. Our findings provided information for more effective ECC practices and training.

Background and Objectives: ABO blood types have been implicated as potential risk factors for various hemorrhagic diseases. No study has investigated the association between gastroesophageal variceal bleeding and ABO blood types. We aimed to evaluate the impact of ABO blood types on mortality and bleeding risk in acute gastroesophageal variceal bleeding. Materials and Methods: This is a retrospective observational study. Patients presenting with acute gastroesophageal varices bleeding diagnosed by endoscopy were enrolled, and were divided by blood type into a type O group and non-type O group. The outcomes were death within 30 days and the proportion of further bleeding. We used generalized linear mixed-effects models to analyze the outcomes. Results: A total of 327 patients and 648 records of emergency room visits were included. The 30-day mortality was 14.8% (21 of 142 patients) in the type O group, and 16.2% (30 of 185 patients) in the non-type O group (p = 0.532). Further bleeding within 30 days occurred in 34 cases (12.6%) in the type O group, and in 26 cases (6.9%) in the non-type O group (p = 0.539). Conclusions: There was no significant difference in blood transfusion volume in 24 h, recurrent bleeding rates, or mortality between patients with blood type O and those with non-type O.

Introduction The standard method of chest compression for adults is a two-handed procedure. One-handed external chest compression (ECC) is used in some situations such as during transport of patients who had an out-of-hospital cardiac arrest, but the quality of one-handed ECC is still not well known. The distribution of force is related to the quality of chest compression and may affect the risk of injury. This study aimed to determine the differences in the quality and potential safety concern between one-handed ECC and two- handed ECC. Methods In this randomised crossover study, participants recruited from National Cheng Kung University Hospital and the ambulance team from the fire bureau were asked to perform one-handed and two-handed ECC on the Resusci Anne manikin according to standard 2015 ECC guidelines. The MatScan Pressure Measurement system was used to investigate the compression pressure and force distribution. Results Two-handed ECC had better results than one-handed ECC in terms of the median (IQR) depth (51.00 (41.50–54.75) mm vs 42.00 (27.00–49.00) mm, p=0.018), the proportion of depth accuracy (82.05% (13.95%–99.86%) vs 11.17% (0.00%–42.13%), p=0.028) and the proportion of incomplete recoil (0.23% (0.01%–0.44%) vs 2.42% (0.60%–4.21%), p=0.002). The maximum force (45.72 (36.10–80.84) kgf vs 35.64 (24.13–74.34) kgf, p<0.001) and ulnar–radial force difference (7.13 (−16.58 to 21.07) kgf vs 23.93 (11.19–38.74) kgf, p<0.001) showed statistically significant differences. The perceived fatigue of two-handed ECC versus one-handed ECC was 5.00 (3.00–6.00) vs 6.00 (5.00–8.00), p<0.001. Conclusion The quality of one-handed ECC, based on depth and recoil, is worse than that of standard two-handed ECC. The pressure and force distribution of one-handed ECC result in greater ulnar pronation of the hand than that of two-handed ECC. One-handed ECC more easily causes operator fatigue. Acknowledging these findings and adjusting training for one-handed ECC would potentially improve the quality of cardiopulmonary resuscitation during transport.

The COVID-19 pandemic has made it necessary for medical personnel to protect themselves from aerosol-producing procedures, especially during airway management. The tracheal intubation process has a significant risk based on the spreading of aerosol, especially when the medical service provider is very close to the airway of the patient. We have developed a novel conservation tent that provides a barrier for healthcare professionals and patients. Through a simulation study, the relationship between the use of the protection tent during intubation and the contamination of medical personnel before and after the movement of the protection tent was explored. A series of experiments in this article provide a theoretical basis for the verification of spray morphology during gas curing and droplet intubation. This inexpensive and simple method for using transparent cloth in the intubation of patients with unknown COVID-19 status can be applied by frontline medical personnel as an additional precautionary measure.