Yutaka Takei’s research while affiliated with Niigata University of Health and Welfare and other places

Objectives: To compare the effects of powered and manual stretchers on participants' perceived comfort and measured acceleration during lifting and loading operations. Methods: This non-randomized, laboratory-based crossover study involved forty-one participants (thirty-one firefighters and ten third-year paramedic students) who served as simulated patients experiencing lifting, lowering, loading, and unloading maneuvers using manual and powered stretchers. Four stretcher types were evaluated: one powered stretcher (Power-PRO™ XT) and three manual stretchers (Matsunaga GT, Exchange 4070, Scad Mate), with each group using the manual stretcher they routinely operated. Linear acceleration data were collected using a nine-axis inertial measurement unit placed at the participants' anterior waist. Root mean square (RMS) and peak accelerations along the X-, Y-, and Z-axes were calculated. Participants completed a twenty-three-item comfort questionnaire based on the Semantic Differential method. Due to non-normal data distribution, nonparametric statistical tests were employed for analysis. Results: The lifting/lowering and loading/unloading movements showed that the powered stretcher significantly reduced the RMS values, maximum accelerations, and minimum accelerations in the vertical axis (Z-axis) compared to manual stretchers. Specifically, the powered stretcher demonstrated lower RMS acceleration (0.29 m/s2 vs. 0.73 m/s2, p < 0.001), maximum acceleration (1.60 m/s2 vs. 2.90 m/s2, p < 0.001), and minimum acceleration (-1.48 m/s2 vs. -3.30 m/s2, p < 0.001) in the vertical direction compared to other manual stretchers. Similar results were observed in the comparison of participant loading/unloading movements. However, no significant differences were observed between the powered and Exchange stretchers in X-axis minimum acceleration, Y-axis maximum and minimum accelerations, or Z-axis maximum acceleration. Similarly, Y-axis minimum accelerations did not significantly differ between the powered stretcher and Matsunaga GT or Scad Mate stretchers. After loading and unloading movements, the questionnaire results showed that the powered stretcher was rated significantly higher on comfort-related items including "comfortable," "secure," "like," "smooth," and "relaxing." Conclusions: In a controlled, laboratory-based setting, simulated use of manual and powered stretchers showed that powered stretchers significantly minimize patient discomfort and vibrations. This study underscores the potential for enhancing patient safety and quality of care. In conclusion, the powered stretcher is a promising tool for improving the quality and safety of patient transportation in prehospital settings.

To elucidate the relationship between the interval from cardiopulmonary resuscitation initiation to return of spontaneous circulation (ROSC) and neurologically favourable 1-month survival in order to determine the appropriate duration of basic life support (BLS) without advanced interventions. This population-based cohort study included patients aged ≥ 18 years with 9132 out-of-hospital cardiac arrest of presumed cardiac origin who were bystander-witnessed and had achieved ROSC between 2018 and 2020. Patients were classified into two groups based on the resuscitation methods as the “BLS-only” and the “BLS with administered epinephrine (BLS-AE)” groups. Receiver operating characteristic (ROC) curve analysis indicated that administering BLS for 9 min yielded the best neurologically outcome for patients with a shockable rhythm [sensitivity, 0.42; specificity, 0.27; area under the ROC curve (AUC), 0.60] in the BLS-only group. Contrastingly, for patients with a non-shockable rhythm, performing BLS for 6 min yielded the best neurologically outcome (sensitivity, 0.65; specificity, 0.43; AUC, 0.63). After propensity score matching, multivariate analysis revealed that BLS-only resuscitation [6.44 (5.34–7.77)] was associated with neurologically favourable 1-month survival. This retrospective study revealed that BLS-only intervention had a significant impact in the initial minutes following CPR initiation. Nevertheless, its effectiveness markedly declined thereafter. The optimal duration for effective BLS-only intervention varied depending on the patient's initial rhythm. Consequently, advanced interventions should be administered within the first few minutes to counteract the diminishing effectiveness of BLS-only intervention.

Introduction: To assess the impact of powered stretchers in comparison to manual stretchers on both patient comfort and psychological benefits. Methods: A simulation study with 41 participants compared powered and manual stretchers. Sensors on participants collected X, Y, and Z-axis acceleration data during simulated patient movements. Participants experienced lifting/lowering and loading/unloading. Post-experiment surveys used a 7-point scale to rate comfort during stretcher movements. Results: The powered stretcher outperformed the manual stretcher in most lifting/lowering and loading/unloading movements, showing significantly lower RMS values, maximum accelerations, and minimum acceleration on each axis. In the Z-axis (vertical direction) acceleration, the powered stretcher demonstrated lower RMS (0.29 m/s² vs. 0.73 m/s², p < 0.001), maximum acceleration (1.60 m/s² vs. 2.90 m/s², p < 0.001), and minimum acceleration (-1.48 m/s² vs. -3.30 m/s², p < 0.001) compared to the manual stretcher. Similar results were observed in the comparison of participant loading/unloading movements, where the powered stretcher exhibited superiority in RMS values, maximum accelerations, and minimum acceleration on each axis. In the Z-axis acceleration, the powered stretcher showed lower RMS (0.32 m/s² vs. 0.89 m/s², p < 0.001), maximum acceleration (2.07 m/s² vs. 3.38 m/s², p < 0.001), and minimum acceleration (-2.34 m/s² vs. -3.72 m/s², p < 0.001) compared to the manual stretcher. Additionally, the powered stretcher significantly improved comfort questionnaire scores compared to the manual stretcher, indicating its potential to alleviate psychological discomfort and anxiety in participants. Conclusion: Powered stretchers demonstrate significant advantages in reducing patient discomfort and vibrations compared to manual stretchers.