Feedback on the Rate and Depth of Chest Compressions during Cardiopulmonary Resuscitation Using Only Accelerometers

Background Quality of cardiopulmonary resuscitation (CPR) is key to increase survival from cardiac arrest. Providing chest compressions with adequate rate and depth is difficult even for well-trained rescuers. The use of real-time feedback devices is intended to contribute to enhance chest compression quality. These devices are typically based on the double integration of the acceleration to obtain the chest displacement during compressions. The integration process is inherently unstable and leads to important errors unless boundary conditions are applied for each compression cycle. Commercial solutions use additional reference signals to establish these conditions, requiring additional sensors. Our aim was to study the accuracy of three methods based solely on the acceleration signal to provide feedback on the compression rate and depth. Materials and Methods We simulated a CPR scenario with several volunteers grouped in couples providing chest compressions on a resuscitation manikin. Different target rates (80, 100, 120, and 140 compressions per minute) and a target depth of at least 50 mm were indicated. The manikin was equipped with a displacement sensor. The accelerometer was placed between the rescuer's hands and the manikin's chest. We designed three alternatives to direct integration based on different principles (linear filtering, analysis of velocity, and spectral analysis of acceleration). We evaluated their accuracy by comparing the estimated depth and rate with the values obtained from the reference displacement sensor. Results The median (IQR) percent error was 5.9% (2.8-10.3), 6.3% (2.9-11.3), and 2.5% (1.2-4.4) for depth and 1.7% (0.0-2.3), 0.0% (0.0-2.0), and 0.9% (0.4-1.6) for rate, respectively. Depth accuracy depended on the target rate (p < 0.001) and on the rescuer couple (p < 0.001) within each method. Conclusions Accurate feedback on chest compression depth and rate during CPR is possible using exclusively the chest acceleration signal. The algorithm based on spectral analysis showed the best performance. Despite these encouraging results, further research should be conducted to asses the performance of these algorithms with clinical data.

Chatter avoidance in the milling of thin floors with bull-nose end mills: Model and stability diagrams

The milling of thin parts is a high added value operation where the machinist has to face the chatter problem. The study of the stability of these operations is a complex task due to the changing modal parameters as the part loses mass during the machining and the complex shape of the tools that are used. The present work proposes a methodology for chatter avoidance in the milling of flexible thin floors with a bull-nose end mill. First, a stability model for the milling of compliant systems in the tool axis direction with bull-nose end mills is presented. The contribution is the averaging method used to be able to use a linear model to predict the stability of the operation. Then, the procedure for the calculation of stability diagrams for the milling of thin floors is presented. The method is based on the estimation of the modal parameters of the part and the corresponding stability lobes during the machining. As in thin floor milling the depth of cut is already defined by the floor thickness previous to milling, the use of stability diagrams that relate the tool position along the tool-path with the spindle speed is proposed. Hence, the sequence of spindle speeds that the tool must have during the milling can be selected. Finally, this methodology has been validated by means of experimental tests.

Use of generalised additive models to categorise continuous variables in clinical prediction

13 P.

Proposal and validation of methodologies for the categorisation of continuous variables in the development of prediction models

158 p.