Recreating the feel of the human chest in a CPR manikin via programmable pneumatic damping

It is well known that the human chest exhibits a strong force-displacement hysteresis during CPR, a stark contrast to the non-hysteretic behavior of standard spring manikins. We hypothesize that individuals with experience performing CPR on humans would perceive a manikin with damping as more realistic and better for training. By analyzing data collected from chest compressions on real patients, we created a dynamic model that accounts for this hysteresis with a linear spring and a one-way variable damper, and we built a new high-fidelity manikin to enact the desired force-displacement relationship. A linkage converts vertical motions of the chest plate to the horizontal displacement of a set of pneumatic dashpot pistons, sending a volume of air into and out of the manikin through a programmable valve. Position and pressure sensors allow a microcontroller to adjust the valve orifice so that the provided damping force closely follows the desired damping force throughout the compression cycle. Eight experienced CPR practitioners tested both the new manikin and an identical looking standard manikin; the manikin with damping received significantly higher ratings for haptic realism and perceived utility as a training tool.