BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach ...BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach called "lean" management. This study aims to(1) evaluate the current patient flow in ED,(2) to identify and eliminate the non-valued added process, and(3) to modify the existing process.METHODS: It was a quantitative, pre- and post-lean design study with a series of lean management work implemented to improve the admission and blood result waiting time. These included structured re-design process, priority admission triage(PAT) program, enhanced communication with medical department, and use of new high sensitivity troponin-T(hsTnT) blood test. Triage waiting time, consultation waiting time, blood result time, admission waiting time, total processing time and ED length of stay were compared.RESULTS: Among all the processes carried out in ED, the most time consuming processes were to wait for an admission bed(38.24 minutes; SD 66.35) and blood testing result(mean 52.73 minutes, SD 24.03). The triage waiting time and end waiting time for consultation were significantly decreased. The admission waiting time of emergency medical ward(EMW) was significantly decreased from 54.76 minutes to 24.45 minutes after implementation of PAT program(P<0.05).CONCLUSION: The application of lean management can improve the patient flow in ED. Acquiescence to the principle of lean is crucial to enhance high quality emergency care and patient satisfaction.展开更多
BACKGROUND Hypoxemia is a common complication in older patients during postoperative recovery and can cause pulmonary complications.Therefore,reducing the incidence of postoperative hypoxemia is a clinical concern.AIM...BACKGROUND Hypoxemia is a common complication in older patients during postoperative recovery and can cause pulmonary complications.Therefore,reducing the incidence of postoperative hypoxemia is a clinical concern.AIM To investigate the clinical efficacy of high-flow nasal cannula oxygen(HFNCO)in the resuscitation period of older orthopedic patients.METHODS In this prospective randomized controlled trial,60 older patients who underwent orthopedic surgery under general anesthesia were randomly divided into two groups:those who used conventional face mask and those who used HFNCO.All patients were treated with 60%oxygen for 1 h after extubation.Patients in the conventional face mask group were treated with a combination of air(2 L)and oxygen(2 L)using a traditional mask,whereas those in the HFNCO group were treated with HFNCO at a constant temperature of 34℃ and flow rate of 40 L/min.We assessed the effectiveness of oxygen therapy by monitoring the patients’arterial blood gas,peripheral oxygen saturation,and postoperative complications.RESULTS The characteristics of the patients were comparable between the groups.One hour after extubation,patients in HFNCO group had a significantly higher arterial partial pressure of oxygen(paO_(2))than that of patients in conventional face mask group(P<0.001).At extubation and 1 h after extubation,patients in both groups showed a significantly higher arterial partial pressure of carbon dioxide(paCO_(2))than the baseline levels(P<0.001).There were no differences in the saturation of peripheral oxygen,paO_(2),and paCO_(2) between the groups before anesthesia and before extubation(P>0.05).There were statistically significant differences in paO_(2) between the two groups before anesthesia and 1 h after extubation and immediately after extubation and 1 h after extubation(P<0.001).However,there were no significant differences in the oxygen tolerance score before leaving the room,airway humidification,and pulmonary complications 3 d after surgery between the two groups(P>0.05).CONCLUSION HFNCO can improve oxygen partial pressure and respiratory function in elderly patients undergoing orthopedic surgery under general endotracheal anesthesia.Thus,HFNCO can be used to prevent postoperative hypoxemia.展开更多
Thirty patients in coma state underwent dynamic SPECT with 133Xe, a validated technique for the quantitation of CBF by SPECT, using a new brain dedicated tomograph: CERTO-96. CMRO2 was computed by multiplying the mean...Thirty patients in coma state underwent dynamic SPECT with 133Xe, a validated technique for the quantitation of CBF by SPECT, using a new brain dedicated tomograph: CERTO-96. CMRO2 was computed by multiplying the mean CBF by AVDO2 according to the Fick’s principle. The mean values of CBF, AVDO2 and CMRO2 in patients with good outcome were significantly different from those with worse outcome. On the basis of the best "discriminant threshold", CBF and AVDO2 demonstrated an intermediate accuracy in separating the two groups, while CMRO2 showed a satisfactory accuracy.展开更多
Severe forms of coronavirus disease 2019 (COVID-19)can lead to hypoxemic pneumonia and the need for treatment with high-flow nasal cannula (HFNC) oxygen therapy.This treatment decreases the need for subsequent invasiv...Severe forms of coronavirus disease 2019 (COVID-19)can lead to hypoxemic pneumonia and the need for treatment with high-flow nasal cannula (HFNC) oxygen therapy.This treatment decreases the need for subsequent invasive ventilation in patients with hypoxemic pneumonia.The oxygen flow in the nasal cannula is driven pneumatically or using a turbine.Oxygen and air are mixed (giving the fraction of inspired oxygen[FiO;]) and propelled at up to 80L·min;.The propelled gases must be heated and humidified.HFNC system is not intended for use outside a hospital environment.展开更多
BACKGROUND High-flow nasal cannula(HFNC)therapy and morphine continuous subcutaneous infusion(CSI)have been used to ameliorate dyspnea in non-cancer patients with end-stage respiratory diseases,including chronic obstr...BACKGROUND High-flow nasal cannula(HFNC)therapy and morphine continuous subcutaneous infusion(CSI)have been used to ameliorate dyspnea in non-cancer patients with end-stage respiratory diseases,including chronic obstructive pulmonary disease and interstitial pneumonia,primarily in hospital settings.However,it is rare to perform home-based medical treatment using these.We observe a case to assess the feasibility of this treatment strategy.CASE SUMMARY Here,we report a case of a 75-year-old man who was diagnosed with interstitial pneumonia 11 years ago and was successfully nursed at home during his terminal phase for over 10 mo without hospitalization,by introducing domiciliary uses of HFNC and morphine CSI with a patient-controlled analgesia device.CONCLUSION Active utilization of HFNC and morphine CSI with patient-controlled analgesia device would substantiate successful end-of-life palliative home care of idiopathic interstitial pneumonia patients.展开更多
In ST-segment elevation myocardial infarction (STEMI), acute reperfusion of the infarct-related artery (IRA)is the main goal in the early minutes after the patient seeks medical attention. Fibrinolytic therapy (FT) an...In ST-segment elevation myocardial infarction (STEMI), acute reperfusion of the infarct-related artery (IRA)is the main goal in the early minutes after the patient seeks medical attention. Fibrinolytic therapy (FT) and/or primary coronary intervention (PCI) were proven to be effective in opening the IRA.展开更多
Urgent care clinics and emergency departments around the world periodically suffer from extended wait times beyond patient expectations due to surges in patient flows.The delays arising from inadequate staffing levels...Urgent care clinics and emergency departments around the world periodically suffer from extended wait times beyond patient expectations due to surges in patient flows.The delays arising from inadequate staffing levels during these periods have been linked with adverse clinical outcomes.Previous research into forecasting patient flows has mostly used statistical techniques.These studies have also predominately focussed on short‐term forecasts,which have limited practicality for the resourcing of medical personnel.This study joins an emerging body of work which seeks to explore the potential of machine learning algorithms to generate accurate forecasts of patient presentations.Our research uses datasets covering 10 years from two large urgent care clinics to develop long‐term patient flow forecasts up to one quarter ahead using a range of state‐of‐the‐art algo-rithms.A distinctive feature of this study is the use of eXplainable Artificial Intelligence(XAI)tools like Shapely and LIME that enable an in‐depth analysis of the behaviour of the models,which would otherwise be uninterpretable.These analysis tools enabled us to explore the ability of the models to adapt to the volatility in patient demand during the COVID‐19 pandemic lockdowns and to identify the most impactful variables,resulting in valuable insights into their performance.The results showed that a novel combination of advanced univariate models like Prophet as well as gradient boosting,into an ensemble,delivered the most accurate and consistent solutions on average.This approach generated improvements in the range of 16%-30%over the existing in‐house methods for esti-mating the daily patient flows 90 days ahead.展开更多
Objective To explore effects of decompressive craniectomy on cerebral blood flow volume and brain metabolism in different aged patients with severe traumatic brain injury. Methods 71 cases were divided into three grou...Objective To explore effects of decompressive craniectomy on cerebral blood flow volume and brain metabolism in different aged patients with severe traumatic brain injury. Methods 71 cases were divided into three groups according age: group A( 【 30 years) ,group B ( 30 ~ 50 years) 。展开更多
Dear editor:We sincerely thank Matthew J.Clarkson for his insightful commentary1 on our recent publication in the Journal of Sport and Health Science.2 Clarkson's pioneering work in the development and application...Dear editor:We sincerely thank Matthew J.Clarkson for his insightful commentary1 on our recent publication in the Journal of Sport and Health Science.2 Clarkson's pioneering work in the development and application of blood flow restriction (BFR) exercise protocols has undeniably laid the groundwork for subsequent investigations in this field,including our own.(3-6)His commentary not only highlights the relevance and timeliness of our study but also offers valuable perspectives on refining safety considerations for intradialytic BFR exercise among hemodialysis patients.展开更多
Nowadays,most researchers focus on the cavity shedding mechanisms of unsteady cavitating flows over different objects,such as 2D/3D hydrofoils,venturi-type section,axisymmetric bodies with different headforms,and so o...Nowadays,most researchers focus on the cavity shedding mechanisms of unsteady cavitating flows over different objects,such as 2D/3D hydrofoils,venturi-type section,axisymmetric bodies with different headforms,and so on.But few of them pay attention to the differences of cavity shedding modality under different cavitation numbers in unsteady cavitating flows over the same object.In the present study,two kinds of shedding patterns are investigated experimentally.A high speed camera system is used to observe the cavitating flows over an axisymmetric blunt body and the velocity fields are measured by a particle image velocimetry(PIV)technique in a water tunnel for different cavitation conditions.The U-type cavitating vortex shedding is observed in unsteady cavitating flows.When the cavitation number is 0.7,there is a large scale cavity rolling up and shedding,which cause the instability and dramatic fluctuation of the flows,while at cavitation number of 0.6,the detached cavities can be conjunct with the attached part to induce the break-off behavior again at the tail of the attached cavity,as a result,the final shedding is in the form of small scale cavity and keeps a relatively steady flow field.It is also found that the interaction between the re-entrant flow and the attached cavity plays an important role in the unsteady cavity shedding modality.When the attached cavity scale is insufficient to overcome the re-entrant flow,it deserves the large cavity rolling up and shedding just as that at cavitation number of 0.7.Otherwise,the re-entrant flow is defeated by large enough cavity to induce the cavity-combined process and small scale cavity vortexes shedding just as that of the cavitation number of0.6.This research shows the details of two different cavity shedding modalities which is worthful and meaningful for the further study of unsteady cavitation.展开更多
Quasi-periodical evolutions such as shedding and collapsing of unsteady cloud cavitating flow, induce strong pressure fluctuations, what may deteriorate maneuvering stability and corrode surfaces of underwater vehicle...Quasi-periodical evolutions such as shedding and collapsing of unsteady cloud cavitating flow, induce strong pressure fluctuations, what may deteriorate maneuvering stability and corrode surfaces of underwater vehicles. This paper analyzed effects on cavitation stability of a trip bar arranged on high-speed underwater projectile. Small scale water tank experiment and large eddy simulation using the open source software Open FOAM were used, and the results agree well with each other. Results also indicate that trip bar can obstruct downstream re-entrant jet and pressure wave propagation caused by collapse, resulting in a relatively stable sheet cavity between trip bar and shoulder of projectiles.展开更多
Purpose: The purpose of this study was to investigate the effects of Micro Vibrational therapy (MVT) on muscle stiffness and blood flow in the skin before and after Micro Vibrational therapy in healthy subjects in ord...Purpose: The purpose of this study was to investigate the effects of Micro Vibrational therapy (MVT) on muscle stiffness and blood flow in the skin before and after Micro Vibrational therapy in healthy subjects in order to scientifically verify the effects of MVT. Methods: Micro Vibrational therapy is nurse care use in Japan. It was performed on the backs of 30 subjects (8 males and 22 females) in their 20 s to 50 s according to the eligibility criteria. The resting state before implementation was set as the baseline for the control group, and after 30 seconds of MVT was set as the intervention group. The effects of the MVT were statistically analyzed by these factors and subjective sensation by Visual Analog Scale. Results: The muscle hardness of the area where the MVT was applied for 30 seconds decreased to 29.54 (SD 5.04) after the application, compared to 30.45 (SD 5.05) before. A corresponding t-test showed a significant difference (p = 0.019). Skin blood flow increased from a median of 0.76 (variance 0.062) before to a median of 0.86 (variance 0.16) after the procedure. The Wilcoxon rank test showed a significant difference (p = 0.000). Circulatory response was confirmed by SBP, DBP, and HR. SBP of 108.6 mmHg (SD 14.8) before the study decreased to 105.7 mmHg (SD 15.0) after the study, and DBP of 65.6 mmHg (SD 11.1) before the study decreased to 62.7 mmHg (SD 11.8) after the study. HR decreased from 71.6 beats per minute (SD 10.3) before to 69.2 beats per minute (SD 11.7) after. There was a significant difference in all cardiovascular indices (p < 0.05). VAS (pain, stiffness, and fatigue) was significantly decreased after MVT (p < 0.05). Conclusion: Micro Vibrational therapy tended to decrease muscle hardness and increase skin blood flow even in the short time of 30 seconds. The results suggest that local vibration stimulation is not likely to cause a sudden increase in blood pressure or pulse rate fluctuation. These results suggest that hand vibration nursing care may be applicable to acute patients with unstable circulatory conditions.展开更多
文摘BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach called "lean" management. This study aims to(1) evaluate the current patient flow in ED,(2) to identify and eliminate the non-valued added process, and(3) to modify the existing process.METHODS: It was a quantitative, pre- and post-lean design study with a series of lean management work implemented to improve the admission and blood result waiting time. These included structured re-design process, priority admission triage(PAT) program, enhanced communication with medical department, and use of new high sensitivity troponin-T(hsTnT) blood test. Triage waiting time, consultation waiting time, blood result time, admission waiting time, total processing time and ED length of stay were compared.RESULTS: Among all the processes carried out in ED, the most time consuming processes were to wait for an admission bed(38.24 minutes; SD 66.35) and blood testing result(mean 52.73 minutes, SD 24.03). The triage waiting time and end waiting time for consultation were significantly decreased. The admission waiting time of emergency medical ward(EMW) was significantly decreased from 54.76 minutes to 24.45 minutes after implementation of PAT program(P<0.05).CONCLUSION: The application of lean management can improve the patient flow in ED. Acquiescence to the principle of lean is crucial to enhance high quality emergency care and patient satisfaction.
文摘BACKGROUND Hypoxemia is a common complication in older patients during postoperative recovery and can cause pulmonary complications.Therefore,reducing the incidence of postoperative hypoxemia is a clinical concern.AIM To investigate the clinical efficacy of high-flow nasal cannula oxygen(HFNCO)in the resuscitation period of older orthopedic patients.METHODS In this prospective randomized controlled trial,60 older patients who underwent orthopedic surgery under general anesthesia were randomly divided into two groups:those who used conventional face mask and those who used HFNCO.All patients were treated with 60%oxygen for 1 h after extubation.Patients in the conventional face mask group were treated with a combination of air(2 L)and oxygen(2 L)using a traditional mask,whereas those in the HFNCO group were treated with HFNCO at a constant temperature of 34℃ and flow rate of 40 L/min.We assessed the effectiveness of oxygen therapy by monitoring the patients’arterial blood gas,peripheral oxygen saturation,and postoperative complications.RESULTS The characteristics of the patients were comparable between the groups.One hour after extubation,patients in HFNCO group had a significantly higher arterial partial pressure of oxygen(paO_(2))than that of patients in conventional face mask group(P<0.001).At extubation and 1 h after extubation,patients in both groups showed a significantly higher arterial partial pressure of carbon dioxide(paCO_(2))than the baseline levels(P<0.001).There were no differences in the saturation of peripheral oxygen,paO_(2),and paCO_(2) between the groups before anesthesia and before extubation(P>0.05).There were statistically significant differences in paO_(2) between the two groups before anesthesia and 1 h after extubation and immediately after extubation and 1 h after extubation(P<0.001).However,there were no significant differences in the oxygen tolerance score before leaving the room,airway humidification,and pulmonary complications 3 d after surgery between the two groups(P>0.05).CONCLUSION HFNCO can improve oxygen partial pressure and respiratory function in elderly patients undergoing orthopedic surgery under general endotracheal anesthesia.Thus,HFNCO can be used to prevent postoperative hypoxemia.
文摘Thirty patients in coma state underwent dynamic SPECT with 133Xe, a validated technique for the quantitation of CBF by SPECT, using a new brain dedicated tomograph: CERTO-96. CMRO2 was computed by multiplying the mean CBF by AVDO2 according to the Fick’s principle. The mean values of CBF, AVDO2 and CMRO2 in patients with good outcome were significantly different from those with worse outcome. On the basis of the best "discriminant threshold", CBF and AVDO2 demonstrated an intermediate accuracy in separating the two groups, while CMRO2 showed a satisfactory accuracy.
文摘Severe forms of coronavirus disease 2019 (COVID-19)can lead to hypoxemic pneumonia and the need for treatment with high-flow nasal cannula (HFNC) oxygen therapy.This treatment decreases the need for subsequent invasive ventilation in patients with hypoxemic pneumonia.The oxygen flow in the nasal cannula is driven pneumatically or using a turbine.Oxygen and air are mixed (giving the fraction of inspired oxygen[FiO;]) and propelled at up to 80L·min;.The propelled gases must be heated and humidified.HFNC system is not intended for use outside a hospital environment.
文摘BACKGROUND High-flow nasal cannula(HFNC)therapy and morphine continuous subcutaneous infusion(CSI)have been used to ameliorate dyspnea in non-cancer patients with end-stage respiratory diseases,including chronic obstructive pulmonary disease and interstitial pneumonia,primarily in hospital settings.However,it is rare to perform home-based medical treatment using these.We observe a case to assess the feasibility of this treatment strategy.CASE SUMMARY Here,we report a case of a 75-year-old man who was diagnosed with interstitial pneumonia 11 years ago and was successfully nursed at home during his terminal phase for over 10 mo without hospitalization,by introducing domiciliary uses of HFNC and morphine CSI with a patient-controlled analgesia device.CONCLUSION Active utilization of HFNC and morphine CSI with patient-controlled analgesia device would substantiate successful end-of-life palliative home care of idiopathic interstitial pneumonia patients.
文摘In ST-segment elevation myocardial infarction (STEMI), acute reperfusion of the infarct-related artery (IRA)is the main goal in the early minutes after the patient seeks medical attention. Fibrinolytic therapy (FT) and/or primary coronary intervention (PCI) were proven to be effective in opening the IRA.
文摘Urgent care clinics and emergency departments around the world periodically suffer from extended wait times beyond patient expectations due to surges in patient flows.The delays arising from inadequate staffing levels during these periods have been linked with adverse clinical outcomes.Previous research into forecasting patient flows has mostly used statistical techniques.These studies have also predominately focussed on short‐term forecasts,which have limited practicality for the resourcing of medical personnel.This study joins an emerging body of work which seeks to explore the potential of machine learning algorithms to generate accurate forecasts of patient presentations.Our research uses datasets covering 10 years from two large urgent care clinics to develop long‐term patient flow forecasts up to one quarter ahead using a range of state‐of‐the‐art algo-rithms.A distinctive feature of this study is the use of eXplainable Artificial Intelligence(XAI)tools like Shapely and LIME that enable an in‐depth analysis of the behaviour of the models,which would otherwise be uninterpretable.These analysis tools enabled us to explore the ability of the models to adapt to the volatility in patient demand during the COVID‐19 pandemic lockdowns and to identify the most impactful variables,resulting in valuable insights into their performance.The results showed that a novel combination of advanced univariate models like Prophet as well as gradient boosting,into an ensemble,delivered the most accurate and consistent solutions on average.This approach generated improvements in the range of 16%-30%over the existing in‐house methods for esti-mating the daily patient flows 90 days ahead.
文摘Objective To explore effects of decompressive craniectomy on cerebral blood flow volume and brain metabolism in different aged patients with severe traumatic brain injury. Methods 71 cases were divided into three groups according age: group A( 【 30 years) ,group B ( 30 ~ 50 years) 。
文摘Dear editor:We sincerely thank Matthew J.Clarkson for his insightful commentary1 on our recent publication in the Journal of Sport and Health Science.2 Clarkson's pioneering work in the development and application of blood flow restriction (BFR) exercise protocols has undeniably laid the groundwork for subsequent investigations in this field,including our own.(3-6)His commentary not only highlights the relevance and timeliness of our study but also offers valuable perspectives on refining safety considerations for intradialytic BFR exercise among hemodialysis patients.
基金Supported by National Natural Science Foundation of China(Grant Nos.51209004,11172040)Beijing Municipal Natural Science Foundation of China(Grant No.3144043)
文摘Nowadays,most researchers focus on the cavity shedding mechanisms of unsteady cavitating flows over different objects,such as 2D/3D hydrofoils,venturi-type section,axisymmetric bodies with different headforms,and so on.But few of them pay attention to the differences of cavity shedding modality under different cavitation numbers in unsteady cavitating flows over the same object.In the present study,two kinds of shedding patterns are investigated experimentally.A high speed camera system is used to observe the cavitating flows over an axisymmetric blunt body and the velocity fields are measured by a particle image velocimetry(PIV)technique in a water tunnel for different cavitation conditions.The U-type cavitating vortex shedding is observed in unsteady cavitating flows.When the cavitation number is 0.7,there is a large scale cavity rolling up and shedding,which cause the instability and dramatic fluctuation of the flows,while at cavitation number of 0.6,the detached cavities can be conjunct with the attached part to induce the break-off behavior again at the tail of the attached cavity,as a result,the final shedding is in the form of small scale cavity and keeps a relatively steady flow field.It is also found that the interaction between the re-entrant flow and the attached cavity plays an important role in the unsteady cavity shedding modality.When the attached cavity scale is insufficient to overcome the re-entrant flow,it deserves the large cavity rolling up and shedding just as that at cavitation number of 0.7.Otherwise,the re-entrant flow is defeated by large enough cavity to induce the cavity-combined process and small scale cavity vortexes shedding just as that of the cavitation number of0.6.This research shows the details of two different cavity shedding modalities which is worthful and meaningful for the further study of unsteady cavitation.
基金the National Nature Science Foundation of China (11332011 and 11202215)
文摘Quasi-periodical evolutions such as shedding and collapsing of unsteady cloud cavitating flow, induce strong pressure fluctuations, what may deteriorate maneuvering stability and corrode surfaces of underwater vehicles. This paper analyzed effects on cavitation stability of a trip bar arranged on high-speed underwater projectile. Small scale water tank experiment and large eddy simulation using the open source software Open FOAM were used, and the results agree well with each other. Results also indicate that trip bar can obstruct downstream re-entrant jet and pressure wave propagation caused by collapse, resulting in a relatively stable sheet cavity between trip bar and shoulder of projectiles.
文摘Purpose: The purpose of this study was to investigate the effects of Micro Vibrational therapy (MVT) on muscle stiffness and blood flow in the skin before and after Micro Vibrational therapy in healthy subjects in order to scientifically verify the effects of MVT. Methods: Micro Vibrational therapy is nurse care use in Japan. It was performed on the backs of 30 subjects (8 males and 22 females) in their 20 s to 50 s according to the eligibility criteria. The resting state before implementation was set as the baseline for the control group, and after 30 seconds of MVT was set as the intervention group. The effects of the MVT were statistically analyzed by these factors and subjective sensation by Visual Analog Scale. Results: The muscle hardness of the area where the MVT was applied for 30 seconds decreased to 29.54 (SD 5.04) after the application, compared to 30.45 (SD 5.05) before. A corresponding t-test showed a significant difference (p = 0.019). Skin blood flow increased from a median of 0.76 (variance 0.062) before to a median of 0.86 (variance 0.16) after the procedure. The Wilcoxon rank test showed a significant difference (p = 0.000). Circulatory response was confirmed by SBP, DBP, and HR. SBP of 108.6 mmHg (SD 14.8) before the study decreased to 105.7 mmHg (SD 15.0) after the study, and DBP of 65.6 mmHg (SD 11.1) before the study decreased to 62.7 mmHg (SD 11.8) after the study. HR decreased from 71.6 beats per minute (SD 10.3) before to 69.2 beats per minute (SD 11.7) after. There was a significant difference in all cardiovascular indices (p < 0.05). VAS (pain, stiffness, and fatigue) was significantly decreased after MVT (p < 0.05). Conclusion: Micro Vibrational therapy tended to decrease muscle hardness and increase skin blood flow even in the short time of 30 seconds. The results suggest that local vibration stimulation is not likely to cause a sudden increase in blood pressure or pulse rate fluctuation. These results suggest that hand vibration nursing care may be applicable to acute patients with unstable circulatory conditions.