Standardization of the Squeezing Technique for Expectoration in Terms of Timing, Pressure, and Direction

[Purpose] The aim of this study was to standardize the timing of breathing, pressure and direction of pressing for removing secretions retained in the airway. [Methods] Nine respiratory therapists with work experience of 5 to >21 years cooperated to establish the standard values. A model to record the timing, pressure, and direction of pressing during compression was prepared. Sixty sensors were arranged corresponding to a handprint on the right chest, the site of pressing, on a mannequin, and the respiratory therapists performed compression using this model. [Results] Timing: Based on the waveforms, the subjects gradually increased the pressure, held their position after reaching the peak, and then sharply reduced the force. Pressure: The compression strength varied among the subjects, but the mean peak sensor value was 400–900, corresponding to about 1–2 kg/cm2. Direction of pressing: The pressure was transmitted from the shoulder side toward the bronchial bifurcation. [Conclusion] In compression performed by 9 respiratory therapists, increasing the pressure to the peak and a subsequent reduction with the respiratory cycle were the main points regarding timing. The mean peak pressure was within the range of 1–2 kg/cm2. The direction of pressing was from the upper region of the lung toward the bronchial bifurcation.