# Impact of Helicopter Vibrations on In-Ear PPG Monitoring for Vital Signs—Mountain Rescue Technology Study (MoReTech)

## TL;DR

This study investigates whether vibrations from a helicopter affect in-ear PPG monitoring of vital signs like pulse rate and oxygen saturation during patient transport.

## Contribution

The study introduces a novel evaluation of in-ear PPG signal quality and vital sign accuracy under simulated helicopter vibrations.

## Key findings

- Simulated helicopter vibrations did not significantly affect signal quality indicators (SQIs) of in-ear PPG.
- Pulse rate showed strong agreement with reference measurements during rest and vibration.
- Oxygen saturation (SpO2) showed poor agreement with reference measurements in both conditions.

## Abstract

Pulsoximeters are widely used in the medical care of preclinical patients to evaluate the cardiorespiratory status and monitor basic vital signs, such as pulse rate (PR) and oxygen saturation (SpO2). In many preclinical situations, air transport of the patient by helicopter is necessary. Conventional pulse oximeters, mostly used on the patient’s finger, are prone to motion artifacts during transportation. Therefore, this study aims to determine whether simulated helicopter vibration has an impact on the photoplethysmogram (PPG) derived from an in-ear sensor at the external ear canal and whether the vibration influences the calculation of vital signs PR and SpO2. The in-ear PPG signals of 17 participants were measured at rest and under exposure to vibration generated by a helicopter simulator. Several signal quality indicators (SQI), including perfusion index, skewness, entropy, kurtosis, omega, quality index, and valid pulse detection, were extracted from the in-ear PPG recordings during rest and vibration. An intra-subject comparison was performed to evaluate signal quality changes under exposure to vibration. The analysis revealed no significant difference in any SQI between vibration and rest (all p > 0.05). Furthermore, the vital signs PR and SpO2 calculated using the in-ear PPG signal were compared to reference measurements by a clinical monitoring system (ECG and SpO2 finger sensor). The results for the PR showed substantial agreement (CCCrest = 0.96; CCCvibration = 0.96) and poor agreement for SpO2 (CCCrest = 0.41; CCCvibration = 0.19). The results of our study indicate that simulated helicopter vibration had no significant impact on the calculation of the SQIs, and the calculation of vital signs PR and SpO2 did not differ between rest and vibration conditions.