Abstract
BACKGROUND AND OBJECTIVES: In the absence of endotracheal intubation, the manual bag-valve is the most frequently used ventilation technique during resuscitation. The efficiency of other devices has been poorly studied. The bench-test study described here was designed to evaluate the effectiveness of an automatic, manually-triggered system, and to compare it with manual bag valve ventilation.
METHODS: A respiratory system bench model was assembled using a lung simulator connected to a manikin, in order to simulate a patient with unprotected airways. Fifty health-care providers from different professional groups (emergency physicians, residents, advanced paramedics, nurses and paramedics; n=10 per group) evaluated manual bag-valve ventilation, and compared it with an automatic manually-triggered device (EasyCPR). Three pathological situations were simulated (restrictive, obstructive, normal). Standard ventilation parameters were recorded; the ergonomics of the system were assessed by the professionals using a standard numerical scale, once the recordings were completed.
RESULTS: The tidal volume fell within the standard range (400-600ml) for 25.6% [0.6-45] of breaths using manual bag-valve ventilation, and for 28.6% [0.3-80] of breaths using the EasyCPR (p<0.0002). Peak inspiratory airway pressure was lower using the EasyCPR (10.6±5 cm H2O vs 15.9±10 cm H2O; p<0.001). The ventilation rate fell consistently within the guidelines, in the case of the EasyCPR only (10.3±2 versus 17.6±6; p<0.001). Significant pulmonary overdistension was observed when using the manual bag-valve device during the normal and obstructive sequences. The nurses and paramedics considered the ergonomics of the EasyCPR to be better than those of the manual device.
CONCLUSION: The use of an automatic, manually-triggered device may improve ventilation efficiency and decrease the risk of pulmonary overdistension, while decreasing the ventilation rate.
Footnotes
- Corresponding author: Pr Erwan L’HER, MD, PhD Service d’Accueil des Urgences Centre Hospitalier Universitaire de la Cavale Blanche Bd Tanguy-Prigent 29609 Brest Cedex, France Tel: +33 298 347 455 E-mail address: erwan.lher{at}chu-brest.fr
EasyCPR was provided free of charge by Weinmann; no other conflict of interest
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