RT Journal Article SR Electronic T1 Evaluation of manual and automatic manually-triggered ventilation performance and ergonomics using a simulation model JF Respiratory Care FD American Association for Respiratory Care SP respcare.02557 DO 10.4187/respcare.02557 A1 Nicolas Marjanovic A1 Soizig Le Floch A1 Morgan Jaffrelot A1 Erwan L’Her YR 2013 UL http://rc.rcjournal.com/content/early/2013/10/29/respcare.02557.abstract AB 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.