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Research ArticleOriginal Research

Evaluation of Manual and Automatic Manually Triggered Ventilation Performance and Ergonomics Using a Simulation Model

Nicolas Marjanovic, Soizig Le Floch, Morgan Jaffrelot and Erwan L'Her
Respiratory Care May 2014, 59 (5) 735-742; DOI: https://doi.org/10.4187/respcare.02557
Nicolas Marjanovic
Emergency Department, Pôle Arsibou, Centre Hospitalier Universitaire de la Cavale Blanche, 29609 Brest, France.
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Soizig Le Floch
Emergency Department, Pôle Arsibou, Centre Hospitalier Universitaire de la Cavale Blanche, 29609 Brest, France.
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Morgan Jaffrelot
Emergency Department, Pôle Arsibou, Centre Hospitalier Universitaire de la Cavale Blanche, 29609 Brest, France.
Centre de Simulation en Santé, LaTim Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1101, Université de Bretagne Occidentale, Université Européenne de Bretagne, 29609 Brest, France.
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Erwan L'Her
Emergency Department, Pôle Arsibou, Centre Hospitalier Universitaire de la Cavale Blanche, 29609 Brest, France.
Centre de Simulation en Santé, LaTim Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1101, Université de Bretagne Occidentale, Université Européenne de Bretagne, 29609 Brest, France.
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  • For correspondence: [email protected]
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Abstract

BACKGROUND: In the absence of endotracheal intubation, the manual bag-valve-mask (BVM) 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 BVM ventilation.

METHODS: A respiratory system bench model was assembled using a lung simulator connected to a manikin 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 BVM 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 health-care professionals using a standard numerical scale once the recordings were completed.

RESULTS: The tidal volume fell within the standard range (400–600 mL) for 25.6% of breaths (0.6–45 breaths) using manual BVM ventilation, and for 28.6% of breaths (0.3–80 breaths) using the automatic manually triggered device (EasyCPR) (P < .0002). Peak inspiratory airway pressure was lower using the automatic manually triggered device (EasyCPR) (10.6 ± 5 vs 15.9 ± 10 cm H2O, P < .001). The ventilation rate fell consistently within the guidelines, in the case of the automatic manually triggered device (EasyCPR) only (10.3 ± 2 vs 17.6 ± 6, P < .001). Significant pulmonary overdistention was observed when using the manual BVM device during the normal and obstructive sequences. The nurses and paramedics considered the ergonomics of the automatic manually triggered device (EasyCPR) to be better than those of the manual device.

CONCLUSIONS: The use of an automatic manually triggered device may improve ventilation efficiency and decrease the risk of pulmonary overdistention, while decreasing the ventilation rate.

  • manual ventilation
  • bag-valve-mask
  • automated system
  • performance evaluation
  • ergonomy
  • simulation

Footnotes

  • Correspondence: Erwan L'Her MD PhD, Service d'Accueil des Urgences, Centre Hospitalier Universitaire de la Cavale Blanche, Boulevard Tanguy-Prigent, 29609 Brest Cedex, France. E-mail: erwan.lher{at}chu-brest.fr.
  • The authors have disclosed a relationship with Weinmann. The authors have disclosed no other conflicts of interest.

  • Copyright © 2014 by Daedalus Enterprises
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Respiratory Care: 59 (5)
Respiratory Care
Vol. 59, Issue 5
1 May 2014
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Evaluation of Manual and Automatic Manually Triggered Ventilation Performance and Ergonomics Using a Simulation Model
Nicolas Marjanovic, Soizig Le Floch, Morgan Jaffrelot, Erwan L'Her
Respiratory Care May 2014, 59 (5) 735-742; DOI: 10.4187/respcare.02557

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Evaluation of Manual and Automatic Manually Triggered Ventilation Performance and Ergonomics Using a Simulation Model
Nicolas Marjanovic, Soizig Le Floch, Morgan Jaffrelot, Erwan L'Her
Respiratory Care May 2014, 59 (5) 735-742; DOI: 10.4187/respcare.02557
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Keywords

  • manual ventilation
  • bag-valve-mask
  • automated system
  • performance evaluation
  • ergonomy
  • simulation

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