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Can first responders achieve and maintain normocapnia when sequentially ventilating with a bag-valve device and two oxygen-driven resuscitators? A controlled clinical trial in 104 patients

Published online by Cambridge University Press:  23 December 2004

G. J. Noordergraaf ,
P. J. van Dun ,
B. P. Kramer ,
M. P. Schors ,
H. P. Hornman ,
W. de Jong  and
A. Noordergraaf
G. J. Noordergraaf
Affiliation:
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands
P. J. van Dun
Affiliation:
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands
B. P. Kramer
Affiliation:
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands
M. P. Schors
Affiliation:
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands
H. P. Hornman
Affiliation:
Fire Department, City of Tilburg, Tilburg, The Netherlands
W. de Jong
Affiliation:
St. Elisabeth Hospital, Department of Clinical Physics EN Tilburg, The Netherlands
A. Noordergraaf
Affiliation:
University of Pennsylvania, Departments of Bioengineering and Anaesthesiology, PA, USA
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Abstract

Summary

Background and objective: To evaluate the capability of first responders to achieve and maintain normal ventilation of the lungs of victims employing a bag-valve device and two oxygen-driven resuscitators.

Methods: Prospective, controlled, blinded, single-centre clinical trial using a bag-valve device and one of two FR-300® devices, with 20 cmH2O working pressure, and flows of either 24 or 30L min−1. One hundred and four patients were analysed. Induction of anaesthesia followed by ventilation of the lungs with a bag-valve device and an Oxylator® in manual and automatic modes performed by a fireman first responder. Each series was repeated for three conditions (anaesthesia; anaesthesia plus muscle relaxation, both with facemask; anaesthesia plus relaxation using an endotracheal tube).

Results: Patients age 49 ± 17 yr; 47% males, 48–132 kg. Normocapnia was achieved and maintained in 66% (bag-valve device), 82% (Oxylator®).

Conclusions: The use of an oxygen-driven device improves the ability of first responders to achieve and maintain normocapnia even when distracted. Use of the Oxylators® improves performance (P < 0.001) vs. the bag-valve device significantly.

Keywords

EQUIPMENT AND SUPPLIES, ventilators, mechanicalEMERGENCY TREATMENT, respiration artificial, first aidHEALTHCARE QUALITY ASSESSMENT AND EVALUATION, technology assessment, biomedical
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 5 , May 2004 , pp. 367 - 372
Copyright
2004 European Society of Anaesthesiology

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References

Braman SS, Dunn SM, Amico CA, Millman RP. Complications of intrahospital transport in critically ill patients. Ann Internal Med 1987; 107: 469–473.Google Scholar
Cummins RO, Austin D, Graves JR, Litwin PE, Pierce J. Ventilation skills of emergency medical technicians: a teaching challenge for emergency medicine. Ann Emerg Med 1986; 15: 1187–1192.Google Scholar
Hess D, Goff G. The effect of two-hand versus one-hand ventilation on volumes delivered during bag-valve ventilation at various resistances and compliances. Resp Care 1987; 32: 1025–1028.Google Scholar
Johannigman JA, Branson RD, Davis K, Hurst JM. Techniques of emergency ventilation: a model to evaluate tidal volume, airway pressure and gastric insufflation. J Trauma 1991; 31: 93–98.Google Scholar
Law GD. Effects of hand size on Ve, Vt and FiO2 during manual resuscitation. Resp Care 1982; 27: 1236–1238.Google Scholar
Menegazzi JJ, Winslow HJ. In-vitro comparison of bag-valve-mask and the manually triggered oxygen powered breathing device. Acad Emerg Med 1994; 1: 29–33.Google Scholar
Osterwalder JJ, Schuhwerk W. Effectiveness of mask ventilation in a training mannikin. A comparison between the oxylator EM100 and the bag-valve device. Resuscitation 1998; 36: 23–27.Google Scholar
Updike G, Mosesso VN, Auble TE, Delgado E. Comparison of bag-valve-mask, manually triggered ventilator, and automated ventilator devices used while ventilating a nonintubated manikin model. Prehosp Emerg Care 1998; 2: 52–55.Google Scholar
Wayne MA, Delbridge TR, Ornato JP, Swor RA, Blackwell T. Concepts and application of prehospital ventilation. Prehosp Emerg Care 2001; 5: 73–78.Google Scholar
Augustine JA, Seidel DR, McGabe JB. Ventilation performance using a self-inflating anaesthesia bag: effect of operator characteristics. Am J Emerg Med 1987; 5: 267–270.Google Scholar
Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2000; 102: I-1–I-384.
Wenzel V, Idris AH, Banner MJ, Kubilis PS, Williams JrJL. Influence of tidal volume on the distribution of gas between the lungs and the stomach in the nonintubated patient receiving positive-pressure ventilation. Crit Care Med 1998; 26: 364–368.Google Scholar
van Dun PJM, Schors MPHJ, Gyssens JMJ, Noordergraaf GJ. The effect of the Oxylator in patients under anaesthesia: end tidal CO2 and airway management. Resuscitation 2000; 45: S18.Google Scholar
Mens M, Zandstra DF. Impact of a mask attached automatic mini-ventilator (Oxylator) in skillslab CPR setting on mask-ventilation performance. Resuscitation 2000; 45: S39.Google Scholar
von Spiegel T, Giannaris S, Schorn B, Wietasch GJK, Hoeft A. Effects of induction of anaesthesia with sufentanil and positive-pressure ventilation on intra- to extrathoracic volume distribution. Eur J Anaesthesiol 2002; 19: 428–435.Google Scholar