1474 ACCURACY OF MANUAL VENTILATION WITH AND WITHOUT A MANOMETER

Abstract

The quality of ventilation in ill neonates and the prevention of acute and chronic respiratory complications depends in part on accuracy and stability of ventilatory performance. While mechanical ventilators are manufactured under strict standards, the performance of manual resuscitators is not and depends upon human skills. Performance of MDs and RNs in the ICN in manual bag ventilation was tested with & without monitoring using a manometer Manual ventilation of a Resusci-Baby using a pediatric Ambu-bag® connected to a manometer (Bird #4407)® and transducer with recorder was performed. Ten ICN RNs and MDs were asked to create stable pressure wave forms at a constant rate (30 breaths/min). One minute samples of recordings at 2 pressure levels (15 & 30 cm H20) with & without the performers observing the manometer were analyzed. Watching the manometer, performers could maintain the above low & high pressures in a range of ±2 cm H2O 70 and 74% of the time respectively. Without the ability to monitor their bagging with a manometer, the desired pressure ranges were maintained in only 18 and 14% respectively. Only 2/10 could maintain the low pressures ±2 cm H2O and only 1/10 could maintain the high pressure ±2 cm H2O accuracy without a manometer at a rate of 30/min. Our results demonstrate that accurate (±2 cm H2O) manual ventilation can only be achieved by the use of a manometer in most instances by skilled neonatal caregivers & that all manual ventilation bags must incorporate a pressure manometer for accurate manual ventilation. (Supp. by HD-13279)