Abstract
Introduction: Bag-valve-mask (BVM) ventilation is the first and important part of the airway management. The aim of present study was to evaluate the quality of four different BVM ventilation techniques – E-C, Thenar Eminence, Thenar Eminence (Dominant hand)-E-C (Non dominant hand), and Thenar Eminence (Non dominant hand)-E-C (Dominant hand) – among two novice and experienced groups. Methods: In a case-control and mannequin based study that was conducted in Tabriz University of medical sciences, 120 volunteers were recruited and divided into two groups. 60 participants in experienced and other 60 as novice group who observed BVM ventilation but hadn’t practical experience about BVM ventilation. Every participant in both groups performed 4 BVM ventilation techniques under the supervision of an experienced assessor. Quality of mannequin chest expansion was recorded by two other experienced assessors who were blind to ventilation process. The data were analyzed with SPSS 17.0. Results: In novice group, when evaluating each technique performance, they did Thenar Eminence (non-dominant hand) - E-C (dominant hand) technique much better than the others (P<0.0001). But in the experienced group, there was no meaningful difference between the all four techniques (P= 0.102). Conclusion: Novice participants did Thenar Eminence (non-dominant hand) - E-C (dominant hand) technique better than the others. Therefore, it is recommended that training of this technique was placed in educational program of medical students.
Highlights
Bag-valve-mask (BVM) ventilation is the first and important part of the airway management
No significant difference could be observed between both groups using the two novel combined methods (Table 1)
Statistically significant differences could be observed in novice group regarding the four different BVM ventilation techniques
Summary
Bag-valve-mask (BVM) ventilation is the first and important part of the airway management. Thenar Eminence technique could be used in which is applied bimanually and another person is required to push the bag (Figure 2).[4,5,6,7,8,9,10] Having more than 55 years old age, male gender, body mass index (BMI)> 31 kg/m2, anesthesia provider, obstructive sleep apnea (OSA), moustache, a short neck, history of neck radiation, short thyromental distance, Mallampati score of 3 and 4 are mentioned as risk factors of difficult BVM ventilation.[7] Golzari et al showed that placing folded sterile gas in buccal cavities in toothless patient scan remarkably improve BVM ventilation when compared to those toothless individuals with or without denture.[2] In the present study, we compared the efficacy of two new combined techniques with these two conventional methods in two groups of the experienced and novice staff on mannequin. Through analysis of obtained results, it was tried to choose the simplest way of BVM ventilation for novice practitioners
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