Abstract
Background and objectives: It is often challenging even for skilled rescuers to provide adequate positive pressure ventilation consistently. This study aimed to investigate the effectiveness of a newly developed real-time ventilation feedback device (RTVFD) that estimates tidal volume (TV) and ventilation interval (VI) in real time. Materials and methods: We conducted a randomised, crossover, manikin simulation study. A total of 26 medical providers were randomly assigned to the RTVFD-assisted ventilation (RAV) first group (n = 13) and the non-assisted ventilation (NV) first group (n = 13). Participants provided ventilation using adult and paediatric bag valves (BVs) for 2 min each. After a washout period, the simulation was repeated by exchanging the participants’ groups. Results: The primary outcome was optimal TV in the RAV and NV groups using adult and paediatric BVs. A secondary outcome was optimal VI in the RAV and NV groups using adult and paediatric BVs. The proportions of optimal TV values were higher for the RAVs when using both adult and paediatric BVs (adult BV: 47.29% vs. 18.46%, p < 0.001; paediatric BV: 89.51% vs. 72.66%, p < 0.001) than for the NVs. The proportions of optimal VI were significantly higher in RAVs when using both adult and paediatric BVs than that in NVs (adult BV: 95.64% vs. 50.20%, p < 0.001; paediatric BV: 95.83% vs. 57.14%, p < 0.001). Additionally, we found that with paediatric BVs, the simulation had a higher OR for both optimal TV (13.26; 95% CI, 9.96–17.65; p < 0.001) and VI (1.32; 1.08–1.62, p = 0.007), regardless of RTVFD use. Conclusion: Real-time feedback using RTVFD significantly improves the TV and VI in both adult and paediatric BVs in a manikin simulation study.
Highlights
Despite the continuous efforts to improve the survival rate of cardiac arrest patients, the rate remains poor worldwide [1,2,3,4]
The primary outcome was the proportion of optimal tidal volume (TV) in the RTVFD-assisted ventilation (RAV) and non-assisted ventilation (NV) groups using adult and paediatric bag valves (BVs)
The secondary outcome was the proportion of optimal ventilation interval (VI) in the RAV and NV
Summary
Despite the continuous efforts to improve the survival rate of cardiac arrest patients, the rate remains poor worldwide [1,2,3,4]. Medicina 2020, 56, 278 with adequate ventilation, namely, optimal tidal volume (TV) and ventilation interval (VI) to produce a visible chest rise [7,8,9,10]. The AHA guidelines for CPR recommend an optimal ventilation rate of 10/min and TV of 6–7 mL/kg in both adult and paediatric patients [10,15]. It is often challenging for rescuers to consistently provide adequate positive ventilation using bag valves (BVs) [16,17,18]. Hyperventilation, even with professional rescuers, has been reported [1,13,14,19] It is often challenging even for skilled rescuers to provide adequate positive pressure ventilation consistently. Participants provided ventilation using adult and paediatric bag valves (BVs) for 2 min each. The simulation was repeated by exchanging the participants’
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