Workload Comparison of Intraoral Mask to Standard Mask Ventilation Using a Cadaver Model

Abstract

Background: The bag-valve mask (BVM) is critical to providing positive pressure ventilation for patients who are not breathing or who are breathing inadequately. This simple hand-held device enables healthcare professionals to quickly provide mechanical ventilation in emergent and non-emergent situations. However, the difficulty of achieving and maintaining an adequate seal between the BVM and face reduces ventilation volume and the success rate of resuscitation efforts. A novel IntraOral Mask (IOM) was developed by NuMask to eliminate these difficulties by creating a seal inside the mouth using a snorkel-like mouthpiece. There have been no published reports comparing the human factors and ergonomics of these masks. Therefore, the aim of this study was to compare the perceived workload of the standard BVM and the NuMask IOM. Method: Twenty-five emergency medicine students performed mechanical ventilation on a cadaver model using both masks. Workload was assessed using the NASA-TLX after ventilating with each mask. Results: Overall workload and effort were rated significantly less for the IOM (p < 0.05). In general, the IOM had lower median ratings for physical demand, mental demand and frustration compared to the BVM. Conclusion: Overall, the IOM appears to facilitate gripping through its novel snorkel-like design and reduced hand interface size by decreasing the perceived effort and workload of the healthcare responder. However, further clinical and ergonomic investigations are needed to ascertain whether the IOM improves mechanical ventilation performance and therefore resuscitation success rates.