Pocket Mask Research Articles

A Study on Quality Improvement of Basic Life Support Using Pocket Mask

A Study on Quality Improvement of Basic Life Support Using Pocket Mask

Competence in the use of supraglottic airways by Australian surf lifesavers for cardiac arrest ventilation in a manikin.

Lifesavers in Australia are taught to use pocket mask (PM) rescue breathing and bag valve mask (BVM) ventilation, despite evidence that first responders might struggle with these devices. Novices have successfully used the Laryngeal Mask Airway (LMA) Supreme and iGel devices previously, but there has been no previous comparison of the ability to train lifesavers to use the supraglottic airways compared to standard techniques for cardiac arrest ventilation. The study is a prospective educational intervention whereby 113 lifesavers were trained to use the LMA and iGel supraglottic airways. Comparisons were made to standard devices on plastic manikins. Successful ventilation was defined as achieving visible chest rise. The median time to first effective ventilation was similar between the PM (16 s, 95% confidence interval 16-17 s), BVM (17 s, 16-17 s) and iGel devices (18 s, 16-20 s), but longer for the LMA (36 s, 33-38 s). The iGel frequently failed to achieve ventilation (10%) compared with the PM (1%, P < 0.01) and LMA (3%, P < 0.01) but was not worse than the BVM (3%, P < 0.57). Hands-off time was similar between the BVM, LMA and iGel (10 s for each device), but worse for the PM (13 s, P = 0.001). Lifesavers using the PM and BVM perform ventilation for cardiopulmonary resuscitation well. There appears to be a limited role for supraglottic airway devices because of limitations in terms of time to first effective ventilation and reliability. Clinical validation of manikin data with live resuscitation performance is required.

Comparison of Pocket Mask vs. bag valve mask ventilation in cardiopulmonary resuscitation

Comparison of Pocket Mask vs. bag valve mask ventilation in cardiopulmonary resuscitation

Abstract 272: Ventilation with i-gel Supraglottic Airway Compared with Mouth-to--Pocket Mask Ventilation Reduces Interruptions in Chest Compressions During Single-Rescuer Lifeguard CPR: A Randomized Simulation Study

Introduction: Minimizing interruptions in chest compression during cardiopulmonary resuscitation (CPR) is a crucial determinant for the outcome following cardiac arrest. The International Life Saving Federation recommends lifeguards to perform CPR using mouth-to-pocket-mask ventilation (MPV). An alternative ventilation method is supraglottic airway ventilation (SAV), however the possible benefit of SAV among lifeguards is currently unknown. The aim of this study was to compare the effect of SAV and MPV on CPR quality. Materials and methods: Surf lifeguards in active service were invited to participate. MPV (Pocket Mask™, Laerdal, Stavanger, Norway) is a mandatory part of surf lifeguard training. All participants were trained in using a supraglottic airway (i-gel, Intersurgical®, Workingham, UK). Subsequently, each surf lifeguard was randomized to perform single rescuer CPR using either SAV or MPV separated by five minutes of rest. Data were obtained from a resuscitation manikin (Ambu® Cardiac Care Trainer System, Ambu, Ballerup, Denmark) and video recordings. Results: In total, 25 surf lifeguards were included (9 female, 16, male, mean age 25.2 years). All were employed as seasonal lifeguards and none of the participants were healthcare professionals. Interruptions in chest compressions were significantly reduced by SAV (mean+/-SD: 4.8+/-1.0 sec) when compared to MPV (7.8+/-1.3 sec, p&lt;0.001). No significant difference in chest compression depth and rate were observed between groups. Time to first ventilation attempt was 1.9+/-3.0 sec faster when using MPV compared to SAV (p=0.003). No difference in effective ventilations (visible chest rise) were observed when comparing SAV (94.1%) to MPV (95.0%, p=0.96). Tidal volumes were significantly lower following MPV (0.48+/-0.19 L) compared to SAV (0.58+/-0.10 L, p=0.04). Conclusion: SAV significantly reduces interruptions in chest compressions during lifeguard CPR and is superior in delivering the recommended tidal volume compared to MPV. Our results suggest that CPR quality is improved using SAV compared to MPV among lifeguards.