Comparative Analysis of Tidal Volume and Airway Pressure with a Bag-valve Mask using RespiTrainer

2022

Healthcare

Bag-valve-mask is a device that manually provides positive oxygen pressure. The grip technique of the character E and C shape is recommended to carry out this effectively. However, when applying this method, the hand in which the direction of the EC technique should be performed and the degree of adhesion pressure while performing the technique are unknown. This study aims to identify the factors influencing tidal volume and to determine the ideal sealing method between mask and face in the one-handed EC technique to optimize the Vt. A simulation study was conducted using a mechanical lung model in a scenario that resembled respiratory arrest. Multiple regression analyses identified high peak pressure, high left spot adhesion strength of the mask, and low right spot and bottom spot adhesion strength of the mask as significant factors. To provide an optimal Vt, it may be necessary to apply more strength to the left area of the mask when forming the “C” shape with the thumb and index finger of left hand using the one-handed EC technique.

Section: Discussioncontrasting

confidence: 62%

“…The data such as Vt and PP were delivered to the PDA via Bluetooth and calculated automatically. The Quick Lung ® was set at a compliance of 50 mL/cmH 2 O and a resistance of 5 cmH 2 O/L⋅s according to the methods used in previous studies [ 17 , 18 ].…”

Section: Methodsmentioning

confidence: 99%

Potential Maneuvers for Providing Optimal Tidal Volume Using the One-Handed EC Technique

2022

Healthcare

“…A previous study (25) reported that PP > 20 cmH2O resulted in adverse effects such as gastric insu ation. In this study, the average PP was 11.62 cmH2O, lower than that from a previous study (13); however, this was higher than the 8.71 cmH2O previously reported (17). PP is directly proportional to TV; low PP was associated with suboptimal TV (321.6 mL) in this study.…”

Section: Discussioncontrasting

confidence: 79%

“…A Quick Lung® (IngMar Medical) and personal digital assistance were connected to the manikin, and data were sent to the personal digital assistance through its embedded device. The Quick Lung® was set with compliance of 50 mL⋅cmH 2 O − 1 and resistance of 5 cmH 2 O⋅L − 1 ⋅s based on previous studies (17,18). Participants were instructed to use a BVM (1600 mL, Ambu Mark -Reusable Resuscitator with silicon face mask size 5; Ambu, Copenhagen, Denmark) to ventilate the manikin, simulating an adult with respiratory arrest, for two minutes (measured using a metronome (10 times/min)).…”

Section: Experimental Environment Tv and Ppmentioning

confidence: 99%

Study on Tidal Volume According to the 4-Point Sealing Forces of Bag-Valve-Mask : An Adult Respiratory Arrest Simulator Based Prospective, Descriptive Study

2021

Preprint

Background For adequate ventilation during bag-valve-mask ventilation, rescuers should ensure a proper mask seal using the one-handed or two-handed technique. Little is known how much sealing forces of bag-valve-mask are needed for adequate ventilation. This study aimed to explored the effect of the 4-point sealing forces of a bag-valve-mask on tidal volume while using the one-handed technique, focusing on the moderating effect of C length ( C length is the distance from the thumb to index finger in the C shape of in the one-hand EC grip). Methods This was a prospective, descriptive simulation study design. Convenience sample of 125 undergraduate paramedic students from two universities was participated. A self-reported questionnaire was used to collect subject data. Tidal volumes, 4-point sealing forces of the mask, peak pressure, and C length of the C shape in the one-hand EC grip, were measured using the mechanical lung model under a simulated adult respiratory arrest. Hierarchical regression analysis was used to determine the moderating effect of C length on tidal volume in bag-valve-mask ventilation. Results The average C length, peak pressure and tidal volume were 7.54 (± 1.85) cm, 11.62 (± 5.40) cmH2O, and 321.66 (± 135.18) mL, respectively. The average range of the 4-point sealing forces were 0.03–0.69 newton. The apex sealing force was the weakest point among the 4-point sealing forces. Hierarchical regression analysis demonstrated that tidal volume accounted for 62.7% of the variance by C length, peak pressure, and apex sealing force during bag-valve-mask ventilation (F = 9.676, p < .001). C length moderated the effect of apex sealing force and peak pressure on tidal volume. That is, the more peak pressure and apex sealing force, the more the tidal volume, and the longer the C length, the more the tidal volume. Conclusion We developed effective advice that can be adopted in clinical practice without side effects as the first simulation study measuring the 4-point sealing forces during bag-valve-mask ventilation, as well as underpin continuous retraining and assessment that focus on individual physical characteristics, such as C length and bag-valve-mask sealing force.

“…A Quick Lung® (IngMar Medical) and personal digital assistant were connected to the manikin, and data were sent to the personal digital assistant through its embedded device. The Quick Lung® was set with compliance of 50 mL·cmH 2 O − 1 and resistance of 5 cmH 2 O·L − 1 ·s based on previous studies [ 19 , 20 ]. Participants were instructed to use a BVM (1600 mL, Ambu Mark IV- Reusable Resuscitator with silicon face mask size 5; Ambu, Copenhagen, Denmark) to ventilate the manikin, simulating an adult with respiratory arrest, for 2 min (measured using a metronome (10 times/min)).…”

Section: Methodsmentioning

confidence: 99%

Tidal volume according to the 4-point sealing forces of a bag-valve-mask: an adult respiratory arrest simulator-based prospective, descriptive study

2021

BMC Emerg Med

Background For adequate ventilation during bag-valve-mask ventilation, rescuers should ensure a proper mask seal using the one-handed or two-handed technique. Little is known about the magnitude of sealing forces of a bag-valve-mask needed for adequate ventilation. This study aimed to explore the effect of the 4-point sealing forces of a bag-valve-mask on tidal volume while using the one-handed technique, focusing on the moderating effect of C length (the distance from the thumb to the index finger in the C shape of the one-hand EC grip). Methods A prospective, descriptive simulation study was conducted. A convenience sample of 125 undergraduate paramedic students from two universities was recruited. A self-reported questionnaire was used to collect subjective variables. Tidal volumes, 4-point sealing forces of the mask, peak pressure, and C length of the C shape in the one-hand EC grip were measured using the mechanical lung model under a simulated adult respiratory arrest. Hierarchical regression analysis was used to determine the moderating effect of C length on tidal volume in bag-valve-mask ventilation. Results The average C length, peak pressure, and tidal volume were 7.54 (± 1.85) cm, 11.62 (± 5.40) cmH2O, and 321.66 (± 135.18) mL, respectively. The average range of the 4-point sealing forces was 0.03–0.69 N. The apex sealing force was the weakest among the 4-point sealing forces. Hierarchical regression analysis demonstrated that tidal volume accounted for 62.7% of the variance by C length, peak pressure, and apex sealing force during bag-valve-mask ventilation (F = 9.676, p < 0.001). C length moderated the effect of the apex sealing force and peak pressure on the tidal volume, meaning the higher the peak pressure and apex sealing force, the more the tidal volume and the longer the C length. Conclusion This first simulation study measuring the 4-point sealing forces during bag-valve-mask ventilation provides effective advice that can be adopted in clinical practice without side effects and underpins the importance of continuous retraining and assessment focused on individual physical characteristics, such as C length and bag-valve-mask sealing forces.