Evaluation of Manual and Automatic Manually Triggered Ventilation Performance and Ergonomics Using a Simulation Model

Marjanovic, Nicolas; Floch, Soizig Le; Jaffrelot, Morgan; L’Her, Erwan

doi:10.4187/respcare.02557

Cited by 7 publications

(9 citation statements)

References 22 publications

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“…Most studies that have analyzed emergency and transport ventilator ergonomics have focused mainly on chronometric measurements and task failure assessments. 1,[8][9][10][11] The purpose of this study was to provide a complete ergonomic evaluation of 13 emergency and transport ventilators, taking into account objective and subjective human/machine interface tests and mental work load evaluation using a multidimensional NASA task load index (NASA-TLX) test.…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Approach for the Ergonomic Evaluation of 13 Emergency and Transport Ventilators

Marjanovic

L’Her

2016

Respir Care

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BACKGROUND: Mechanical ventilation is an important part of emergency medicine and is frequently used for transportation. Human errors during ventilator settings are frequent and may be associated with high morbidity/mortality. The aim of the study was to provide a complete ergonomic evaluation of emergency and transport ventilators, taking into account objective and subjective human-machine interface assessments and individual mental work load. METHODS: We performed a prospective bench ergonomic evaluation of 13 emergency and transport ventilators, using standardized conditions and a global methodological approach. The study was performed in an evaluation laboratory dedicated to respiratory care, and 12 emergency physicians unfamiliar with the tested devices were included in the evaluation. The ventilators were classified into 3 categories (simple, sophisticated, and ICU-like). Objective chronometric evaluations were conducted considering 9 tasks, and subjective evaluations were performed (ease of use, willingness to use, and user-friendliness of monitoring) using Likert scales. Mental work load evaluation was performed using the NASA Task Load Index scale. RESULTS: Overall task failure rate represented 4% of all attempts. Setting modifications, ventilation mode changes, and powering down durations were different between simple and other emergency and transport ventilator categories (P < .005). There was no difference between ventilator categories for the ease of use and userfriendliness of the monitoring. In contrast, the willingness to use was lower for simple devices, compared with sophisticated and ICU-like emergency and transport ventilators (2.9 ؎ 1.4 vs 3.9 ؎ 1.2, P ‫؍‬ .002 and 4.3 ؎ 1, P < .001). No differences were observed between devices regarding the mental work load, except for several specific devices in the sophisticated category. CONCLUSIONS: A comprehensive ergonomic evaluation provides valuable information while investigating operational friendliness in emergency and transport ventilators. The choice of a device not only depends on its technical characteristics but should take into account its clinical operational setting and ergonomics in order to decrease mental work load. Sophisticated emergency and transport ventilators should only be used by clinicians who demonstrate expertise in mechanical ventilation.

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Section: Introductionmentioning

confidence: 99%

A Comprehensive Approach for the Ergonomic Evaluation of 13 Emergency and Transport Ventilators

Marjanovic

L’Her

2016

Respir Care

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“…1). Of these, six were manikinbased studies and three were clinical trials [15][16][17][18][19][20][21][22][23]. The ventilatory variables that were recorded in bench studies were tidal volume (V T ), ventilation rate (V R ), peak airway pressure (P peak ), peak inspiratory flow (PF), minute volume (V m ), gastric inflation volume (V gastric ), inspiratory time fraction (T i /T tot ), inspiratory time (I time) and inspiratory/expiratory ratio (I/E).…”

Section: Resultsmentioning

confidence: 99%

“…However, there were significant differences between studies regarding the tolerance ranges used to define whether V T and V R were considered adequate or not. While some studies defined adequate V T from 6 ml.kg À1 to 7 ml.kg À1 [18,19,21,22], other studies used a basic range of 400-600 ml [16,23], regardless of the patient's weight. von Goedecke et al defined an adequate V T as approximately 350 ml [17], and Bergrath et al considered a V T lower than 200 ml to be clinically insufficient [21].…”

Section: Resultsmentioning

confidence: 99%

Performance of manual ventilation: how to define its efficiency in bench studies? A review of the literature

et al. 2015

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Bench studies have become the preferred way to evaluate the performance of airway equipment, since clinical trials are not specifically required before marketing these devices. However, it is difficult to assess the efficiency of ventilation without recording physiological data. This review analyses how efficiency of manual ventilation has been defined in recent studies, and how their results may be affected. We searched electronic databases from 2000 to April 2014. The main inclusion criterion was the analysis of performance of ventilation. Nine relevant articles were selected from 53 eligible publications. Most studies used the same parameters; tidal volume and ventilation rate. However, there were significant differences between the definitions of performance of ventilation, both in terms of criteria of judgement and methods of analysis. None of these approaches is able to provide a clear understanding of variability of ventilation during a given period. A new definition may increase the relevance of bench studies to clinical medicine, by more appropriately assessing the performance of ventilation.

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“…60 More recently, educators are using HF more overtly in addressing procedures 61 and also indirectly through the measurement of learner cognitive load during the training process. 29,30 Investigators have utilized HFA to approach simulation-based training and assessment of procedures, including intraosseous line insertion, 62 epistaxis management, 63 bag-valve-mask ventilation, 64 intravenous catheter insertion, 65 emergency ultrasound technique, 66 and central venous catheter placement.…”

Section: Hf In Emmentioning

confidence: 99%

Human Factors and Simulation in Emergency Medicine

Hayden

Wong

Ackerman

et al. 2017

Academic Emergency Medicine

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This consensus group from the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes" held in Orlando, Florida, on May 16, 2017, focused on the use of human factors (HF) and simulation in the field of emergency medicine (EM). The HF discipline is often underutilized within EM but has significant potential in improving the interface between technologies and individuals in the field. The discussion explored the domain of HF, its benefits in medicine, how simulation can be a catalyst for HF work in EM, and how EM can collaborate with HF professionals to effect change. Implementing HF in EM through health care simulation will require a demonstration of clinical and safety outcomes, advocacy to stakeholders and administrators, and establishment of structured collaborations between HF professionals and EM, such as in this breakout group.

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Evaluation of Manual and Automatic Manually Triggered Ventilation Performance and Ergonomics Using a Simulation Model

Cited by 7 publications

References 22 publications

A Comprehensive Approach for the Ergonomic Evaluation of 13 Emergency and Transport Ventilators

A Comprehensive Approach for the Ergonomic Evaluation of 13 Emergency and Transport Ventilators

Performance of manual ventilation: how to define its efficiency in bench studies? A review of the literature

Human Factors and Simulation in Emergency Medicine

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