Retention of mouth-to-mouth, mouth-to-mask and mouth-to-face shield ventilation

Abstract

Background: Retention of mouth-to-mouth, mouth-tomask and mouth-to-face shield ventilation techniques is poorly understood. Methods: A prospective randomised clinical trial was undertaken in January 2004 in 70 candidates randomly assigned to training in mouth-to-mouth, mouth-to-mask or mouth-to-face shield ventilation. Each candidate was trained for 10 min, after which tidal volume, respiratory rate, minute volume, peak airway pressure and the presence or absence of stomach inflation were measured. 58 subjects were reassessed 1 year later and study parameters were recorded again. Data were analysed with ANOVA, x 2 and McNemar tests. Results: Tidal volume, minute volume, peak airway pressure, ventilation rate and stomach inflation rate increased significantly at reassessment with all ventilation techniques compared with the initial assessment. However, at reassessment, mean (SD) tidal volume (960 (446) vs 1008 (366) vs 1402 (302) ml; p,0.05), minute volume (12 (5) vs 13 (7) vs 18 (3) l/min; p,0.05), peak airway pressure (14 (8) vs 17 (13) vs 25 (8) cm H 2 O; p,0.05) and stomach inflation rate (63% vs 58% vs 100%; p,0.05) were significantly lower with mouth-tomask and mouth-to-face shield ventilation than with mouth-to-mouth ventilation. The ventilation rate at reassessment did not differ significantly between the ventilation techniques. Conclusions: One year after a single episode of ventilation training, lay persons tended to hyperventilate; however, the degree of hyperventilation and resulting stomach inflation were lower when a mouth-to-mask or a face shield device was employed. Regular training is therefore required to retain ventilation skills; retention of skills may be better with ventilation devices.

A randomised crossover comparison of mouth-to-face-shield ventilation and mouth-to-pocket-mask ventilation by surf lifeguards in a manikin

“…In contrast to our results, one study showed no differences in the delivered tidal volume, degree of stomach inflation and peak airway pressure among high school students using MFV and MPV [12]. Another study reported a reduced tidal volume with MFV compared with MPV, but laypersons using MFV were still able to achieve ventilation with a tidal volume of 0.69 l [13].…”

Cardiopulmonary Resuscitation Quality by Helicopter Rescue Swimmers While Flying

“…The use of a pocket mask with a good technique that could limit air leaks could also explain the excessive ventilations observed, as was found in another study. 27 We speculate that in real victims, namely after drowning with poor compliance lungs, HRSs would deliver lower tidal volumes that could fit within the 500-to 600-mL recommended range. Unfortunately, it would be very difficult to record tidal volumes in real victims rescued by HRSs and transported by helicopter to contrast this hypothesis.…”

Should the Neopuff T‐piece resuscitator be restricted to frequent users?

“…It is not surprising that the ability to use the Neopuff adequately in the areas of infrequent resuscitation is poor, as many studies have shown a deterioration in resuscitation skills in the absence of regular use of these skills (6–8). Similarly, the NRP has highlighted poor retention of skills beyond 6 months (9).…”