Validity Evidence for a Novel, Comprehensive Bag–Mask Ventilation Assessment Tool

Whalen, Allison; Merves, Matthew; Kharayat, Priyanka; Barry, James; Glass, Kristen; Berg, Robert A.; Sawyer, Taylor; Boyer, Donald; Nishisaki, Akira

doi:10.1016/j.jpeds.2022.02.017

Cited by 8 publications

(5 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interventions to close existing knowledge gaps should focus on summarizing existing medical literature on benefits of premedication, pharmacokinetics/ pharmacodynamics of premedication agents and their side effects, and use of reversal agents. To complement these sessions, simulation-based opportunities to practice both technical aspects of airway management (including bagvalve mask ventilation, intubation, and use of alternative airways or modes, such as videolaryngoscopy [14][15][16] ) with a goal of performance improvement, as well as logistical aspects of drawing up and administering premedication correctly, may incorporate opportunities to manage medication-related side effects or procedural challenges (such as chest wall rigidity or an unexpectedly difficult airway requiring use of an adjunct device), and facilitate optimal teamwork and communication. Additionally, sharing centerspecific data compared with multicenter data published through the international NEAR4NEOs database may be another strategy to address knowledge gaps and dispel fears (https://pubmed.ncbi.nlm.nih.gov/?term¼near4neos).…”

Section: Discussionmentioning

confidence: 99%

Assessing Barriers to Utilization of Premedication for Neonatal Intubation Based on the Theoretical Domains Framework

Lee¹,

Bruno

Sharifi

et al. 2023

Am J Perinatol

View full text Add to dashboard Cite

Objective This study aimed to identify barriers and facilitators of premedication utilization for nonemergent neonatal intubations (NIs) in a level IV neonatal intensive care unit (NICU). Study Design Between November 2018 and January 2019, multidisciplinary providers at a level IV NICU were invited to participate in an anonymous, electronic survey based on Theoretical Domains Framework to identify influences on utilization of evidence-based recommendations for NI premedication. Results Of 186 surveys distributed, 84 (45%) providers responded. Most agreed with premedication use in the following domains: professional role/identity (86%), emotions (79%), skills (72%), optimism (71%), and memory, attention, and decision process (71%). Domains with less agreement include social influences (42%), knowledge (57%), intention (60%), belief about capabilities (63%), and behavior regulation (64%). Additional barriers include environmental context and resources, and beliefs about consequences. Conclusion Several factors influence premedication use for nonemergent NI and may serve as facilitators and/or barriers. Efforts to address barriers should incorporate a multidisciplinary approach to improve patient outcomes and decrease procedure-related pain. Key Points

show abstract

Section: Discussionmentioning

confidence: 99%

Assessing Barriers to Utilization of Premedication for Neonatal Intubation Based on the Theoretical Domains Framework

Lee¹,

Bruno

Sharifi

et al. 2023

Am J Perinatol

View full text Add to dashboard Cite

show abstract

“…A checklist based on the International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE) network checklist for neonatal BMV was created for the pediatric population. Training in pediatric medicine shifts toward entrustment-based assessment as competence during unsupervised practice forms the end point of medical training (22). Incorporating such a checklist in basic medical training might be worth considering.…”

Section: Discussionmentioning

confidence: 99%

Bag-mask ventilation by low- or untrained rescuers during adult and pediatric resuscitation: a randomized cross-over manikin study

Borremans,

Geerts,

Coppens

et al. 2023

Front. Disaster Emerg. Med.

View full text Add to dashboard Cite

AimBag-mask ventilation (BMV) is often applied during advanced cardiopulmonary resuscitation (CPR). Lay rescuers usually apply mouth-to-mouth ventilation, which is contraindicated in case of potential disease transmission (e.g., during the COVID-19 pandemic). This study evaluates the influence of rescuers' before BMV training in following the correct BMV procedures during adult and infant CPR.MethodsMedical students (n = 112) were enrolled in a randomized cross-over manikin study: 60 first-year students (53.6%) (untrained, without any prior knowledge of CPR) and 52 fourth-year students (46.4%) (BLS-trained, with three consecutive years of basic CPR training), excluding Basic Life Support (BLS) certificate holders or lifeguards. Student-formed duos (i.e., two students from the same year working together) received a 15-min just-in-time onsite training in full CPR cycle using BMV and were tested during five cycles of 2-person CPR following the European Resuscitation Council (ERC) guidelines with the inclusion of BMV. Tidal volumes of 300–600 ml (adults) and 20–60 ml (infants) were considered as correct ventilations.ResultsFrom the initial 56 duos, 17 (30.4%) were excluded after applying incorrect numbers of ventilation or uninterpretable values. In adult CPR, comparing BLS-trained rescuers to untrained ones in correctly administrating ventilations using BMV after a 15-min just-in-time onsite training revealed no statistically significant difference [first years: 63.0% (n = 136 out of 216 ventilations); fourth years: 59.5% (n = 119 out of 200 ventilations); with a proportional difference of −3.5% (−12.8; 5.9)]. In infant CPR, a significant difference was observed in effective ventilations [first years: 55.5% (n = 120 out of 216 ventilations); fourth years: 72.3% (n = 133 out of 184 ventilations); with a proportional difference of 16.8 (7.25; 26.21)].ConclusionTwo-person BMV is a complex skill to perform both in adults and children, requiring sufficient and regular training. Lay rescuers receiving a 15-min just-in-time onsite BMV training could perform decent BMV in an adult CPR setting. BMV during infant CPR requires more extensive prior training and should not be entrusted to lay rescuers, even after a 15-min just-in-time onsite training.

show abstract

“…Previous authors have reported comparisons of GSA scores on simulation-based assessments to EPA ratings [28,29]. This may provide additional data for EPA assignment, potentially identifying thresholds for entrustment.…”

Section: Relationship Between Checklist Score and Epa Assessmentmentioning

confidence: 99%

Comparison of a dichotomous versus trichotomous checklist for neonatal intubation

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background To compare validity evidence for dichotomous and trichotomous versions of a neonatal intubation (NI) procedural skills checklist. Methods NI skills checklists were developed utilizing an existing framework. Experts were trained on scoring using dichotomous and trichotomous checklists, and rated recordings of 23 providers performing simulated NI. Videolaryngoscope recordings of glottic exposure were evaluated using Cormack-Lehane (CL) and Percent of Glottic Opening scales. Internal consistency and reliability of both checklists were analyzed, and correlations between checklist scores, airway visualization, entrustable professional activities (EPA), and global skills assessment (GSA) were calculated. Results During rater training, raters gave significantly higher scores on better provider performance in standardized videos (both p < 0.001). When utilized to evaluate study participants’ simulated NI attempts, both dichotomous and trichotomous checklist scores demonstrated very good internal consistency (Cronbach’s alpha 0.868 and 0.840, respectively). Inter-rater reliability was higher for dichotomous than trichotomous checklists [Fleiss kappa of 0.642 and 0.576, respectively (p < 0.001)]. Sum checklist scores were significantly different among providers in different disciplines (p < 0.001, dichotomous and trichotomous). Sum dichotomous checklist scores correlated more strongly than trichotomous scores with GSA and CL grades. Sum dichotomous and trichotomous checklist scores correlated similarly well with EPA. Conclusions Neither dichotomous or trichotomous checklist was superior in discriminating provider NI skill when compared to GSA, EPA, or airway visualization assessment. Sum scores from dichotomous checklists may provide sufficient information to assess procedural competence, but trichotomous checklists may permit more granular feedback to learners and educators. The checklist selected may vary with assessment needs.

show abstract

Validity Evidence for a Novel, Comprehensive Bag–Mask Ventilation Assessment Tool

Cited by 8 publications

References 30 publications

Assessing Barriers to Utilization of Premedication for Neonatal Intubation Based on the Theoretical Domains Framework

Assessing Barriers to Utilization of Premedication for Neonatal Intubation Based on the Theoretical Domains Framework

Bag-mask ventilation by low- or untrained rescuers during adult and pediatric resuscitation: a randomized cross-over manikin study

Comparison of a dichotomous versus trichotomous checklist for neonatal intubation

Contact Info

Product

Resources

About