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Application of a cuirass and institution of biphasic extra-thoracic ventilation by gear-protected physicians
Ron Ben-Abraham1, Ilan Gur, Ephraim Bar-Yishay
1Department of Anesthesiology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel.
Objectives:
To evaluate the speed by which cuirass application, followed by biphasic extra-thoracic ventilation, can be instituted by full anti-chemical protective gear-wearing physicians.
Materials And Methods:
Ten physicians of variable subspecialties applied a cuirass on an adult volunteer and instituted biphasic extra-thoracic ventilation, using the RTX respirator (Medivent, London, UK). Endotracheal (ET) intubation and manual ventilation of a mannequin and its ventilation was comparatively assessed. Performances were conducted in a prospective, crossover, randomized manner. Times to successful applications as well as failure rates were recorded.
Results:
Cuirass application was performed more rapidly (102 +/- 9 s, 177 +/- 31 s, respectively, P <.01) and with a slightly lower failure rate than ET intubation.
Conclusions:
Physicians wearing full anti-chemical protective gear applied the cuirass and instituted biphasic extra-thoracic ventilation faster than ET intubation and manual positive pressure ventilation. Extra-thoracic ventilation should be further evaluated as an option for emergent respiratory support during toxic mass casualty events.
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