Evaluation of bag-valve-mask ventilation in simulated toxic environments

Bag-valve-mask ventilation is a key component of life support, but only one handheld resuscitator is designed to operate in contaminated or toxic atmospheres. Following Institutional Review Board approval we determined the efficacy of this device. Twenty anaesthetists ventilated a modified manikin, either with or without a combination filter attached to the resuscitator inlet. The mean (SD) maximum minute volume achieved without the filter was 9.3 (3.1) l x min(-1). Use of the inlet filtration system reduced the maximum minute volume significantly to 6.4 (2.2) l x min(-1) (reduction of 30%, p = 0.0017). The achieved maximum minute volumes ranged from 13.4 to 4 l x min(-1) in the controls and from 9.5 to 3 l x min(-1) in the filter group. The delay in refilling of the self-inflatable bag may have resulted in reduced achievable minute volumes. The range of the maximum minute volumes in both groups highlights the need for continuous bag-valve-mask ventilator training.