Face mask ventilation: a comparison of three techniques.

Area of Science:

• Emergency Medicine
• Respiratory Care
• Airway Management

Background:

• Multiple face-mask (FM) ventilation techniques exist.
• Previous studies compared one-handed versus two-handed C-E techniques in pediatric and adult populations.
• No studies have directly compared various two-handed FM ventilation methods.

Purpose of the Study:

• To compare the effectiveness of three FM ventilation techniques on a simulated difficult airway model.
• To measure ventilation performance, including mask seal, volume, and pressure.

Main Methods:

• Prospective randomized study involving healthcare providers.
• Utilized a modified airway-training mannequin with variable resistance.
• Subjects performed three FM ventilation techniques (one-handed C-E, two-handed C-E, two-handed V-E) for 3 minutes each.
• Measured median exhaled tidal volume and proximal peak flow pressure.

Main Results:

• Seventy subjects participated in the study.
• Both two-handed techniques (C-E and V-E) were significantly more effective than the one-handed C-E technique in terms of volume and pressure.
• Median volumes: 428.4 mL (one-handed C-E) vs. 550.8 mL (two-handed C-E) and 538 mL (two-handed V-E).
• Median peak pressures: 54.6 cm H2O (one-handed C-E) vs. 66 cm H2O (two-handed C-E) and 66.6 cm H2O (two-handed V-E).
• No significant difference was found between the two two-handed techniques.

Conclusions:

• The developed model effectively differentiates the efficacy of FM ventilation techniques.
• Two-handed FM ventilation methods are superior to one-handed techniques.
• Two-handed ventilation methods should be considered for inclusion in healthcare provider airway training programs.