Pulmonary resuscitators

We evaluated 22 exhaled-air pulmonary resuscitators (EAPRs) of two types (Type I, face mask--17 units from 15 manufacturers; Type II, face shield--5 units from 4 manufacturers) and 13 disposable manual (bag-mask) pulmonary resuscitators (DMPRs) of three sizes (adult--7 units from 7 manufacturers, child--4 units from 4 manufacturers, and infant--2 units from 2 manufacturers. Our ratings and rankings of EAPRs were based on their effectiveness as a breathing adjunct and as a barrier between the resucer and patient, on the ease with which they established an effective seal, and on their design and ease of use. Most Type I EAPRs were rated Acceptable; one was rated Acceptable-Not Recommended. Most Type II EAPRs were rated Conditionally Acceptable; one was rated Conditionally Acceptable-Not Recommended; and one was rated Unacceptable because it has high flow resistance. Our ratings and rankings of DMPRs were based on their performance during CPR, particularly their ability to achieve adequate compression rates in all climates (which could affect their usefulness in emergency situations) and their supplemental oxygen capacity, as well as on their design and ease of use. Of the adult models, three were rated Acceptable; two were rated Conditionally Acceptable; and two were rated Conditionally Acceptable-Not Recommended. All of the child and infant units were rated Acceptable.