Bag Valve Mask Ventilation as a Perceptual-Cognitive Skill

Area of Science:

• Pediatric emergency medicine
• Respiratory therapy
• Human factors engineering

Background:

• Bag valve mask ventilation (BVMV) is crucial for pediatric respiratory emergencies.
• Effective BVMV delivery is inconsistent among healthcare providers.
• The role of visual feedback in guiding BVMV performance is under-explored.

Purpose of the Study:

• To investigate how provider experience influences the use of visual feedback during infant BVMV.
• To determine the relationship between feedback utilization and BVMV quality.

Main Methods:

• High-fidelity infant mannequin simulations were used.
• Six expert and six novice respiratory therapists participated.
• Ventilation rates, eye movements, and verbal reports were measured with and without SpO2 feedback.

Main Results:

• Novices over-relied on electronic vital signs, leading to faster ventilation rates when SpO2 feedback was absent.
• Experts maintained recommended ventilation rates and utilized direct patient observation more when SpO2 was unavailable.
• Individual differences in feedback use correlated with BVMV quality.

Conclusions:

• Provider experience significantly impacts feedback utilization during BVMV.
• Effective BVMV quality is influenced by how providers integrate technological and direct observational cues.
• Findings have implications for training novice providers in pediatric respiratory emergencies.