Using gel for difficult mask ventilation on the bearded patients: a simulation-based study

Area of Science:

• Medical Devices
• Respiratory Care
• Anesthesiology

Background:

• Beards commonly cause air leaks during mask ventilation, complicating respiratory support.
• Existing methods to mitigate beard-related air leaks have limitations.
• A novel technique involves applying a gel to the mask edge to improve seal.

Purpose of the Study:

• To evaluate the efficacy of a gel technique in improving mask ventilation in bearded simulation models.
• To assess the comfort level of healthcare providers using the gel technique.

Main Methods:

• A randomized crossover study design was employed.
• Respiratory therapists (RTs) performed mask ventilation on a bearded simulation model for 2 minutes.
• Ventilation efficacy was measured by tidal volume (TV) and successful ventilation attempts, with and without gel application.

Main Results:

• Median TV significantly increased from 283 mL without gel to 467 mL with gel (p < 0.01).
• The proportion of successful ventilations increased by 65% (95% CI 51-75%, p < 0.01) with the gel.
• The gel technique was found to be comfortable or natural by the vast majority of participants.

Conclusions:

• Applying gel to mask edges is an effective method to improve mask ventilation in bearded individuals.
• The gel technique enhances ventilation efficacy without negatively impacting provider comfort.
• Further research and education on this basic airway management technique are recommended.