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Emergency Medical Services Responder Manual Ventilation Performance.
Samantha A Ni1, Randy S Carpenter2, J Richard Walker3
1Department of Emergency Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
Prehospital Emergency Care
|April 20, 2022
Summary
Emergency medical services responders show significant variability in manual ventilation, with most exceeding safe limits. Two-hand ventilation was linked to higher pressures and volumes, highlighting a need for bag-valve-mask improvements.
Area of Science:
- Emergency Medicine
- Respiratory Care
- Medical Device Technology
Background:
- Manual ventilation is a critical skill for emergency medical services (EMS) responders.
- Current methods lack feedback mechanisms for volume, pressure, or frequency control.
- Improper manual ventilation can lead to patient morbidity.
Purpose of the Study:
- To quantify the delivered volume and peak pressures during manual ventilation by EMS responders.
- To assess the variability and identify factors influencing ventilation parameters.
- To evaluate the effectiveness of current bag-valve-mask (BVM) techniques.
Main Methods:
- 199 EMS responders participated, manually ventilating a simulated lung with a BVM for 18 breaths.
- Peak pressures (Ppeak) and tidal volumes (VT) were recorded.
- Multivariable linear regression analyzed correlations between ventilation parameters and various factors.
Main Results:
- High variability in delivered Ppeak and VT was observed.
- 82.9% of clinicians exceeded safety thresholds for at least one breath.
- Two-hand ventilation was associated with significantly higher Ppeak and VT.
Conclusions:
- Significant variability exists in manual ventilation techniques among EMS responders.
- The use of two hands versus one hand appears to be a clinically significant factor.
- Improvements in BVM design are needed to ensure safe and effective ventilation delivery.
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