The Combibag: an evaluation of a new self-inflating resuscitator

The Combibag self-inflating resuscitator incorporates an adult and a paediatric segment as well as a two-stage pressure-limiting safety valve. The resuscitator is not without problems. A sizeable forward leak of gas can occur beyond the patient valve. The patient valve design is such that a spontaneously breathing patient draws his inspired gas entirely from room air. Problems can also occur with the valve either sticking or being blown forward off its seating, thereby making the resuscitator inoperable and dangerous. The use of a two-stage pressure-limiting safety valve should prevent unnecessary barotrauma but could well lead to unrecognised venting with inadequate ventilation when used by inexperienced personnel.