Impact of Real-Time Feedback Devices on Paramedic Bag-Valve-Mask Ventilation Performance

Ventilation using a self-expanding bag and face mask poses important challenges, even for experienced healthcare professionals. Several devices have been developed and introduced to the market with the aim of improving the quality of bag-valve-mask (BVM) ventilation. The objective of this study was to evaluate whether the use of a real-time ventilation feedback device (VFD) influences ventilation quality.

This study recruited one hundred paramedics to perform manual ventilation on a high-fidelity manikin using a BVM, first without and subsequently with the VFD. Participants received a brief instruction on the use of VFDs. Each ventilation session lasted four minutes and was performed twice under both conditions. Ventilation parameters, including tidal volume and ventilation rate, were recorded using the SimMan manikin and LLEAP software.

Significant differences in ventilation parameters were observed between the two conditions. Ventilation without the VFD was associated with a higher mean tidal volume (390.1 mL vs. 373.9 mL, p < 0.001) and a higher mean ventilation rate (8.9 breaths per minute [bpm] vs. 8.1 bpm, p < 0.001). Minute ventilation was also significantly greater without the VFD (3504.0 mL vs. 3118.8 mL, p < 0.001). Despite these differences, the use of the VFD led to a slight improvement in compliance with European Resuscitation Council (ERC) ventilation guidelines, increasing the rate of correct ventilations from 1% to 3%.

While the use of the VFD was associated with reductions in tidal volume and ventilation rate, it resulted in a modest improvement in adherence to ERC ventilation guidelines. The clinical impact of this device remains unclear. Future studies can focus on novel/innovative ways to enhance compliance with established ventilatory parameters.