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Nurses' ability to achieve hyperinflation and hyperoxygenation with a manual resuscitation bag during endotracheal
C Glass1, M J Grap, M C Corley
1Medical College of Virginia Hospitals, Richmond.
Objective:
To examine nurses' ability to deliver 1.5 times the ventilated tidal volume at 100% FIO2 with a manual resuscitation bag during endotracheal suctioning.
Design:
Prospective, descriptive.
Setting:
Six adult critical care units in a large university-affiliated medical center.
Subjects:
One hundred nurses randomly selected from the six adult intensive care units.
Outcome Measures:
Nurses' manual resuscitation bag delivery of tidal volume and oxygen, as well as bagging rate, number of breaths delivered, and number of suction catheter passes performed. Patients' heart rate, mean arterial pressure, and arterial oxygen saturation.
Results:
The mean FIO2 delivered was 0.71 (range 0.24 to 0.97). Oxygen liter flow and nurses' delivered minute ventilation predicted 24% of the variance in FIO2 delivered. Mean bagging rate was 31 compressions per minute. The mean volume per breath delivered was 626 cc, which resulted in achievement of 57% of the standard (1128 cc). Volume achieved was related to patient lung compliance, but not related to nurses' experience, unit of employment, hand strength, or size.
Conclusions:
Nurses observed were unable to meet the standard for volume or oxygen delivery. However this did not affect the patient's heart rate, mean arterial pressure, or SaO2.