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An Evaluation of Emergency Medical
Technicians' Ability to Use Manual Ventilation Devices.
Elling
R, Politis J Annals of Emergency Medicine 1983 Vol. 12.
Pages 765-768.
Three hundred and twenty Emergency Medical Technicians (238
males and 82 females) were tested for the ability to ventilate
a pre-calibrated Laerdal Recording Resusci-Anne using both
a bag-valve-mask and pocket mask ventilator. The majority of
participants were members of volunteer ambulance services (222-70.2%),
while the remaining rescuers came from both private ambulance
services (41-12.9%) and municipal police and fire departments
(53-16.7%). 67.4% were certified as EMT's for more than three
years, 22.7% for more than one year but less than three, while
the remaining 11% were certified less than one year. 76.5%
had never used the pocket mask previously. Having been given
time to read the package instructions, all participants were
asked to ventilate the mannequin using the Laerdal pocket mask
while the tester recorded the first six ventilation attempts.
Each rescuer was then given a choice from among five different
brands of BVMs (Laerdal, PMR-2, Ohio Hope-2, Ambu, and Robertshaw)
and was asked to pick the one he/she felt most comfortable
using. Only one brand of mask that would definitely attain
a seal if correct technique was applied was used with all the
BVMs. The participants then again ventilated the mannequin
with the first six ventilation attempts recorded. More than
50% of the EMTs were not capable of ventilating to the minimum
standard (800 ml tidal volume) using a bag-valve-mask. The
mean tidal volume for all BVMs was 641ml, well below the minimum
standard. The study demonstrates that the pocket mask method
is far superior to the bag-valve-mask method, mean tidal volume
for the pocket mask being 999 ml. The authors recommend that
if these experimental results are confirmed by clinical findings,
future educational courses should teach the bag-valve-mask
as a four-hand/two-person skill, with one rescuer squeezing
the bag with both hands and the second rescuer maintaining
hyperextension. |
