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Retention of Ventilation Skills by Emergency Nurses Three and Six Months After Training: Smart Bag© Compared with Standard Bag.
De Regge Melissa, Vogels C, Calle PA, Monsieurs KG.
Ghent University Hospital , Belgium and Cliniques Universitaires St. Luc, Brussels , Belgium.
ERC Congress Budapest , Hungary September 2004
Published in Resuscitation
The 2000 Guidelines recommend inspiratory times between one and two seconds to reduce gastric insufflation when using Bag-Valve-Mask devices. Studies have shown that the SMART BAG® reduced gastric insufflation because of a pressure/flow responsive valve. However, these studies did not study the retention of ventilation skills after training. We decided to compare the quality of ventilation with a Standard BVM and the SMART BAG® by twenty emergency department nurses in a simulated setting of combined ventilation and chest compression.
A CPR training manikin ( Simulaids , USA ) was fitted with an artificial stomach and a PEEP valve set at 20 cm H20 to simulate the lower oesophageal sphincter pressure. Inspiratory time, airway pressure and ventilation volume were measured (CPRview® Software, Michigan Instruments, USA ). Gastric insufflation was measured with a volume meter ( Medishield , UK ). To assess their base line ventilation skill level, the nurses performed CPR for 2 minutes in pairs with a Standard BVM. Immediately following and after three months, they were re-tested using a Standard BVM and a SMART BAG®. Mean values over 2 minutes are reported. Data from nurses failing to achieve a free airway and any insufflation were excluded.
SMART BAG®, three months after training, generated the longest inspiratory times and good ventilation volumes without gastric insufflation. In contrast, the Standard BVM resulted in shorter inspiratory times, with gastric insufflation continuing to be created by ~32% of the nurses. This data supports the clinical use of the SMART BAG®.
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