Can first responders achieve and maintain normocapnia when sequentially ventilating with a bag-valve device and two oxygen-driven resuscitators? A controlled clinical trial in 104 patients
Background and objective: To evaluate the capability of first responders to achieve and maintain normal ventilation of the lungs of victims employing a bag-valve device and two oxygen-driven resuscitators.
Methods: Prospective, controlled, blinded, single-centre clinical trial using a bag-valve device and one of two FR-300® devices, with 20 cmH2O working pressure, and flows of either 24 or 30L min−1. One hundred and four patients were analysed. Induction of anaesthesia followed by ventilation of the lungs with a bag-valve device and an Oxylator® in manual and automatic modes performed by a fireman first responder. Each series was repeated for three conditions (anaesthesia; anaesthesia plus muscle relaxation, both with facemask; anaesthesia plus relaxation using an endotracheal tube).
Results: Patients age 49 ± 17 yr; 47% males, 48–132 kg. Normocapnia was achieved and maintained in 66% (bag-valve device), 82% (Oxylator®).
Conclusions: The use of an oxygen-driven device improves the ability of first responders to achieve and maintain normocapnia even when distracted. Use of the Oxylators® improves performance (P < 0.001) vs. the bag-valve device significantly.(Accepted October 2003)
Key Words: EQUIPMENT AND SUPPLIES, ventilators, mechanical; EMERGENCY TREATMENT, respiration artificial, first aid; HEALTHCARE QUALITY ASSESSMENT AND EVALUATION, technology assessment, biomedical.
c1 Correspondence to: Gerrit Noordergraaf, Department of Anaesthesiology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 GC Tilburg, The Netherlands. E-mail: firstname.lastname@example.org; Tel: +31 (0)13 539 1313 (beeper 6440); Fax: +31 (0)13 504 4926