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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

Published online by Cambridge University Press:  23 December 2004

G. J. Noordergraaf ,
P. J. van Dun ,
B. P. Kramer ,
M. P. Schors ,
H. P. Hornman ,
W. de Jong  and
A. Noordergraaf
G. J. Noordergraaf
Affiliation:
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands
P. J. van Dun
Affiliation:
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands
B. P. Kramer
Affiliation:
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands
M. P. Schors
Affiliation:
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands
H. P. Hornman
Affiliation:
Fire Department, City of Tilburg, Tilburg, The Netherlands
W. de Jong
Affiliation:
St. Elisabeth Hospital, Department of Clinical Physics EN Tilburg, The Netherlands
A. Noordergraaf
Affiliation:
University of Pennsylvania, Departments of Bioengineering and Anaesthesiology, PA, USA
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Abstract

Summary

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.

Keywords

EQUIPMENT AND SUPPLIES, ventilators, mechanicalEMERGENCY TREATMENT, respiration artificial, first aidHEALTHCARE QUALITY ASSESSMENT AND EVALUATION, technology assessment, biomedical
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 5 , May 2004 , pp. 367 - 372
Copyright
2004 European Society of Anaesthesiology

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