(P2-85) Automatic vs. Manual Bag Valve Resuscitation: An Experimental Bench Test

Abstract

Introduction

Efficiency of resuscitation has been fewly assessed. The aim of our study was to compare standard manual to automatic ventilation using a new device.

Methods

5 categories of healthcare professionals were included (paramedics, nurses, respiratory therapists, senior and junior emergency physicians; n = 10 in each group) and they evaluated 2 different apparatus: manual bag valve (BVM) and automated resuscitator (EasyCPR, Weinman). The experimental bench test consisted in an artificial test lung (ASL5000, IngmarMed), simulating 3 pathological status (COPD, ALI, ASA) and connected to a resuscitation-training manikin for the interface with the mask. Recorded parameters were: tidal volume (Vt), Peak Inspiratory Pressure (PIP), Residual Volume (Vr), overall distension (Vt + Vr), respiratory rate (RR). The ergonomy of the device was assessed at the end of each sequence (1–very uneasy à 5–very easy to use).

Results

Mean Vt reached the goal (400–600 ml) for only 26% [0, 6–45] of the cycles with BVM and 29% [0, 3–80] with the CPR. Within a same pathological status, PIP was higher with BVM (21 ± 17 cmH2O), as compared to CPR (11 ± 3 cmH2O; p < 0.001). Mean RR was 18 ± 6 C/minute with BVM and 10 ± 2 C/minute with CPR. Overall distension was significantly higher with BVM (491 ± 328 ml; up to 1750 ml), as compared to CPR (380 ± 168 ml; p < 0.001). Ergonomy of CPR was considered better for paramedics and nurses (p < 0.05).

Conclusion

BVM resuscitation does not allow reaching the standards in terms of Vt and RR, and may expose to overpressure (gastric distension) and thoracic overinflation. Automatic resuscitation (CPR) may standardize emergency ventilation, allowing a better fit to recommendations and an ergonomy enhancement.