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Six-Hour Manual Ventilation with a Bag-Valve-Tube Device by Briefly Trained Non-Medical Personnel is Feasible

Published online by Cambridge University Press:  01 June 2020

Nana Maklada ,
Malka Katz Shalhav Open the ORCID record for Malka Katz Shalhav [Opens in a new window] ,
Emanuele Lagazzi  and
Pinchas Halpern
Nana Maklada
Affiliation:
Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Malka Katz Shalhav
Affiliation:
Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Emanuele Lagazzi
Affiliation:
University of Genoa, School of Medical and Pharmaceutical Sciences, Genova, Italy
Pinchas Halpern*
Affiliation:
Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
*
Correspondence: Pinchas Halpern, MD Chair, Division of Emergency Medicine, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv6423906, Israel, E-mail: dr_halperin@tlvmc.gov.il
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Abstract

Rationale:

Manual ventilation with a bag-valve device (BVD) is a Basic Life Support skill. Prolonged manual ventilation may be required in resource-poor locations and in severe disasters such as hurricanes, pandemics, and chemical events. In such circumstances, trained operators may not be available and lay persons may need to be quickly trained to do the job.

Objectives:

The current study investigated whether minimally trained operators were able to manually ventilate a simulated endotracheally intubated patient for six hours.

Methods:

Two groups of 10 volunteers, previously unfamiliar with manual ventilation, received brief, structured BVD-tube ventilation training and performed six hours of manual ventilation on an electronic lung simulator. Operator cardiorespiratory variables and perceived effort, as well as the quality of the delivered ventilation, were recorded. Group One ventilated a “normal lung” (compliance 50cmH2O/L, resistance 5cmH2O/L/min). Group Two ventilated a “moderately injured lung” (compliance 20cmH2O/L, resistance 20cmH2O/L/min).

Results:

Volunteers’ blood pressure, heart rate (HR), respiratory rate (RR), and peripheral capillary oxygen saturation (SpO2) were stable throughout the study. Perceived effort was minimal. The two groups provided clinically adequate and similar RRs (13.3 [SD = 3.0] and 14.1 [SD = 2.5] breaths/minute, respectively) and minute volume (MV; 7.6 [SD = 2.1] and 7.7 [SD = 1.4] L/minute, respectively).

Conclusions:

The results indicate that minimally trained persons can effectively perform six hours of manual BVD-tube ventilation of normal and moderately injured lungs, without undue effort. Quality of delivered ventilation was clinically adequate.

Keywords

bag-valve-tube devicedisastermanual ventilationminimally trained operatorsterrorism
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 4 , August 2020 , pp. 358 - 363
Copyright
© World Association for Disaster and Emergency Medicine 2020

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