Crossover Assessment of Intraoral and Cuffed Ventilation by Emergency Responders. (21st March 2019)

• Record Type: Journal Article
• Authors: McCrory, Bernadette; Lowndes, Bethany R; Thompson, Darcy L; Wadman, Michael C; Sztajnkrycer, Matthew D; Walker, Richard; Lomneth, Carol S; Hallbeck, M Susan
• Is Part Of: Military medicine. Volume 184(2019)Supplement 1
• Page Start: 310
• Page End: 317
• Publication Date: 2019-03-21
• Subjects: EMT -- paramedic -- tidal volume -- workload -- usability; Surgery, Military -- Societies, etc; Medicine, Military -- Societies, etc; Medicine, Military -- Periodicals; Surgery, Military -- Periodicals; Medicine, Military; Surgery, Military; Military Medicine -- Periodicals; Periodicals; Electronic journals; 616.98023
• DOI: 10.1093/milmed/usy304
• Languages: English
• ISSNs: 0026-4075

Abstract

Abstract: Objectives: A cuffed bag valve mask (BVM) is the most common device used by emergency medical responders to ventilate patients. The BVM can be difficult for users to seal around the patient's mouth and nose. An intraoral mask (IOM) with snorkel-like design may facilitate quicker and better ventilation particularly under austere conditions. Methods: Both a BVM and IOM were utilized by 27 trained emergency medical technicians and paramedics to ventilate a lightly embalmed cadaver. Ventilation efficacy, workload, and usability were assessed for both devices across four study conditions. Results: The IOM was superior to the BVM in delivered tidal volume ratio (measure of leak, p < 0.03) and minute ventilation ( p < 0.0001). Workload, ergonomic and usability assessments indicated that the IOM facilitated gripping through the reduced hand interface size ( p < 0.01), decreased user effort ( p < 0.001), and reduced upper limb workload ( p = 0.0088). Conclusions: In the assessed model, the IOM represented a better choice for airway management than the standard cuffed BVM. An emergency medical device that is intuitive, efficacious and less demanding has the potential to reduce responder stress and improve resuscitation efforts, especially during austere rescue and patient transport.