Paeds BVM for adult resuscitation

July 3, 2011 by  
Filed under Acute Med, All Updates, EMS, ICU, Resus

Three hand-ventilation systems were used in a simulated adult resuscitation to determine the delivered volumes. The mean minute ventilation delivered by each of the three devices investigated was significantly different, with the paediatric (500-ml) self-inflating bag producing the result most consistent with the guideline.

There is a discrepancy between resuscitation teaching and witnessed clinical practice. Furthermore, deleterious outcomes are associated with hyperventilation. We therefore conducted a manikin-based study of a simulated cardiac arrest to evaluate the ability of three ventilating devices to provide guideline-consistent ventilation. Mean (SD) minute ventilation was reduced with the paediatric self-inflating bag (7.0 (3.2) l.min(-1) ) compared with the Mapleson C system (9.8 (3.5) l.min(-1) ) and adult self-inflating bag (9.7 (4.2) l.min(-1) ; p = 0.003). Tidal volume was also lower with the paediatric self-inflating bag (391 (52) ml) compared with the others (582 (87) ml and 625 (103) ml, respectively; p < 0.001), as was peak airway pressure (14.5 (5.2) cmH(2) O vs 20.7 (9.0) cmH(2) O and 30.3 (11.4) cmH(2) O, respectively; p < 0.001). Participants hyperventilated patients' lungs in simulated cardiac arrest with all three devices. The paediatric self-inflating bag delivered the most guideline-consistent ventilation. Its use in adult cardiopulmonary resuscitation may ensure delivery of more guideline-consistent ventilation in patients with tracheal intubation.

Comparison of the Mapleson C system and adult and paediatric self-inflating bags for delivering guideline-consistent ventilation during simulated adult cardiopulmonary resuscitation
Anaesthesia. 2011 Jul;66(7):563-7

Comments

4 Responses to “Paeds BVM for adult resuscitation”

  1. Christopher on July 4th, 2011 12:53

    I’ve always thought about doing that when I’ve got an overactive bagger at the helm. Perhaps they could study giving 0.5 mg ativan and adult BVMs to the person responsible for ventilations.

  2. Cliff on July 4th, 2011 19:59

    ‘Ativan’ of course being lorazepam for the majority of our readers ;o)

  3. precordialthump on July 6th, 2011 02:16

    I once got hand a neonatal BVM kit while resus’ing a 14 year old – not a great option… stayed with mout-to-mouth til the cavalry arrived…
    C

  4. The LITFL Review 026 - Life in the FastLane Medical Blog on July 15th, 2011 03:11

    […] Paeds BVM for adult resuscitation may help to deliver more guideline-consistent ventilation in patients with tracheal intubation. […]