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Randomized Controlled Trial Clinical Trial
Airway management by first responders when using a bag-valve device and two oxygen-driven resuscitators in 104 patients.
- G J Noordergraaf, P J van Dun, B P Kramer, M P Schors, H P Hornman, W de Jong, and A Noordergraaf.
- St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands. g.noordergraaf@elisabeth.nl
- Eur J Anaesthesiol. 2004 May 1;21(5):361-6.
Background And ObjectiveTo evaluate the capability of first responders to ensure an airway and ventilate the lungs of a patient employing a bag-valve device and two oxygen-driven resuscitators.MethodsProspective, controlled, blinded, single-centre clinical trial using a bag-valve device and one of two FR-300 devices, with 20 cmH2O working pressure, flows of 24 and 30 L min(-1). One-hundred-and-four patients were analysed. Induction of anaesthesia was followed by ventilation of the lungs with a bag-valve device and an Oxylator (CPR Medical Devices Corp., Markham, Ontario, Canada) in manual and automatic modes. Each series was repeated twice by a fireman first responder using a hand-held mask to seal the airway, once under anaesthesia and then again under anaesthesia with muscle relaxation.ResultsPatients' mean age 49 +/- 17 yr; 47% male, 48-132 kg. Only 29% had optimal facial and airway physiognomy. Airway management was significantly poorer when the bag-valve device was used than with either Oxylator mode (P < 0.0001); 23% of cases were not manageable with the bag-valve device. Gastric insufflation was markedly less with the Oxylator (P < 0.02).ConclusionsThe use of an oxygen-driven device improves the ability of first responders to secure an airway and reduce gastric insufflation, even when distracted. Oxylators perform significantly better (P < 0.0001) than the bag-valve device.
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