• Ron Ben-Abraham, Ilan Gur, Ephraim Bar-Yishay, Guy Lin, Amir Blumenfeld, Boaz Kalmovich, and Avi A Weinbroum.
• Department of Anesthesiology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel.
• J Crit Care. 2004 Mar 1; 19 (1): 36-41.

ObjectivesTo evaluate the speed by which cuirass application, followed by biphasic extra-thoracic ventilation, can be instituted by full anti-chemical protective gear-wearing physicians.Materials And MethodsTen physicians of variable subspecialties applied a cuirass on an adult volunteer and instituted biphasic extra-thoracic ventilation, using the RTX respirator (Medivent, London, UK). Endotracheal (ET) intubation and manual ventilation of a mannequin and its ventilation was comparatively assessed. Performances were conducted in a prospective, crossover, randomized manner. Times to successful applications as well as failure rates were recorded.ResultsCuirass application was performed more rapidly (102 +/- 9 s, 177 +/- 31 s, respectively, P <.01) and with a slightly lower failure rate than ET intubation.ConclusionsPhysicians wearing full anti-chemical protective gear applied the cuirass and instituted biphasic extra-thoracic ventilation faster than ET intubation and manual positive pressure ventilation. Extra-thoracic ventilation should be further evaluated as an option for emergent respiratory support during toxic mass casualty events.

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