Crossover assessment of intraoral and cuffed ventilation by emergency responders

Bernadette McCrory, Bethany R. Lowndes, Darcy L. Thompson, Michael C. Wadman, Matthew D. Sztajnkrycer, Richard Walker, Carol S. Lomneth, M. Susan Hallbeck

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)310-317
Number of pages8
JournalMilitary medicine
Volume184
DOIs
StatePublished - Mar 1 2019

Fingerprint

Emergency Responders
Masks
Ventilation
Workload
Equipment and Supplies
Emergency Medical Technicians
Allied Health Personnel
Airway Management
Human Engineering
Tidal Volume
Nose
Cadaver
Resuscitation
Upper Extremity
Mouth

Keywords

  • EMT
  • paramedic
  • tidal volume
  • usability
  • workload

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Crossover assessment of intraoral and cuffed ventilation by emergency responders. / McCrory, Bernadette; Lowndes, Bethany R.; Thompson, Darcy L.; Wadman, Michael C.; Sztajnkrycer, Matthew D.; Walker, Richard; Lomneth, Carol S.; Hallbeck, M. Susan.

In: Military medicine, Vol. 184, 01.03.2019, p. 310-317.

Research output: Contribution to journalArticle

McCrory, Bernadette ; Lowndes, Bethany R. ; Thompson, Darcy L. ; Wadman, Michael C. ; Sztajnkrycer, Matthew D. ; Walker, Richard ; Lomneth, Carol S. ; Hallbeck, M. Susan. / Crossover assessment of intraoral and cuffed ventilation by emergency responders. In: Military medicine. 2019 ; Vol. 184. pp. 310-317.
@article{658315645e354ef7993b643583450ece,
title = "Crossover assessment of intraoral and cuffed ventilation by emergency responders",
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.",
keywords = "EMT, paramedic, tidal volume, usability, workload",
author = "Bernadette McCrory and Lowndes, {Bethany R.} and Thompson, {Darcy L.} and Wadman, {Michael C.} and Sztajnkrycer, {Matthew D.} and Richard Walker and Lomneth, {Carol S.} and Hallbeck, {M. Susan}",
year = "2019",
month = "3",
day = "1",
doi = "10.1093/milmed/usy304",
language = "English (US)",
volume = "184",
pages = "310--317",
journal = "Military Medicine",
issn = "0026-4075",
publisher = "Association of Military Surgeons of the US",

}

TY - JOUR

T1 - Crossover assessment of intraoral and cuffed ventilation by emergency responders

AU - McCrory, Bernadette

AU - Lowndes, Bethany R.

AU - Thompson, Darcy L.

AU - Wadman, Michael C.

AU - Sztajnkrycer, Matthew D.

AU - Walker, Richard

AU - Lomneth, Carol S.

AU - Hallbeck, M. Susan

PY - 2019/3/1

Y1 - 2019/3/1

N2 - 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.

AB - 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.

KW - EMT

KW - paramedic

KW - tidal volume

KW - usability

KW - workload

UR - http://www.scopus.com/inward/record.url?scp=85063669325&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063669325&partnerID=8YFLogxK

U2 - 10.1093/milmed/usy304

DO - 10.1093/milmed/usy304

M3 - Article

C2 - 30901420

AN - SCOPUS:85063669325

VL - 184

SP - 310

EP - 317

JO - Military Medicine

JF - Military Medicine

SN - 0026-4075

ER -