Comparison of Three Techniques on Facility of Bag-Mask Ventilation: Thenar Eminence, E-O and E-C

Abstract

BackgroundRapid and secure management of airway is an important lifesaving intervention in critically ill patients at emergency wards. Training undergraduate students about airway management must be regarded as a priority in their education period. The aim of the present study was to compare the quality of three ventilation techniques with a bag and mask among two groups of undergraduate students (Novices) and senior group (Experienced) in Tabriz University of Medical Sciences.MethodsThis study was a mannequin type research that was carried out in the faculty of medicine, Tabriz University of Medical Sciences. The study population consisted of two elementary groups (Novices) and senior group (Experienced). The number of participants included 100 individuals. Ventilation quality by bag and mask in two groups was recorded based on the rise of lungs and two reviewers' opinions who gave a score from 1 as weak to 4 as excellent using three techniques of E-C, E-O, and Thenar Eminence. In the E-C technique, index fingers and thumbs form two “C”s facing each other while the remaining fingers lift the mandible and form two “E”s. In E-O techniques, the web between thumb and index finger is used to form a circle around the neck of the mask while other fingers perform a chin lift. In thenar eminence techniques, the thenar eminence and thumb are placed on the top of the mask while other fingers perform jaw thrust.ResultsIn our study, 27% of undergraduate participants and 59% of seniors were male and the others were female. The mean of age of elementary and seniors were 24 and 33.5, respectively (P < 0.05). E-O technique was well done by the novices group.ConclusionsBased on our results, it was concluded that the elementary group performed E-O bag and mask ventilation technique appropriately. Therefore, it can be suggested that training of this technique will be placed in educational curriculum of undergraduate students.

Tidal volume according to the 4-point sealing forces of a bag-valve-mask: an adult respiratory arrest simulator-based prospective, descriptive study

“…The average C length in this study was 7.54 cm, with a longer C length being associated with a greater TV; however, a previous study [ 14 ] reported that the EO technique, where the distance from the thumb to the index finger is 0 cm, provided more TV than the EC technique. In the novice group, BVM ventilation was more effective using the EO technique than using the thenar eminence or the EC technique [ 15 ]. Traditionally, the EC grip has been recommended for effective BVM ventilation by the AHA guidelines.…”

Evaluation the quality of Bag-Mask Ventilation by E/C, T/E and Hook technique (a new proposed technique)

“…We will review different techniques for doing BMV to reach a general conclusion. In another study, Soleimanpour M, et al (7). compared three techniques on Facility of Bag-Mask Ventilation: Thenar Eminence, E-O, and E-C.…”

Management of the Difficult Airway

“…Holding a mask seal with a thenar approach compared with the E-C technique may also improve ventilation as shown in Figure 1. Similarly, when personnel resources allow, a 2-provider masking technique can improve ventilation 51–53 . If abdominal distension is contributing to difficulty delivering assisted breaths, gastric decompression can help facilitate diaphragmatic excursion, provided that decompression attempts do not interfere with other airway management efforts.…”