Ventilation during cardiopulmonary resuscitation in the infant. Mouth to mouth and nose, or bag-valve-mask? A quasi-experimental study

Santos-Folgar, Myriam; Otero-Agra, Martín; Fernández-Méndez, Felipe; Hermo-Gonzalo, María Teresa; Barcala-Furelos, Roberto; Rodrı́guez-Núñez, Antonio

doi:10.1016/j.anpede.2017.12.005

Cited by 5 publications

(11 citation statements)

References 37 publications

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“…The MMV volume in the adult is highly variable, with a trend towards excessive volumes, in keeping with previous studies [25,27]. With BMV, the values show less variability, with a trend towards insufficient volumes, also in keeping with previous studies [17,25].In the infant, a trend towards adequate volumes with MMV and excessive volumes with BMV are observed, which is also in line with previous studies [20]. Ventilations with excessive volume cause an increase in intrathoracic pressure which affects cardiac output during the compression phase, rendering them less effective [16,29,30].…”

Section: Discussionsupporting

confidence: 91%

“…When BMV was used, the results show significantly lower volumes in the adult and significantly higher ones in the infant. The MMV volume in the adult is highly variable, with a trend towards excessive volumes, in keeping with previous studies [25,27]. With BMV, the values show less variability, with a trend towards insufficient volumes, also in keeping with previous studies [17,25].In the infant, a trend towards adequate volumes with MMV and excessive volumes with BMV are observed, which is also in line with previous studies [20].…”

Section: Discussionsupporting

confidence: 91%

“…With regard to the compression variables, no differences that might have influenced the CPR quality were observed. Nor did any other studies reveal any differences in the compression variables when evaluating different ventilation techniques performed on a manikin [20,25]. The compression values were high quality (higher than 70%) and are in line with the values recommended under current guidelines [1,22,26].…”

Section: Discussionsupporting

confidence: 75%

“…Evidence indicating greater effectiveness using the MMV technique exists In brackets, the effect size calculation with Rosenthal or Cohen test. [20,25]. BMV is a technique that involves greater difficulty than MMV and it is therefore less simple to carry out adequate insufflations with said technique [21,29].…”

Section: Discussionmentioning

confidence: 99%

“…The values obtained when carrying out compressions did exceed what was considered the minimum quality level [26]. but ventilation skills required more time spent on training, especially with the BMV technique [17,18,25]. One option for improving these quality results could be to carry out self-guided re-training sessions using visual feedback in real time after an initial training session like the one in this design.…”

Section: Discussionmentioning

confidence: 99%

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Assessing Ventilation Skills by Nursing Students in Paediatric and Adult Basic Life Support: A Crossover Randomized Simulation Study Using Bag-Valve-Mask (BMV) vs Mouth-to-Mouth Ventilation (MMV)

Otero-Agra¹,

Hermo-Gonzalo²,

Santos-Folgar³

et al. 2020

Signa Vitae

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To evaluate nursing students’ CPR skills using mouth-to-mouth (MMV) and bag-valve-mask (BMV) ventilation techniques on manikin simulators for infant and adult victims after practical and theoretical training. A quasi-experimental randomised cross-over design study with 44 nursing students was carried out. The participants attended a 5-hour theoretical and practical CPR training session using MMV and BMV on adult and infant manikins. A month later, four 4-minute CPR tests were performed in pairs. Two tests were performed on the infant manikin and two on the adult, using the two ventilation techniques (MMV and BMV). No significant differences between the tests were observed in the quality of chest compression (p > 0.008). Significantly higher values of effective ventilations were observed with MMV as compared with BMV in both age groups: Adult (MMV: 98 ± 7% / BMV: 84 ± 17% / p = 0.003) and Infant (MMV: 97 ± 11% / BMV: 76 ± 26% / p = 0.001). CPR quality was significantly higher when using MMV on the infant (68 ± 16%; p < 0.001) than in the other tests. The nursing students did not manage to master BMV with either victim. New complementary strategies to help them grasp the necessary BMV skills will be required.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Assessing Ventilation Skills by Nursing Students in Paediatric and Adult Basic Life Support: A Crossover Randomized Simulation Study Using Bag-Valve-Mask (BMV) vs Mouth-to-Mouth Ventilation (MMV)

Otero-Agra¹,

Hermo-Gonzalo²,

Santos-Folgar³

et al. 2020

Signa Vitae

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Infant Cardiopulmonary Resuscitation Quality While Walking Fast

et al. 2021

Self Cite

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Objective: This study focuses on the characteristics (feasibility, resuscitation quality, and physical demands) of infant cardiopulmonary resuscitation (CPR) on the forearm during fast walking, performed by a trained lay rescuer.Methods: Twenty-one university students from the infant education degree participated in a randomized crossover simulation study to compare a standard pediatric CPR versus a walking pediatric CPR with a manikin on the rescue forearm. Each rescuer performed 2 resuscitation tests of 2 minutes on the infant manikin. Cardiopulmonary resuscitation, physiological, and perceived effort variables were measured. Results:The quality of chest compressions was higher in standard pediatric CPR than in walking pediatric CPR (72% vs 51%; P < 0.001) and overall CPR quality (59% vs 49%; P = 0.02). There were no differences between ventilation quality (47% vs 46%). Walking pediatric CPR presented a higher percentage of maximum heart rate (52% vs 69%; P < 0.001) and perceived exertion rate (2 vs 5; P < 0.001). Participants walked an average of 197 m during the test. Conclusions:In conclusion, pediatric walking CPR is feasible although it represents a slight quality decrease in a simulation infant CPR setting. The option "CPR while walking fast to a safe place" seems to be suitable in terms of safety both for the victim and the rescuer, as well as CPR quality in special circumstances.

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Five vs. two initial rescue breaths during infant basic life support: A manikin study using bag-mask-ventilation

et al. 2022

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Background and objectivesChildren are more likely to suffer a hypoxic-ischaemic cause for cardiac arrest. Early ventilation may provide an advantage in outcome during paediatric cardiopulmonary resuscitation [CPR]. European Resuscitation Council guidelines recommend five initial rescue breaths [IRB] in infants, stemming from the hypothesis that rescuers might need 5 attempts in order to deliver 2 effective ventilations. This study aimed to verify this hypothesis.MethodsParticipants (n = 112, convenience sample) were medical students from the Faculty of Medicine and Health Sciences Ghent University, Belgium. Students were divided into duos and received a 15 min just-in-time training regarding the full CPR-cycle using BMV. Participants then performed five cycles of 2-person CPR. The IRB were given by 1-person BMV, as opposed to a 2-persons technique during the further CPR-cycle. Correct ventilations for the infant were defined as tidal volumes measured (Laerdal® Q-CPR) between 20 and 60 ml, with n = 94 participants included in the analysis. The primary outcome consisted of the difference in the % of medical student duos providing at least 2 effective IRB between 2 and 5 attempts.ResultsOff all duos, 55,3% provided correct volumes during their first 2 initial ventilations. An increase up to 72,4% was noticed when allowing 5 ventilations. The proportional difference between 2 and 5 IRB allowed was thus significant [17,0%, 95% confidence interval (5.4; 28.0)].ConclusionIn this manikin study, 5 IRB attempts during infant CPR with BMV increased the success rate in delivering 2 effective ventilations. Besides, students received training emphasizing the need for 5 initial rescue breaths. This study provides evidence supporting European Resuscitation Council guidelines.

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Ventilation during cardiopulmonary resuscitation in the infant. Mouth to mouth and nose, or bag-valve-mask? A quasi-experimental study

Cited by 5 publications

References 37 publications

Assessing Ventilation Skills by Nursing Students in Paediatric and Adult Basic Life Support: A Crossover Randomized Simulation Study Using Bag-Valve-Mask (BMV) vs Mouth-to-Mouth Ventilation (MMV)

Assessing Ventilation Skills by Nursing Students in Paediatric and Adult Basic Life Support: A Crossover Randomized Simulation Study Using Bag-Valve-Mask (BMV) vs Mouth-to-Mouth Ventilation (MMV)

Infant Cardiopulmonary Resuscitation Quality While Walking Fast

Five vs. two initial rescue breaths during infant basic life support: A manikin study using bag-mask-ventilation

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