Are Pediatric Manual Resuscitators Only Fit for Pediatric Use? A Comparison of Ventilation Volumes in a Moving Ambulance.
Prehospital Emergency Care · 2022-04-15 · Observational study
Abstract
Background: The manual resuscitator device is the most common method of ventilating patients with respiratory failure, either with a facemask, or with an advanced airway such as an endotracheal tube (ETT). Barotrauma and gastric inflation from excessive ventilation volumes or pressure are concerning complications. Ventilating adult patients with pediatric manual resuscitator may provide more lung-protective tidal volumes based on stationary patient simulations. However, use of a pediatric manual resuscitator in mobile simulations contradictorily generates inadequate tidal volumes.Methods: Sixty-two emergency medical services (EMS) clinicians in a moving ambulance ventilated a manikin using pediatric and adult manual resuscitators in conjunction with oral-pharyngeal airway, i-gel, King LTS-D, or an endotracheal tube.Results: Oral-pharyngeal airway data were discarded due to EMS clinician inability to produce measurable tidal volumes. Mean ventilation volumes using the pediatric manual resuscitator were inadequate compared to those with the adult manual resuscitator on all other airway devices. In addition, i-gel, King LTS-D, and endotracheal tube volumes were statistically comparable. Paramedics ventilated larger volumes than emergency medical technicians.Conclusions: Using a pediatric manual resuscitator on adult patients is not supported by our findings.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Bag-valve-mask ventilation · Interfacility & critical care transport · Paramedics & EMTs · Supraglottic airway
Related articles
- Continuous flow insufflation of oxygen compared with manual ventilation during out-of-hospital cardiac arrest: A survey of the paramedics. (SAGE Open Med, 2021)
- Can EMS Providers Provide Appropriate Tidal Volumes in a Simulated Adult-sized Patient with a Pediatric-sized Bag-Valve-Mask? (Prehosp Emerg Care, 2017)
- Comparison of different airway management strategies to ventilate apneic, nonpreoxygenated patients. (Crit Care Med, 2003)
- Effect of intermediate airway management on ventilation parameters in simulated paediatric out-of-hospital cardiac arrest: a multicentre randomised crossover trial. (Swiss Med Wkly, 2025)
- Outcomes With the Use of Bag-Valve-Mask Ventilation During Out-of-hospital Cardiac Arrest in the Pragmatic Airway Resuscitation Trial. (Acad Emerg Med, 2020)
- Use of Supraglottic Airway Devices by Paramedics in the Management of Adult Prehospital Cardiac Arrest Patients (Paramedicine, 2017)