Document Detail


Airway management by first responders when using a bag-valve device and two oxygen-driven resuscitators in 104 patients.
MedLine Citation:
PMID:  15141793     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: To evaluate the capability of first responders to ensure an airway and ventilate the lungs of a patient employing a bag-valve device and two oxygen-driven resuscitators. METHODS: Prospective, controlled, blinded, single-centre clinical trial using a bag-valve device and one of two FR-300 devices, with 20 cmH2O working pressure, flows of 24 and 30 L min(-1). One-hundred-and-four patients were analysed. Induction of anaesthesia was followed by ventilation of the lungs with a bag-valve device and an Oxylator (CPR Medical Devices Corp., Markham, Ontario, Canada) in manual and automatic modes. Each series was repeated twice by a fireman first responder using a hand-held mask to seal the airway, once under anaesthesia and then again under anaesthesia with muscle relaxation. RESULTS: Patients' mean age 49 +/- 17 yr; 47% male, 48-132 kg. Only 29% had optimal facial and airway physiognomy. Airway management was significantly poorer when the bag-valve device was used than with either Oxylator mode (P < 0.0001); 23% of cases were not manageable with the bag-valve device. Gastric insufflation was markedly less with the Oxylator (P < 0.02). CONCLUSIONS: The use of an oxygen-driven device improves the ability of first responders to secure an airway and reduce gastric insufflation, even when distracted. Oxylators perform significantly better (P < 0.0001) than the bag-valve device.
Authors:
G J Noordergraaf; P J van Dun; B P Kramer; M P Schors; H P Hornman; W de Jong; A Noordergraaf
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  21     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-14     Completed Date:  2004-10-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  361-6     Citation Subset:  IM    
Affiliation:
St. Elisabeth Hospital, Department of Anaesthesiology, Tilburg, The Netherlands. g.noordergraaf@elisabeth.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anesthesia, General / methods
Anesthetics, Intravenous / therapeutic use
Emergency Treatment / methods*
Female
Humans
Insufflation
Laryngeal Masks*
Male
Middle Aged
Muscle Relaxants, Central / therapeutic use
Propofol / therapeutic use
Prospective Studies
Respiration, Artificial / instrumentation*,  methods
Single-Blind Method
Statistics, Nonparametric
Sufentanil / therapeutic use
Ventilators, Mechanical / statistics & numerical data*
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 0/Muscle Relaxants, Central; 2078-54-8/Propofol; 56030-54-7/Sufentanil

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