Document Detail


Residents' mental model of bag-mask ventilation.
MedLine Citation:
PMID:  20805782     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVES: Our objectives were to characterize resident knowledge of bag-mask ventilation (BMV) and to identify predictors of a well-developed mental model of BMV.
METHODS: A pilot survey of airway experts identified 6 steps considered essential in situations of difficult BMV. Subsequently, residents from pediatric, emergency medicine, and medicine-pediatric programs at a tertiary care hospital completed the same pediatric scenario-based item given to airway experts.
RESULTS: Of all surveys, 75% (n = 103) were completed. No resident identified all 6 maneuvers for difficult BMV. With decreasing frequency, the items identified were as follows: reposition patient/airway (82%), oral airway (61%), nasal airway (39%), jaw thrust (37%), 2-person technique (7%), and call for help (4%). Emergency medicine residents had a higher mean (SD) score than the medicine-pediatric and pediatric residents of a possible 6 (2.71 (1.26) vs 2.01 (1.07), P = 0.004) and were significantly more likely to identify certain maneuvers: oral airway (81% vs 52%, P = 0.006), nasal airway (57% vs 29%, P = 0.006), and 2-person technique (14% vs 3%, P = 0.042). Only 15% of all residents were able to identify 4 or more essential maneuvers. Higher level of training was associated with identifying the 2-person technique. In addition, residents who completed 1 month of pediatric or adult anesthesia were more likely to identify use of nasal airway, oral airway and 2-person technique, and to identify 4 or more maneuvers.
CONCLUSIONS: Emergency medicine residents identified more steps to optimize difficult BMV, although most residents exhibited a poorly developed mental model for difficult BMV compared with the consistent mental model of airway experts. Future research should investigate strategies for improving residents' mental model of BMV and its impact on patient care.
Authors:
Walter J Eppich; Mark R Zonfrillo; Kristen L Nelson; Elizabeth A Hunt
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric emergency care     Volume:  26     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  646-52     Citation Subset:  IM    
Affiliation:
Division of Emergency Medicine, Children's Memorial Hospital, Chicago, IL 60614, USA. weppich@childrensmemorial.org
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