Single operator cardiopulmonary resuscitation in ambulances. Which ventilation device?

Cardiopulmonary resuscitation en route to hospital is performed by a single-handed operator in many British ambulances. In this study, three emergency ventilation devices, and mouth-to-mouth breathing, were compared for effectiveness in unintubated patients. Seventeen paramedics used each method on a Laerdal manikin in a randomised order, under identical conditions. Three experienced cardiopulmonary resuscitation instructors repeated the tests in a moving ambulance. There were significant differences in minute volume (p less than 0.01) and number of effective chest compressions (p less than 0.05); mouth-to-mouth breathing produced the best overall results and the simplest device was a close second. The value of automatic ventilators for single-operator cardiopulmonary resuscitation in unintubated patients is questioned.