Performance of a novel modified bag-valve-mask ventilation technique during manual ventilation and cardiopulmonary resuscitation: a randomized crossover manikin study.

BACKGROUND: The conventional one-handed grip during bag-valve-mask (BVM) ventilation often fails to achieve guideline recommendations. We evaluated a modified BVM ventilation method that allows a single practitioner to compress the bag while maintaining a two-handed mask seal and compared it with the conventional BVM ventilation method in simulated manikin in non-CPR and CPR settings.

METHODS: In a randomized, crossover manikin study, we compared the two methods in two scenarios: Manual Ventilation-No CPR (n = 60) and Manual Ventilation-CPR (n = 56). In each scenario, participants used both BVM methods in a randomized order. The primary outcome was the proportion of ventilations with adequate tidal volume. A ventilation with a tidal volume between 350 mL and 600 mL was considered adequate. Tidal volume, inspiratory time, and ventilation rate, chest compression quality metrics, chest compression fraction (CCF) were also evaluated.

RESULTS: In Manual Ventilation-No CPR scenario, the modified method significantly increased the proportion of adequate ventilations (p < 0.001). In Manual Ventilation-CPR scenario, the modified BVM ventilation method significantly increased the proportion of adequate ventilations (p < 0.001), with a comparable performance in chest compression quality (chest compressions depth, rate and recoil) and no compromise to the CCF.

CONCLUSIONS: Our simulated manikin study demonstrated that a modified BVM ventilation method improves ventilation performance within an adequate range in both CPR and non-CPR settings. Future studies are warranted to further assess this proposed method.