Retention of ventilation skills of emergency nurses after training with the SMART BAG® compared to a standard bagvalvemask

De Regge, Melissa; Vogels, Catherine; Monsieurs, Koenraad G.; Calle, Paul A.

doi:10.1016/J.RESUSCITATION.2005.07.013

Title

Retention of ventilation skills of emergency nurses after training with the SMART BAG® compared to a standard bagvalvemask

Author

De Regge, Melissa

Vogels, Catherine

Monsieurs, Koenraad G.

Calle, Paul A.

Abstract

Background and purpose Studies show that nurses retain resuscitation skills poorly and that retention of ventilation skills is particularly difficult. We formed the hypothesis that the SMART BAG® (SB, O-Two Medical Technologies Inc., Canada), i.e. a bag-valve-mask device with a pressure/flow responsive valve, would assist nurses in providing more efficient ventilation six months after training. Materials and methods Prior to training, 39 emergency nurses performed CPR for 2 min, in pairs, using a standard bag-valve-mask device (STBVM, Laerdal, Norway) to assess their base line skills. A CPR training manikin (Simulaids, USA) equipped with a PEEP valve in the oesophagus set at 20 cm H2O was used to measure inspiratory time, tidal volume (Vt), peak pressure and gastric insufflation (GI). Immediately following training they were tested using an O-Two STBVM and a SB. Half of the nurses were retested after three months, the other half after six months. Efficient ventilation was defined as a mean Vt > 400 ml and GI < 50 ml in 1 min. Results Before training, only 16% of nurses ventilated efficiently: 63% had GI and 28% had Vt < 400 ml. Three months after training the efficiency of the STBVM and the SB was high (81 and 75%, respectively). Six months after training, there was a trend towards higher efficiency for the SB (63%) compared to the STBVM (25%) (p = 0.07). For instances with the STBVM producing a Vt > 400 ml, those without GI had a lower peak pressure than those with GI (7.8 cm H2O versus 17.7 cm H2O, p = 0.0001) and showed a trend towards a longer inspiratory time (1.28 s versus 1.08 s, p = 0.08). Of all efficient ventilations with a STBVM, 26% had a Vt > 600 ml. Conclusions Six months after training, nurses ventilated at least as efficiently with the SB, compared with the STBVM. This illustrates the ability of the SB to compensate for the deterioration over time in skill. On the other hand, training with a STBVM should focus primarily on prolonging the inspiratory time, and therefore the peak pressure, whilst maintaining an adequate Vt.

Language

English

Source (journal)

Resuscitation. - Limerick, 1972, currens

Publication

Limerick : 2006

ISSN

0300-9572 [print]

1873-1570 [online]

DOI

10.1016/J.RESUSCITATION.2005.07.013

Volume/pages