Consultant Anesthetist and Honorary Senior Lecturer, King's College, St. Thomas' Campus, London, UK.
Prehosp Disaster Med. 2009 Sep-Oct;24(5):398-401. doi: 10.1017/s1049023x00007214.
Bag-valve-mask ventilation is a key component of life support, but only one handheld resuscitator is designed to operate in contaminated or toxic atmospheres.
After Institutional Review Board approval, the efficacy of this device was evaluated. The distal trachea of a Laerdal Airway Management Trainer was connected to a mechanical Draeger Volumeter 3000, to enable determination of the minute volume delivered by BVM ventilation. Nineteen paramedics wearing chemical, biological, radiological, or nuclear (CBRN) protective equipment were asked to ventilate this modified airway trainer, either with or without a CBRN filter attached to the inlet filtration system of the AMBU Mark III Resuscitator. The maximum levels of minute ventilation achieved were compared. Values are given as mean +/-SD. A paired t-test was used to detect any differences between the two groups, p-values of <0.05 were defined to show statistical significance.
The described model allowed a reproducible and reliable measurement of the delivered minute ventilation. All paramedics were able to operate the device without prior CBRN training. The maximum minute volume achieved without the filter was 9.5 +/-2.7 l/min. Use of the inlet CBRN filtration system reduced the maximum minute volume to 6.3 +/-2.0 l/min, reduction: 23%. The achieved maximum minute volumes ranged from 15 to 4.9 l/min in the controls and from 9.8 to 1.4 l/min in the CBRN group. Four paramedics were unable to achieve a minute volume >5 l/min in the CBRN group, one participant failed to achieve that value in the control group. The inherent breathing resistance of the CBRN filter appears to reduce the inflow of air into the self-inflatable bag. This delay in refilling may have resulted in a reduced achievable minute volume.
The range of maximum minute volumes observed in both groups highlights the need for continuous BVM ventilator training.
球囊面罩通气是生命支持的关键组成部分，但只有一种手持式复苏器被设计用于在污染或有毒环境中运行。
在机构审查委员会批准后，评估了该设备的功效。将 Laerdal 气道管理训练器的远端气管连接到机械 Draeger Volumeter 3000，以确定通过 BVM 通气输送的分钟通气量。19 名佩戴化学、生物、放射性或核（CBRN）防护设备的护理人员被要求通过带有或不带有连接到 AMBU Mark III 复苏器入口过滤系统的 CBRN 过滤器来通风此改良的气道训练器。比较了达到的最大分钟通气量。值以平均值 +/-SD 给出。使用配对 t 检验检测两组之间的任何差异，p 值 <0.05 定义为具有统计学意义。
所描述的模型允许对输送的分钟通气量进行可重复且可靠的测量。所有护理人员都能够在没有事先 CBRN 培训的情况下操作该设备。不使用过滤器可达到的最大分钟通气量为 9.5 +/-2.7 l/min。使用入口 CBRN 过滤系统将最大分钟通气量降低至 6.3 +/-2.0 l/min，降低了 23%。在对照组中，达到的最大分钟通气量范围为 15 至 4.9 l/min，在 CBRN 组中为 9.8 至 1.4 l/min。在 CBRN 组中，有 4 名护理人员无法达到 >5 l/min 的分钟通气量，在对照组中，有 1 名参与者未能达到该值。CBRN 过滤器的固有呼吸阻力似乎会降低进入自充气袋的空气流量。这可能导致可达到的分钟通气量减少。
两组观察到的最大分钟通气量范围突出表明需要持续进行 BVM 通气器培训。
